Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: A prospective cohort study in the UK

Abstract

Background Experiencing multiple adverse childhood experiences (ACEs) is a risk factor for many adverse outcomes. We explore associations of ACEs with educational attainment and adolescent health and the role of family and socioeconomic factors in these associations. Methods and findings Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective cohort of children born in southwest England in 1991-1992, we assess associations of ACEs between birth and 16 years (sexual, physical, or emotional abuse; emotional neglect; parental substance abuse; parental mental illness or suicide attempt; violence between parents; parental separation; bullying; and parental criminal conviction, with data collected on multiple occasions between birth and age 16) with educational attainment at 16 years (n = 9,959) and health at age 17 years (depression, obesity, harmful alcohol use, smoking, and illicit drug use; n = 4,917). We explore the extent to which associations are robust to adjustment for family and socioeconomic factors (home ownership, mother and partner's highest educational qualification, household social class, parity, child's ethnicity, mother's age, mother's marital status, mother's depression score at 18 and 32 weeks gestation, and mother's partner's depression score at 18 weeks gestation) and whether associations differ according to socioeconomic factors, and we estimate the proportion of adverse educational and health outcomes attributable to ACEs or family or socioeconomic measures. Among the 9,959 participants (49.5% female) included in analysis of educational outcomes, 84% reported at least one ACE, 24% reported 4 or more ACEs, and 54.5% received 5 or more General Certificates of Secondary Education (GCSEs) at grade C or above, including English and Maths. Among the 4,917 participants (50.1% female) included in analysis of

Exposure to Adverse Childhood Experiences (ACEs) and Stress among the Community-based Urban Pediatric Population in Korea

“…In the UK cohort study between birth and 16 years, the prevalence of emotional neglect was 26.5% in boys and 21.2% in girls. 39 Our findings are consistent with previous results that emotional abuse (33%) was identified most commonly among 60,598 respondents. 43 This is similar to the finding that adolescents (n = 1,284) 10–14 years of age in 14 countries most commonly reported emotional abuse (51.87%).…”

“…The prospective cohort study (n = 9,959; aged from 0 to 16 years) conducted in the United Kingdom reported that the distribution of ACE scores was similar in boys and girls. 39 There were differences in the prevalence of bullying (28.6% in boys and 23.7% in girls) and physical abuse (17.1% in boys and 20.9% in girls) by sex. According to the reports of the ACEs in 1,284 adolescents (aged 10–14 years) in resource-poor neighborhoods, 40 the boys reported more exposure than girls to physical neglect (32.95%), violence victimization (52.27%), and sexual abuse (8.77%).…”

How do early-life adverse childhood experiences mediate the relationship between childhood socioeconomic conditions and adolescent health outcomes in the UK?

“…We investigated outcomes at 14 years, captured in the latest MCS data sweep. Following our previous study, 23 and recognising the impact of ACEs on a broad range of health and developmental outcomes, 11 we have used three outcomes to capture aspects of mental and physical health, and cognitive ability.…”

“…These ACEs are commonly used in other studies, which can facilitate comparisons. 3 6 11 The full details of coding of the potential mediators are provided in online supplemental material S2 and online supplemental material S3. In the mediation analysis, we used the naturally occurring coding of the mediators in the MCS (multicategory variables) to maximise power to capture mediation through our ACEs variables.…”

“…15 16 By contrast, other authors have adjusted for SECs in order to assess independent associations between ACEs and later health outcomes. 4 11 17–20 We have previously raised concerns that this might lead to the importance of SECs being overlooked when considering policy responses to ACEs. 10…”