Associations between adverse childhood experiences and adverse health outcomes among adolescents in Bangkok, Thailand

Abstract

The association of adverse childhood experiences (ACEs) on health outcomes has garnered attention as a public health concern. The present study aimed to examine the prevalence and associations between ACEs and adverse health outcomes among adolescents. In 2017, a cross-sectional study was conducted to identify the retrospective prevalence of ACEs and their association with adverse health conditions. A total of 2,058 adolescents completed the on-line questionnaire. Exposures included psychological, physical, and sexual forms of abuse, neglect and violence as well as household dysfunction. Main outcome measures included sexual behavior, drinking, illegal drug use, smoking, depression, and anxiety. Multiple logistic regression assessed the independent relationship between individual ACEs, ACE score categories, and adverse health conditions in adolescents, while controlling for covariates. A total of 51.4 % of respondents reported at least one ACE and 12.2% reported three or more ACEs. A score of >3 ACEs was associated with increased odds of experiencing high anxiety (AOR = 3.91, 95%CI = 2.92,5.25), high depression (AOR = 4.02, 95%CI = 3.00,5.38), sexual experience (AOR = 3.12, 95%CI = 2.23,4.37), binge drinking (AOR = 3.32, 95%CI = 1.74,3.08), smoking (AOR = 3.14, 95%CI = 2.31,4.28), and illegal drug use (AOR = 2.59, 95%CI = 1.80,3.67). The study found a link between exposure to multiple ACEs and anxiety, depression, alcohol use, tobacco use, and illicit drug use. In addition, the individual ACEs had different effects on adverse health conditions. Finally, the individual ACEs had different effects on adverse health outcome. In addition to having a cumulative effect, individual ACE components have differential effects on adverse health outcome, after controlling for important confounders.