Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan.
Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan.
JAMA Netw Open. 2024 Sep 3;7(9):e2436150. doi: 10.1001/jamanetworkopen.2024.36150.
It is widely known that individuals with adverse childhood experiences (ACEs) have an increased risk of abusing their own children, thereby perpetuating the cycle of violence. However, the association between ACEs and elder abuse perpetration has not been fully examined.
To examine the association between ACEs and elder abuse and the mediating factors.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data collected via the self-administered Japan COVID-19 and Society Internet Survey from September 12 to October 19, 2022. Men and women aged 20 to 64 years who responded to related questions were included. Data were analyzed from July 2023 to April 2024.
ACEs, defined as the experience of any of 7 items-interpersonal loss (parental loss and parental divorce), family psychopathology (parental mental disease and violence in family), abuse (physical and psychological abuse), and neglect-before the age of 18 years.
The primary outcome was the perpetration of physical and/or psychological abuse against an older person (aged ≥65 years) self-reported via questionnaire. The direct and indirect effect estimates were determined using logistic regression analyses.
Of a total of 13 318 participants (mean [SD] age, 41.1 [12.1] years; 6634 female [49.8%]), 1133 (8.5%) reported perpetrating violence against older adults. Compared with individuals without ACEs, the odds ratios (ORs) for perpetrating violence were 3.22 (95% CI, 2.74-3.79) for those with 1 ACE and 7.65 (95% CI, 6.41-9.13) for those with 2 or more ACEs. In the mediation analysis, factors with large indirect effect estimates included depression (OR, 1.13; 95% CI, 1.11-1.14; proportion mediated [PM], 18.6%), mental illness other than depression (OR, 1.12; 95% CI, 1.10-1.14; PM, 17.3%), and self-rated health (OR, 1.04; 95% CI, 1.03-1.05; PM, 6.0%).
These findings suggest that intergenerational cycles of violence may extend to any vulnerable group, not only children but also older adults. Further research into the prevention of ACEs and breaking these cycles of violence is warranted.
众所周知，经历过不良童年经历（ACEs）的个体更有可能虐待自己的孩子，从而使暴力循环持续下去。然而，ACEs 与虐待老人行为之间的关联尚未得到充分研究。
研究 ACEs 与虐待老人行为之间的关联以及中介因素。
设计、设置和参与者：这是一项横断面研究，使用了 2022 年 9 月 12 日至 10 月 19 日通过“日本新冠肺炎和社会互联网调查”（Japan COVID-19 and Society Internet Survey）自填式问卷收集的数据。纳入年龄在 20 至 64 岁之间、回答相关问题的男性和女性。数据分析于 2023 年 7 月至 2024 年 4 月进行。
ACEs 定义为在 18 岁之前经历的 7 项事件之一，包括人际损失（父母去世和父母离婚）、家庭精神病理学（父母精神疾病和家庭内暴力）、虐待（身体和心理虐待）以及忽视。
主要结局是通过问卷调查报告的对年龄≥65 岁的老年人实施身体和/或心理虐待的行为。使用逻辑回归分析确定直接和间接效应估计值。
在总计 13318 名参与者（平均[标准差]年龄 41.1[12.1]岁；6634 名女性[49.8%]）中，有 1133 名（8.5%）报告对老年人实施了暴力行为。与没有 ACEs 的个体相比，具有 1 项 ACE 的个体发生暴力行为的比值比（OR）为 3.22（95%CI，2.74-3.79），具有 2 项或更多 ACE 的个体为 7.65（95%CI，6.41-9.13）。在中介分析中，具有较大间接效应估计值的因素包括抑郁（OR，1.13；95%CI，1.11-1.14；介导比例[PM]，18.6%）、非抑郁精神疾病（OR，1.12；95%CI，1.10-1.14；PM，17.3%）和自我评估的健康状况（OR，1.04；95%CI，1.03-1.05；PM，6.0%）。
这些发现表明，代际暴力循环可能会扩展到任何弱势群体，不仅是儿童，还有老年人。需要进一步研究预防 ACEs 和打破这些暴力循环的方法。
