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Relationship between adverse childhood experiences and homelessness and the impact of Axis I and II disorders

Author

Listed:
  • Roos, L.E.
  • Mota, N.
  • Afifi, T.O.
  • Katz, L.Y.
  • Distasio, J.
  • Sareen, J.

Abstract

Objectives. We investigated the links between homelessness associated with serious mental and physical healthy disparities and adverse childhood experiences (ACEs) in nationally representative data, with Axis I and II disorders as potential mediators. Methods. We examined data from the National Epidemiologic Survey of Alcohol and Related Conditions in 2001-2002 and 2004-2005, and included 34 653 participants representative of the noninstitutionalized US population who were 20 years old or older. We studied the variables related to 4 classes of Axis I disorders, all 10 Axis II personality disorders, a wide range of ACEs, and a lifetime history of homelessness. Results. Analyses revealed high prevalences of each ACE in individuals experiencing lifetime homelessness (17%-60%). A mediation model with Axis I and II disorders determined that childhood adversities were significantly related to homelessness through direct effects (adjusted odd ratios = 2.04, 4.24) and indirect effects, indicating partial mediation. Population attributable fractions were also reported. Conclusions. Although Axis I and II disorders partially mediated the relationship between ACEs and homelessness, a strong direct association remained. This novel finding has implications for interventions and policy. Additional research is needed to understand relevant causal pathways.

Suggested Citation

  • Roos, L.E. & Mota, N. & Afifi, T.O. & Katz, L.Y. & Distasio, J. & Sareen, J., 2013. "Relationship between adverse childhood experiences and homelessness and the impact of Axis I and II disorders," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 275-281.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2013.301323_5
    DOI: 10.2105/AJPH.2013.301323
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    Cited by:

    1. Mzwandile A. Mabhala & Asmait Yohannes, 2019. "Being at the Bottom Rung of the Ladder in an Unequal Society: A Qualitative Analysis of Stories of People without a Home," IJERPH, MDPI, vol. 16(23), pages 1-19, November.
    2. Alyssa Tate & Kaéla Edwards & Nichole Holmes & Steven Buffer & Zachary Fusfeld & Willie Baronet & Rosemary Frasso, 2022. "‘Even a smile helps’: Exploring the interactions between people experiencing homelessness and passersby in public spaces," International Journal of Social Psychiatry, , vol. 68(3), pages 525-532, May.
    3. Mzwandile Mabhala & Winifred Adaobi Esealuka & Amanda Nkolika Nwufo & Chinwe Enyinna & Chelsea Nonkosi Mabhala & Treasure Udechukwu & John Reid & Asmait Yohannes, 2021. "Homelessness Is Socially Created: Cluster Analysis of Social Determinants of Homelessness (SODH) in North West England in 2020," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    4. Daniel K Cooper & Mayra Bámaca-Colbert & Eric K Layland & Emily G Simpson & Benjamin L Bayly, 2021. "Puerto Ricans and Mexican immigrants differ in their psychological responses to patterns of lifetime adversity," PLOS ONE, Public Library of Science, vol. 16(10), pages 1-22, October.
    5. Hiles Howard, Amanda R. & Parris, Sheri & Hall, Jordan S. & Call, Casey D. & Razuri, Erin Becker & Purvis, Karyn B. & Cross, David R., 2015. "An examination of the relationships between professional quality of life, adverse childhood experiences, resilience, and work environment in a sample of human service providers," Children and Youth Services Review, Elsevier, vol. 57(C), pages 141-148.
    6. Mersky, Joshua P. & Janczewski, Colleen E. & Nitkowski, Jenna C., 2018. "Poor mental health among low-income women in the U.S.: The roles of adverse childhood and adult experiences," Social Science & Medicine, Elsevier, vol. 206(C), pages 14-21.
    7. Shiyou Wu & Lac Ta & Jaime Vieira & Kendall Schwartz & Joshua Perez & Justin Zeien & Danyi Li & Jennifer Hartmark-Hill, 2024. "Adverse Childhood Experiences and Depression among Homeless Young Adults: A Social Determinants of Health Perspective," IJERPH, MDPI, vol. 21(1), pages 1-15, January.
    8. Cohen-Cline, Hannah & Jones, Kyle & Vartanian, Keri, 2021. "Direct and indirect pathways between childhood instability and adult homelessness in a low-income population," Children and Youth Services Review, Elsevier, vol. 120(C).

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