{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:13:30Z","timestamp":1790208810462,"version":"4.1.0"},"reference-count":64,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP-130405 and FDN-167263"],"award-info":[{"award-number":["MOP-130405 and FDN-167263"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The associations between adverse childhood experiences (ACEs) and psychopathology have been well-established in the general population. Research on ACEs in the homeless population has been limited. This study examined whether ACE exposure is associated with specific mental health outcomes among a national sample of homeless adults with mental illness and whether this association varies according to ACE dimension and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study utilized data from a national sample of 2,235 homeless adults with mental illness in Canada to evaluate their sociodemographic characteristics, exposure to ACEs, and mental health outcomes. Exploratory and confirmatory factor analyses were conducted to identify and confirm ACE dimensions (maltreatment, sexual abuse, neglect, divorce, and household dysfunction) from individual ACE items. Multivariable logistic regression was used to examine the associations between total ACE score and ACE dimensions with mental illness diagnoses and psychopathology severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean total ACE score among all study participants was 4.44 (standard deviation [ SD]: 2.99). Total ACE score was positively associated with several mental illness diagnoses and psychopathology severity. Unique associations were found between specific ACE dimensions and poor mental health outcomes. The prevalence of almost all ACEs was significantly higher among women. Yet, associations between several ACE dimensions and poor mental health outcomes existed uniquely among men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There are unique and gender-specific associations between specific ACE dimensions and mental health outcomes among homeless adults. Better understanding of the mechanisms underlying these associations is needed to inform screening, prevention, and treatment efforts, particularly given the very high prevalence of ACEs among this vulnerable and marginalized population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0706743721989158","type":"journal-article","created":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T10:12:18Z","timestamp":1611742338000},"page":"906-917","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Overall and Gender-specific Associations between Dimensions of Adverse Childhood Experiences and Mental Health Outcomes among Homeless Adults: Associations G\u00e9n\u00e9rales et Sexosp\u00e9cifiques Entre les Dimensions des Exp\u00e9riences D\u00e9favorables de L\u2019enfance et les R\u00e9sultats de Sant\u00e9 Mentale Chez les Adultes Sans Abri"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-8797","authenticated-orcid":false,"given":"Michael","family":"Liu","sequence":"first","affiliation":[{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cilia","family":"Mejia-Lancheros","sequence":"additional","affiliation":[{"name":"MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lachaud","sequence":"additional","affiliation":[{"name":"MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Latimer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, McGill University, Montreal, Canada"},{"name":"Douglas Research Centre, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Aubry","sequence":"additional","affiliation":[{"name":"School of Psychology and Centre for Research on Educational and Community Services, University of Ottawa, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Somers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Simon Fraser University, Burnaby, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jino","family":"Distasio","sequence":"additional","affiliation":[{"name":"Department of Geography, University of Winnipeg, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky","family":"Stergiopoulos","sequence":"additional","affiliation":[{"name":"MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Canada"},{"name":"Department of Psychiatry, University of Toronto, Canada"},{"name":"Center for Addiction and Mental Health, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Hwang","sequence":"additional","affiliation":[{"name":"MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Canada"},{"name":"Division of General Internal Medicine, Department of Medicine, University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,1,27]]},"reference":[{"key":"bibr1-0706743721989158","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.119826"},{"key":"bibr2-0706743721989158","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-005-0624-4"},{"key":"bibr3-0706743721989158","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2009.214"},{"key":"bibr4-0706743721989158","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"bibr5-0706743721989158","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.24.3089"},{"key":"bibr6-0706743721989158","doi-asserted-by":"crossref","unstructured":"Horwitz AV, Widom CS, McLaughlin J, White HR. 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