Adverse Childhood Experiences and Intimate Partner Violence Among Youth in Cambodia: A Latent Class Analysis

Abstract

Adverse childhood experiences (ACEs) are a global public health problem, including in low- and middle-income country settings, and are associated with increased risk of intimate partner violence (IPV) during young adulthood. However, current measurement of ACEs may underestimate sequelae of different combinations, or classes, of ACEs and mask class-specific associations with adult exposure to IPV. We used data among ever-partnered young women and men aged 18–24 years from the Cambodia Violence Against Children Survey ( Nw = 369; Nm = 298). Participants retrospectively reported on seven ACEs and lifetime physical and/or sexual IPV victimization and perpetration. Latent classes comprised of ACEs were used as predictors of physical and/or sexual IPV perpetration and victimization, controlling for household wealth. Identified latent classes for women were “Low ACEs” (60%), “Community Violence and Physical Abuse” (23%), and “Physical, Sexual and Emotional Abuse” (17%). Latent classes for men were “Low ACEs” (48%) and “Household and Community Violence” (52%). Among women, those in the Physical, Sexual and Emotional Abuse class were more likely to experience and perpetrate physical and/or sexual IPV in their romantic relationships compared to the reference group (Low ACEs). Women in the Community Violence and Physical Abuse class were more likely to perpetrate physical and/or sexual IPV, but not experience IPV, compared to women in the Low ACEs class. Among men, those in the Household and Community Violence class were more likely to perpetrate physical and/or sexual IPV against a partner, compared to men in the Low ACEs class. Overall, patterns of ACEs were differently associated with IPV outcomes among young women and men in Cambodia. National violence prevention efforts might consider how different combinations of childhood experiences shape risk of young adulthood IPV and tailor interventions accordingly to work with youth disproportionately affected by varied combinations of ACEs.

A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges

“…These study outcomes include unmet care coordination needs (Anyigbo et al, 2021), prenatal social networks (Napier et al, 2023), school performance (Merians et al, 2019;Stempel et al, 2017), cognitive functioning (Yuan et al, 2022), resilience/ flourishing (S. S. Chen, He, et al, 2022;L. Wang, Yu, et al, 2022), victimization and perpetration of IPV/violent behavior (Aizpurua et al, 2023;Burke et al, 2022;Lee et al, 2021;Miedema et al, 2023;Zietz et al, 2020), and offspring's socio-emotional functioning (Stargel & Easterbrooks, 2020).…”

“…In addition to the original ACEs questionnaire developed from the Kaiser-CDC ACEs study (Felitti et al, 1998), researchers used the following scales to collect primary ACEs data. The scales included the Maltreatment and Abuse Chronology of Exposure Scale and Childhood Sexual Abuse Questionnaire (Barra et al, 2018), the Adverse Childhood Experiences-International Questionnaire (ACE-IQ; S. S. Chen, He, et al, 2022;Hemady et al, 2022;Ho et al, 2019;Li et al, 2022;Liu et al, 2022;Miedema et al, 2023;L. Wang, Yu, et al, 2022;Xiao et al, 2023;Yuan et al, 2022;Zietz et al, 2020), the Childhood Trauma Questionnaire (S. S. Chen, He, et al, 2022;M.…”

“…Other non-maltreatment family adversities were expanded such as (a) parental/guardian death (studies based on NSCH; studies using ACE-IQ; Aizpurua et al, 2023;Hemady et al, 2022;Lacey, Pinto Pereira, et al, 2020;Lacey et al, 2022;MacLochlainn et al, 2022;Miedema et al, 2023;Smith et al 2023;G. F. Wang, Yuan, et al, 2022;Xiao et al, 2023;Yu et al, 2022;Yuan et al, 2022 also added sibling death; Zhang et al, 2020;Zietz et al, 2020); (b) disadvantaged household socioeconomic status such as poverty/material hardship/financial struggles (studies based on FFCWS, NSCH; S. S. Chen, He, et al, 2022;Heidinger & Willson, 2022;Kim, Lee, et al, 2020;Yu et al, 2022), parents' unemployment (Heidinger & Willson, 2022;Zhang et al, 2020), and low maternal education (Zhang & Monnat, 2022); (c) illness/ disability/accident experienced by a family member (S. S. Chen, He, et al, 2022;MacLochlainn et al, 2022;G.…”

“…Likewise, physical abuse was specified by perpetrators and activities. Miedema et al (2023) included both "physical abuse by family" and "physical abuse by community." Others specified physical abuse as "spanking, slapping, kicking, punching or beating you up" and "hit or cut you with an object, such as a stick (or cane), bottle, club, knife, whip, etc."…”

Reconsidering the Unwanted Sexual Touching of Boys by Adults: An Ethnographic Study in Rural Cambodia

“…UST can occur subtly or overtly in physically violent ways, especially in settings of conflict. UST can have long-term effects, including suicide attempts and non-suicidal self injury (Bikmazer et al, 2022) especially in the case of poly-victimization (Juan et al, 2019), posttraumatic stress disorder (Boumpa et al, 2022), and intimate partner violence (Miedema et al, 2023).…”