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@ARTICLE{Drner:275881,
      author       = {Dörner, Marc and von Känel, Roland and Pazhenkottil, Aju
                      P and Altwegg, Rahel and König, Noelle and Nager, Ladina
                      and Attanasio, Veronica and Guth, Lisa and Zirngast, Sina
                      and Menzi, Anna and Princip, Mary and Zuccarella-Hackl,
                      Claudia},
      title        = {{C}ross-sectional study on the impact of adverse childhood
                      experiences on psychological distress in patients with an
                      implantable cardioverter-defibrillator.},
      journal      = {Journal of psychosomatic research},
      volume       = {189},
      issn         = {0022-3999},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DZNE-2025-00116},
      pages        = {112033},
      year         = {2025},
      abstract     = {Previous studies implied detrimental effects of adverse
                      childhood experiences (ACE) on cardiovascular disease and
                      mental health. Still, data on the influence of ACE on
                      psychological distress in patients with an implantable
                      cardioverter-defibrillator (ICD) are lacking.We
                      prospectively recruited 423 patients with an ICD. To
                      determine associations between ACE (ACE questionnaire,
                      cut-off ≥4), depression (Patient Health Questionnaire-8),
                      anxiety (Generalized Anxiety Disorder-7 scale), and
                      post-traumatic stress disorder (PTSD) symptoms
                      (Post-Traumatic Stress Diagnostic Scale), we conducted a
                      binary logistic regression analysis. Regression models were
                      adjusted for conventional risk factors of psychological
                      distress in ICD patients. To identify indirect mediating
                      effects of resilience (Resilience Scale) on ACE and
                      psychological distress, we applied the PROCESS regression
                      path analysis modeling tool.49.1 $\%$ of all patients
                      reported at least one ACE, and 9.7 $\%$ experienced even
                      four or more ACE. A high-risk ACE profile (≥ 4) was
                      associated with higher levels of anxiety (OR 3.68, 95 $\%$
                      CI 1.37-9.84, p = 0.009), depression (OR 4.08, 95 $\%$ CI
                      1.67-9.97, p = 0.002), and PTSD symptoms (OR 2.20, 95 $\%$
                      CI 1.03-5.21, p = 0.041). Greater resilience partially
                      mediated the relationship between ACE and depression
                      (indirect effect 0.11, 95 $\%$ CI 0.01-0.26) as well as
                      anxiety (indirect effect 0.08, 95 $\%$ CI 0.008-0.19).The
                      current study suggests an association between ACE and
                      psychological distress in patients with an ICD. However,
                      resilience could mitigate the adverse effects of ACE. Future
                      studies should strive to unravel the complex mechanisms of
                      ACE and its effects on cardiovascular and mental health in
                      ICD patients.},
      keywords     = {Humans / Defibrillators, Implantable: psychology / Female /
                      Male / Cross-Sectional Studies / Middle Aged / Psychological
                      Distress / Adverse Childhood Experiences / Stress Disorders,
                      Post-Traumatic: psychology / Anxiety: psychology / Aged /
                      Depression: psychology / Adult / Resilience, Psychological /
                      Prospective Studies / Risk Factors / Stress, Psychological:
                      psychology / Adverse childhood experiences (Other) / Anxiety
                      (Other) / Depression (Other) / Implantable
                      cardioverter-defibrillator (Other) / Post-traumatic stress
                      disorder (Other) / Resilience (Other)},
      cin          = {AG Schreiber},
      ddc          = {610},
      cid          = {I:(DE-2719)1310010},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39787970},
      doi          = {10.1016/j.jpsychores.2024.112033},
      url          = {https://pub.dzne.de/record/275881},
}