Shanghai Jiao Tong University School of Nursing, Shanghai, China.
Johns Hopkins School of Nursing, 525N Wolfe Street, Baltimore, MD, 21205, USA.
BMC Public Health. 2022 Mar 29;22(1):612. doi: 10.1186/s12889-022-13063-6.
Adverse childhood experiences (ACEs) are prevalent and associated with negative health and social outcomes. However, our understanding of how patterns of ACEs exposure relate to positive outcomes in adulthood remains limited. This study aims to identify patterns of ACEs and examine associations with flourishing in a sample of Chinese young adults.
This cross-sectional study was conducted from August to November 2020. Young adults, ages 18-35, enrolled in undergraduate or graduate programs at universities in Mainland China were recruited through convenience and snowball sampling to participate in a survey. The exposure to ACEs was measured by the twelve-item Chinese version of the ACE-International Questionnaire. Additional measures included six domains of flourishing assessed using the Chinese version of the Flourishing Measure, and demographic covariates (i.e., gender, age, year in university, marital status). Descriptive statistical analysis and latent class analysis (LCA) were performed using SPSS 27 and Mplus 8.5.
Participants included 9468 young adults (mean age = 20.1 years). Majority of participants were female (75.3%), undergraduate students (96.4%), and single (79.8%). Approximately 56% of participants reported at least one ACE; 7.0% reported four or more ACEs. Emotional neglect (33.2%), household violence (20.6%), and parental separation/divorce (13.9%) were the most frequently reported ACEs. LCA identified three ACEs classes: multiple maltreatment and household violence (4.7%), emotional neglect and household violence (16.2%), and low ACEs (79.1%). Individuals in the low ACEs class had the highest level of flourishing whereas individuals in multiple maltreatment and household violence had the lowest level of flourishing in all six domains. There were no significant differences in flourishing between the multiple maltreatment and household violence and the emotional neglect and household violence classes except in the physical and mental health (means = 6.17 vs 6.51, p = 0.02) and the financial and material stability domains (means = 5.25 vs 5.66, p = 0.04).
Patterns of multiple ACEs exposures were associated with lower levels of flourishing. Our findings have implications for efforts to prevent ACEs exposure through monitoring and promoting family well-being and routine screening to identify those with ACEs exposure to prevent negative social and health sequelae.
不良的童年经历(ACEs)普遍存在,并与负面的健康和社会结果相关。然而,我们对于 ACEs 暴露模式如何与成年人的积极结果相关的理解仍然有限。本研究旨在确定 ACEs 的模式,并在中国青年成年人样本中检查与繁荣的关联。
本横断面研究于 2020 年 8 月至 11 月进行。通过方便和滚雪球抽样,招募在中国大陆大学就读本科或研究生课程的 18-35 岁青年成年人参加调查。通过十二项中文 ACE-国际问卷测量 ACEs 的暴露情况。其他测量包括使用中文繁荣量表评估的繁荣的六个领域,以及人口统计学协变量(即性别、年龄、大学年级、婚姻状况)。使用 SPSS 27 和 Mplus 8.5 进行描述性统计分析和潜在类别分析(LCA)。
参与者包括 9468 名青年成年人(平均年龄 20.1 岁)。大多数参与者为女性(75.3%)、本科生(96.4%)和单身(79.8%)。大约 56%的参与者报告至少有一种 ACE;7.0%报告了四种或更多 ACE。情感忽视(33.2%)、家庭暴力(20.6%)和父母分离/离婚(13.9%)是最常报告的 ACE。LCA 确定了三种 ACE 类:多种虐待和家庭暴力(4.7%)、情感忽视和家庭暴力(16.2%)和低 ACEs(79.1%)。低 ACEs 类的个体在所有六个领域中表现出最高水平的繁荣,而在多种虐待和家庭暴力类的个体则表现出最低水平的繁荣。在繁荣方面,多种虐待和家庭暴力类与情感忽视和家庭暴力类之间没有显著差异,除了在身心健康(均值=6.17 与 6.51,p=0.02)和财务和物质稳定领域(均值=5.25 与 5.66,p=0.04)。
多种 ACEs 暴露模式与较低的繁荣水平相关。我们的发现对于通过监测和促进家庭幸福以及常规筛查来预防 ACEs 暴露以防止负面的社会和健康后果的努力具有重要意义。