Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores

Alhowaymel, Fahad; Kalmakis, Karen A.; Chiodo, Lisa M.; Kent, Nicole; Almuneef, Maha

doi:10.3390/ijerph20021651

Cited by 17 publications

(8 citation statements)

References 46 publications

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“…The results of our study indicate a potentially high prevalence of ACEs compared to previous studies performed in Pakistan. Almost 80% of the sample population had experienced 3 or more ACEs, which is a cut-off point indicated in global studies for a high risk of developing health and behavioural issues later in life 20 . The most prevalent categories of ACEs in this study population were exposure to community/peer violence (82.9%) and exposure to physical abuse (65.2%).…”

Section: Discussionmentioning

confidence: 99%

Exploring the Co-occurrence and Latent Class Analysis of Adverse Childhood Experiences in University Students in Lahore, Pakistan

Fatima,

Saleem,

Ishaq

et al. 2024

Preprint

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Adverse childhood experiences (ACEs) are one of the major public health concerns and act as a predisposing factor leading to numerous chronic health issues. This study aims to determine the prevalence and likelihood of the co-occurrence of different childhood adversities and explore the latent classes in university students in Lahore, Pakistan. An online version of the ACE-IQ was used to collect data from students of randomly selected universities in Lahore with their consent. Descriptive statistics, the chi-square test, Cramer-V, and latent class analysis (LCA) were applied to the collected dataset. All domains had a prevalence of between 30 and 85%, with community/peer violence exposure being the most common (82.9%), followed by physical abuse exposure (65.2%). According to the LCA results, three classes were observed, i.e., Class 1, High/Multiple ACEs; Class 2, Low ACEs; and Class 3, Neglect, Physical Abuse and Violence related ACEs. The percentages of our population in Classes 1, 2, and 3 were 21.38%, 39.26%, and 39.36%, respectively. This study concluded that the prevalence of ACEs is very high in university students in Lahore, with a moderately strong correlation among different adversities, which increases the likelihood of their co-occurrence.

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Section: Discussionmentioning

confidence: 99%

Exploring the Co-occurrence and Latent Class Analysis of Adverse Childhood Experiences in University Students in Lahore, Pakistan

Fatima,

Saleem,

Ishaq

et al. 2024

Preprint

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“…The summary score of 13 domains ranged from 0 to 13, with a higher score denoting more childhood adversities. According to previous studies on the cut-off values of ACEs and the distribution of ACEs in the present study ( 19 , 20 ), we then classified participants into the following three groups based the ACEs score: low levels of ACEs (0–1), intermediate levels of ACEs (2–3), and high levels of ACEs (≥4).…”

Section: Methodsmentioning

confidence: 99%

Adverse childhood experiences, unhealthy lifestyle, and nonsuicidal self-injury: findings from six universities in Shaanxi province, China

Zhang,

Wang,

Chen

et al. 2023

Front. Public Health

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BackgroundNonsuicidal self-injury (NSSI) is a serious public health problem. The role of adverse childhood experiences (ACEs) and lifestyle on the risk for NSSI is still underexplored, especially among college students. We aimed to investigate the association of ACEs with the risk of NSSI, and effect modifications by lifestyle among college students.MethodsA total of 18,723 college students from six universities were recruited through a multistage, random cluster sampling method in Shaanxi province, China. The Adverse Childhood Experiences International Questionnaire was used to assess ACEs for each participant, and the Chinese version of the Ottawa Self-injury Inventory was used to assess the presence or absence of NSSI behaviors. Information about lifestyle was collected by a self-designed questionnaire. The associations of NSSI with ACEs and lifestyle were analyzed using logistic regression models. Furthermore, we constructed a combination score of multiple lifestyles and evaluated whether lifestyle modified the effect of ACEs on the risk of NSSI.ResultsThe prevalence of NSSI for the past 1 month, 6 months, and 12 months was 3.8, 5.3, and 6.5%, respectively. 82.6% of participants have reported experiencing at least one type of ACEs, and participants with higher levels of ACEs (≥4) were more likely to have higher odds of developing NSSI during the past 1 month (OR, 4.10; 95%CI, 3.38–4.97), 6 months (OR, 4.76; 95%CI, 4.03–5.62), and 12 months (OR, 5.62; 95%CI, 4.83–6.55), as compared with participants with low levels of ACEs (0–1). There were additive interactions between ACEs and lifestyle. Compared with participants with low levels of ACEs and healthy lifestyle, participants with high levels of ACEs and unhealthy lifestyle had the highest odds of NSSI during the past 1 month (OR, 5.56; 95%CI, 3.80–8.31), 6 months (OR, 6.62; 95%CI, 4.73–9.42), and 12 months (OR, 7.62; 95%CI, 5.59–10.52).ConclusionThese results suggest that ACEs play an important role in the occurrence of NSSI among college students, especially in those with unhealthy lifestyle. Our findings may help develop targeted intervention strategies for the prevention of NSSI.

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“…The ACE-J includes comprehensive adverse experiences, such as parental death, parental divorce or separation, mental illness in the household, addiction in the household, mother being treated violently, emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, childhood poverty, bullying, hospitalization due to chronic disease, and natural disasters. Those who experienced four or more episodes were identi ed as having ACEs 3,25,27 . Data on ACEs were collected at T1.…”

Section: Measurement Independent Variablementioning

confidence: 99%

Nonrestorative Sleep Mediates the Influence of Adverse Childhood Experiences on Psychological Distress, Physical Health, Mental Health, and Activity Limitation: A Longitudinal Study for the General Population in Japan

Megumi,

Kentaro,

Takahiro

et al. 2024

Preprint

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Background: This study explores the associations between adverse childhood experiences (ACEs), health problems, and increased daytime inactivity, emphasizing nonrestorative sleep (NRS), a subjective perception of unrefreshing sleep, as a significant contributing factor. Methods: A longitudinal online survey utilizing data from the Japan COVID-19 and Society Internet Survey was employed. The Kessler distress scale (K6) served as the primary outcome measure, with a score of K6 ≥ 13 indicating psychological distress. Health-Related Quality of Life-4 was utilized to assess mentally unhealthy days, physically unhealthy days, and days with activity limitation, indicating mental health problems, physical health problems, and daytime inactivity if exceeding 14 days monthly, respectively. NRS frequency within the past 30 days was evaluated on a 5-point scale, with "usually" (16 days or more) indicating NRS presence. ACEs were identified when four or more items from a validated ACEs list were selected. A causal mediation analysis was performed. Results: Among the 17,042 participants, 52.8% were male, averaging 50.35 years of age (SD = 17.73). Approximately 11.1% reported four or more ACEs. Notably, 16.7% met NRS criteria, while 9.6% met psychological distress criteria. The proportions of individuals with physical health problems, mental health problems, and activity limitations were 6.4%, 6.2%, and 4.2%, respectively. Significant mediational pathways via NRS were observed from ACEs to psychological distress (RR = 1.14, 95% CI = 1.08–1.19, p < 0.001), physical health problems (RR = 1.30, 95% CI = 1.21–1.40, p < 0.001), mental health problems (RR = 1.20, 95% CI = 1.13–1.28, p < 0.001), and daytime inactivity (RR = 1.27, 95% CI = 1.17–1.37, p < 0.001). Conclusion: This study suggests that NRS mediates the impact of ACEs on mental or physical health issues and daytime inactivity. Further research is needed to determine whether targeting NRS can alleviate ACE-associated health problems.

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Adverse Childhood Experiences and Chronic Diseases: Identifying a Cut-Point for ACE Scores

Cited by 17 publications

References 46 publications

Exploring the Co-occurrence and Latent Class Analysis of Adverse Childhood Experiences in University Students in Lahore, Pakistan

Exploring the Co-occurrence and Latent Class Analysis of Adverse Childhood Experiences in University Students in Lahore, Pakistan

Adverse childhood experiences, unhealthy lifestyle, and nonsuicidal self-injury: findings from six universities in Shaanxi province, China

Nonrestorative Sleep Mediates the Influence of Adverse Childhood Experiences on Psychological Distress, Physical Health, Mental Health, and Activity Limitation: A Longitudinal Study for the General Population in Japan

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