Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany.

Adjustment Childhood adversity Childhood trauma Early life adversity Epidemiological Health-related quality of life Life satisfaction Representative Social participation Stress Well-being

Journal

Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702

Informations de publication

Date de publication:
10 2023
Historique:
received: 04 07 2022
revised: 17 05 2023
accepted: 25 07 2023
medline: 22 8 2023
pubmed: 1 8 2023
entrez: 1 8 2023
Statut: ppublish

Résumé

Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. A representative sample of the German population (N = 2531; M Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.

Sections du résumé

BACKGROUND
Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity.
OBJECTIVES
Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations.
METHOD
A representative sample of the German population (N = 2531; M
RESULTS
Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses.
CONCLUSIONS
This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.

Identifiants

pubmed: 37527561
pii: S0145-2134(23)00370-8
doi: 10.1016/j.chiabu.2023.106382
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106382

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

David Bürgin (D)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland. Electronic address: david.buergin@upk.ch.

Vera Clemens (V)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany.

Andreas Witt (A)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany.

Cedric Sachser (C)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany.

Andreas Jud (A)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany.

Elmar Brähler (E)

Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.

Bernhard Strauß (B)

Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany.

Katja Petrowski (K)

Medical Psychology and Medical Sociology, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.

Marc Schmid (M)

University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland.

Jörg M Fegert (JM)

Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany.

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