Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents.

Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. Four hundred and ten adolescents (age 10–16 years old) from Malawi. The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi =.20, p < 0,01; across subdomains (phi =.10, p < 0,01); partial agreement among children with the same caregiver (ICC =.43, p <.001) and correlation between ACE and depression (predictive validity; r =.35, p <.001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R 2 =.12 to.15, p <.001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r =.25, p < 0,01). Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context. [ABSTRACT FROM AUTHOR]