Adverse Child Experiences and Their Effects on Child Behavior and Mental Health
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Background: The association between Adverse Child Exposures (ACEs) and risk for child mental health outcomes such as depression, anxiety problems, and behavior/conduct problems has not been thoroughly investigated for three age groups - ages 6 to 10 (elementary school), ages 11 to 13 (middle school), and ages 14 to 17 (high school). We examined the relationship of these three mental health outcomes with a variety of ACEs among children 6 to 17 years old. We also examined the prevalence of ACEs for each mental health outcome in order to better understand the nature of any influential exposures. Methods: National Survey of Children’s Health 2011-2012 dataset was used to investigate nine ACEs: socioeconomic hardship, divorce/separation of parent, death of a parent, parent served time in jail, witness to domestic violence, victim of neighborhood violence, lived with someone who was mentally ill or suicidal, lived with someone with an alcohol/drug problem, and treated or judged unfairly due to race/ethnicity. Total number of ACE exposures were categorized cumulatively into 5 classes: 0, 1, 2, 3, ≥4. They were then compared with the three child mental health outcomes: depression, anxiety problems, and behavior/conduct problems. Results: A dose response relationship was observed between each of the child mental health outcomes and the number of ACEs for the full model (where age groups are included as a co-variable). The odds for depression in the full model increases by 2.59, 3.08, 6.24, and 9.66 for those exposed to 1, 2, 3, or 4 or more ACEs respectively, when compared to those who had not been exposed to an ACE. Children with 1, 2, 3, or 4 or more ACEs were 2.01, 2.28, 2.88, and 5.45 times more likely to have anxiety problems, respectively. Children with 1, 2, 3, or 4 or more ACEs were 3.21, 3.80, 6.96, and 10.51 times more likely to have behavior/conduct problems, respectively. Conclusion: A dose response relationship was observed between the number of ACEs and risk of developing each of the examined child mental health outcomes (depression, anxiety problems, and behavior/conduct problems). Further examination of relationships between specific ACEs and the chosen mental health outcomes may help researchers identify significant or influential combinations of ACE risk factors.