{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:37:04Z","timestamp":1790627824441,"version":"4.1.0"},"reference-count":42,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100000058","name":"Substance Abuse and Mental Health Services Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Child Abuse & Neglect"],"published-print":{"date-parts":[[2020,8]]},"DOI":"10.1016\/j.chiabu.2020.104492","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T18:33:43Z","timestamp":1590086023000},"page":"104492","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":51,"special_numbering":"C","title":["Synergistic adversities and behavioral problems in traumatized children and adolescents"],"prefix":"10.1016","volume":"106","author":[{"given":"Frank W.","family":"Putnam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Amaya-Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen T.","family":"Putnam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernestine C.","family":"Briggs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.chiabu.2020.104492_bib0005","series-title":"Manual for the child behavior checklist\/4-18 and 1991 profile","author":"Achenbach","year":"1991"},{"key":"10.1016\/j.chiabu.2020.104492_bib0010","series-title":"Manual for the ASEBA school-age forms & profiles","author":"Achenbach","year":"2001"},{"issue":"1","key":"10.1016\/j.chiabu.2020.104492_bib0015","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1037\/a0039713","article-title":"Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents","volume":"6","author":"Adams","year":"2015","journal-title":"Psychology of Violence"},{"key":"10.1016\/j.chiabu.2020.104492_bib0020","doi-asserted-by":"crossref","DOI":"10.1016\/j.amepre.2020.01.009","article-title":"Inside the Adverse Childhood Experience score: Strengths, limitations, and misapplications","author":"Anda","year":"2020","journal-title":"American Journal of Preventive Medicine"},{"issue":"3","key":"10.1016\/j.chiabu.2020.104492_bib0025","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1176\/jnp.2008.20.3.292","article-title":"Preliminary evidence for sensitive periods in the effect of childhood sexual abuse on regional brain development","volume":"20","author":"Andersen","year":"2008","journal-title":"Journal of Neuropsychiatry and Clinical Neurosciences"},{"key":"10.1016\/j.chiabu.2020.104492_bib0030","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s10654-005-7835-x","article-title":"Calculating measures of biological interaction","volume":"20","author":"Andersson","year":"2005","journal-title":"European Journal of Epidemiology"},{"key":"10.1016\/j.chiabu.2020.104492_bib0035","doi-asserted-by":"crossref","first-page":"3305","DOI":"10.1017\/S0033291715001300","article-title":"Latent classes of childhood trauma exposure predict the development of behavioral health outcomes in adolescence and young adulthood","volume":"45","author":"Ballard","year":"2015","journal-title":"Psychological Medicine"},{"issue":"1","key":"10.1016\/j.chiabu.2020.104492_bib0040","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1177\/0886260512448847","article-title":"Genetic risk for violent behavior and environmental exposure to disadvantage and violent crime","volume":"28","author":"Barnes","year":"2012","journal-title":"Journal of Interpersonal Violence"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0045","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jadohealth.2012.06.006","article-title":"Childhood abuse and age at menarche","volume":"52","author":"Boynton-Jarrett","year":"2013","journal-title":"Journal of Adolescent Health"},{"issue":"1","key":"10.1016\/j.chiabu.2020.104492_bib0050","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/19361521.2012.646413","article-title":"Trauma exposure, psychosocial functioning, and treatment needs of youth in residential care: Preliminary findings from the NCTSN Core Data Set","volume":"5","author":"Briggs","year":"2012","journal-title":"Journal of Child & Adolescent Trauma"},{"issue":"8","key":"10.1016\/j.chiabu.2020.104492_bib0055","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1289\/ehp.9863","article-title":"Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology","volume":"115","author":"Clougherty","year":"2007","journal-title":"Environmental Health Perspectives"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0060","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.chc.2014.01.002","article-title":"The biological effects of childhood trauma","volume":"23","author":"De Bellis","year":"2014","journal-title":"Child and Adolescent Psychiatric Clinics of North America"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0065","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/S0145-2134(03)00105-4","article-title":"The relationship of exposure to childhood sexual abuse to other forms of abuse, neglect, and household dysfunction during childhood","volume":"27","author":"Dong","year":"2003","journal-title":"Child Abuse & Neglect"},{"issue":"7","key":"10.1016\/j.chiabu.2020.104492_bib0070","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.chiabu.2004.01.008","article-title":"The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction","volume":"28","author":"Dong","year":"2004","journal-title":"Child Abuse & Neglect"},{"issue":"4","key":"10.1016\/j.chiabu.2020.104492_bib0075","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study","volume":"14","author":"Felitti","year":"1998","journal-title":"American Journal of Preventive Medicine"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0080","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.chiabu.2006.12.018","article-title":"Exposure to childhood sexual and physical abuse and adjustment in early adulthood","volume":"32","author":"Fergusson","year":"2008","journal-title":"Child Abuse & Neglect"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0085","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1097\/EDE.0b013e31829e3e03","article-title":"Arsenic, tobacco smoke, and occupation","volume":"24","author":"Ferreccio","year":"2013","journal-title":"Epidemiology"},{"issue":"5","key":"10.1016\/j.chiabu.2020.104492_bib0090","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.ypmed.2007.12.009","article-title":"Synergistic effects of child abuse and intimate partner violence on depressive symptoms in women","volume":"46","author":"Fogarty","year":"2008","journal-title":"Preventive Medicine"},{"issue":"8","key":"10.1016\/j.chiabu.2020.104492_bib0095","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.cjca.2017.05.008","article-title":"Sex-specific differences in the association between childhood adversity and cardiovascular disease in adulthood: Evidence from a National Cohort Study","volume":"33","author":"Garad","year":"2017","journal-title":"Canadian Journal of Cardiology"},{"issue":"3","key":"10.1016\/j.chiabu.2020.104492_bib0100","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1177\/0886260513505217","article-title":"Traumatic childhood experiences in the 21st century: Broadening and building on the ACE studies with data from the National Child Traumatic Stress Network","volume":"29","author":"Greeson","year":"2014","journal-title":"Journal of Interpersonal Violence"},{"issue":"5","key":"10.1016\/j.chiabu.2020.104492_bib0105","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/00001648-199209000-00012","article-title":"Confidence interval estimation of interaction","volume":"3","author":"Hosmer","year":"1992","journal-title":"Epidemiology"},{"issue":"8","key":"10.1016\/j.chiabu.2020.104492_bib0110","doi-asserted-by":"crossref","first-page":"e356","DOI":"10.1016\/S2468-2667(17)30118-4","article-title":"The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis","volume":"2","author":"Hughes","year":"2017","journal-title":"Lancet Public Health"},{"key":"10.1016\/j.chiabu.2020.104492_bib0115","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.chiabu.2016.11.005","article-title":"Adverse childhood experiences and behavioral problems in middle childhood","volume":"67","author":"Hunt","year":"2017","journal-title":"Child Abuse & Neglect"},{"issue":"4","key":"10.1016\/j.chiabu.2020.104492_bib0120","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.acap.2016.12.009","article-title":"Adverse childhood experiences and ADHD diagnosis at age 9 years in a national urban sample","volume":"17","author":"Jimenez","year":"2017","journal-title":"Academic Pediatrics"},{"issue":"8","key":"10.1016\/j.chiabu.2020.104492_bib0125","doi-asserted-by":"crossref","first-page":"e342","DOI":"10.1016\/S2468-2667(17)30139-1","article-title":"Inequality and intergenerational transmission of complex adversity","volume":"2","author":"Kinner","year":"2017","journal-title":"The Lancet Public Health"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0130","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10654-011-9554-9","article-title":"Estimating measures of interaction on an additive scale for preventive exposures","volume":"26","author":"Knol","year":"2011","journal-title":"European Journal of Epidemiology"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0135","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/jcpp.13135","article-title":"Practitioner review: Twenty years of research with adverse childhood experience scores \u2013 Advantages, disadvantages and applications to practice","volume":"61","author":"Lacey","year":"2020","journal-title":"Journal of Child Psychology and Psychiatry"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0140","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/00001648-200103000-00014","article-title":"Family history of coronary heart disease, a strong risk factor for myocardial infarction interacting with other cardiovascular risk factors: Results from the Stockholm Hearth Epidemiology Program (SHEEP)","volume":"12","author":"Leander","year":"2001","journal-title":"Epidemiology"},{"key":"10.1016\/j.chiabu.2020.104492_bib0145","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.3389\/fphar.2019.01384","article-title":"Additive dose response models: Defining synergy","volume":"10","author":"Lederer","year":"2019","journal-title":"Frontiers in Pharmacology"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0150","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1017\/S0033291713001918","article-title":"Apolipoprotein E epsilon 4 genotype and a physically active lifestyle in late life: Analysis of gene-environment interaction for the risk of dementia and Alzheimer's disease dementia","volume":"44","author":"Luck","year":"2013","journal-title":"Psychological Medicine"},{"key":"10.1016\/j.chiabu.2020.104492_bib0155","series-title":"NCCTS Leadership: The Core Data Set","author":"National Child Traumatic Stress Network","year":"2009"},{"issue":"6","key":"10.1016\/j.chiabu.2020.104492_bib0160","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.chiabu.2007.09.008","article-title":"Sexual abuse of children\u2014Unique in its effects on development?","volume":"32","author":"Noll","year":"2008","journal-title":"Child Abuse & Neglect"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0165","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1001\/archpedi.161.2.186","article-title":"Conjoined effects of low birth weight and childhood abuse on adaptation and well-being in adolescence and adulthood","volume":"161","author":"Nomura","year":"2007","journal-title":"Archives of Pediatrics and Adolescent Medicine"},{"key":"10.1016\/j.chiabu.2020.104492_bib0170","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.chiabu.2015.03.007","article-title":"Children neglected: Where cumulative risk theory fails","volume":"45","author":"O\u2019Hara","year":"2015","journal-title":"Child Abuse & Neglect"},{"issue":"6464","key":"10.1016\/j.chiabu.2020.104492_bib0175","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1126\/science.aax2342","article-title":"Dissecting racial bias in an algorithm used to manage the health of populations","volume":"366","author":"Obermeyer","year":"2019","journal-title":"Science"},{"issue":"4","key":"10.1016\/j.chiabu.2020.104492_bib0180","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/jts.21833","article-title":"Synergistic childhood adversities and complex adult psychopathology","volume":"26","author":"Putnam","year":"2013","journal-title":"Journal of Traumatic Stress"},{"key":"10.1016\/j.chiabu.2020.104492_bib0185","series-title":"Modern epidemiology","author":"Rothman","year":"1998"},{"issue":"2","key":"10.1016\/j.chiabu.2020.104492_bib0190","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s11920-004-0048-2","article-title":"The University of California at Los Angeles post-traumatic stress disorder reaction index","volume":"6","author":"Steinberg","year":"2004","journal-title":"Current Psychiatry Reports"},{"issue":"1","key":"10.1016\/j.chiabu.2020.104492_bib0195","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jts.21780","article-title":"Psychometric properties of the UCLA PTSD reaction index: Part 1","volume":"26","author":"Steinberg","year":"2013","journal-title":"Journal of Traumatic Stress"},{"issue":"Suppl 1","key":"10.1016\/j.chiabu.2020.104492_bib0200","doi-asserted-by":"crossref","first-page":"S50","DOI":"10.1037\/a0037798","article-title":"The NCTSN core data set: emerging findings, future directions, and implications for theory, research, practice, and policy","volume":"6","author":"Steinberg","year":"2014","journal-title":"Psychological Trauma: Theory, Research, Practice, and Policy"},{"issue":"3","key":"10.1016\/j.chiabu.2020.104492_bib0205","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1001\/archpediatrics.2008.555","article-title":"Maternal intimate partner violence and increased asthma incidence in children","volume":"163","author":"Suglia","year":"2009","journal-title":"Archives of Pediatrics and Adolescent Medicine"},{"issue":"8","key":"10.1016\/j.chiabu.2020.104492_bib0210","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1093\/aje\/kwn418","article-title":"Sex-modified effect of Hepatitis B virus infection on mortality from primary liver cancer","volume":"169","author":"Wang","year":"2009","journal-title":"American Journal of Epidemiology"}],"container-title":["Child Abuse & Neglect"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0145213420301472?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0145213420301472?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T01:14:40Z","timestamp":1758935680000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0145213420301472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":42,"alternative-id":["S0145213420301472"],"URL":"https:\/\/doi.org\/10.1016\/j.chiabu.2020.104492","relation":{},"ISSN":["0145-2134"],"issn-type":[{"value":"0145-2134","type":"print"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Synergistic adversities and behavioral problems in traumatized children and adolescents","name":"articletitle","label":"Article Title"},{"value":"Child Abuse & Neglect","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.chiabu.2020.104492","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}],"article-number":"104492"}}