Adverse Childhood Experiences Of Xinjiang College Students And Associations With Mental Health And Health-harming Behaviors In Early Adulthood

Objectives: Children are the hope of the family,the future of our motherland.As social vulnerable groups,phenomenon of children treated by neglect,abuse,and the status of the family dysfunction is a long-standing in the process of their growth.Adverse childhood experiences will not only cause instant manifestation of children’s body and mental trauma,but also long-term harms.China has the largest number of children in the world.Due to the imbalance of economic development,problem of left-behind children by migrant workers of the agricultural population,the big differences between rural and urban areas,influence of traditional ideas as well as special family planning policy,has made ACEs problem more serious and complicated.This research explored to develop suitable screening scale for ACEs on the basis of modified ACEs scale recommended by CDC.Based on the cross-sectional study,we mainly retrospectively examined the prevalence rate of different adverse childhood experiences among college students in Xinjiang Medical University.We explore association among various ACEs and different health outcomes in adult,including the adult psychological and health risk behaviors and conditions.We also evaluate the cumulative effect of what ? between different ACEs and health outcomes.Methods: 1)6800 college students from ten different colleges were chosen by stratified cluster sampling and investigated by ACEs questionnaire.2)We collected data about ACEs status,health risk behaviors and mental health in adulthood.Results: 1)Item analysis results showed that the Chinese version of ACEs scale discrimination of each item was high in overall,and in different levels of subjects.Exploratory factor analysis and confirmatory factor analysis showed good structure validity of Chinese version of ACEs scale.The cronbach α coefficient and Split-half coefficients of ACEs scale and ten different subscales were above 0.700.Correlation coefficients after repeated measuring ranged 0.812～0.914,indicating good validity and reliability of Chinese ACEs scale,which can be used for the screening of ACEs.2)The incidence of adverse childhood experience of Xinjiang college students is 68.8%.The incidence of ten different types of adverse childhood experiences are 6.7%～33.9%,the commest one is substance abuse in home.The coexistence phenomenon of all kinds of ACE is widespread.Unconditioned logistic regression model after adjustment of the influence of other variables shows that,risk of appearing ACE in female college student is 0.654(0.578～0.740)times as one of male college student.Mother’s age at delivery affect the comprehensive situation of ACE.Subjects were classified into 4 groups based on their mother’s age at delivery,groups 1 to 4 for maternal age of～-20 years,20～ years,30～years,and 40～ years.Compared with group 1,the risk of appearing ACE of college students in group 1 is 0.384(0.268～0.551)for group2,0.415(0.280～0.616)for group3,and 0.497(0.312～0.792)for group 4.After the adjustment of other variables,risk of ACE is 0.777(0.665～0.909)in college students whose mother with junior middle school educaiton,0.772(0.640～0.932)for students whose mother with high school education,compared with students whose mother had lower education.After the adjustment of the influence of other variables,risk of appearing ACE were 0.487(0.359～0.661),0.462(0.342～0.624)and 0.475(0.350～0.646)for students with number of family member of 3,4 and 5 compared with those with only 2 family members.The risk of ACE is 2.249(1.655～3.623)in college students with poor self-reported mental health status compared with students with excellent self-reported mental health status.3)11.8% of the subjects were overweight or obese.24.6% of subjects reported never or almost no exercise.22.9% of students were smokers,the rate is 18.5% and 16.2% for current smokers and ever smokers.13.44% of subjects reported drunk at least once,3.8% of subjects reported used drugs,14.9% of subjects reported had sexual behavior before the age of 18.After adjusting by age,gender,nationality,students,parents educational level,family income,etc,it showed signiciant does relationship between ACEs score and health risk behaviors(conditions),such as lack of exercise,smoking,drinking,drug use,early sexual behavior.4)The detection rate of mental problem is 38.7%.The incidence of recent depression,Prolonged depression and anxiety was 21.5%,32.4%,,and 9.9% respectively.14.4% of subjects had suicidal thoughts;4.7% of subjects reported committed suicide.After adjusting by age,gender,nationality,students,parents educational level,family income,etc,the adult psychological problems,recent depression,long-term depression and anxiety,linearly increase with ACEs score.Conclusions: 1)Chinese ACEs scale has good reliability and validity,can be used for the screening of ACEs.2)ACEs is common in XinJiang college students,varying by demographic suggroups.ACEs is less common in male,ethnic minorities,mother delivered at younger age,and students from the rural cadastral,but more common in in students from single-parent family.3)After adjusting by age,gender,nationality,students,parents educational level and family income,ACEs score increase with health risk behaviors(conditions),such as lack exercise,smoking,drinking,drug use,early sexual behavior,showing obvious dose response relationship.