Adverse childhood experiences among Hispanic and Latino Americans

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Adverse childhood experiences (ACEs) are identified as serious and traumatizing experiences, such as abuse, neglect, exposure to violence, substance use, and other harmful events or situations that occur within a child's household or environment. [1] Unfortunately, exposure to ACEs within the child's community is all too common in low-income households and neighborhoods, with close to 43% of children in the United States (U.S.) living in low-income families. [2] ACEs were first identified by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente's Adverse Childhood Experiences Study conducted from 1995 to 1997, where ACEs were examined and correlated with later-life well-being. [3] With one in four children experiencing or witnessing a potentially traumatic event, children who grow up in an unsafe environment are at risk for developing adverse health outcomes, affecting brain development, immune systems, and regulatory systems. [1] [4] [5]

Contents

Further research on ACEs determined that children who experience them are more likely than their similar-aged peers to experience challenges in their biological, emotional, social, and cognitive functioning. [6] Also, children who have experienced an ACE are at higher risk of being re-traumatized or suffering multiple ACEs. [7] The amount and types of ACEs can cause significant negative impacts and increase the risk of internalizing and externalizing in children. [8]

To date, there is still limited research on how ACEs impact Latino children. As of 2019, there were nearly 61 million Latino individuals in the U.S. [9] With the Latino population becoming one of the largest minority groups within the U.S., it is crucial to examine how ACEs negatively impact Latino children's development and develop ways to reduce the rate at which ACEs are experienced in this population. [10]

Latino Americans Trauma Experiences

When it comes to trauma, Latino children are at higher risk, almost twice as much, than their white peers of experiencing ACEs. [11] Also, they are at higher risk of developing posttraumatic stress disorder (PTSD) or PTSD symptoms due to increased challenges that these families face. Challenges include immigration, discrimination, violence, low socioeconomic status (SES), alcohol and substance use. [11] [12] Many U.S.-born Latino children have a foreign-born parent who is considered an unauthorized immigrant, presenting many challenges for the family. [13] For children who have migrated to the U.S. with their families are at higher risk of experiencing traumatic events, as they tend to experience trauma in their home country and during their migration and settlement to the U.S. [14] Children who have undocumented parents, their chances of ACEs are further elevated since they may witness their parents being arrested, detained, or deported for being undocumented. [15] With the increased stress that Latino families face because of the described challenges, there is a greater risk of gang involvement, exposure to substance use, mental health problems, harmful parenting practices, and medical difficulties. [11]

Latino parents who have migrated to the U.S. tend to have less education and do not speak or understand English fluently. These barriers reduce their chances of finding stable and well-paying jobs, increasing the risk of low SES among this population. [16] With the increased amount of barriers with language, education, and low SES, Latino families’ stress may increase as they cannot access resources such as food assistance, health coverage, and mental health support, thereby increasing their likelihood of ACEs. [17] There is minimal research on how ACEs impact children from Latino families because many of them may go unreported in fear of deportation or separation from the children. [18]

Intimate and domestic violence is another example of an ACE that many Latino families face. Within this population, gender roles are clearly defined and implemented within the family dynamic. It is culturally expected that men present as powerful and dominant while women are submissive and self-sacrificing. [19] Due to these gender roles and the transmission of these cultural roles, women tend to give in to their partner's power and endure various forms of violence. [20] For many Latino women, incidents of domestic violence go unreported due to fear of affecting family cohesion, police involvement, deportation, and feelings of shame, embarrassment and criticism that they may endure from the extended family and community. [21] A longitudinal study showed that 45% of females and 50% of males reported having witnessed physical violence between their parents during their childhood. [22] With increased domestic violence observed in the home, Latino children are more likely to express or develop unhealthy coping skills and continue the transmission of violence in their own relationships. [23]

Latino children who experience ACEs such as incarceration, maltreatment, and interpersonal trauma are at heightened risk and susceptibility for substance use disorders (SUDs) in later life. [24] [25] Research suggests that Latino children who experience household incarceration are at risk of increased binge drinking, marijuana use, and negative substance use consequences in emerging adulthood. [26] Those who do not experience household incarceration but experience accumulative ACEs are at increased odds of cigarette smoking. [26] Latino children who experience maltreatment are 23% more likely to have problematic alcohol use in adulthood. [24]

Protective Factors of ACEs

Protective factors are the variables within an individual or their community that help promote their well-being against adversity. [27] Although Latino families are at risk of experiencing more ACEs, research suggests that Latino cultural values can be protective factors to ACEs and long-term trauma. [28] Cultural values are the strong beliefs, traditions, and values that Latino holds firmly within their culture. [29] Cultural values include the traditional values of respect, religion, familial, and gender roles. [30] These cultural values are held in high regard in Latino culture and endorsed at a young age; without these values, families can experience increased levels of dysfunction. [31] Parents must transmit their children's cultural values to continue the culture. [32] Children also learn about the culture's values through socialization with extended family members. [33]

Within the Latino population, family cohesion is embedded in the traditional cultural value known as familism. [34] In Latino culture, familism refers to the emotional bonding and supportiveness between family members, which leads to positive family functioning. [35] Within Latino culture, families must stick together and utilize family, both immediate and extended, as a support system, which ensures the children stay physically and psychologically healthy through social interactions and secure attachments with their family members. [34] With an increased amount of support, the risk of parental stress experienced by Latino parents can be minimized, reducing the chances of ACE exposure. Family cohesion can be identified as a protective factor. For example, one study found that strong familial orientation among Latino families contributed to higher school success in Latino children. [36] [29]

Research suggests that high family cohesion minimizes the risk of exposure to violence and negative mental health outcomes in adolescence and adulthood. [36] Still, for some Latino families, family cohesion is not as vital, which can be detrimental to the family dynamic when ACEs are present. [37] Those who do not have substantial cohesion levels in their environments are more likely to experience negative mental health outcomes such as depression, anxiety, and psychotic symptoms. [38] ACEs can lead to increased emotional and psychological distress in parents, which can negatively affect family cohesion. [37] For this reason, it is essential to see how ACEs negatively impact family cohesion within the Latino population.

Related Research Articles

<span class="mw-page-title-main">Causes of mental disorders</span> Etiology of psychopathology

A mental disorder is an impairment of the mind disrupting normal thinking, feeling, mood, behavior, or social interactions, and accompanied by significant distress or dysfunction. The causes of mental disorders are very complex and vary depending on the particular disorder and the individual. Although the causes of most mental disorders are not fully understood, researchers have identified a variety of biological, psychological, and environmental factors that can contribute to the development or progression of mental disorders. Most mental disorders result in a combination of several different factors rather than just a single factor.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones generally with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples of distressing events include violence, rape, or a terrorist attack.

<span class="mw-page-title-main">Child abuse</span> Maltreatment or neglect of a child

Child abuse is physical, sexual, emotional and/or psychological maltreatment or neglect of a child, especially by a parent or a caregiver. Child abuse may include any act or failure to act by a parent or a caregiver that results in actual or potential wrongful harm to a child and can occur in a child's home, or in organizations, schools, or communities the child interacts with.

Emotional dysregulation is characterized by an inability to flexibly respond to and manage emotional states, resulting in intense and prolonged emotional reactions that deviate from social norms, given the nature of the environmental stimuli encountered. Such reactions not only deviate from accepted social norms but also surpass what is informally deemed appropriate or proportional to the encountered stimuli.

Sibling abuse includes the physical, psychological, or sexual abuse of one sibling by another. More often than not, the younger sibling is abused by the older sibling. Sibling abuse is the most common of family violence in the US, but the least reported. As opposed to sibling rivalry, sibling abuse is characterized by the one-sided treatment of one sibling to another.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Charles L. Whitfield was an American medical doctor in private practice specializing in assisting survivors of childhood trauma with their recovery, and with addictions including alcoholism and related disorders. He was certified by the American Society of Addiction Medicine, a founding member of the National Association for the Children of Alcoholics, and a member of the American Professional Society on the Abuse of Children.

The effects of domestic violence on children have a tremendous impact on the well-being and developmental growth of children witnessing it. Children can be exposed to domestic violence in a multitude of ways and goes beyond witnessing or overhearing, although there is disagreement in how it should be measured. Children who are exposed to domestic violence in the home often believe that they are to blame, live in a constant state of fear, and are 15 times more likely to be victims of child abuse. Close observation during an interaction can alert providers to the need for further investigation and intervention, such as dysfunctions in the physical, behavioral, emotional, and social areas of life, and can aid in early intervention and assistance for child victims.

Early childhood is a critical period in a child's life that includes ages from birth to five years old. Psychological stress is an inevitable part of life. Human beings can experience stress from an early age. Although stress is a factor for the average human being, it can be a positive or negative molding aspect in a young child's life.

Child neglect, often overlooked, is the most common form of child maltreatment. Most perpetrators of child abuse and neglect are the parents themselves. A total of 79.4% of the perpetrators of abused and neglected children are the parents of the victims, and of those 79.4% parents, 61% exclusively neglect their children. The physical, emotional, and cognitive developmental impacts from early childhood neglect can be detrimental, as the effects from the neglect can carry on into adulthood.

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary mode of transmission is the shared family environment of the infant causing psychological, behavioral and social changes in the individual.

Early childhood trauma refers to various types of adversity and traumatic events experienced during the early years of a person's life. This is deemed the most critical developmental period in human life by psychologists. A critical period refers to a sensitive time during the early years of childhood in which children may be more vulnerable to be affected by environmental stimulation. These traumatic events can include serious illness, natural disasters, family violence, sudden separation from a family member, being the victim of abuse, or suffering the loss of a loved one. Traumatic experiences in early childhood can result in severe consequences throughout adulthood, for instance developing post-traumatic stress disorder, depression, or anxiety. The effects of this trauma can be experienced very differently depending on factors such as how long the trauma was, how severe and even the age of the child when it occurred. Negative childhood experiences can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. However, not all children who are exposed to negative stimuli in early childhood will be affected severely in later life; some children come out unscathed after being faced with traumatic events, which is known as resilience. Many factors can account for the invulnerability displayed by certain children in response to adverse social conditions: gender, vulnerability, social support systems, and innate character traits. Much of the research in this area has referred to the Adverse Childhood Experiences Study (ACE) study. The ACE study found several protective factors against developing mental health disorders, including mother-child relations, parental health, and community support. However, having adverse childhood experiences creates long-lasting impacts on psychosocial functioning, such as a heightened awareness of environmental threats, feelings of loneliness, and cognitive deficits. Individuals with ACEs are more prone to developing severe symptoms than individuals in the same diagnostic category.

<span class="mw-page-title-main">Immigrant paradox in the United States</span>

The immigrant paradox in the United States is an observation that recent immigrants often outperform more established immigrants and non-immigrants on a number of health-, education-, and conduct- or crime-related outcomes, despite the numerous barriers they face to successful social integration.

Betrayal trauma is defined as a trauma perpetrated by someone with whom the victim is close to and reliant upon for support and survival. The concept was originally introduced by Jennifer Freyd in 1994. Betrayal trauma theory (BTT), addresses situations when people or institutions on which a person relies for protection, resources, and survival violate the trust or well-being of that person. BTT emphasizes the importance of betrayal as a core antecedent of dissociation, implicitly aimed at preserving the relationship with the caregiver. BTT suggests that an individual, being dependent on another for support, will have a higher need to dissociate traumatic experiences from conscious awareness in order to preserve the relationship.

Adverse childhood experiences (ACEs) include childhood emotional, physical, or sexual abuse and household dysfunction during childhood. The categories are verbal abuse, physical abuse, contact sexual abuse, a battered mother/father, household substance abuse, household mental illness, incarcerated household members, and parental separation or divorce. The experiences chosen were based upon prior research that has shown to them to have significant negative health or social implications, and for which substantial efforts are being made in the public and private sector to reduce their frequency of occurrence. Scientific evidence is mounting that such adverse childhood experiences (ACEs) have a profound long-term effect on health. Research shows that exposure to abuse and to serious forms of family dysfunction in the childhood family environment are likely to activate the stress response, thus potentially disrupting the developing nervous, immune, and metabolic systems of children. ACEs are associated with lifelong physical and mental health problems that emerge in adolescence and persist into adulthood, including cardiovascular disease, chronic obstructive pulmonary disease, autoimmune diseases, substance abuse, and depression.

Out-of-home placements are an alternative form of care when children must be removed from their homes. Children who are placed out of the home differ in the types and severity of maltreatment experienced compared to children who remain in the home. One-half to two-thirds of youth have experienced a traumatic event leading to increased awareness and growing literature on the impact of trauma on youth. The most common reasons for out-of-home placements are due to physical or sexual abuse, violence, and neglect. Youth who are at risk in their own homes for abuse, neglect, or maltreatment, as well as youth with severe emotional and behavior issues, are placed out of the home with extended family and friends, foster care, or in residential facilities. Out-of-home placements aim to provide children with safety and stability. This temporary, safe environment allows youth to have their physical, mental, moral, and social needs met. However, these youth are in a vulnerable position for experiencing repeated abuse and neglect.

LGBT trauma is the distress an individual experiences due to being a lesbian, gay, bisexual, trans, queer person or from possessing another minoritized sexual or gender identity. This distress can be harmful to the individual and predispose them to trauma- and stressor-related disorders.

Hispanic immigrants living in the United States have been found to have higher levels of exposure to trauma and lower mental health service utilization than the general population. Those who met the criteria for asylum and experience trauma before migrating are vulnerable to post-traumatic stress disorder (PTSD) symptoms. Higher levels of trauma-related symptoms are associated with increased post-migration living difficulties. Despite the need for mental health services for Hispanic immigrants living in the United States, cultural and structural barriers make accessing treatment challenging.

Trauma-informed care (TIC) or Trauma-and violence-informed care (TVIC), is a framework for relating to and helping people who have experienced negative consequences after exposure to dangerous experiences. There is no one single TIC framework, or model, and some go by slightly different names, including Trauma- and violence-Informed Care (TVIC). They incorporate a number of perspectives, principles and skills. TIC frameworks can be applied in many contexts including medicine, mental health, law, education, architecture, addiction, gender, culture, and interpersonal relationships. They can be applied by individuals and organizations.

Katherine Ortega Courtney is an American psychologist and author who co-developed the 100% Community model, a theoretical framework designed to guide the state and local work of preventing two interrelated public health and education challenges: adverse childhood experiences (ACEs) and adverse social determinants of health (SDH). As bureau chief of New Mexico's Child Protective Services Research, Assessment, and Data Bureau and developer of a data-scholars program for child welfare managers across the nation, she saw firsthand child welfare's lack of capacity to implement a data-driven strategy to prevent maltreatment by ensuring families had access to the vital services of medical care, mental health care, food security programs, and safe housing.

References

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