Associations of adverse and positive childhood experiences with adult physical and mental health and risk behaviours in Slovenia

Abstract

Background: Many studies demonstrated the relationship between adverse childhood experiences (ACEs) and diminished health functioning in adulthood. A growing literature has shown that positive childhood experiences (PCEs) co-occurring with ACEs reduce the risks for negative outcomes. Objective: The aim was to investigate how ACEs and PCEs are simultaneously associated with health outcomes in adulthood, including self-rated health, physical and mental health outcomes, and health-risk behaviours. Methods: A panel sample of 4,847 Slovenian adults was used and the data were weighted to closely resemble the Slovenian population. A series of logistic regression analyses were performed to examine how ACEs and PCEs predict the risk of various health outcomes. Results: Significant associations, as measured by adjusted odds ratios, were found between higher ACEs exposure and each of the 16 health outcomes evaluated. Adjusting for above median PCEs attenuated the association between ACEs and 6 health outcomes (poor self-rated physical and mental health, depression, anxiety, suicide attempt, physical inactivity; OR for ≥ 4 vs. 0 ACEs, 1.48-9.34). Mirroring these findings, above median PCEs were associated with lowered odds of these 6 health outcomes after adjusting for ACEs (OR for above vs. below median PCEs, 0.46-0.67), but not with odds of physical health outcomes and most of the health-risk behaviours. Stratified analyses by ACEs exposure level showed that the association between PCEs and self-rated health remained stable across ACEs exposure levels, while the association between PCEs and mental health outcomes and physical inactivity varied across ACEs exposure levels. Conclusions: Our results suggest that above median PCEs attenuate the association between ACEs and poor self-rated health, mental health problems, and physical inactivity in later life, and are negatively associated with these health problems even in the concurrent presence of ACEs. Interventions to promote PCEs can help to reduce unfavourable long-term health outcomes following childhood adversity. Asociación de experiencias infantiles adversas y positivas con la salud física y mental, y las conductas de riesgo de los adultos en EsloveniaAntecedentes: Muchos estudios demostraron la relación entre las experiencias adversas en la infancia (ACE) y una disminución en el funcionamiento de la salud en la edad adulta. Una creciente literatura ha demostrado que las experiencias infantiles positivas (PCE) que concurren con ACE reducen los riesgos de resultados negativos. Objetivo: El objetivo era investigar cómo las ACE y PCE se asocian simultáneamente con los resultados de salud en la edad adulta, incluida la salud autoevaluada, las condiciones de salud física y mental y las conductas de riesgo para la salud. Métodos: Se utilizó una muestra de panel de 4.847 adultos eslovenos y los datos se ponderaron para asimilarlos a la población eslovena. Se realizó una serie de análisis de regresión logística para examinar cómo los ACE y PCE predicen el riesgo de varios res...

Association of positive and adverse childhood experiences with risky behaviours and mental health indicators among Chinese university students in Hong Kong: an exploratory study

“…Regarding the independent associations, the findings in this study were consistent with the evidence in previous studies, which supported PCEs as a protective factor for health which included self-rated physical health, self-rated mental health, depression, anxiety, post-traumatic stress disorder symptoms after accounting for ACEs (Bethell et al, 2019 ; Chung et al, 2008 ; Kuhar & Zager Kocjan, 2021 ; Narayan et al, 2018 ). This study further discovered the independent association of PCEs with the reduced risk of loneliness, low life satisfaction, and low meaning in life, which are all important predictors of health outcomes and mortality (Cohen et al, 2016 ; Holt-Lunstad et al, 2015 ).…”

“…However, the count of PCEs was not an independent protective factor for risky behaviours such as smoking, binge drinking, and early sex initiation in this study. In Kuhar et al’s study, PCEs were also not significantly associated with smoking and harmful alcohol use after adjusting for ACEs in a population with a mean age of 46.5 years old (Kuhar & Zager Kocjan, 2021 ). This may indicate that PCE is a stronger protective factor for mental health than health-risk behaviours.…”

“…This may indicate that PCE is a stronger protective factor for mental health than health-risk behaviours. This weak protection for health-risk behaviours may be explained by the role of other social determinants of these risky behaviours, including networks, socio-economic, cultural, and environmental factors, which may influence the relationship between childhood experiences and risky behaviours (Kuhar & Zager Kocjan, 2021 ; Marmot & Wilkinson, 2005 ).…”

Measuring positive memories of home and family during childhood: The development and initial validation of the ‘Memories of Home and Family Scale’

“…Research has shown how individuals with chronic ACE exposure who also report high levels of BCEs experience fewer PTSD (posttraumatic stress disorder) symptoms and stressful life events than those who have experienced multiple ACEs and few BCEs (Narayan et al, 2020 ). Similarly, other studies have demonstrated how many of the associations between ACEs and health outcomes attenuate or disappear after accounting for BCEs, suggesting that BCEs can counteract the deleterious effects of ACEs (Crandall et al, 2019 , 2020 ; Kuhar & Zager Kocjan, 2021 ). Moreover, parental BCEs offer protection from the intergenerational transmission of ACEs (Narayan et al, 2021 ).…”

Trauma assessment in outpatient psychotherapy and associations with psychotherapist’s gender, own traumatic events, length of work experience, and theoretical orientation

“…Traumatic events are risk factors for most mental illnesses including depression, psychosis, anxiety disorders, sleep disorders, eating disorders, sexual dysfunction, personality disorders, dissociative disorder, posttraumatic stress disorder (PTSD), somatoform disorders, and substance misuse (Bachmann, Czwikla, Jacobs, Fegert, & Hoffmann, 2021 ; Kessler et al, 2010 ; Longden & Read, 2016 ; Read, Sampson, & Critchley, 2016 ; Yeh et al, 2021 ). Moreover, studies showed a strong link between multiple exposure to childhood abuse and chronic illness, mental health problems, and health-risk behaviours in adulthood (Kuhar & Zager Kocjan, 2021 ). Nearly 50% of severely mentally ill (SMI) patients have been exposed to repeated violence and 30% is suffering from PTSD (Mauritz et al, 2016 ).…”