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  • Karen Hughes
    Public Health Wales, WHO Collaborating Centre on Investment for Health and Well-being, Wrexham, UK.College of Human Sciences, Bangor University, Wrexham, UK.
  • Mark A Bellis
    Public Health Wales, WHO Collaborating Centre on Investment for Health and Well-being, Wrexham, UK.College of Human Sciences, Bangor University, Wrexham, UK.
  • Dinesh Sethi
    Division of Non-Communicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark.
  • Rachel Andrew
    Public Health Wales, WHO Collaborating Centre on Investment for Health and Well-being, Wrexham, UK.
  • Yongjie Yon
    Division of Non-Communicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, Copenhagen, Denmark.
  • Sara Wood
    Public Health Wales, WHO Collaborating Centre on Investment for Health and Well-being, Wrexham, UK.
  • Kat Ford
    College of Human Sciences, Bangor University, Wrexham, UK.
  • Adriana Baban
    Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania.
  • Larisa Boderscova
    WHO Country Office, Chisinau, Republic of Moldova.
  • Margarita Kachaeva
    Forensic Psychiatric Department, V. Serbsky Federal Medical Research Centre for Psychiatry and Narcology, Ministry of Health, Moscow, Russian Federation.
  • Katarzyna Makaruk
    Empowering Children Foundation, Warsaw, Poland.
  • Marija Markovic
    Centre for Promotion of Health, Institute of Public Health of Belgrade, Belgrade, Serbia.
  • Robertas Povilaitis
    Institute of Psychology, Vilnius University, Vilnius, Lithuania.
  • Marija Raleva
    University Clinic of Psychiatry, School of Medicine-Skopje, Skopje, Republic of Macedonia.
  • Natasa Terzic
    Center for Health System Development, Institute of Public Health of Montenegro, Podgorica, Montenegro.
  • Milos Veleminsky
    Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, České Budějovice, Czech Republic.
  • Joanna Włodarczyk
    Empowering Children Foundation, Warsaw, Poland.
  • Victoria Zakhozha
    Kiev International Institute of Sociology, Kyiv, Ukraine.

BACKGROUND: Adverse childhood experiences (ACEs) can increase risks of health-harming behaviours and poor health throughout life. While increases in risk may be affected by resilience resources such as supportive childhood relationships, to date few studies have explored these effects.

METHODS: We combined data from cross-sectional ACE studies among young adults (n = 14 661) in educational institutions in 10 European countries. Nine ACE types, childhood relationships and six health outcomes (early alcohol initiation, problem alcohol use, smoking, drug use, therapy, suicide attempt) were explored. Multivariate modelling estimated relationships between ACE counts, supportive childhood relationships and health outcomes.

RESULTS: Almost half (46.2%) of participants reported ≥1 ACE and 5.6% reported ≥4 ACEs. Risks of all outcomes increased with ACE count. In individuals with ≥4 ACEs (vs. 0 ACEs), adjusted odds ratios ranged from 2.01 (95% CIs: 1.70-2.38) for smoking to 17.68 (95% CIs: 12.93-24.17) for suicide attempt. Supportive childhood relationships were independently associated with moderating risks of smoking, problem alcohol use, therapy and suicide attempt. In those with ≥4 ACEs, adjusted proportions reporting suicide attempt reduced from 23% with low supportive childhood relationships to 13% with higher support. Equivalent reductions were 25% to 20% for therapy, 23% to 17% for problem drinking and 34% to 32% for smoking.

CONCLUSIONS: ACEs are strongly associated with substance use and mental illness. Harmful relationships are moderated by resilience factors such as supportive childhood relationships. Whilst ACEs continue to affect many children, better prevention measures and interventions that enhance resilience to the life-long impacts of toxic childhood stress are required.

Iaith wreiddiolSaesneg
Tudalennau (o-i)741-747
Nifer y tudalennau7
CyfnodolynEuropean Journal of Public Health
Cyfrol29
Rhif y cyfnodolyn4
Dyddiad ar-lein cynnar20 Maw 2019
Dynodwyr Gwrthrych Digidol (DOIs)
StatwsCyhoeddwyd - 1 Awst 2019
Cyhoeddwyd yn allanolIe
Gweld graff cysylltiadau