University of California, Davis, Sacramento, CA, USA.
Acad Psychiatry. 2019 Aug;43(4):369-374. doi: 10.1007/s40596-019-01047-5. Epub 2019 Mar 8.
The primary purpose of the study was to assess the prevalence of adverse childhood experiences (ACEs) in a cohort of third-year medical students and characterize their childhood protective factors.
The authors developed a web-based anonymous survey distributed to all third-year medical students in one school (N = 98). The survey included the 10-item ACE Study questionnaire, a list of childhood protective factors (CPF) and questions to assess students' perception of the impact of ACEs on their physical and mental health. The medical school's IRB approved the student survey as an exempt study. The authors computed descriptive and comparative statistical analyses.
Eighty-six of 98 students responded (88% response rate). Forty-four students (51%) reported at least one ACE exposure and 10 (12%) reported ≥ 4 exposures. The latter were all female. The average difference in the ACE score between male and female medical students was - 1.1 (independent t test with unequal variances t(57.7) = - 2.82, P = .007). Students with an ACE score of ≥ 4 were significantly more likely to report a moderate or significant effect on their mental health, compared with students with scores ≤ 3 (chi-square test, P = < .0001). Most students reported high levels of CPF (median score = 13 of a maximum score = 14). ACEs and CPF were inversely associated (Pearson correlation = - 0.32, P = .003).
A sizeable minority of medical students reported exposure to multiple ACEs. If replicated, findings suggest a significant vulnerability of these medical students to health risk behaviors and physical and mental health problems during training and future medical practice.
本研究的主要目的是评估一个三年级医学生队列中不良童年经历（ACEs）的发生率，并描述其童年保护因素。
作者开发了一个基于网络的匿名调查，分发给一所学校的所有三年级医学生（N=98）。该调查包括 ACE 研究问卷的 10 个项目、一份童年保护因素（CPF）清单以及评估学生对 ACE 对其身心健康影响的感知的问题。该医学院的 IRB 批准了学生调查作为豁免研究。作者进行了描述性和比较性统计分析。
98 名学生中有 86 名（88%的回应率）做出了回应。44 名学生（51%）报告至少有一种 ACE 暴露，10 名学生（12%）报告≥4 种暴露。后者均为女性。男、女医学生 ACE 评分的平均差异为-1.1（独立样本 t 检验，方差不齐 t(57.7)=-2.82，P=0.007）。ACE 评分≥4 的学生报告对其心理健康有中度或显著影响的可能性明显高于评分≤3 的学生（卡方检验，P<0.0001）。大多数学生报告具有较高水平的 CPF（中位数为 13，最大值为 14）。ACEs 和 CPF 呈负相关（皮尔逊相关系数=-0.32，P=0.003）。
相当一部分医学生报告暴露于多种 ACEs。如果得到复制，这些发现表明这些医学生在培训和未来的医疗实践中面临着健康风险行为和身体及心理健康问题的显著脆弱性。
