BACKGROUND: Adverse childhood experiences (ACEs) are pervasive across communities, including medical students and physicians. Exposure to childhood trauma influences career decisions, such as social workers and nurses. However, the impact of ACEs on medical students career interests remains unexplored. METHODS: From August to October 2022, a survey was designed and administered to medical students at UT Health San Antonio School of Medicine (Texas, USA). Ten household-level and four community-level ACEs were assessed. Associations between ACE distribution and interest in medical specialties, academia, and primary care were analyzed by Mann-Whitney U test. RESULTS: Four hundred nineteen (47.0%) of 891 total students completed the survey, of which 310 (74.3%) reported at least one ACE and 107 (25.7%) reported four or more. The most common ACE was living with a household member with mental illness (154, 36.9%). Students interested in psychiatry (p<.01) or academic medicine (p=.02) had significantly higher ACE scores than those not interested in these fields. No associations were observed between ACEs and students interest in primary care. DISCUSSION: The prevalence of medical students living with a household member with mental illness was approximately double than reported in population-based studies. Childhood trauma exposure may influence medical students interests in psychiatry and academic medicine careers. Further research is needed to investigate how ACEs influence medical students career considerations. Research exploring ACEs exposure in academic physicians and psychiatrists may further illuminate the associations found in this brief report. Importantly, advancements in trauma-informed approaches to medical education are necessary to facilitate safe learning environments.

Clinicians trained to assess and treat child psychopathology are facing an increasing need to expand their clinical expertise outside of traditional frameworks, which have historically focused largely on the child or the child-mother dyad. Clinicians treating children also need to be prepared to assess and address the systems of care that affect a childs mental health, starting with their family. There is a scarcity of Latino mental health providers and limited clinical opportunities or settings that serve this population by incorporating a developmental, cultural, and sociopolitical framework into high quality care of the whole family.

COVID-19 has had disproportionate contagion and fatality in Black, Latino, and Native American communities and among the poor in the United States. Toxic stress resulting from racial and social inequities have been magnified during the pandemic, with implications for poor physical and mental health and socioeconomic outcomes. It is imperative that our country focus and invest in addressing health inequities and work across sectors to build self-efficacy and long-term capacity within communities and systems of care serving the most disenfranchised, now and in the aftermath of the COVID-19 epidemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Dialectical behavior therapy (DBT) has shown preliminary success in the treatment of youth in forensic settings. However, the implementation of DBT varies considerably from facility to facility. A scoping review was conducted to detail DBT intervention protocols in juvenile correctional and detention facilities. We described eight works treatment setting, study design, youth characteristics, staff training, DBT approach, DBT skills modules, and main findings. All works involved DBT skills sessions, but few incorporated other DBT components such as individual therapy or skills coaching. Outcomes included reducing problematic behaviors such as aggression, improving mental health, and largely positive feedback regarding the DBT intervention from youth and staff. Our results consolidate the existing literature regarding DBT intervention in forensic settings for youth and inform future implementation and research of DBT in such facilities.