Gender differences in youth Adverse Childhood Experience

scores: Exploring implications in a

concurrent program

Margot Crane, MC, RSW, RPsychRebeccah Marsh, PhDBina Nair, MD FRCPC

Faculty/Presenter Disclosure Faculty/Presenters:

Margot Crane, MC, RSW, RPsych Rebeccah Marsh, PhD Bina Nair, MD FRCPC

Relationships with commercial interests: Not applicable

CASA Child, Adolescent and Family Mental Health

• Concurrent Addiction and Mental Health Program (CAMP):• For youth under 18 years• Treatment is family-centred, multi-disciplinary,

trauma-informed • Grounded in a harm reduction philosophy • Goal is to help youth replace unhealthy coping

strategies with healthy behaviours

Who is joining us today?

Adverse Childhood Experiences (ACEs) Study 10-year study in the 1990s 17,000 participants Looked at impact of adverse childhood experiences

on many aspects of health over the lifespan

http://www.kzoo.edu/praxis/files/2015/06/CEs_infographic_print_2015.4.5_v2.jpg

Physical

Emotional

Sexual

Physical

Emotional

Physical

Mother Treated Violently

Incarcerated Relative

Substance Abuse

Family Break-up

Early Death

Disease, Disability

Adoption of Health-Risk Behaviours

Social, Emotional, and Cognitive Impairment

Disrupted Neurodevelopment

Adverse Childhood Experiences

ACEs are associated with poorer lifelong health outcomes

Youth self-report of ACEs at admission to CAMP

61%

49% 46%42%

26% 26%22% 21% 20% 18%

18%21% 21%

11% 11%15% 13%

0%

10%

20%

30%

40%

50%

60%

70%CAMP AB Study2013 Alberta ACEs Study

Girls self-report a higher prevalence than boys

All significantly different (p<0.05)

70%63% 63%

57%53%

38%

54%

34%39% 36% 34%

10%

0%

20%

40%

60%

80%

FamilyBreak-Up

FamilyMemberMentalIllness

EmotionalNeglect

VerbalAbuse

Family DrugAbuse

SexualAbuse

Girls Boys

Girls in CAMP are more likely to report higher total ACE exposure

Girls Boys

61% report

4+ ACEs

34% report

4+ ACEs

Higher ACE score in CAMP is associated with:

Higher severity of mental health symptoms Diagnosis of depression Diagnosis of substance abuse disorder Total number of diagnoses

Not associated with diagnosis of ADHD or anxiety

How this informs our practice

Patient

Program

Organization

Reflection