Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: Results from a cross-sectional survey

Qu, Guangbo; Ma, Shaodi; Liu, Haixia; Han, Tiantian; Zhang, Huimei; Sun, Liang; Qin, Qirong; Chen, Ming-Chun; Sun, Yehuan

doi:10.1016/j.chiabu.2022.105511

Cited by 29 publications

(17 citation statements)

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“…In this study, 81.4% of adolescents were reported with ACEs exposure, which were slightly lower than the results of previous studies [ 17 , 25 ], but higher than the results of Qu et al in China [ 42 ]. To our knowledge, how ACEs were measured and evaluated also varied widely across Chinese ACE studies, the rate of exposure to at least one ACEs varied widely from 35.1% to 89.4% [ 17 , 25 , 42 , 43 ].…”

Section: Discussioncontrasting

confidence: 86%

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

Zhang

Wang

et al. 2023

Child Adolesc Psychiatry Ment Health

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Purpose Adolescents exposed to adverse childhood experiences (ACEs) are at increased risk for health-compromising behaviors. However, few studies have investigated how ACEs correlate with patterns of health risk behaviors (HRBs) during adolescence, a crucial developmental period. The aim was to extend the current knowledge about the relationship between ACEs and HRB patterns among adolescents, and to explore gender differences. Methods A multi-centered population-based survey was conducted in 24 middle schools in three provinces across China between 2020 and 2021. A total of 16,853 adolescents effectively completed anonymous questionnaires covering exposure to eight ACE categories and 11 HRBs. Clusters were identified using latent class analysis. Logistic regression models were utilized to test the association between them. Results There were four classes of HRB patterns: “Low all” (58.35%), “Unhealthy lifestyle” (18.23%), “Self-harm” (18.42%), and “High all” (5.0%). There were significant differences between HRB patterns in terms of the different numbers and types of ACEs in three logistic regression models. Specifically, compared to “Low all,” different types of ACEs were positively associated with the three other HRB patterns, and there were significant trends toward increase in the three latent classes of HRBs with higher ACEs. In general, females with ACEs had a higher risk of “High all” except sexual abuse than males. Conclusion Our study comprehensively considers the association between ACEs and aggregation categories of HRBs. The results support efforts to improve clinical healthcare, and future work may explore protective factors based on individual, family, and peer education to mitigate the negative trajectory of ACEs.

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Section: Discussioncontrasting

confidence: 86%

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

Zhang

Wang

et al. 2023

Child Adolesc Psychiatry Ment Health

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“…The majority (91.97%) of our study participants reported high levels of PCEs (7–9 PCEs). This is higher than rates of PCEs reported in prior studies with Chinese samples, such as Chinese primary and secondary school students ( n = 6363, 26.4% reported 6–7 PCEs [ 19 ]), Chinese elementary school students ( n = 2288, 10.8% reported 4–5 PCEs [ 20 ], and Hong Kong university students ( n = 332, 24% reported 9–10 PCEs [ 59 ]). Rates of PCEs in our sample are also higher than those reported in studies with US samples, including adults in Wisconsin ( n = 6188, 52.3% reported 6–7 PCEs [ 13 ]) and juvenile offenders in Florida ( n = 28,048, 31.97% reported 6 or more PCEs [ 17 ]).…”

Section: Discussionmentioning

confidence: 57%

“…The variations in rates of reported PCEs can be explained by the differences in sample size, participants’ characteristics, and PCEs measures used across studies. For example, Qu and colleagues as well as Bethell and colleagues (2019) used the 7-item PCE measure [ 13 , 19 ]. Zhang and colleagues (2021) developed a 5-item PCEs index based on the presence or absence of five components, including high parental education, high perceived socioeconomic status, high parental warmth, two-parent family, and high peer support, to measure PCEs [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…An emerging body of literature has demonstrated the long-term benefits of PCEs on health and well-being, such as reducing the risks of developing poor mental health (e.g., depression and anxiety) in adolescence and adulthood [ 13 , 18 , 19 , 20 ]; promoting adult relational health [ 13 ]; positive functioning [ 21 ]; and cardiovascular health in midlife [ 22 ]; and lowering the level of risky reproductive planning and prenatal stressful life events [ 23 ]. PCEs are also modifiable protective factors and can be an important source of resilience that buffers the deleterious effects of ACEs on health outcomes, such as childhood obesity [ 24 ], adolescent pregnancy [ 25 ], risky behaviors [ 26 ], mental health conditions [ 13 , 27 , 28 ], and educational attendance [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, little is known about the prevalence and impact of PCEs in mainland China. In a cross-sectional sample of 6363 Chinese primary and secondary school students aged 8–18 years, 27.2% reported 0–2 PCEs, 46.4% reported 3–5 PCEs; and 26.4% reported 6–7 PCEs [ 19 ]. This study also found that PCEs may buffer the adverse impact of ACEs on adolescent depression and anxiety.…”

Section: Introductionmentioning

confidence: 99%

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Positive Childhood Experiences Associate with Adult Flourishing Amidst Adversity: A Cross Sectional Survey Study with a National Sample of Young Adults

Wang

Chen

et al. 2022

IJERPH

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The purpose of this study was to examine the prevalence of PCEs among young adults in Mainland China and the extent to which the cumulative number of PCEs moderates the associations between ACEs and flourishing in adulthood. Between August and November 2020, we used convenience and snowball sampling to recruit 9468 young adults, ages 18–35, enrolled in undergraduate or graduate programs at universities in Mainland China to participate in a survey, which included measures on flourishing, exposure to ACEs and PCEs, and demographic characteristics. Approximately 92% of participants reported experiencing seven to nine PCEs, with harmonious family relationships (96.9%), feeling supported by friends (96.8%) and being treated fairly at school (96.3%) being the most common PCEs reported. Results of the multiple regression indicated that the cumulative number of PCEs statistically significantly moderated the relation between the cumulative number of ACEs and flourishing (interaction term b = −0.060 [−0.071, −0.049], p < 0.001, adjusted R2 = 0.183); as the number of ACEs increased up through eight ACEs, decreases in flourishing were smaller among those with higher numbers of PCEs. PCEs are common among young adults from Mainland China and serve a potential buffering effect against exposure to ACEs.

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Association between adverse childhood experiences and sleep quality, emotional and behavioral problems and academic achievement of children and adolescents

Liu

Han

et al. 2023

Eur Child Adolesc Psychiatry

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The impact of adverse childhood experiences (ACEs) on adult health has been extensively examined, but the association between ACEs and sleep, emotion, behavior and academic outcomes of children and adolescents is not well known. A total of 6363 primary and middle school students were included to examine the effect of ACEs on sleep quality, emotional and behavioral problems and academic achievement and further explore the mediation role of sleep quality and emotional and behavioral problems. Children and adolescents with ACE exposure had 1.37 times risk of poor sleep quality (adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI]: 1.21–1.55), 1.91 times risk of emotional and behavioral problems (adjusted OR = 1.91, 95%CI: 1.69–2.15) and 1.21 times risk of self-reported lower academic achievement (adjusted OR = 1.21, 95%CI: 1.08–1.36). Most types of ACEs were significantly associated with poor sleep quality, emotional and behavioral problems and lower academic achievement. There were dose-response relationships between cumulative ACE exposure and risk of poor sleep quality, emotional and behavioral problems, and lower academic achievement. Sleep quality and emotional and behavioral performance mediated 45.9% of the effect of ACEs exposure on math scores and 15.2% of the effect of ACEs exposure on English scores. Early detection and prevention of ACEs among children and adolescents are urgent and essential, and targeted interventions for sleep and emotional and behavioral performance as well as early educational interventions are recommended for children with ACEs exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s00787-023-02185-w.

show abstract

Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: Results from a cross-sectional survey

Cited by 29 publications

References 53 publications

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

Exploring associations of adverse childhood experiences with patterns of 11 health risk behaviors in Chinese adolescents: focus on gender differences

Positive Childhood Experiences Associate with Adult Flourishing Amidst Adversity: A Cross Sectional Survey Study with a National Sample of Young Adults

Association between adverse childhood experiences and sleep quality, emotional and behavioral problems and academic achievement of children and adolescents

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