Soares Ana Luiza Gonçalves, Howe Laura D, Matijasevich Alicia, Wehrmeister Fernando C, Menezes Ana M B, Gonçalves Helen
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
MRC Integrative Epidemiology Unit at the University of Bristol, School of Social & Community Medicine, University of Bristol, Bristol, UK.
Child Abuse Negl. 2016 Jan;51:21-30. doi: 10.1016/j.chiabu.2015.11.017. Epub 2015 Dec 19.
Adverse childhood experiences (ACEs) can affect people's health and wellbeing not only at the time the ACE is experienced, but also later in life. The majority of studies on ACEs are carried out in high-income countries and little is known about its prevalence in low and middle-income countries. Thus, the aim of this study was to assess the prevalence of ACEs, associations between ACEs and sociodemographic factors, and the interrelationship between types of ACEs in adolescents of a Brazilian birth cohort. Data from 3,951 adolescents (78.4% of the original cohort) from the 1993 Pelotas Cohort were analyzed. Seven types of ACEs were assessed in those up to 18 years old: physical abuse, sexual abuse, physical neglect, emotional neglect, domestic violence, parental separation and parental death. The most common ACE was parental separation (42%), followed by emotional neglect (19.7%) and domestic violence (10.3%). Approximately 85% of the adolescents experienced at least one ACE, and females reported a higher number of adversities. Several socioeconomic, demographic and family-related characteristics were associated with the occurrence of ACEs, e.g. non-white skin color, low family income, low maternal schooling, absence of mother's partner, maternal smoking, and poor maternal mental health. A strong interrelationship was observed among the ACEs, indicating clustering of risk. These aspects should be considered by health and social care professionals in the prevention and identification of childhood adversities.
童年不良经历(ACEs)不仅会在经历ACEs时影响人们的健康和幸福,还会在其日后的生活中产生影响。大多数关于ACEs的研究是在高收入国家进行的,而对于其在低收入和中等收入国家的流行情况知之甚少。因此,本研究的目的是评估巴西一个出生队列中青少年ACEs的流行情况、ACEs与社会人口学因素之间的关联,以及不同类型ACEs之间的相互关系。对来自1993年佩洛塔斯队列的3951名青少年(占原始队列的78.4%)的数据进行了分析。对18岁及以下的青少年评估了七种类型的ACEs:身体虐待、性虐待、身体忽视、情感忽视、家庭暴力、父母分居和父母死亡。最常见的ACEs是父母分居(42%),其次是情感忽视(19.7%)和家庭暴力(10.3%)。约85%的青少年至少经历过一次ACEs,女性报告的不良经历数量更多。一些社会经济、人口统计学和家庭相关特征与ACEs的发生有关,例如非白人肤色、家庭收入低、母亲受教育程度低、母亲的伴侣不在身边、母亲吸烟以及母亲心理健康状况差。在ACEs之间观察到了很强的相互关系,表明存在风险聚集。健康和社会护理专业人员在预防和识别儿童期逆境时应考虑这些方面。