Department of Psychiatry and Behavioural Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA.
Oklahoma State University College of Osteopathic Medicine at Cherokee Nation, Office of Medical Student Research, Tahlequah, OK, USA.
J Osteopath Med. 2023 Mar 22;123(7):357-363. doi: 10.1515/jom-2022-0221. eCollection 2023 Jul 1.
Many studies have shown increases in negative social aspects in the United States that may increase the likelihood of a child experiencing adversity. These rising trends include household dysfunction, poor mental health and substance use, crime rates, and incarceration. Additionally, the pathway of adverse childhood experiences (ACEs) may also perpetuate intergenerational trauma.
Given these increased trends, our objective was to determine the mean ACEs reported among adults by year of birth to assess trends of ACEs over time.
To assess ACEs trends in the United States, we utilized data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey. We summed individuals' reported ACEs and then calculated the mean ACE score within age cohorts (in 1-year increments) by year of birth. We utilized an auto-regressive integrated moving average (ARIMA) model to forecast mean ACEs through 2030.
Respondents to the ACEs module (n=116,378) represented 63,076,717 adults in the United States, with an average age cohort of 1715 individuals. The mean reported ACEs among individuals 80 years or older (born in or before 1940) was 0.79, while the highest mean ACEs (2.74) were reported among the cohort born in 1998-an average increase of 0.022 ACEs per year. The ARIMA model forecasted that individuals born in 2018 will, on average, surpass a cumulative of three ACEs.
Given the connection of ACEs to poor health outcomes and quality of life, this trend is alarming and provides evidence for the necessity of child maltreatment prevention. Multigenerational trauma-informed care and education are warranted for individuals with ACEs and may even prevent the cycle from recurring.
许多研究表明，美国的负面社会方面有所增加，这可能增加儿童经历逆境的可能性。这些上升趋势包括家庭功能障碍、心理健康和药物使用不良、犯罪率和监禁率。此外，不良儿童经历（ACEs）的途径也可能使代际创伤永久化。
鉴于这些趋势的增加，我们的目的是确定按出生年份报告的成年人的平均 ACEs，以评估随着时间的推移 ACEs 的趋势。
为了评估美国 ACEs 的趋势，我们利用了 2020 年行为风险因素监测系统（BRFSS）的数据，这是一项具有全国代表性的调查。我们将个人报告的 ACEs 相加，然后按出生年份计算年龄组（每年增加 1 年）内的平均 ACE 得分。我们利用自回归综合移动平均（ARIMA）模型预测到 2030 年的平均 ACEs。
ACEs 模块的受访者（n=116,378）代表了美国 63,076,717 名成年人，平均年龄组为 1715 人。80 岁或以上（出生于或之前 1940 年）的个体报告的平均 ACEs 为 0.79，而出生于 1998 年的队列报告的平均 ACEs 最高（2.74），平均每年增加 0.022 ACEs。ARIMA 模型预测，2018 年出生的个体平均将超过三个 ACEs。
鉴于 ACEs 与不良健康结果和生活质量的联系，这种趋势令人震惊，并为儿童虐待预防的必要性提供了证据。需要对 ACEs 个体进行代际创伤知情的护理和教育，甚至可能阻止这种循环再次发生。
