Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
PLoS One. 2019 Feb 7;14(2):e0211850. doi: 10.1371/journal.pone.0211850. eCollection 2019.
Adverse childhood experiences (ACEs) have been associated with poor health status later in life. The objective of the present study was to examine the relationship between ACEs and health-related behaviors, chronic diseases, and mental health in adults.
A cross-sectional study was performed with 1501 residents of Macheng, China. The ACE International Questionnaire (ACE-IQ) was used to assess ACEs, including psychological, physical, and sexual forms of abuse, as well as household dysfunction. The main outcome variables were lifetime drinking status, lifetime smoking status, chronic diseases, depression, and posttraumatic stress disorder. Multiple logistic regression models were used to examine the associations between overall ACE score and individual ACE component scores and risk behaviors/comorbidities in adulthood after controlling for potential confounders.
A total of 66.2% of participants reported at least one ACE, and 5.93% reported four or more ACEs. Increased ACE scores were associated with increased risks of drinking (adjusted odds ratio [AOR] = 1.09, 95% confidence intervals [CI]: 1.00-1.09), chronic disease (AOR = 1.17, 95% CI: 1.06-1.28), depression (AOR = 1.37, 95% CI: 1.27-1.48), and posttraumatic stress disorder (AOR = 1.32, 95% CI: 1.23-1.42) in adulthood. After adjusting for confounding factors, the individual ACE components had different impacts on risk behavior and health, particularly on poor mental health outcomes in adulthood.
ACEs during childhood were significantly associated with risk behaviors and poor health outcomes in adulthood, and different ACE components had different long-term effects on health outcomes in adulthood.
不良的童年经历（ACEs）与成年后健康状况不佳有关。本研究的目的是探讨 ACEs 与成年人的健康相关行为、慢性疾病和心理健康之间的关系。
本研究采用横断面研究，共纳入中国麻城的 1501 名居民。使用 ACE 国际问卷（ACE-IQ）评估 ACEs，包括心理、身体和性虐待以及家庭功能障碍。主要结局变量为终生饮酒状况、终生吸烟状况、慢性疾病、抑郁和创伤后应激障碍。在控制潜在混杂因素后，采用多因素 logistic 回归模型探讨 ACE 总分和各 ACE 成分与成年后风险行为/合并症之间的关系。
共有 66.2%的参与者报告至少有一种 ACE，5.93%报告有四种或更多 ACE。ACE 评分升高与饮酒风险增加相关（调整后的优势比 [AOR] = 1.09，95%置信区间 [CI]：1.00-1.09）、慢性疾病（AOR = 1.17，95% CI：1.06-1.28）、抑郁（AOR = 1.37，95% CI：1.27-1.48）和成年后创伤后应激障碍（AOR = 1.32，95% CI：1.23-1.42）。在调整混杂因素后，个体 ACE 成分对风险行为和健康有不同的影响，尤其是对成年后不良心理健康结局的影响。
儿童时期的 ACEs 与成年后风险行为和健康不良结局显著相关，不同的 ACE 成分对成年后健康结局有不同的长期影响。
