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. 2020 May 12;20(1):657.
doi: 10.1186/s12889-020-08789-0.

Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews

Theo Lorenc  1 , Sarah Lester  2 , Katy Sutcliffe  2 , Claire Stansfield  2 , James Thomas  2
Affiliations

Interventions to support people exposed to adverse childhood experiences: systematic review of systematic reviews

Theo Lorenc et al. BMC Public Health. .

Abstract

Background: Adverse Childhood Experiences (ACEs) such as abuse, neglect or household adversity may have a range of serious negative impacts. There is a need to understand what interventions are effective to improve outcomes for people who have experienced ACEs.

Methods: Systematic review of systematic reviews. We searched 18 database sources from 2007 to 2018 for systematic reviews of effectiveness data on people who experienced ACEs aged 3-18, on any intervention and any outcome except incidence of ACEs. We included reviews with a summary quality score (AMSTAR) of 5.5 or above.

Results: Twenty-five reviews were included. Most reviews focus on psychological interventions and mental health outcomes. The strongest evidence is for cognitive-behavioural therapy for people exposed to abuse. For other interventions - including psychological therapies, parent training, and broader support interventions - the findings overall are inconclusive, although there are some positive results.

Conclusions: There are significant gaps in the evidence on interventions for ACEs. Most approaches focus on mitigating individual psychological harms, and do not address the social pathways which may mediate the negative impacts of ACEs. Many negative impacts of ACEs (e.g. on health behaviours, social relationships and life circumstances) have also not been widely addressed by intervention studies.

Keywords: Adverse childhood experiences; Child abuse; Resilience, psychological; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of literature through the review
See this image and copyright information in PMC

References

    1. Bellis MA, Ashton K, Hughes K, Ford K, Bishop J, Paranjothy S. Adverse childhood experiences and their impact on health-harming behaviours in the welsh adult population. Cardiff: Public Health Wales; 2015.
    1. Allen M, Donkin A. The impact of adverse experiences in the home on the health of children and young people, and inequalities in prevalence and effects. London: UCL Institute of Health Equity; 2015.
    1. Bellis MA, Hughes K, Leckenby N, Hardcastle KA, Perkins C, Lowey H. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey. J Public Health. 2015;37:445–454. doi: 10.1093/pubmed/fdu065. - DOI - PMC - PubMed
    1. Danese A, McEwen BS. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav. 2012;106:29–39. doi: 10.1016/j.physbeh.2011.08.019. - DOI - PubMed
    1. Pollock M, Fernandes RM, Becker LA, Pieper D, Hartling L. Chapter V: Overviews of Reviews. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated March 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.

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