Adverse Child Experiences and Their Effects on Child Behavior and Mental Health




Pulvino, Steven
Mbise-Floyd, Lilian
Patel, Neha
Patel, Tarang
Davis, Ann
Homan, Sharon


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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.


Research Appreciation Day Award Winner - 2015 School of Public Health & Public Health Student Association - 1st Place Poster Presentation