School of Public Health, Xuzhou Medical University.
Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University.
Environ Health Prev Med. 2023;28:17. doi: 10.1265/ehpm.22-00242.
There has been minimal research on the role of benevolent childhood experiences (BCEs) and how such events may offer protection from the insidious effects of adverse childhood experiences (ACEs) or later in life.
This research aims to learn how BCEs and ACEs interact to affect adolescents' psychological distress.
Cross-sectional survey was conducted in three cities (Xuzhou, Nanjing, and Wuhan) in China from March 2021 to May 2021. Latent class analysis (LCA) was used to classify the patterns of ACEs and BCEs. We adopted hierarchical multivariable regression to examine the influences of ACEs and BCEs on depression and suicidal ideation.
To explore the relationship between childhood experience and suicidal ideation and depression, LCA revealed three patterns of ACEs: (1) emotional abuse (10.57%); (2) high ACEs (0.55%); and (3) low ACEs classes (88.88%). Adolescents with emotional abuse (depression: OR = 3.82, 95%CI = 2.80-5.22, P < 0.001; suicidal ideation: OR = 5.766, 95%CI = 3.97-8.38, P < 0.001) and high ACEs class (suicidal ideation: OR = 5.93, 95%CI = 1.19-29.66, P < 0.05) had an increased risk of psychological distress (reference: low ACEs). LCA revealed four patterns of BCEs: (1) relationship support (14.54%); (2) low BCEs (4.85%); (3) high BCEs (55.34%); and (4) high quality of life classes (25.28%). Adolescents with a high quality of life (depression: OR = 0.09, 95%CI = 0.05-0.16, P < 0.001; suicidal ideation: OR = 0.22, 95%CI = 0.12-0.40, P < 0.001) and high BCEs (depression: OR = 0.05, 95%CI = 0.03-0.09, P < 0.001; suicidal ideation: OR = 0.15, 95%CI = 0.09-0.26, P < 0.001) protected the mental health of adolescents (reference: low BCEs).
High ACEs and emotional abuse classes were significantly associated with poorer mental health symptoms, including suicidal ideation and depression. In contrast, high BCEs and high quality of life classes were associated with better mental health. These findings point out that it is more necessary to identify and support victims of ACEs, and it is urgent to increase BCEs in early childhood.
关于仁慈的童年经历（BCEs）的作用以及此类事件如何保护人们免受不良童年经历（ACEs）或以后生活的潜在影响，研究甚少。
本研究旨在了解 BCEs 和 ACEs 如何相互作用，从而影响青少年的心理困扰。
2021 年 3 月至 2021 年 5 月，在中国的三个城市（徐州、南京和武汉）进行了横断面调查。采用潜在类别分析（LCA）对 ACEs 和 BCEs 的模式进行分类。我们采用分层多元回归分析来研究 ACEs 和 BCEs 对抑郁和自杀意念的影响。
为了探讨童年经历与自杀意念和抑郁之间的关系，LCA 揭示了 ACEs 的三种模式：（1）情绪虐待（10.57%）；（2）高 ACEs 类（0.55%）；和（3）低 ACEs 类（88.88%）。经历情绪虐待的青少年（抑郁：OR = 3.82，95%CI = 2.80-5.22，P < 0.001；自杀意念：OR = 5.766，95%CI = 3.97-8.38，P < 0.001）和高 ACEs 类（自杀意念：OR = 5.93，95%CI = 1.19-29.66，P < 0.05）的心理困扰风险增加（参考：低 ACEs）。LCA 揭示了 BCEs 的四种模式：（1）关系支持（14.54%）；（2）低 BCEs（4.85%）；（3）高 BCEs（55.34%）；和（4）高生活质量类（25.28%）。具有高生活质量的青少年（抑郁：OR = 0.09，95%CI = 0.05-0.16，P < 0.001；自杀意念：OR = 0.22，95%CI = 0.12-0.40，P < 0.001）和高 BCEs（抑郁：OR = 0.05，95%CI = 0.03-0.09，P < 0.001；自杀意念：OR = 0.15，95%CI = 0.09-0.26，P < 0.001）对青少年的心理健康有保护作用（参考：低 BCEs）。
高 ACEs 和情绪虐待类与较差的心理健康症状（包括自杀意念和抑郁）显著相关。相比之下，高 BCEs 和高生活质量类与更好的心理健康相关。这些发现表明，更有必要识别和支持 ACEs 的受害者，迫切需要在儿童早期增加 BCEs。
