Cross-sectional study on the impact of adverse childhood experiences on psychological distress in patients with an implantable cardioverter-defibrillator.

Dörner, Marc; Zuccarella-Hackl, Claudia; Guth, Lisa; Pazhenkottil, Aju P; Menzi, Anna; Nager, Ladina; Attanasio, Veronica; König, Noelle; Princip, Mary; von Känel, Roland; Altwegg, Rahel; Zirngast, Sina

doi:10.1016/j.jpsychores.2024.112033

Items
Marc 21

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024	7	_	\|a 10.1016/j.jpsychores.2024.112033 \|2 doi
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024	7	_	\|a 0022-3999 \|2 ISSN
024	7	_	\|a 1879-1360 \|2 ISSN
037	_	_	\|a DZNE-2025-00116
041	_	_	\|a English
082	_	_	\|a 610
100	1	_	\|a Dörner, Marc \|0 P:(DE-2719)9002951 \|b 0 \|e First author \|u dzne
245	_	_	\|a Cross-sectional study on the impact of adverse childhood experiences on psychological distress in patients with an implantable cardioverter-defibrillator.
260	_	_	\|a Amsterdam [u.a.] \|c 2025 \|b Elsevier Science
336	7	_	\|a article \|2 DRIVER
336	7	_	\|a Output Types/Journal article \|2 DataCite
336	7	_	\|a Journal Article \|b journal \|m journal \|0 PUB:(DE-HGF)16 \|s 1737451543_4881 \|2 PUB:(DE-HGF)
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520	_	_	\|a 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.
536	_	_	\|a 353 - Clinical and Health Care Research (POF4-353) \|0 G:(DE-HGF)POF4-353 \|c POF4-353 \|f POF IV \|x 0
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650	_	7	\|a Adverse childhood experiences \|2 Other
650	_	7	\|a Anxiety \|2 Other
650	_	7	\|a Depression \|2 Other
650	_	7	\|a Implantable cardioverter-defibrillator \|2 Other
650	_	7	\|a Post-traumatic stress disorder \|2 Other
650	_	7	\|a Resilience \|2 Other
650	_	2	\|a Humans \|2 MeSH
650	_	2	\|a Defibrillators, Implantable: psychology \|2 MeSH
650	_	2	\|a Female \|2 MeSH
650	_	2	\|a Male \|2 MeSH
650	_	2	\|a Cross-Sectional Studies \|2 MeSH
650	_	2	\|a Middle Aged \|2 MeSH
650	_	2	\|a Psychological Distress \|2 MeSH
650	_	2	\|a Adverse Childhood Experiences \|2 MeSH
650	_	2	\|a Stress Disorders, Post-Traumatic: psychology \|2 MeSH
650	_	2	\|a Anxiety: psychology \|2 MeSH
650	_	2	\|a Aged \|2 MeSH
650	_	2	\|a Depression: psychology \|2 MeSH
650	_	2	\|a Adult \|2 MeSH
650	_	2	\|a Resilience, Psychological \|2 MeSH
650	_	2	\|a Prospective Studies \|2 MeSH
650	_	2	\|a Risk Factors \|2 MeSH
650	_	2	\|a Stress, Psychological: psychology \|2 MeSH
700	1	_	\|a von Känel, Roland \|b 1
700	1	_	\|a Pazhenkottil, Aju P \|b 2
700	1	_	\|a Altwegg, Rahel \|b 3
700	1	_	\|a König, Noelle \|b 4
700	1	_	\|a Nager, Ladina \|b 5
700	1	_	\|a Attanasio, Veronica \|b 6
700	1	_	\|a Guth, Lisa \|b 7
700	1	_	\|a Zirngast, Sina \|b 8
700	1	_	\|a Menzi, Anna \|b 9
700	1	_	\|a Princip, Mary \|b 10
700	1	_	\|a Zuccarella-Hackl, Claudia \|b 11
773	_	_	\|a 10.1016/j.jpsychores.2024.112033 \|g Vol. 189, p. 112033 - \|0 PERI:(DE-600)1500642-6 \|p 112033 \|t Journal of psychosomatic research \|v 189 \|y 2025 \|x 0022-3999
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910	1	_	\|a Deutsches Zentrum für Neurodegenerative Erkrankungen \|0 I:(DE-588)1065079516 \|k DZNE \|b 0 \|6 P:(DE-2719)9002951
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Marc 21

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