A sizeable literature shows that adverse childhood experiences (ACEs) are associated with poor health outcomes in later life. However, most studies on the prevalence and predictors of ACEs have been carried out in high-income countries using cross-sectional approaches. The present study explores the prevalence and predictors of ACEs in Malawi, a low-income country, using prospective longitudinal data collected on adolescents. We use data on 1375 adolescents and their biological mothers from the (MLSFH). ACEs were reported by adolescents over two survey waves, in 2017–18 and 2021. Predictors were reported by mothers in 2008 and 2010. Multivariate ordinary least square and logistic regression analyses of ACEs exposure reported by adolescents on indicators of family arrangements and resources. Adolescents report having been exposed to nearly seven ACEs on average. Among indicators of family arrangements and resources, the only significant predictors of cumulative ACEs exposure are polygyny (linked to parental absence) and mother's SF-12 mental health score (linked to physical abuse and witnessing domestic violence). ACEs are much more prevalent in the low-income country under study than in middle- and high-income countries surveyed in prior research. Despite adversity being widespread, most indicators of family arrangements and resources highlighted in prior studies are not associated with adolescents' cumulative ACEs exposure in this context. Mothers' mental health in childhood nevertheless emerges as a significant predictor of adolescents' self-reported ACEs. These findings inform efforts aimed at preventing ACEs in high-adversity contexts.

中文翻译：

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不良童年经历的患病率和早期生活预测因素：来自低收入国家的纵向见解


大量文献表明，不良的童年经历（ACE）与以后生活中不良的健康结果有关。然而，大多数关于 ACE 患病率和预测因素的研究都是在高收入国家使用横断面方法进行的。本研究利用收集到的青少年前瞻性纵向数据，探讨了低收入国家马拉维 ACE 的患病率和预测因素。我们使用来自 (MLSFH) 的 1375 名青少年及其亲生母亲的数据。青少年在 2017-18 年和 2021 年的两轮调查中报告了 ACE。预测变量由母亲在 2008 年和 2010 年报告。根据家庭安排和资源指标，对青少年报告的 ACE 暴露进行多元普通最小二乘和逻辑回归分析。青少年报告平均接触过近七种 ACE。在家庭安排和资源指标中，累积 ACE 暴露的唯一显着预测因素是一夫多妻制（与父母缺席有关）和母亲的 SF-12 心理健康评分（与身体虐待和目睹家庭暴力有关）。 ACE 在所研究的低收入国家中比在先前研究中调查的中高收入国家中更为普遍。尽管逆境普遍存在，但先前研究中强调的大多数家庭安排和资源指标与青少年在此背景下累积的 ACE 暴露无关。然而，母亲在儿童时期的心理健康状况已成为青少年自我报告的 ACE 的重要预测因素。这些发现为旨在预防高逆境环境中的 ACE 的努力提供了信息。