Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease

Background: Adverse childhood experiences (ACEs) are associated with poorer health outcomes, including a higher risk of acquired cardiovascular disease. This was the first investigation of ACEs in adults with congenital heart disease (CHD). Methods: Adults with CHD completed the following surveys in...

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Main Authors: Marshall Taunton, Lidija McGrath, Craig Broberg, Sheldon Levy, Adrienne H. Kovacs, Abigail Khan
Format: Article
Language:English
Published: Elsevier 2021-10-01
Series:International Journal of Cardiology Congenital Heart Disease
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666668521001415
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author Marshall Taunton
Lidija McGrath
Craig Broberg
Sheldon Levy
Adrienne H. Kovacs
Abigail Khan
author_facet Marshall Taunton
Lidija McGrath
Craig Broberg
Sheldon Levy
Adrienne H. Kovacs
Abigail Khan
author_sort Marshall Taunton
collection DOAJ
description Background: Adverse childhood experiences (ACEs) are associated with poorer health outcomes, including a higher risk of acquired cardiovascular disease. This was the first investigation of ACEs in adults with congenital heart disease (CHD). Methods: Adults with CHD completed the following surveys in the outpatient setting: ACE questionnaire, measure of attachment style, and linear analogue measure of quality of life. We performed Chi-square tests and t-tests to explore relationships between ACE scores with other surveys as well as demographic and clinical characteristics. Results: A total of 100 patients participated in the study (age 40 ​± ​13 years; 60% female); 90% had CHD of moderate or great complexity. The total number of reported ACEs ranged from 0 to 9 out of a possible total of 10, with a mean of 2.6 ​± ​2.5.30% of participants reported ≥ 4 ACEs, which is higher than the reported prevalence in the general population. The most frequently reported ACEs were parental divorce (46%), emotional abuse (42%), and parental substance abuse (32%). ACE scores did not differ as a function of age, sex or CHD defect complexity. Total ACE scores were significantly associated with two attachment styles (preoccupied: p ​< ​0.001; fearful: p ​= ​0.002). Quality of life scores were lower among those with ≥4 ACEs, although this did not reach statistical significance (68.6 vs. 75.7, p ​= ​0.07). Conclusion: ACEs appear to be common in adults with CHD and are associated with negative attachment styles. Further research is needed to determine the impact of ACEs on long-term outcomes.
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spelling doaj.art-5d53654fb41b44548bad95ad8dd730612022-12-21T21:20:55ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852021-10-015100217Adverse childhood experience, attachment style, and quality of life in adult congenital heart diseaseMarshall Taunton0Lidija McGrath1Craig Broberg2Sheldon Levy3Adrienne H. Kovacs4Abigail Khan5Knight Cardiovascular Institute, Oregon Health &amp; Science University, Portland, OR. 3161 SW Pavilion Loop, Portland, OR, 97239, USAAdult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health &amp; Science University, Portland, OR, USAAdult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health &amp; Science University, Portland, OR, USADepartment of Family Medicine, Oregon Health &amp; Science University, Portland, OR, USAAdult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health &amp; Science University, Portland, OR, USAAdult Congenital Heart Disease Program, Knight Cardiovascular Institute, Oregon Health &amp; Science University, Portland, OR, USA; Corresponding author. UHN-63 3161 SW Pavilion Loop, Portland, OR, 97239, USA.Background: Adverse childhood experiences (ACEs) are associated with poorer health outcomes, including a higher risk of acquired cardiovascular disease. This was the first investigation of ACEs in adults with congenital heart disease (CHD). Methods: Adults with CHD completed the following surveys in the outpatient setting: ACE questionnaire, measure of attachment style, and linear analogue measure of quality of life. We performed Chi-square tests and t-tests to explore relationships between ACE scores with other surveys as well as demographic and clinical characteristics. Results: A total of 100 patients participated in the study (age 40 ​± ​13 years; 60% female); 90% had CHD of moderate or great complexity. The total number of reported ACEs ranged from 0 to 9 out of a possible total of 10, with a mean of 2.6 ​± ​2.5.30% of participants reported ≥ 4 ACEs, which is higher than the reported prevalence in the general population. The most frequently reported ACEs were parental divorce (46%), emotional abuse (42%), and parental substance abuse (32%). ACE scores did not differ as a function of age, sex or CHD defect complexity. Total ACE scores were significantly associated with two attachment styles (preoccupied: p ​< ​0.001; fearful: p ​= ​0.002). Quality of life scores were lower among those with ≥4 ACEs, although this did not reach statistical significance (68.6 vs. 75.7, p ​= ​0.07). Conclusion: ACEs appear to be common in adults with CHD and are associated with negative attachment styles. Further research is needed to determine the impact of ACEs on long-term outcomes.http://www.sciencedirect.com/science/article/pii/S2666668521001415Adult congenital heart diseaseQuality of lifeAdverse childhood experiencesAttachment style
spellingShingle Marshall Taunton
Lidija McGrath
Craig Broberg
Sheldon Levy
Adrienne H. Kovacs
Abigail Khan
Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
International Journal of Cardiology Congenital Heart Disease
Adult congenital heart disease
Quality of life
Adverse childhood experiences
Attachment style
title Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
title_full Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
title_fullStr Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
title_full_unstemmed Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
title_short Adverse childhood experience, attachment style, and quality of life in adult congenital heart disease
title_sort adverse childhood experience attachment style and quality of life in adult congenital heart disease
topic Adult congenital heart disease
Quality of life
Adverse childhood experiences
Attachment style
url http://www.sciencedirect.com/science/article/pii/S2666668521001415
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