Background
Our integrated conceptual framework
Objectives and associated hypotheses
Methods
Participants
Setting and data collection procedure
Measures
Adverse childhood experiences
ACE (Yes/No in 13 areas) | Examples (number of items) | Prevalence |
---|---|---|
Neglect
| % | |
1 Physical neglect | 1. Caregiver not give you enough food or sending you to school even it could easily been done; too drunk/ intoxicated by drugs to take care of you (any 3 items) | 38.5 |
2 Emotion neglect | 2. Caregiver not understand your problems/worries, knowing what you were doing with your free time (any 2 items) | 42.6 |
Psychological Distress of Family Members
| ||
3 One or no parents, parental separation or divorce | 1. Parents ever separated/divorced, or father/mother/guardian die (any 2 items) | 53.8 |
4 Alcohol/drug abuser in the household | 2. Live with a household member who was a problem drinker, alcoholic, or misused street/prescription drugs (1 item) | 44.1 |
5 Someone chronically depressed, mentally ill | 3. Live with a household member who was depressed, mentally ill, or suicidal (1 item) | 21.7 |
6 Incarcerated household member | 4. Live with a household member who ever sent to jail or prison (1 item) | 19.6 |
Violence at Home
| ||
7 Household member treated violently | 1. See or hear a parent/household member being yelled at/screamed at/sworn at/ insulted or humiliated; being slapped/kicked/punched/beaten up; or being hit/cut with an object (any 3 items) | 74.8 |
8 Emotion abuse | 2. You being yelled/screamed/sworn/insulted or humiliated, or being threaten/abandon, thrown out by parents/guardian (any 2 items) | 38.0 |
9 Physical abuse | 3. You being spanked/ slapped/kicked/ punched/beaten up; or being hit/cut with an object by parents/guardian (any 2 items) | 39.2 |
Violence in Community
| ||
10 Bullying many time | 1. Being bullied (1 item) | 22.4 |
11 Community violence | 2. See or hear someone being beaten up, stabbed, short, or being threatened with a knife or gun in real life (any 3 items) | 44.6 |
12 Collective violence | 3. Force to go and live in other place; family member or friend killed or beaten up by soldiers, police, gangs, or militia (any 4 items) | 39.6 |
Sexual violence
| ||
13 Contact sexual abuse | 1. Someone touch/fondle you, make you touch their body, attempt oral/anal/vaginal intercourse with you, or actually have intercourse with you in a sexual way when you did not want them to (any 4 item) | 16.0 |
Nnumber of ACE Risk By Domain
| Mean (SD) | |
Neglect (score 0–2) | • Physical + Emotional Neglect | 0.81 (0.72) |
Psychological distress of family members (score 0–4) | • One or no parent + substance abuse + mental ill + incarcerated household member | 1.38 (1.09) |
Violence at home (score 0–3) | • Emotion abuse + physical abuse + household member treated violently | 1.52 (1.04) |
Violence in community (score 0–3) | • Bullying + community + collective violence | 1.06 (0.90) |
Total # ACE risk (0–13)
| 13 areas in ACEs | 4.93 (2.52) |
Maternal Physical and Mental Health
Child Mental Health
Demographics and Covariates
Data analysis
Results
Socio-demographic characteristics
Adverse childhood experiences (ACEs) of mothers
Association between maternal ACEs and maternal and child health
Child Health | Maternal Health | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
ACE (Yes/No in 13 areas) | At-risk for Child Externalizing Problems | At-Risk for Child Internalizing Problems | At-Risk for Maternal Mental Disorder | Adolescent Pregnancy | Poor Maternal Physical Health | |||||
OR | p | OR | p | OR | p | OR | p | OR | p | |
Neglect
| ||||||||||
Physical neglect | 1.56 | .040 | 1.92 | .002 | 3.33 | <.001 | 1.83 | .006 | 1.63 | .017 |
Emotion neglect | 0.65 | .054 | 0.92 | .685 | 1.22 | .343 | 2.03 | .001 | 1.36 | .129 |
Psychological Distress of Family Members
| ||||||||||
One or no parents, parental separation or divorce | 1.07 | .742 | 1.36 | .128 | 1.17 | .470 | 1.55 | .045 | 1.01 | .968 |
Alcohol/drug abuser in the household | 1.03 | .910 | 1.21 | .338 | 1.37 | .141 | 1.32 | .205 | 1.15 | .502 |
Someone chronically depressed, mentally ill | 0.67 | .147 | 0.66 | .091 | 1.65 | .042 | 1.18 | .530 | 1.00 | .983 |
Incarcerated household member | 1.33 | .275 | 1.17 | .521 | 1.69 | .040 | 1.14 | .626 | .913 | .720 |
Violence at Home
| ||||||||||
Household member treated violently | 1.26 | .357 | 1.85 | .009 | 1.27 | .334 | 1.18 | .508 | .840 | .444 |
Emotion abuse | 1.89 | .003 | 4.14 | <.001 | 2.36 | <.001 | 2.34 | <.001 | 1.49 | .051 |
Physical abuse | 2.32 | <.001 | 3.37 | <.001 | 1.81 | .005 | 1.30 | .232 | 1.15 | .487 |
Violence in Community
| ||||||||||
Bullying many time | 1.44 | .148 | 1.22 | .411 | 1.95 | .005 | 1.72 | .029 | 2.00 | .004 |
Community violence | 1.68 | .015 | 1.46 | .061 | 1.14 | .547 | 1.29 | .241 | 1.07 | .727 |
Collective violence | 1.01 | .951 | 1.18 | .418 | 2.39 | <.001 | 1.25 | .306 | 1.08 | .715 |
Sexual violence
| ||||||||||
Contact sexual abuse | 1.50 | .145 | 1.49 | .142 | 1.42 | .205 | 1.93 | .017 | 1.37 | .243 |
Number of ACE Risk By Domain (Score Range) | ||||||||||
Neglect (0–2) | 1.29 | .065 | 1.01 | .951 | 1.92 | <.001 | 1.86 | <.001 | 1.45 | .008 |
Psychological distress of family members (0–4) | 1.09 | .373 | 1.02 | .826 | 1.28 | .010 | 1.22 | .045 | 1.01 | .923 |
Violence at home (0–3) | 2.05 | <.001 | 1.45 | <.001 | 1.45 | <.001 | 1.33 | .008 | 1.09 | .358 |
Violence in community (0–3) | 1.23 | .061 | 1.27 | .044 | 1.55 | <.001 | 1.30 | .027 | 1.21 | .084 |
Total # ACE risk (0–13)
| 1.21 | <.001 | 1.11 | .013 | 1.26 | <.001 | 1.20 | <.001 | 1.08 | .051 |