Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom.
Depatment of Psychology, University of Birmingham, Birmingham, United Kingdom.
PLoS One. 2024 Aug 28;19(8):e0308038. doi: 10.1371/journal.pone.0308038. eCollection 2024.
The focus of this review was to systematically review and meta-analyse the prevalence of ACEs among university students in the UK.
The systematic searching of six electronic databases (conducted February 2024) identified ten relevant articles (peer-reviewed articles of a quantitative nature that included ACE prevalence). PROSPERO reference: CRD42022364799.
Pooled prevalence for number of ACEs endured was 55.4% (95% CI: 32.4% - 78.4%; I2 > 99.5%) for one or more, and 31.6% (7.5% - 55.6%; I2 > 99.5%) for three or more. Pooled prevalence was: 15.9% (7.0% - 24.7%; I2 > 94.5%) for physical abuse; 27.0% (18.1% - 35.9%; I2 > 94.5%) for emotional abuse; 12.1% (5.2% - 19.0%; I2 > 94.5%) for sexual abuse; 8.4% (1.7% - 15.1%; I2 > 95.4%) for physical neglect, and 30.0% (21.5% - 38.5%; I2 > 95.4%) for emotional neglect. Pooled prevalence for household dysfunction categories were: 34.4% (22.8% - 46.0%) for parental separation; 18.4% (10.1% - 26.8%) for domestic violence; 35.2% (23.6% - 46.8%) for mental health difficulties; 21.4% (12.9% - 29.9%) for substance use; and 5.7% (2.3% - 9.1%) for incarceration (I2 > 88.8% for all household dysfunction items). Significant heterogeneity was observed between studies for most categories of adversity, and it was not possible to explain/reduce this variance by removing small numbers of influential/discrepant studies. Further analyses suggested potential influences of measurement tool used, country of data collection, and age and sex of participants.
Results demonstrate considerable, largely unaccounted-for, heterogeneity in estimates of the prevalence of ACEs, impeding confidence in any summary statistics. Conclusions must be tentative due to analyses being underpowered given small numbers of papers, as well as potential confounds, meaning results may not be truly representative. However, results do suggest high prevalence rates which warrant further investigation, with appropriate support offered to students.
本研究旨在系统地回顾和荟萃分析英国大学生中 ACEs 的流行情况。
系统检索了六个电子数据库（2024 年 2 月进行），确定了 10 篇相关文章（定量性质的同行评审文章，包括 ACE 流行率）。PROSPERO 参考：CRD42022364799。
累计发生率为 1 个或多个 ACE 的发生率为 55.4%（95%CI：32.4% - 78.4%；I2>99.5%），3 个或更多 ACE 的发生率为 31.6%（7.5% - 55.6%；I2>99.5%）。累积发生率为：身体虐待 15.9%（7.0% - 24.7%；I2>94.5%）；情感虐待 27.0%（18.1% - 35.9%；I2>94.5%）；性虐待 12.1%（5.2% - 19.0%；I2>94.5%）；身体忽视 8.4%（1.7% - 15.1%；I2>95.4%）；情感忽视 30.0%（21.5% - 38.5%；I2>95.4%）。家庭功能障碍类别的累积发生率为：父母分居 34.4%（22.8% - 46.0%）；家庭暴力 18.4%（10.1% - 26.8%）；心理健康困难 35.2%（23.6% - 46.8%）；物质使用 21.4%（12.9% - 29.9%）；监禁 5.7%（2.3% - 9.1%）（I2>88.8% 用于所有家庭功能障碍项目）。大多数逆境类别的研究之间存在显著的异质性，并且通过去除少数有影响力的/不一致的研究，无法解释/减少这种差异。进一步的分析表明，测量工具的使用、数据收集的国家以及参与者的年龄和性别可能存在潜在影响。
结果表明 ACEs 流行率存在相当大的、在很大程度上未被解释的异质性，这阻碍了对任何汇总统计数据的信心。由于论文数量较少，以及潜在的混杂因素，分析的功效不足，因此结论必须是暂定的，这意味着结果可能不是真实的代表性。然而，结果确实表明高流行率值得进一步调查，并为学生提供适当的支持。
