{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:26:34Z","timestamp":1760059594612,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychiatry International"],"abstract":"<jats:p>The COVID-19 pandemic is considered a potentially traumatic event, as it introduced new challenges and threats to people around the world, disrupting daily life due to the restrictions imposed. The psychological defenses of individuals mobilized to deal with stress reactions are influenced by a set of factors, including previous traumatic experiences, which can amplify the current trauma. Recognizing that people exposed to adverse childhood experiences (ACEs) have increased risks of an array of adverse mental and physical health outcomes throughout life, the present study aimed to investigate the relationship between ACEs\u2014more specifically, child abuse and child neglect\u2014and PTSD symptoms in a sample of European adults during the pandemic. A sample of 8459 participants (67.1% female and 32.9% male, with a mean of 43.95 years old) was evaluated. The survey questionnaire included questions on sociodemographic and clinical characteristics, the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), and the Adverse Childhood Experiences (ACEs) questionnaire. According to our findings, younger women who have suffered from child abuse or child neglect are more likely to develop PTSD symptoms. The most significant factor influencing the PTSD risk was child neglect, contrary to many studies that indicate that child abuse is the most impactful adverse childhood experience.<\/jats:p>","DOI":"10.3390\/psychiatryint6030076","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T10:45:08Z","timestamp":1751366708000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship Between Adverse Childhood Experiences and PTSD: An Analysis of the Pandemic Responses in a Sample of European Adults"],"prefix":"10.3390","volume":"6","author":[{"given":"In\u00eas","family":"Mo\u00e7o","sequence":"first","affiliation":[{"name":"Trauma Observatory, Center for Social Studies, University of Coimbra, 3000-389 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6184-7211","authenticated-orcid":false,"given":"Joana Proen\u00e7a","family":"Becker","sequence":"additional","affiliation":[{"name":"Trauma Observatory, Center for Social Studies, University of Coimbra, 3000-389 Coimbra, Portugal"},{"name":"Miguel Torga Institute of Higher Education, 3000-132 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s11818-022-00351-x","article-title":"Dreams and nightmares during the pandemic","volume":"26","author":"Ableidinger","year":"2022","journal-title":"Somnologie"},{"key":"ref_2","unstructured":"(2024, March 01). World Health Organization. Available online: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/question-and-answers-hub\/q-a-detail\/coronavirus-disease-covid-19."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Solomonova, E., Picard-Deland, C., Rapoport, I.L., Pennestri, M.H., Saad, M., Kendzerska, T., Veissiere, S.P., Godbout, R., Edwards, J.D., and Quilty, L. (2021). Stuck in a lockdown: Dreams, bad dreams, nightmares, and their relationship to stress, depression and anxiety during the COVID-19 pandemic. PLoS ONE, 16.","DOI":"10.31234\/osf.io\/hbm84"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1192\/j.eurpsy.2021.2263","article-title":"Did we learn something positive out of the COVID-19 pandemic? Post-traumatic growth and mental health in the general population","volume":"64","author":"Menculini","year":"2021","journal-title":"Eur. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1057\/s41271-020-00247-w","article-title":"Leveraging media and health communication strategies to overcome the COVID-19 infodemic","volume":"41","author":"Mheidly","year":"2020","journal-title":"J. Public Health Policy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1037\/drm0000272","article-title":"Dreaming about the Pandemic: A thematic analysis of COVID-19-related dream during the outbreak in Portugal","volume":"34","author":"Becker","year":"2024","journal-title":"Dreaming"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1177\/08901171211055312","article-title":"Sleep, Dreams, and Nightmares During the COVID-19 Pandemic","volume":"35","author":"Kennedy","year":"2021","journal-title":"Am. J. Health Promot."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"74","DOI":"10.3390\/psych2010008","article-title":"A Relational Model for Stress: A Systematic Review of the Risk and Protective Factors for Stress-Related Diseases in Firefighters","volume":"2","author":"Becker","year":"2020","journal-title":"Psych"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Tomaszek, K., and Muchacka-Cymerman, A. (2020). Thinking about My Existence during COVID-19, I Feel Anxiety and Awe\u2014The Mediating Role of Existential Anxiety and Life Satisfaction on the Relationship Between PTSD Symptoms and Post-Traumatic Growth. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17197062"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s40653-020-00308-y","article-title":"The Relationship Between ACEs, Trauma-Related Psychopathology and Resilience in Vulnerable Youth: Implications for Screening and Treatment","volume":"14","author":"Goldenson","year":"2021","journal-title":"J. Child Adolesc. Trauma"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1192\/bjp.bp.116.197640","article-title":"Childhood adversities and post-traumatic stress disorder: Evidence for stress sensitisation in the World Mental Health Surveys","volume":"211","author":"McLaughlin","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1001\/jamapsychiatry.2024.0039","article-title":"Adverse Childhood Experiences and Adult Mental Health Outcomes","volume":"81","author":"Aspelund","year":"2024","journal-title":"JAMA Psychiatry"},{"key":"ref_13","unstructured":"(2024, March 01). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/violenceprevention\/aces\/index.html."},{"key":"ref_14","unstructured":"Gonzales, D., Mirabal, A.B., McCall, J.D., and Doerr, C. (2024). Child Abuse and Neglect (Nursing), StatPearls Publishing LLC."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1037\/trm0000209","article-title":"Cognitive Complaints in Neuropsychologically Normal Adults: A Brief Report on the Roles of Childhood Abuse and Rumination","volume":"26","author":"Szabo","year":"2020","journal-title":"Traumatology"},{"key":"ref_16","first-page":"4","article-title":"Bipolar Disorder and Early Affective Trauma","volume":"28","author":"Codt","year":"2016","journal-title":"Psychiatria Danubina"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Manyema, M., Norris, S.A., and Richter, L.M. (2018). Stress begets stress: The association of adverse childhood experiences with psychological distress in the presence of adult life stress. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5767-0"},{"key":"ref_18","first-page":"100003","article-title":"Adverse Childhood Experiences and Trauma-Informed Care in Regabilitation Clinical Practice","volume":"1","author":"Ranjbar","year":"2019","journal-title":"Arch. Rehabil. Res. Clin. Transl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/acps.13268","article-title":"Childhood trauma and adult mental disorder: A systematic review and meta-analysis of longitudinal cohort studies","volume":"143","author":"McKay","year":"2021","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_20","unstructured":"(2021, June 06). Psychology Today. Available online: https:\/\/www.psychologytoday.com\/intl\/blog\/overcoming-destructive-anger\/202106\/how-adverse-childhood-experiences-aces-impact-adult-anger."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e193007","DOI":"10.1001\/jamapediatrics.2019.3007","article-title":"Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample\u2014Associations Across Adverse Childhood Experiences Levels","volume":"173","author":"Bethell","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e184493","DOI":"10.1001\/jamanetworkopen.2018.4493","article-title":"Association of Childhood Trauma Exposure With Adult Psychiatric Disorders and Functional Outcomes","volume":"1","author":"Copeland","year":"2018","journal-title":"JAMA Netw. Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"39","DOI":"10.5455\/ajpmph.20191204050137","article-title":"The long shadow of adverse childhood events (ACEs): 2. Physical health outcomes in an adult community sample","volume":"6","author":"Dobson","year":"2020","journal-title":"Am. J. Prev. Med. Public Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.schres.2020.03.015","article-title":"Childhood trauma is associated with poorer social functioning in severe mental disorders both during an active illness phase and in remission","volume":"243","author":"Hjelseng","year":"2020","journal-title":"Schizophr. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.chiabu.2011.04.003","article-title":"Associations of childhood trauma, trauma in adulthood and previous-year stress with psychopathology in patients with major depression and borderline personality disorder","volume":"35","author":"Wingenfeld","year":"2011","journal-title":"Child Abus. Negl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1037\/drm0000231","article-title":"Impact of the COVID-19 pandemic on sleep and dreams: Study in a Portuguese sample","volume":"33","author":"Farate","year":"2023","journal-title":"Dreaming"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"105208","DOI":"10.1016\/j.chiabu.2021.105208","article-title":"The impact of childhood maltreatment on the severity of childhood-related posttraumatic stress disorder in adults","volume":"120","author":"Rameckers","year":"2021","journal-title":"Child Abuse Negl."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1176\/ajp.156.8.1223","article-title":"Posttraumatic stress disorder in abused and neglected children grown up","volume":"156","author":"Widom","year":"1999","journal-title":"Am. J. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s11524-022-00628-4","article-title":"Examining associations between adverse childhood experiences and posttraumatic stress disorder symptoms among young survivors of urban violence","volume":"99","author":"Tabb","year":"2022","journal-title":"J. Urban Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1780832","DOI":"10.1080\/20008198.2020.1780832","article-title":"Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic\u2014Study protocol of the European society for traumatic stress studies (ESTSS) pan-European study","volume":"11","author":"Lotzin","year":"2020","journal-title":"Eur. J. Psychotraumatology"},{"key":"ref_31","unstructured":"(2020, May 29). European Society for Traumatic Stress Studies. Available online: https:\/\/estss.org\/estss-pan-european-study-focused-on-exploring-the-impact-of-covid-19-related-crisis-on-the-wellbeing-of-the-general-population."},{"key":"ref_32","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","volume":"14","author":"Felitti","year":"1998","journal-title":"Am. J. Prev. Med."},{"key":"ref_33","first-page":"181","article-title":"The Assessment of Adverse Childhood Experiences: Factor Structure and Convergent Validity of Multiple Measures","volume":"7","author":"Dobson","year":"2021","journal-title":"Am. J. Prev. Med. Public Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1007\/s11606-016-3703-5","article-title":"The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample","volume":"31","author":"Prins","year":"2016","journal-title":"J. Gen. Intern. Med."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Leitch, L. (2017). Action steps using ACEs and trauma-informed care: A resilience model. Health Justice, 5.","DOI":"10.1186\/s40352-017-0050-5"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1177\/10775595231171617","article-title":"Interventions to support children\u2019s recovery from neglect\u2014A systematic review","volume":"29","author":"Jackson","year":"2024","journal-title":"Child Maltreat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1002\/jts.20683","article-title":"Posttraumatic stress and related symptoms among neglected and physically and sexually maltreated adolescents","volume":"24","author":"Kearney","year":"2011","journal-title":"J. Trauma. Stress"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1176\/appi.ajp.2019.19010020","article-title":"The devastating clinical consequences of child abuse and neglect: Increased disease vulnerability and poor treatment response in mood disorders","volume":"177","author":"Lippard","year":"2020","journal-title":"Am. J. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"401","DOI":"10.3928\/00485713-20050501-06","article-title":"Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories","volume":"35","year":"2005","journal-title":"Psychiatr. Ann."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1002\/jts.20478","article-title":"A prospective study of sex differences in the lifetime risk of posttraumatic stress disorder among abused and neglected children grown up","volume":"22","author":"Koenen","year":"2009","journal-title":"J. Trauma. Stress"},{"key":"ref_41","unstructured":"(2023, April 13). American Psychological Association. Available online: https:\/\/www.apa.org\/topics\/women-girls\/women-trauma."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1351204","DOI":"10.1080\/20008198.2017.1351204","article-title":"Sex and gender differences in post-traumatic stress disorder: An update","volume":"8","author":"Olff","year":"2017","journal-title":"Eur. J. Psychotraumatology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1037\/0033-2909.132.6.959","article-title":"Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research","volume":"132","author":"Tolin","year":"2006","journal-title":"Psychol. Bull."},{"key":"ref_44","unstructured":"Boccia, M. (2024, April 18). Available online: https:\/\/www.psychologytoday.com\/us\/blog\/the-well-lived-life\/202103\/covid-19-and-how-it-affects-our-children."},{"key":"ref_45","unstructured":"Cooper, R., and Hanlon, C. (2024, April 18). States\u2019 Efforts to Address Adverse Childhood Experiences Are Critical During COVID-19. Available online: https:\/\/nashp.org\/states-efforts-to-address-adverse-childhood-experiences-are-critical-during-covid-19\/."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s42844-021-00038-6","article-title":"Adverse and Benevolent Childhood Experiences Predict Mental Health During the COVID-19 Pandemic","volume":"2","author":"Doom","year":"2021","journal-title":"Advers. Resil. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Choudhury, S., Yeh, P., and Markham, C. (2022). Coping with adverse childhood experiences during the COVID-19 pandemic: Perceptions of mental health service providers. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.975300"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Bellis, M., Hughes, K., Ford, K., and Lowey, H. (2023). Measuring changes in adult health and well-being during the COVID-19 pandemic and their relationship with adverse childhood experiences and current social assets: A cross-sectional survey. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16549-z"}],"container-title":["Psychiatry International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-5318\/6\/3\/76\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:58:14Z","timestamp":1760032694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-5318\/6\/3\/76"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":48,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["psychiatryint6030076"],"URL":"https:\/\/doi.org\/10.3390\/psychiatryint6030076","relation":{},"ISSN":["2673-5318"],"issn-type":[{"type":"electronic","value":"2673-5318"}],"subject":[],"published":{"date-parts":[[2025,6,25]]}}}