Yamagishi Mika, Satomura Yoshihiro, Sakurada Hanako, Kanehara Akiko, Sakakibara Eisuke, Okada Naohiro, Koike Shinsuke, Yagishita Sho, Ichihashi Kayo, Kondo Shinsuke, Jinde Seiichiro, Fukuda Masato, Kasai Kiyoto
Department of Neuropsychiatry, Graduate School of Medicine The University of Tokyo Tokyo Japan.
Center for Diversity in Medical Education & Research, Graduate School of Medicine The University of Tokyo Tokyo Japan.
PCN Rep. 2022 Nov 17;1(4):e58. doi: 10.1002/pcn5.58. eCollection 2022 Dec.
Adverse childhood experiences (ACEs) are highly prevalent in the general population, and their lifelong impact on physical and mental health is profound. In assessing ACEs, it is vital to consider the pathways and modalities by which an individual internalizes events as an adverse experience and its effects on their biological, psychological, and social function. However, conventional assessments of ACEs are inadequate in that they do not comprehensively assess the source of the adverse event and the pathway and mode of its impact on the individual.
This study developed an original scale for ACEs that classifies the source of the event and the pathway and mode of its impact on the individual from a retrospective review of medical charts. We also used this scale to investigate the ACEs in 536 patients with psychiatric disorders (depression, bipolar disorder, and schizophrenia).
This scale consisted of 28 items, and its reliability and validity were sufficient. We also found that 45.9% of the patients studied had at least one ACE, ranging from 43.5% to 51.5% for all disorders. Psychological trauma (bullying) from peers was the most common cause at 27.2%.
We developed a retrospective chart review-based assessment tool for ACEs which enables the examination of the source of the events of ACEs and the pathways and modalities of their impact on the individual. The frequency of ACEs is high regardless of the type of psychiatric disorder, and horizontal trauma (bullying victimization) is as frequent as vertical trauma (parental maltreatment).
童年不良经历(ACEs)在普通人群中高度普遍,其对身心健康的终身影响深远。在评估ACEs时,至关重要的是要考虑个体将事件内化为不良经历的途径和方式及其对生物、心理和社会功能的影响。然而,传统的ACEs评估并不充分,因为它们没有全面评估不良事件的来源及其对个体影响的途径和方式。
本研究开发了一种原创的ACEs量表,通过对病历的回顾性审查来对事件来源及其对个体影响的途径和方式进行分类。我们还使用该量表调查了536名精神疾病(抑郁症、双相情感障碍和精神分裂症)患者的ACEs情况。
该量表由28个项目组成,其信效度良好。我们还发现,45.9%的研究患者至少有一次ACEs,所有疾病的发生率在43.5%至51.5%之间。来自同龄人的心理创伤(欺凌)最为常见,占27.2%。
我们开发了一种基于病历回顾性审查的ACEs评估工具,该工具能够检查ACEs事件的来源及其对个体影响的途径和方式。无论精神疾病类型如何,ACEs的发生率都很高,横向创伤(受欺凌)与纵向创伤(父母虐待)的发生率相当。