Adverse childhood experiences: prevalence and associated factors among South African young adults

Manyema, Mercy; Richter, Linda

doi:10.1016/j.heliyon.2019.e03003

Cited by 39 publications

(41 citation statements)

References 48 publications

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“…Two studies of children and adolescents in Uganda found that depression was associated with loss of a parent and alcohol consumption [34] and domestic violence [35]. These and other studies have indicated a high prevalence of ACEs and associations with depression and suicidality among children, adolescents, and young adults in sub-Saharan Africa [31,32,36,37]. To address the gap in the literature on ACEs and mental health among adults, we aimed to estimate the associations between ACEs and depression symptom severity, major depressive disorder, and suicidal ideation in a population-based sample of adults in rural Uganda.…”

Section: Introductionmentioning

confidence: 84%

“…While research studies from sub-Saharan Africa indicate a high prevalence of childhood adversity [29][30][31][32], research on the associations between ACEs and adult depression and suicidal ideation in these settings is limited. A study from South Africa found that emotional neglect and sexual abuse before age 18 were both associated with suicidality, problematic substance use, and depression 2 years after initial measurement among adolescents and young adults aged 15 to 26 [30].…”

Section: Introductionmentioning

confidence: 99%

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Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study

et al. 2021

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Background Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda. Methods and findings Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a modified version of the Adverse Childhood Experiences-International Questionnaire, and depression symptom severity and suicidal ideation were assessed using the Hopkins Symptom Checklist for Depression (HSCL-D). We applied a validated algorithm to determine major depressive disorder diagnoses. Overall, 1,458 participants (90%) had experienced at least one ACE, 159 participants (10%) met criteria for major depressive disorder, and 28 participants (1.7%) reported suicidal ideation. We fitted regression models to estimate the associations between cumulative number of ACEs and depression symptom severity (linear regression model) and major depressive disorder and suicidal ideation (Poisson regression models). In multivariable regression models adjusted for age, sex, primary school completion, marital status, self-reported HIV status, and household asset wealth, the cumulative number of ACEs was associated with greater depression symptom severity (b = 0.050; 95% confidence interval [CI], 0.039–0.061, p < 0.001) and increased risk for major depressive disorder (adjusted relative risk [ARR] = 1.190; 95% CI, 1.109–1.276; p < 0.001) and suicidal ideation (ARR = 1.146; 95% CI, 1.001–1.311; p = 0.048). We assessed the robustness of our findings by probing for nonlinearities and conducting analyses stratified by age. The limitations of the study include the reliance on retrospective self-report as well as the focus on ACEs that occurred within the household. Conclusions In this whole-population, cross-sectional study of adults in rural Uganda, the cumulative number of ACEs had statistically significant associations with depression symptom severity, major depressive disorder, and suicidal ideation. These findings highlight the importance of developing and implementing policies and programs that safeguard children, promote mental health, and prevent trajectories toward psychosocial disability.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study

et al. 2021

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“…Poverty is recognized as a significant barrier to children’s well-being, impacting on health and educational opportunities and increasing vulnerability to child maltreatment ( Fernandez, Delfabbro, Ramia, & Kovacs, 2019 ; Loffell, 2008 ; Manyema & Richter, 2019 ; Meinck, Cluver, & Boyes, 2015 ). Artz et al (2016) found that approximately 40% of young people in South Africa have had direct experiences of abuse.…”

Section: Literature Reviewmentioning

confidence: 99%

‘When will I be free’: Lessons from COVID-19 for Child Protection in South Africa

Haffejee¹,

Levine

2020

Child Abuse & Neglect

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Background COVID-19 has highlighted and amplified structural inequalities; drawing attention to issues of racism, poverty, xenophobia as well as arguably ineffective government policies and procedures. In South Africa, the pandemic and the resultant national lockdown has highlighted the shortcomings in the protection and care of children. Children in alternative care are particularly at risk as a result of disrupted and uncoordinated service delivery. Objective The aim of this study was to explore the experiences and impact of the pandemic and the resulting social isolation on the wellbeing and protection of children living in a residential care facility. Methods and participants: We used qualitative, participatory approaches – specifically draw-and-write methods – to engage with 32 children (average age = 13.5 years) living in a residential care facility in Gauteng. Findings Children in care demonstrated an awareness of the socio-economic difficulties facing communities in South Africa, and shared deep concerns about the safety, well-being and welfare of parents and siblings. Although they expressed frustration at the lack of contact with family members, they acknowledged the resources they had access to in a residential care facility, which enabled them to cope and which ensured their safety. Discussion and conclusion We focus our discussion on the necessity of a systemic response to child welfare, including a coordinated approach by policy makers, government departments and child welfare systems to address the structural factors at the root of inequality and inadequate, unacceptable care. This is essential not only during COVID-19 but also in pre- and post-pandemic context.

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“…Min et al found that children living in poverty were more likely to engage in sedentary behaviors and have a poor BMI growth trajectory than children of higher socioeconomic status [36]. Other recent studies have also reported a higher ACEs prevalence among children of lower socioeconomic status [37][38][39]. In addition, previous studies show that birth weight is an important predictor of childhood obesity and therefore could be a potential confounder [28,29].…”

Section: Plos Onementioning

confidence: 99%

Association between cumulative exposure to adverse childhood experiences and childhood obesity

2020

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Background Exposure to adverse childhood experiences (ACEs) is associated with many childhood diseases and poor health outcomes in adulthood. However, the association with childhood obesity is inconsistent. We investigated the association between reported cumulative ACE score and body mass index (BMI) in a large sample of patients at a single institution. Methods This cross-sectional study included children aged 2-20 years that were screened in a general pediatrics clinic for ACEs utilizing the Center for Youth Wellness ACEs questionnaire between July 2017 and July 2018. Overall ACE score was categorized as 'no exposure' (score = 0), 'low exposure' (score = 1), and 'high exposure' (score� 2). BMI was categorized as overweight/obese (BMI percentile � 85) or non-obese (BMI percentile < 85). The association between ACEs score and obesity was determined using univariate and multivariable logistic regression. Results Of the 948 patients included in the study, 30% (n = 314) were overweight/obese and 53% (n = 504) had no ACE exposure, 19% (n = 179) had low ACE exposure, and 28% (n = 265) had high ACE exposure. High ACE exposure was associated with increased odds of obesity (OR = 1.47, 95%CI = 1.07-2.03, p = 0.026). However, after adjusting for age, race/ethnicity, insurance type, and birth weight, the association attenuated and was null (OR = 1.01, 95% CI = 0.70-1.46, p = 0.97).

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Adverse childhood experiences: prevalence and associated factors among South African young adults

Cited by 39 publications

References 48 publications

Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study

Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda: A cross-sectional, population-based study

‘When will I be free’: Lessons from COVID-19 for Child Protection in South Africa

Association between cumulative exposure to adverse childhood experiences and childhood obesity

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