Adverse childhood experiences and associations with self-reported gastrointestinal symptoms in young adults

Abstract

Background: Given the high burden of disease in the elderly population, health-related indicators and health-related quality of life (HRQoL) are central. Emotional health and pain are two main dimensions of HRQoL along with physical or functional health. Data focusing on these aspects in the elderly are scarce. However, assessment of HRQoL is crucial to evaluation research in this population. Method: A cross-sectional study was conducted to assess aspects of physical and psychological health in community-dwelling adults aged ≥65 years selected randomly from population records in Switzerland. The sample was stratified by age (65-69 years; 70-74; 75-79; 80-84; 85-89; ≥90) and gender. Participants were interviewed using a comprehensive questionnaire including the EQ-5D, a validated instrument assessing HQoL. The EQ-5D consists of 3-point (1 = no problems; 2 = moderate problems; 3 = severe problems) Likert scales assessing Mobility, Self-Care, Usual Activities, Pain/ Discomfort, Anxiety/Depression, and a VAS that rates overall current health state. Univariate Chi-square and multivariate regression analyses were conducted. Results: Among the 3061 elderly adults, mean EQ-5D global score was 75 (SD = 20) for the total sample, and decreased with age, ranging from 79 (SD = 19) in the younger group to 71 (SD = 22) in the oldest. However, for Anxiety/Depression, Results showed that the effect of age was not significant, and that only the oldest groups reported more difficulties. Even in these groups, it did not involve more than 25% of the respondents while up to 65% reported problems related to Pain/Discomfort which showed a steady growth across age groups. Interestingly, the global VAS score was impacted by the severity of Pain/Discomfort and Anxiety/Depression only. Conclusion: HRQoL in community-dwelling older adults is overall good although it decreases with age. Interestingly, not all dimensions are equally sensitive to age and emotional dimensions seem to be less affected by age than functional dimensions. There is a similar trend for the global score.

Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe

“…The frequency of IPV identified in the present study is very similar to that of ACE and other studies, indicating roughly about 60% emotional IPV and 20% physical IPV ( Baban et al, 2013 ; Kelmendi et al, 2019 ; Lesco et al, 2018 ; Raleva et al, 2013 ). Mothers exposed to any IPV were seven times more likely to show any form of CM within the past month than mothers who were not exposed, which is in line with previous findings on past year reports in other more western regions (e.g., OR adj = 5.32; Hamby et al, 2010 ).…”

“…The rates of child neglect reported in our study (14%–21%) are comparable to estimates reported in a global meta-analysis (16%; Stoltenborgh et al, 2012 ) as well as the local ACE studies (7%–31%; Baban et al, 2013 ; Lesco et al, 2018 ; Raleva et al, 2013 ). These comparable rates may be partly explained by parental failure to meet the child´s need for food, which is an item consistently used to assess physical neglect across studies.…”

“…In line with previous studies from LMICs (e.g., Kumar et al, 2019 ; Petrovic et al, 2016 ), more than half of the mothers (56%–72%) reported perpetrating at least one incident of physical CM in the form of slapping, spanking, pushing, pinching, shaking, or disciplining the child with an object (e.g., stick or belt) during the last month. The ACE studies ( Baban et al, 2013 ; Lesco et al, 2018 ; Raleva et al, 2013 ) found lower prevalence rates of physical CM in Romania (27%), North Macedonia (21%), and the Republic of Moldova (12%). A potential explanation for this is that we applied a broader definition of physical CM.…”

“…Almost every mother in our samples reported perpetrating at least one incident of emotional CM within the last month (91%–96%). The ACE studies found considerably lower rates for emotional CM, ranging from 11% to 24% across the three countries ( Baban et al, 2013 ; Lesco et al, 2018 ; Raleva et al, 2013 ). Our 1-month prevalence rates for emotional CM further exceeded the lifetime estimates found in studies that used the child version of the ICAST measure in samples from India (73%; Kumar et al, 2019 ), across nine Balkan countries (64%–83%; Nikolaidis et al, 2018 , BECAN study), and Saudi Arabia (75%; Al-Eissa et al, 2016 ).…”

“…ACE studies in Romania ( N = 2,088), North Macedonia ( N = 664), and the Republic of Moldova ( N = 1,534) found childhood lifetime prevalence rates ranging from 12% to 27% for physical CM, 11% to 24% for emotional CM, 4% to 13% for sexual CM, 7% to 20% for physical neglect, and 13% to 31% for emotional neglect. Regarding the co-occurrence of ACEs in these countries, 10% to 17% of youth reported witnessing violence against their mother with co-occurrence rates of 32% to 39% for physical CM and 20% to 44% for emotional CM of those who also witnessed IPV ( Baban et al, 2013 ; Lesco et al, 2018 ; Raleva et al, 2013 ). Rates found in ACE studies are provided by country in the supplementary material .…”