adverse childhood experiences (ACEs)

不良童年经历 ( ACES )
  • 文章类型: Case Reports
    这个病例报告提出了一个小说,非药物治疗2型糖尿病46岁男性,使用称为神经情绪技术(NET)的身心干预(MBI)进行8种治疗后,证明血液化学和心理测量标记的改善。患者诊断为2型糖尿病(T2D),疼痛,压力和焦虑的社会心理指标,ACE-Q(儿童不良经历问卷)得分为4分,这与慢性病和自身免疫性疾病的易感性一致。该患者的葡萄糖水平高于正常水平(通常在10-15mmol/L之间,最佳范围在4-10mmol/L之间)持续至少两个月,尽管标准使用常规抗糖尿病药物(胰岛素注射)。该患者表现出许多慢性应激指标,这些指标被认为是他的医学诊断的基础,建议在4周内进行一系列8次NET治疗。在基线(治疗前)记录心理测试和血糖测量,4周(治疗结束时)和8周(治疗结束后4周)。结果显示葡萄糖水平降低,和自我报告的抑郁指标,焦虑,压力,4周后,痛苦和痛苦都从高和极端水平下降到正常范围内,在8周时持续改善。McEwen描述了同种异体负荷的概念以及累积压力对身心健康的破坏性影响。假设NET减少了同种异体负荷,从而强化了稳态和涉及从慢性病中恢复的致盐度应激反应机制。可能通过心理-免疫-神经内分泌(PINE)网络。需要进行更大样本量的进一步研究,以确定这些结果是否可以外推到更广泛的人群中,然而,这个案例的结果表明,它可能是有益的考虑共同管理的T2D与MBI,如NET。
    This case report presents a novel, non-pharmacological treatment of Type 2 Diabetes in a 46-year-old male, demonstrating improvements in blood chemistry and psychometric markers after 8 treatments using a Mind-Body Intervention (MBI) called Neuro-Emotional Technique (NET). The patient presented with a diagnosis of Type 2 Diabetes (T2D), pain, psychosocial indicators of stress and anxiety, and a score of 4 on the ACE-Q (Adverse Childhood Experiences Questionnaire) that is consistent with a predisposition to chronic disease and autoimmune disorders. Glucose levels for this patient were above normal levels (typically between 10-15mmol/L where optimal range is between 4-10mmol/L) for at least two months prior to the 4-week NET intervention period, despite the standard use of conventional antidiabetic medications (insulin injections). The patient exhibited numerous indictors of chronic stress that were hypothesised to be underlying his medical diagnosis and a series of 8 NET treatments over a period of 4 weeks was recommended. Psychometric tests and glucose measurements were recorded at baseline (prior to treatment), 4 weeks (at the conclusion of treatment) and at 8 weeks (4 weeks following the conclusion of treatment). Results show that glucose levels were reduced, and self-reported measures of depression, anxiety, stress, distress and pain all decreased from high and extreme levels to within normal ranges after 4 weeks, with ongoing improvement at 8 weeks. McEwen described the concept of allostatic load and the disruptive effects that cumulative stress can have on both mental and physical health. It is hypothesized that NET reduces allostatic load thereby fortifying homeostasis and the salutogenic stress response mechanisms involved in recovery from chronic illness, possibly via the Psycho-Immune-Neuroendocrine (PINE) network. Further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, however the results of this case suggest that it may be beneficial to consider co-management of T2D with an MBI such as NET.
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  • 文章类型: Case Reports
    甲状腺功能减退通常被认为是一种自身免疫性疾病,典型的医疗管理包括终身服用左甲状腺素(合成甲状腺激素)。该病例报告详细介绍了一种称为神经情绪技术(NET)的身心干预(MBI)的结果,该技术用于治疗一名28岁的白种人女性,其症状和血液标志物与两年的甲状腺功能减退症和长期的历史压力。患者的医生在血液检查后诊断为甲状腺功能减退,显示促甲状腺激素(TSH)水平高,为6.87mIU/L(可接受范围为0.40-3.50mIU/L),游离T4(FT4)水平低,为8.6pmol/L(可接受范围为9.0-19.0pmol/L)。在基线和治疗12周后完成心理测试,以评估心理健康和情绪健康状况的变化。不良儿童经历问卷(ACE-Q)揭示了高度的儿童创伤,可能易感潜在的自身免疫性甲状腺功能障碍。治疗期结束时,血清促甲状腺激素(TSH)和游离T4在正常范围内,心理测量指标恢复正常。我们假设这些变化可能是由于NET的减压机制,并概述了通过心理-免疫-神经内分泌(PINE)网络的可能机制。PINE网络模型断言,慢性压力是病理生理学的潜在驱动因素,可导致一种或多种医学和心理健康状况。虽然需要更大样本量的进一步研究来确定这些结果是否可以外推到更广泛的人群,本病例的结果提示,亚临床甲状腺功能减退症可能需要考虑与相对快速且具有成本效益的MBI(如NET)共同治疗.
    Hypothyroidism is generally considered an autoimmune condition, and typical medical management involves taking levothyroxine (synthetic thyroid hormone) for life. This case report details the results of a mind-body intervention (MBI) called the Neuro-Emotional Technique (NET) used to treat a 28-year-old Caucasian female presenting with symptoms and bloodwork markers associated with two years of hypothyroidism and a long history of stress. The patient\'s medical doctor provided a diagnosis of hypothyroidism after blood tests showed that thyroid-stimulating hormone (TSH) levels were high at 6.87 mIU/L (where the acceptable range is 0.40-3.50 mIU/L) and free T4 (FT4) levels were low at 8.6 pmol/L (where the acceptable range is 9.0-19.0 pmol/L). Psychometric tests were completed at baseline and after 12 weeks of treatment to evaluate changes in mental health and emotional well-being. The Adverse Childhood Experiences Questionnaire (ACE-Q) revealed a high degree of childhood trauma that may have predisposed to the underlying autoimmune thyroid dysfunction. At the conclusion of the treatment period, serum thyroid-stimulating hormone (TSH) and free T4 were within normal ranges and psychometric indicators normalized. We hypothesize that these changes may be due to the stress-reducing mechanism of NET and outline possible mechanisms via the Psycho-Immune-Neuroendocrine (PINE) network. The PINE network model asserts that chronic stress acts as a potential driver of pathophysiology that can lead to one or more medical and mental health conditions. While further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, the results of this case suggest that it may be pertinent to consider co-management of subclinical hypothyroidism with a relatively quick and cost-effective MBI such as NET.
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  • 文章类型: Case Reports
    This case report describes associations between childhood adversity, adult stress exposure, and Multiple Sclerosis (MS) to highlight the intersection between mental health and neurological illness in persons with MS (PwMS). We focus on a high-adversity, high-resource patient who self-referred to mental health services for depression and suicidal ideation, without ever being screened for past or current stress exposure. MS and common comorbid symptoms (e.g., fatigue, depression, suicidality) may be affected by adversity and compounded by pandemic-related stressors, including socio-political and economic sequelae. This case illustrates the potential benefit of screening for lifetime stressors as a mechanism to improve case conceptualizations, enable referrals to mental health specialists to promote coping and resiliency, reduce future MS morbidity, and illuminate stress as an important research focus that deserves further exploration in PwMS.
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  • 文章类型: Journal Article
    虐待儿童等不良儿童经历(ACE)与不良健康结果有关。打屁股表明与健康结果有类似的关联,但到目前为止还没有被认为是ACE。先前的研究表明,身体和情感虐待具有高度相关性,并且在性质上可能与打屁股相似。为了确定打屁股是否应该被认为是ACE,这项研究旨在检查1):打屁股与身体和情感虐待的分组;2)打屁股是否与成人健康不良问题有类似的关联,并解释了其他模型差异。成人心理健康问题包括抑郁情绪,自杀未遂,中度到重度饮酒,街头吸毒。数据来自CDC-KaiserACE研究(N=8316,应答率=65%)。打屁股与身体和情感虐待物品的因素相同。此外,打屁股与自杀企图的几率增加相关(调整后赔率(AOR)=1.37;95%CI=1.02~1.86),中度至重度饮酒(AOR)=1.23;95%CI=1.07至1.41),在经历身体和情感虐待的成年期,使用街头毒品(AOR)=1.32;95%CI=1.4至1.52)。这表明打屁股解释了额外的模型差异,并提高了我们对这些结果的理解。因此,从经验上讲,打屁股类似于身体和情感上的虐待,包括打屁股与虐待增加了我们对这些心理健康问题的理解。打屁股也应被视为ACE,并在预防暴力的努力中加以解决。
    Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.
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