Jang Jihoon, Gonzales Gilbert
Vanderbilt University School of Medicine, 1161 21stAve S #D3300, Nashville, TN, USA.
Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA.
J Gen Intern Med. 2025 Feb;40(3):579-586. doi: 10.1007/s11606-024-09186-8. Epub 2024 Oct 31.
Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) impact adult health. However, differences in ACEs, PCEs, and mental health have not been extensively studied among Asian Americans.
To examine the association between childhood experiences and adult mental health in first and second generation Asian Americans.
This study used data from the 2021-2022 California Health Interview Survey (CHIS), an address-based sampling of noninstitutionalized Californians conducted online or by phone.
Asian American respondents aged 18-65 years.
Fifteen different ACEs and seven different PCEs.
Adjusted prevalence ratios (aPR) of severe psychological distress for each generation. Survey weights were applied to all analyses for population-based representation.
5,744 Asian Americans (48.0% male, 16.4% aged 18-25) were included in the current study. We found that second generation Asian Americans experienced a greater prevalence of ACEs (65.4% reported ≥1 ACE vs 47.5% in first generation Asian Americans) and lower prevalence of PCEs (32.1% reported ≤2 PCEs vs 22.6% in first generation Asian Americans). Second generation Asian Americans were more likely to report ≥4 ACEs (aPR, 1.46; 95% CI, 1.13 to 1.88) and ≤2 PCEs (aPR, 1.51; 95% CI, 1.29 to 1.78) relative to first generation Asian Americans. Second generation Asian Americans with ≥4 ACEs or ≤2 PCEs were more likely to report severe psychological distress (aPR, 2.54; 95% CI, 1.55 to 4.17 and aPR, 1.48; 95% CI, 1.03 to 2.13, respectively) relative to first generation Asian Americans. When examining ACEs and PCEs individually, domestic, physical, and verbal abuse; divorce; racism; and lacking support systems were significantly associated with severe psychological distress in second generation Asian Americans.
Second generation Asian Americans are more likely to experience more ACEs, fewer PCEs, and poorer mental health as a result. Our study indicates that physicians should screen for childhood experiences and leverage trauma-informed care among Asian American subpopulations.
童年不良经历（ACEs）和童年积极经历（PCEs）会影响成人健康。然而，亚裔美国人在ACEs、PCEs和心理健康方面的差异尚未得到广泛研究。
研究第一代和第二代亚裔美国人童年经历与成人心理健康之间的关联。
本研究使用了2021 - 2022年加利福尼亚健康访谈调查（CHIS）的数据，这是一项基于地址对加利福尼亚非机构化居民进行的在线或电话抽样调查。
年龄在18 - 65岁的亚裔美国受访者。
15种不同的ACEs和7种不同的PCEs。
各代严重心理困扰的调整患病率比（aPR）。所有分析均应用调查权重以实现基于人群的代表性。
本研究纳入了5744名亚裔美国人（48.0%为男性，16.4%年龄在18 - 25岁）。我们发现第二代亚裔美国人ACEs的患病率更高（65.4%报告有≥1次ACEs，而第一代亚裔美国人为47.5%），PCEs的患病率更低（32.1%报告有≤2次PCEs，而第一代亚裔美国人为22.6%）。相对于第一代亚裔美国人，第二代亚裔美国人更有可能报告有≥4次ACEs（aPR，1.46；95%置信区间，1.13至1.88）和≤2次PCEs（aPR，1.51；95%置信区间，1.29至1.78）。有≥4次ACEs或≤2次PCEs的第二代亚裔美国人相对于第一代亚裔美国人更有可能报告有严重心理困扰（aPR分别为2.54；95%置信区间，1.55至4.17和aPR，1.48；95%置信区间，1.03至2.13）。在单独研究ACEs和PCEs时，家庭内、身体和言语虐待；离婚；种族主义；以及缺乏支持系统与第二代亚裔美国人的严重心理困扰显著相关。
第二代亚裔美国人更有可能经历更多的ACEs、更少的PCEs，因此心理健康状况更差。我们的研究表明，医生应该筛查童年经历，并在亚裔美国亚人群体中采用创伤知情护理。
