The prevalence of adverse childhood experiences in systematic reviews of primary headache and cancer
Bibliographic record
Abstract
Introduction Adverse childhood experiences (ACEs) describe an array of stressful exposures that occur during childhood/ adolescence, including types of abuse and neglect. As ACEs occur during a critical period of human development, they have been associated with a range of chronic diseases in adulthood. Objectives We aimed to systematically analyze the prevalence of ACEs in studies in two different disease severity populations, including primary headache and cancer. The objectives of this study are to examine, The prevalence of ACEs hypothesized to impact chronic disease The pooled association of the presence of “disease”, which consists for this study only primary headache and/or cancer, with ACEs Methods The inclusion criteria for the studies in the systematic reviews/meta-analyses included observational studies with a comparator group, ACE(s) occurrence at ≤18 years of age, and disease diagnosis at ≥21 years of age. Searches were conducted up to Mar 16, 2023. Two review authors independently screened articles, extracted data, assessed risk of bias using QUIPS, and conducted GRADE assessment as part of the systematic reviews. In this study, we calculated the prevalence and the odds of experiencing ACEs among those with disease compared to those without disease. Results Of the total 39,658 articles screened, 44 studies were eligible for synthesis of 437,852 participants from 22 countries across five continents. Among included studies, the most commonly examined ACEs were physical abuse (82% of studies), sexual abuse (77%), household substance or alcohol abuse (52%), witnessing or threat of violence (50%), having a household member with a mental illness (45%), and emotional abuse (43%). Of the 437,852 participants in the synthesis, an estimated total of 196,587 participants (45%) reported experiencing at least one ACE. Among participants with primary headache and/or cancer, 51% (29,838/58,580) reported experiencing at least one ACE, compared to 44% (166,749/379,272) of participants without primary headache and/or cancer (crude odds ratio = 1.32, 95% confidence interval: 1.30, 1.35). Conclusions The prevalence of ACEs is high when hypothesized to be associated with diseases, independent of the risk for mortality (i.e., primary headache low mortality, cancer high mortality). Abuse ACEs are more commonly considered in studies than neglect ACEs, and therefore, more consistent and comprehensive reporting of ACEs is needed. There is untapped opportunity for the expertise of psychiatrists to collaborate with clinicians and researchers of adult chronic disease studies. Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.047 | 0.211 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.013 | 0.013 |
| Bibliometrics | 0.027 | 0.024 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".