Tian Zheng, Zhang Nan, Li Yimiao, Wu Yibo, Wang Lan
School of Nursing, Tianjin Medical University, Tianjin, China.
School of Public Health, Peking University, Beijing, China.
Epidemiol Psychiatr Sci. 2024 Dec 10;33:e75. doi: 10.1017/S2045796024000775.
Investigate the prevalence of adverse childhood experience (ACE) and intimate partner violence (IPV) using a large representative Chinese sample, explore the association mechanism between ACE and adult exposure to IPV and to examine gender differences.
A total of 21,154 participants were included in this study. The ACE scale was used to assess participants' exposure to ACE before the age of 18. Participants were evaluated for IPV experienced after the age of 18 using the IPV Scale. Logistic regression model was used to analyse the association between ACE and the risk of IPV exposure in adulthood. Principal component analysis was used to extract the main patterns of ACEs in the Chinese population. Network analyses were employed to identify the most critical types of ACE and IPV, analyse the association mechanisms between ACEs and IPVs, explore gender differences in this association and compare gender differences in the severity of IPVs experienced in adulthood.
Participants with at least one ACE event faced a 215.5% higher risk of IPV compared to those without ACE experiences. In population-wide and gender-specific networks, The ACE and IPV nodes with the highest expected influence are 'ACE1 (Verbal abuse + physical abuse pattern)' and 'IPV5 (Partner compares me to other people and blatantly accuses me, making me feel embarrassed and unsure of myself)'. Positive correlations were found between 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' and 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', which were the three edges with the highest edge weight values in the ACE pattern and IPV edges. 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE2 (Exposure to sexual assault pattern)'-'IPV2 (Partner would have physical or sexual contact with me against my will)', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' in the male network and 'ACE1 (Verbal abuse + physical abuse pattern)'-'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])', 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)', 'ACE3 (Substance abuse + mental illness + violent treatment of mother or stepmother pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' in the female network are the three edges with the highest edge weights among the ACE and IPV edges in their networks, respectively, all displaying positive correlations. The strength of 'IPV3 (Partner does not care about me when I am in bad shape [not feeling well or in a bad mood])' was higher in the male network than in the female (male = 0.821, female = 0.755, = 0.002). The edge weight values of 'ACE3 (Substance abuse + mental illness + violent treatment of mother or stepmother pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' ( = 0.043) and 'ACE4 (Violent treatment of mother or stepmother + criminal acts in the family pattern)'-'IPV1 (Partner has ever directly assaulted or hurt me with the help of an instrument)' ( = 0.032) are greater for females than males.
The most common type of ACE in the Chinese population is verbal violence combined with physical violence, while the predominant type of IPV is verbal violence. Males experience higher levels of emotional neglect from their partners compared to females. The association between witnessing physical violence in childhood and experiencing physical violence from a partner in adulthood is stronger in females than in males. The homotypic continuum between ACE and IPV is a crucial mechanism in understanding intergenerational domestic violence. Enhance economic and educational levels, promote correct parenting concepts, reduce child abuse, establish accurate perceptions of intimate relationships, eliminate shame about violence and further advance gender equality. These efforts are vital for reducing IPV prevalence and breaking the cycle of violence in victims' lives.
使用具有广泛代表性的中国样本调查童年不良经历(ACE)和亲密伴侣暴力(IPV)的患病率,探讨ACE与成年期遭受IPV之间的关联机制,并研究性别差异。
本研究共纳入21154名参与者。使用ACE量表评估参与者18岁之前的ACE暴露情况。使用IPV量表评估参与者18岁之后经历的IPV。采用逻辑回归模型分析ACE与成年期遭受IPV风险之间的关联。采用主成分分析提取中国人群中ACE的主要模式。采用网络分析确定ACE和IPV最关键的类型,分析ACE与IPV之间的关联机制,探讨这种关联中的性别差异,并比较成年期遭受的IPV严重程度的性别差异。
与没有ACE经历的参与者相比,至少有一次ACE事件的参与者遭受IPV的风险高215.5%。在总体人群和特定性别的网络中,预期影响最高的ACE和IPV节点分别是“ACE1(言语虐待+身体虐待模式)”和“IPV5(伴侣将我与其他人比较并公然指责我,让我感到尴尬和不自信)”。在“ACE1(言语虐待+身体虐待模式)”-“IPV3(当我状态不好[感觉不舒服或心情不好]时伴侣不关心我)”、“ACE4(对母亲或继母的暴力对待+家庭中的犯罪行为模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”和“ACE2(遭受性侵犯模式)”-“IPV2(伴侣违背我的意愿与我进行身体或性接触)”之间发现了正相关,这是ACE模式和IPV模式中边权重值最高的三条边。男性网络中的“ACE1(言语虐待+身体虐待模式)”-“IPV3(当我状态不好[感觉不舒服或心情不好]时伴侣不关心我)”、“ACE2(遭受性侵犯模式)”-“IPV2(伴侣违背我的意愿与我进行身体或性接触)”、“ACE4(对母亲或继母的暴力对待+家庭中的犯罪行为模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”以及女性网络中的“ACE1(言语虐待+身体虐待模式)”-“IPV3(当我状态不好[感觉不舒服或心情不好]时伴侣不关心我)”、“ACE4(对母亲或继母的暴力对待+家庭中的犯罪行为模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”、“ACE3(药物滥用+精神疾病+对母亲或继母的暴力对待模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”分别是各自网络中ACE和IPV模式里边权重最高的三条边,均显示出正相关。“IPV3(当我状态不好[感觉不舒服或心情不好]时伴侣不关心我)”在男性网络中的强度高于女性(男性=0.821,女性=0.755,P=0.002)。“ACE3(药物滥用+精神疾病+对母亲或继母的暴力对待模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”(P=0.043)和“ACE4(对母亲或继母的暴力对待+家庭中的犯罪行为模式)”-“IPV1(伴侣曾借助工具直接攻击或伤害我)”(P=0.032)的边权重值女性大于男性。
中国人群中最常见的ACE类型是言语暴力与身体暴力相结合,而IPV的主要类型是言语暴力。与女性相比,男性从伴侣那里经历的情感忽视程度更高。童年目睹身体暴力与成年期遭受伴侣身体暴力之间的关联在女性中比在男性中更强。ACE与IPV之间的同型连续体是理解代际家庭暴力的关键机制。提高经济和教育水平,推广正确的育儿观念,减少儿童虐待,建立对亲密关系的正确认知,消除对暴力的羞耻感并进一步推进性别平等。这些努力对于降低IPV患病率和打破受害者生活中的暴力循环至关重要。