1. The prevalence and profiles of adverse childhood experiences and their associations with adult mental health outcomes in China: a cross-sectional studyResearch in context
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Peilin Xu, Zhaorui Liu, Yifeng Xu, Tao Li, Guangming Xu, Xiangdong Xu, Limin Wang, Yongping Yan, Shuiyuan Xiao, Lingjiang Li, Tingting Zhang, Jie Yan, Yaqin Yu, Xiufeng Xu, Zhizhong Wang, Bo Wang, Wanjun Guo, and Yueqin Huang
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Adverse childhood experiences ,Mental health outcomes ,Latent class analysis ,Population-attributable fractions ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Background: Adverse childhood experiences (ACEs) are common and associated with mental disorders. However, the prevalence and co-occurrence of ACEs and their association with mental health outcomes among Chinese adults have not been well demonstrated. Methods: China Mental Health Survey, a cross-sectional nationally representative survey consisting of 28,140 adults, was conducted from July 2013 to March 2015. Twelve ACEs and mental health outcomes, including mood disorder, anxiety disorder, substance-use disorder, and suicide were measured using the Composite International Diagnostic Interview (CIDI) 3.0 in a weighted representative subsample of 9378 respondents. Latent class analysis was used to identify the co-occurrence profiles of ACEs, and logistic regression was applied to examine the association between ACEs and mental health outcomes. Population-attributable fractions (PAFs) were calculated to quantify the attribution of ACEs to these outcomes. Findings: Among the 9378 respondents, the weighted count (proportion) of females was 4642 (49.5%), with a weighted mean (SD) age of 43.0 (15.8) years. In this study, 27.1% of respondents showed at least one ACE, with multiple ACEs common (37.6%) among those affected. Neglect was the most prevalent ACE (11.3%), followed by physical abuse (9.1%). Latent class analysis identified four co-occurrence profiles: low risk of ACEs, maltreatment, caregiver’s maladjustment and parental loss. The strongest association with mental health outcomes was found in the caregiver’s maladjustment group (OR, 4.9; 95% CI, 3.2–7.6). Estimates of PAFs indicated that all ACEs together explained 39.4% (95% CI, 31.3%–47.4%) of observed mental health outcomes. Gender differences were noted in prevalence and associations with outcomes. Interpretation: ACEs are highly prevalent and interrelated in China, attributing to over one-third of the mental disorder burden. In resource-limited settings, prioritizing the reduction of the most prevalent and impactful ACEs through education and policy can more effectively alleviate the disease burden. Funding: The National Twelfth Five-Year Plan for Science and Technology Support from the Chinese Ministry of Science and Technology (grant numbers 2012BAI01B01 & 2015BAI13B00), and the National Key R&D Program of China (grant numbers 2017YFC0907800 and 2017YFC0907801).
- Published
- 2024
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