Program in Public Health and Department of Family, Population and Preventive Medicine, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States of America.
Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104-6298, United States of America.
Child Abuse Negl. 2024 Aug;154:106895. doi: 10.1016/j.chiabu.2024.106895. Epub 2024 Jun 12.
A sizeable literature shows that adverse childhood experiences (ACEs) are associated with poor health outcomes in later life. However, most studies on the prevalence and predictors of ACEs have been carried out in high-income countries using cross-sectional approaches.
The present study explores the prevalence and predictors of ACEs in Malawi, a low-income country, using prospective longitudinal data collected on adolescents.
We use data on 1375 adolescents and their biological mothers from the Malawi Longitudinal Study of Families and Health (MLSFH). ACEs were reported by adolescents over two survey waves, in 2017-18 and 2021. Predictors were reported by mothers in 2008 and 2010.
Multivariate ordinary least square and logistic regression analyses of ACEs exposure reported by adolescents on indicators of family arrangements and resources.
Adolescents report having been exposed to nearly seven ACEs on average. Among indicators of family arrangements and resources, the only significant predictors of cumulative ACEs exposure are polygyny (linked to parental absence) and mother's SF-12 mental health score (linked to physical abuse and witnessing domestic violence).
ACEs are much more prevalent in the low-income country under study than in middle- and high-income countries surveyed in prior research. Despite adversity being widespread, most indicators of family arrangements and resources highlighted in prior studies are not associated with adolescents' cumulative ACEs exposure in this context. Mothers' mental health in childhood nevertheless emerges as a significant predictor of adolescents' self-reported ACEs. These findings inform efforts aimed at preventing ACEs in high-adversity contexts.
大量文献表明，童年逆境经历（ACEs）与晚年健康状况不佳有关。然而，大多数关于 ACEs 的患病率和预测因素的研究都是在高收入国家使用横断面方法进行的。
本研究使用前瞻性纵向数据，探讨了马拉维这一低收入国家 ACEs 的患病率和预测因素，该数据来自青少年。
我们使用来自马拉维家庭与健康纵向研究（MLSFH）的 1375 名青少年及其生物母亲的数据。ACEs 由青少年在 2017-18 年和 2021 年的两次调查中报告。预测因素由母亲在 2008 年和 2010 年报告。
对青少年报告的家庭安排和资源指标进行多元普通最小二乘法和逻辑回归分析。
青少年平均报告经历了近七种 ACEs。在家庭安排和资源指标中，仅有一夫多妻制（与父母缺席有关）和母亲的 SF-12 心理健康评分（与身体虐待和目睹家庭暴力有关）是累积 ACEs 暴露的显著预测因素。
与先前研究中调查的中高收入国家相比，在研究中的低收入国家 ACEs 更为普遍。尽管逆境普遍存在，但在这种情况下，大多数先前研究中强调的家庭安排和资源指标与青少年的累积 ACEs 暴露无关。然而，母亲在童年时期的心理健康状况仍然是青少年自我报告 ACEs 的一个重要预测因素。这些发现为旨在预防高逆境环境中的 ACEs 的努力提供了信息。
