Maxia Dong
Centers for Disease Control and Prevention
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Featured researches published by Maxia Dong.
Circulation | 2004
Maxia Dong; Wayne H. Giles; Vincent J. Felitti; Shanta R. Dube; Janice E. Williams; Daniel P. Chapman; Robert F. Anda
Background—The purpose of this study was to assess the relation of adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction, to the risk of ischemic heart disease (IHD) and to examine the mediating impact on this relation of both traditional IHD risk factors and psychological factors that are associated with ACEs. Methods and Results—Retrospective cohort survey data were collected from 17 337 adult health plan members from 1995 to 1997. Logistic regression adjusted for age, sex, race, and education was used to estimate the strength of the ACE–IHD relation and the mediating impact of IHD risk factors in this relation. Nine of 10 categories of ACEs significantly increased the risk of IHD by 1.3- to 1.7-fold versus persons with no ACEs. The adjusted odds ratios for IHD among persons with ≥7 ACEs was 3.6 (95% CI, 2.4 to 5.3). The ACE–IHD relation was mediated more strongly by individual psychological risk factors commonly associated with ACEs than by traditional IHD risk factors. We observed significant association between increased likelihood of reported IHD (adjusted ORs) and depressed affect (2.1, 1.9 to 2.4) and anger (2.5, 2.1 to 3.0) as well as traditional risk factors (smoking, physical inactivity, obesity, diabetes and hypertension), with ORs ranging from 1.2 to 2.7. Conclusions—We found a dose-response relation of ACEs to IHD and a relation between almost all individual ACEs and IHD. Psychological factors appear to be more important than traditional risk factors in mediating the relation of ACEs to the risk of IHD. These findings provide further insights into the potential pathways by which stressful childhood experiences may increase the risk of IHD in adulthood.
Child Abuse & Neglect | 2003
Maxia Dong; Robert F. Anda; Shanta R. Dube; Wayne H. Giles; Vincent J. Felitti
OBJECTIVE This study assesses the relationship of childhood sexual abuse (CSA) to nine other categories of Adverse Childhood Experiences (ACEs), including childhood abuse, neglect, and multiple types of household dysfunction. METHODS Retrospective cohort study data were collected from 17,337 adult health plan members who responded to a survey questionnaire. Regression models adjusted for age, race, and education were used to estimate the strength of the association of CSA to each of the other nine ACEs and a graded relationship between measures of the severity of CSA and the number of other ACEs (ACE score). RESULTS CSA was reported by 25% of women and 16% of men. In comparison with persons who were not exposed to CSA, the likelihood of experiencing each category of ACE increased 2- to 3.4-fold for women and 1.6- to 2.5-fold for men (p < 0.05). The adjusted mean ACE score showed a significant positive graded relationship to the severity, duration, and frequency of CSA and an inverse relationship to age at first occurrence of CSA (p < 0.01). CONCLUSIONS CSA is strongly associated with experiencing multiple other forms of ACEs. The strength of this association appears to increase as the measures of severity of the CSA increases. The understanding of the interrelatedness of CSA with multiple ACEs should be considered in the design of studies, treatment, and programs to prevent CSA as well as other forms of ACEs.
BMC Public Health | 2009
Robert F. Anda; Maxia Dong; David W. Brown; Vincent J. Felitti; Wayne H. Giles; Geraldine S. Perry; Edwards J Valerie; Shanta R. Dube
BackgroundTo assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who report having more ACEs would be more likely to have family members at risk of premature death.MethodsWe used data from 17,337 adult health plan members who completed a survey about 10 types of ACEs and whether a family member died before age 65. The prevalence of family member premature death and its association with ACEs were assessed.ResultsFamily members of respondents who experienced any type of ACEs were more likely to have elevated prevalence for premature death relative to those of respondents without such experience (p < 0.01). The highest risk occurred among those who reported having been physically neglected and living with substance abusing or criminal family members during childhood. A powerful graded relationship between the number of ACEs and premature mortality in the family was observed for all age groups, and comparison between groups reporting 0 ACE and ≥ 4 ACEs yielded an OR of 1.8 (95%CI, 1.6–2.0).ConclusionAdverse childhood experiences may be an indicator of a chaotic family environment that results in an increased risk of premature death among family members.
Child Abuse & Neglect | 2004
Maxia Dong; Robert F. Anda; Vincent J. Felitti; Shanta R. Dube; David F. Williamson; Theodore J. Thompson; Clifton M Loo; Wayne H. Giles
American Journal of Preventive Medicine | 2005
Shanta R. Dube; Robert F. Anda; Charles L. Whitfield; David W. Brown; Vincent J. Felitti; Maxia Dong; Wayne H. Giles
Preventive Medicine | 2003
Shanta R. Dube; Vincent J. Felitti; Maxia Dong; Wayne H. Giles; Robert F. Anda
Journal of Adolescent Health | 2006
Shanta R. Dube; Jacqueline W. Miller; David W. Brown; Wayne H. Giles; Vincent J. Felitti; Maxia Dong; Robert F. Anda
JAMA Internal Medicine | 2003
Maxia Dong; Shanta R. Dube; Vincent J. Felitti; Wayne H. Giles; Robert F. Anda
JAMA Pediatrics | 2005
Maxia Dong; Robert F. Anda; Vincent J. Felitti; David F. Williamson; Shanta R. Dube; David W. Brown; Wayne H. Giles
Archive | 2003
Maxia Dong; Shanta R. Dube; Vincent J. Felitti; Wayne H. Giles; Robert F. Anda