Development and Evaluation of a Short Adverse Childhood Experiences Measure.
Development and Evaluation of a Short Adverse Childhood Experiences Measure.
复制标题
短期不良童年经历衡量标准的制定和评估。
DOI：
10.1016/j.amepre.2016.09.033
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发表时间：
2017
影响因子：
5.5
通讯作者：
Forrest,ChristopherB
中科院分区：
文献类型：
--
作者：
WadeJr,Roy;Becker,BrandonD;Bevans,KatherineB;Ford,DerekC;Forrest,ChristopherB
IntroductionClinicians需要工具来快速识别具有重大童年逆境的个体，作为常规初级保健的一部分。本研究的目的是缩短11项行为风险因素监测系统不良儿童经历（ACE）措施，并评估这种缩短措施的可行性和有效性，作为筛选，以确定成年人谁经历了重大的童年advertises.MethodsStatistical分析进行了2015年。将从2011-2012年行为风险因素监测系统数据中获得的ACE项目反应合并，以形成71，413名年龄≥18岁的成年人的样本。11项行为风险因素监测系统ACE措施，随后减少到一个两项筛选保持两个维度的虐待和家庭压力，并选择每个dimension.ResultsThe筛选中最普遍的项目，包括家庭酒精和儿童情绪虐待项目。总体而言，42%的受访者和至少75%拥有四个或更多ACE的个人认可其中一个或两个体验。使用11项ACE测量作为标准，一个或多个ACE的截止值产生了99%的灵敏度，但特异性较低（66%）。当使用两个ACE的截止值时，特异性提高到94%，但灵敏度降低（70%）。有11个和两个项目的ACE措施之间没有实质性的差异，他们的实力与一系列的健康outcomes.ConclusionsA两个项目的ACE筛选适合快速识别的成年人谁经历了重大的童年逆境。
IntroductionClinicians require tools to rapidly identify individuals with significant childhood adversity as part of routine primary care. The goal of this study was to shorten the 11-item Behavioral Risk Factor Surveillance System Adverse Childhood Experiences (ACEs) measure and evaluate the feasibility and validity of this shortened measure as a screener to identify adults who have experienced significant childhood adversity.MethodsStatistical analysis was conducted in 2015. ACE item responses obtained from 2011–2012 Behavioral Risk Factor Surveillance System data were combined to form a sample of 71,413 adults aged ≥18 years. The 11-item Behavioral Risk Factor Surveillance System ACE measure was subsequently reduced to a two-item screener by maintaining the two dimensions of abuse and household stressors and selecting the most prevalent item within each dimension.ResultsThe screener included household alcohol and childhood emotional abuse items. Overall, 42% of respondents and at least 75% of the individuals with four or more ACEs endorsed one or both of these experiences. Using the 11-item ACE measure as the standard, a cut off of one or more ACEs yielded a sensitivity of 99%, but specificity was low (66%). Specificity improved to 94% when using a cut off of two ACEs, but sensitivity diminished (70%). There was no substantive difference between the 11-and two-item ACE measures in their strength of association with an array of health outcomes.ConclusionsA two-item ACE screener appropriate for rapid identification of adults who have experienced significant childhood adversity was developed.