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Background: This cross-sectional study aimed to identify adverse childhood experience (ACE) subtypes using variable- and person-centered approaches and examine the possible sex-differentiated associations with violence involvement as victim, perpetrator, and victim-perpetrator.Methods: Adolescents aged 10-14 years in three junior high schools in Shanghai, China, were selected using a cluster sampling method in November and December 2017. Participants were surveyed anonymously using a computer-assisted self-interview approach via tablets. Thirteen items modified from the CDC-Kaiser ACE study were used to measure the ACEs. Results show subtypes as neglect, abuse, and household dysfunction by developing cumulative index score from the variable perspective and subgroups identified through the latent class analysis (LCA) from the person perspective. Logistic regression analyses were used to test the association between each ACE subtype and violence victimization and perpetration after adjusting for some demographic characteristics.Results: A total of 1,700 participants were included in the final analysis. Approximately 1,322 (77.76 %) participants reported experiencing at least one ACE. The prevalence of neglect, abuse, and household dysfunction was 64.12 % (n = 1090), 61.29 % (n = 1042), and 18.24 % (n = 310), respectively. Three classes were identified through the LCA: low exposure to all ACEs (n = 854, 50.23 %), high exposure to emotional and physical abuse and neglect (n = 715, 42.06 %), and high exposure to all ACEs (n = 131,7.71 %). After controlling the covariates, experiencing abuse, neglect, and household dysfunction was significantly related to violence victimization (adjusted odds ratio [aOR] = 3.19, 3.29, 2.37, P < 0.001) and victim-perpetrator (aOR = 3.48, 4.41, 5.16, P < 0.001). Adolescent violence perpetration was only found to be associated with being neglected (aOR = 2.37, P = 0.003) and suffering household dysfunction (aOR = 3.25, P < 0.001). LCA revealed the cumulative effects of ACEs on adolescent violence victimization and perpetration. Sex-stratified analysis indicate that girls were more vulnerable to the negative effects of ACEs, with a higher risk of perpetration among girls exposed to distinctive subtypes or multiple ACEs.Conclusions: ACEs were ubiquitous and significantly associated with an elevated risk of violence victimization and perpetration during early adolescence. Future research should examine whether these associations persist over time and the intermediating mechanism from the perspectives of individual neurodevelopment, cognition and resilience ability, and social support. [ABSTRACT FROM AUTHOR]

Background: China is experiencing a sizeable rural-urban flow, which may influence the health of internal migrant youth deeply. Disadvantages in the city are highly likely to contribute to health issues among the young internal migrant population. The current qualitative study is to explore how internal migrant young people view the health issues they face, and the services and opportunities they could seek in their host community.Methods: Data were collected from 90 internal migrant youth aged between 15 and 19 years old and 20 adult service providers who worked with them in a community of Shanghai, where the population of internal migrants was relatively large. Four types of qualitative research methods were used, including key informant interviews with adults, in-depth interviews with adolescents, a photovoice activity with adolescents and community mapping & focus group discussions with adolescents. Guided by the ecological systems framework and the acculturation theory, thematic analysis was conducted using ATLAS.Ti 7.0 software.Results: While younger migrants had a limited understanding of health, elder migrant youths were more sensitive to societal and political factors related to their health. Mental health and health risk behaviors such as smoking, violence and premarital unsafe sex were thought as major health issues. Internal migrant youths rarely seek health information and services initiatively from formal sources. They believed their health concerns weren't as pressing as the pressure coming from the high cost of living, the experience of being unfairly treated and the lack of opportunities. Participants also cited lack of family and social support, lack of awareness and supportive policies to get access to community and public services as impacting health factors.Conclusions: The study's findings provide the insight to the social contexts which influence the health experience, health seeking behaviors, and city adaptation of young internal migrants in their host community. This research stresses the importance of understanding social networks and structural barriers faced by migrant youth in vulnerable environments. A multidimensional social support is essential for internal migrant youth facing present and potential health risks. [ABSTRACT FROM AUTHOR]