Associations Between Adverse Childhood Experiences, High-Risk Behaviors, and Morbidity in Adulthood. Am J Prev Med 2016 Mar;50(3):344-352
Date
10/18/2015Pubmed ID
26474668Pubmed Central ID
PMC4762720DOI
10.1016/j.amepre.2015.07.022Scopus ID
2-s2.0-84958162302 (requires institutional sign-in at Scopus site) 451 CitationsAbstract
INTRODUCTION: Adverse childhood experiences (ACEs) are associated with early mortality and morbidity. This study evaluated the association among ACEs, high-risk health behaviors, and comorbid conditions, as well as the independent effect of ACE components.
METHODS: Data were analyzed on 48,526 U.S. adults from five states in the 2011 Behavioral Risk Factor Surveillance System survey. Exposures included psychological, physical, and sexual forms of abuse as well as household dysfunction such as substance abuse, mental illness, violence, and incarceration. Main outcome measures included risky behaviors and morbidity measures, including binge drinking, heavy drinking, current smoking, high-risk HIV behavior, obesity, diabetes, myocardial infarction, coronary heart disease, stroke, depression, disability caused by poor health, and use of special equipment because of disability. Multiple logistic regression assessed the independent relationship between ACE score categories and risky behaviors/comorbidities in adulthood, and assessed the independent relationship between individual ACE components and risky behaviors/comorbid conditions in adulthood controlling for covariates.
RESULTS: A total of 55.4% of respondents reported at least one ACE and 13.7% reported four or more ACEs. An ACE score ≥4 was associated with increased odds for binge drinking, heavy drinking, smoking, risky HIV behavior, diabetes, myocardial infarction, coronary heart disease, stroke, depression, disability caused by health, and use of special equipment because of disability. In addition, the individual components had different effects on risky behavior and comorbidities.
CONCLUSIONS: In addition to having a cumulative effect, individual ACE components have differential relationships with risky behaviors, morbidity, and disability in adulthood after controlling for important confounders.
Author List
Campbell JA, Walker RJ, Egede LEAuthors
Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of WisconsinLeonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Adult Survivors of Child Adverse Events
Aged
Behavioral Risk Factor Surveillance System
Child
Child Abuse
Cross-Sectional Studies
Depression
Disabled Persons
Female
Humans
Logistic Models
Male
Middle Aged
Morbidity
Risk-Taking
Smoking
Substance-Related Disorders
Surveys and Questionnaires
United States
