School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Medicine, Faculty of Health Science, Universitat Jaume I, Castellón de la Plana, Spain.
Pediatr Neonatol. 2019 Aug;60(4):368-376. doi: 10.1016/j.pedneo.2018.08.004. Epub 2018 Aug 24.
Adverse childhood experiences (ACEs) can leave negative impacts on one's health behaviors or social functioning later in life. Resilient characteristics have been shown to mitigate effects against risk behaviors in developing adolescents. However, clinical and research attention has rarely been given to jointly consider the effects of ACEs and resilient characteristics on health behaviors in Taiwanese youth.
A total of 200 individuals aged 15-22 years were recruited from primary care settings, communities, and schools. Participants completed questionnaires assessing their ACEs, resilient characteristics, and health behaviors. Univariate analysis was firstly used to describe the correlates of ACEs and resilient characteristics. Further multivariate logistic regression analysis was used to examine the association of both factors with health behaviors.
More than half (61.5%) of those surveyed had been exposed to at least one category of ACE. Verbal (37%) and physical (21%) abuses were the most common types of ACEs. The counts in the ACE categories were associated with being involved in physical fights (odds ratio 1.28 [confidence interval 1.01-1.63]), property damage (1.29 [1.03-1.61]), running away from home (1.30 [1.05-1.60]), bullying victimization (1.37 [1.16-1.61]), and sleep problems/tiredness (1.25 [1.03-1.52]). Meanwhile, resilience scores were associated with decreased odds of infrequent seatbelt use (0.47 [0.23-0.97]), low fruit and vegetable intake (0.42 [0.21-0.86]) unsatisfied body image (0.46 [0.22-0.97]), and sleep problems/tiredness (0.37 [0.18-0.79]).
ACEs and resilience characteristics play a significant role in shaping youth health behaviors. Further research should be undertaken to identify ways to build resilience against health risks in youth with prior ACE exposure.
不良的童年经历（ACEs）可能会对一个人以后的健康行为或社会功能产生负面影响。弹性特征已被证明可以减轻青少年发展中风险行为的影响。然而，临床和研究注意力很少关注共同考虑 ACEs 和弹性特征对台湾青少年健康行为的影响。
从初级保健机构、社区和学校共招募了 200 名 15-22 岁的参与者。参与者完成了评估他们 ACEs、弹性特征和健康行为的问卷。首先使用单变量分析来描述 ACEs 和弹性特征的相关性。进一步使用多变量逻辑回归分析来检验这两个因素与健康行为的关系。
超过一半（61.5%）的调查对象至少接触过一类 ACE。言语（37%）和身体（21%）虐待是最常见的 ACE 类型。ACE 类别的次数与参与身体打架（比值比 1.28[置信区间 1.01-1.63]）、财产损失（1.29[1.03-1.61]）、离家出走（1.30[1.05-1.60]）、欺凌受害（1.37[1.16-1.61]）和睡眠问题/疲劳（1.25[1.03-1.52]）有关。同时，弹性得分与不常系安全带的可能性降低有关（0.47[0.23-0.97]）、水果和蔬菜摄入量低（0.42[0.21-0.86]）、不满意的身体形象（0.46[0.22-0.97]）和睡眠问题/疲劳（0.37[0.18-0.79]）。
ACEs 和弹性特征在塑造青少年健康行为方面起着重要作用。应进一步研究确定如何在有 ACE 暴露史的青少年中建立对健康风险的抵御能力。
