Abstract
Association of childhood adversities with psychosocial difficulties among Chinese children and adolescents
Li, Y., Shang, Y., Yang, Y., Hou, C., Yang, H., Hu, Y., ... & Zhang, W.
Background: Adverse childhood experiences (ACEs) have been well recognized as risk factors for various adverse outcomes. However, the
impacts of ACEs on psychological wellbeing among Chinese children and adolescents are unknown.
Methods: In total, 27 414 participants (6592 Grade 4–6 and 20 822 Grade 7–12 students) were included and information on ACEs and various
psychosocial outcomes was collected. We identified subgroups with distinct psychosocial statuses using cluster analysis and logistic regression
was applied to measure the associations of ACEs [individual, cumulative numbers by categories or co-occurring patterns identified by using
multiple correspondence analysis (MCA)] with item- and cluster-specific psychosocial difficulties.
Results: Three and four cluster-based psychosocial statuses were identified for Grade 4–6 and Grade 7–12 students, respectively, indicating that
psychosocial difficulties among younger students were mainly presented as changes in relationships/behaviours, whereas older students were
more likely featured by deviations in multiple domains including psychiatric symptoms and suicidality. Strongest associations were found for
threat-related ACEs (e.g. bullying experiences) with item- or cluster-based psychosocial difficulties (e.g. for cluster-based difficulties, the highest
odds ratios ¼ 1.72–2.08 for verbal bullying in Grade 4–6 students and 6.30–12.81 for cyberbullying in Grade 7–12 students). Analyses on
cumulative numbers of ACEs and MCA-based ACE patterns revealed similar risk patterns. Additionally, exposure patterns predominated by poor
external environment showed significant associations with psychosocial difficulties among Grade 7–12 students but not Grade 4–6 students.
Conclusions: Chinese adolescents faced different psychosocial difficulties that varied by age, all of which were associated with ACEs,
particularly threat-related ACEs. Such findings prompt the development of early interventions for those key ACEs to prevent psychosocial
adversities among children and adolescents.