Adverse Childhood Experiences (ACEs) and Child Behavior Problems in KwaZulu Natal, South Africa.
Adverse Childhood Experiences (ACEs) and Child Behavior Problems in KwaZulu Natal, South Africa.
复制标题
南非夸祖鲁纳塔尔省的不良童年经历 (ACE) 和儿童行为问题。
DOI：
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
L. Davidson
中科院分区：
文献类型：
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作者：
Meaghan L Nazareth;J. Kvalsvig;C. Mellins;C. Desmond;S. Kauchali;L. Davidson
背景
童年不良事件 (ACE) 与成年后的负面健康影响相关。尽管了解这些后期影响，但对于中低收入国家 (LMIC) ACE 对后期儿童行为的早期影响知之甚少。
方法
以人群为基础的 Asenze 队列研究在南非夸祖鲁-纳塔尔省的农村地区进行，该地区由五个祖鲁部落地区组成。检查了两波数据：儿童平均 5 岁时的家庭信息和 ACE 暴露以及大约两年后（平均年龄 7 岁）的儿童行为问题（优势和困难问卷 (SDQ)）。 Logistic 回归分析用于检查累积 ACE 与 SDQ 总分（分为前 10% 与其余分数）以及选定的 SDQ 子量表之间未经调整和调整的关系。
结果
观察到 ACE 暴露增加与 SDQ 总分之间存在显着关系。 SDQ 情绪症状和品行问题分量表也存在同样的关系，但多动症则不然。将亲密伴侣暴力排除在 ACE 测量之外的敏感性分析结果也显示出类似的结果。
结论
在该中低收入人群中，接触 ACE 与后来的儿童行为问题之间存在关联，这表明 ACE 会产生早期负面影响。虽然之前的研究重点关注 ACE 对成人健康的影响，但这项研究提供了 ACE 与儿童行为问题之间早期关系的证据，这可能是后来产生健康影响的机制的一部分。
BACKGROUND
Adverse childhood events (ACEs) are associated with negative health effects in adulthood. Despite knowledge of these later impacts, little is known about the earlier effect of ACEs on later child behavior in low- and middle-income countries (LMIC).
METHODS
The population-based Asenze cohort study was implemented in a peri-rural area of KwaZulu-Natal, South Africa, comprising five Zulu tribal areas. Two waves of data were examined: family information and ACEs exposure when children were on average 5 years old and child behavior problems (Strengths and Difficulties Questionnaire (SDQ)) approximately two years later (average age 7 years). Logistic regression analysis was used to examine unadjusted and adjusted relationships between cumulative ACEs experienced and the SDQ total scores (dichotomized as top 10% vs. the rest) as well as selected SDQ subscales.
RESULTS
A significant relationship between increased ACEs exposure and SDQ total score was observed. The same relationship was also seen for the SDQ emotional symptoms and conduct problem subscales, but not for hyperactivity. The results of a sensitivity analysis excluding intimate partner violence from the ACEs measure demonstrated similar results.
CONCLUSIONS
There is an association between exposure to ACEs and later child behavior problems within this LMIC population demonstrating an early negative impact for ACEs. While previous research has focused on the effects of ACEs on adult health, this study provided evidence for an earlier relationship between ACEs and child behavior problems that may be a part of the mechanism through which later health effects arise.