OBJECTIVE Adverse childhood experiences (ACEs) are preventable, potentially traumatic events with lifelong negative impacts. Population-level data on ACEs among adolescents have historically relied on parent reports and excluded abuse-related ACEs. We present the self-reported prevalence of ACEs among a large population-based sample of US high school students. METHODS Using cross-sectional, state-representative data from 16 states that included core ACE questions on their 2021 Youth Risk Behavior Survey, we estimate the prevalence of 8 individual (lifetime emotional, physical, or sexual abuse, physical neglect, witnessed intimate partner violence, household substance use, household poor mental health, incarcerated parent or guardian) and cumulative ACEs (0, 1, 2-3, ≥4) among a large population-based sample of adolescents, overall and by demographic characteristics (sex, race and ethnicity, age, sexual orientation). RESULTS Emotional abuse (65.8%), household poor mental health (36.1%), and physical abuse (32.5%) had the highest prevalence. ACEs were very common, with 80.5% of adolescents experiencing at least 1 ACE and 22.4% experiencing ≥4 ACEs. Experiencing ≥4 ACEs was highest among adolescents who were female (27.7%), non-Hispanic multiracial (33.7%), non-Hispanic American Indian or Alaska Native (27.1%), gay or lesbian (36.5%), bisexual (42.1%), or who described their sexual identity some other way or were not sure of their sexual identity (questioning) (36.5%). CONCLUSIONS Self-reported ACE estimates among adolescents exceed previously published parent-reported estimates. ACEs are not equally distributed, with important differences in individual and cumulative ACEs by demographic characteristics. Collecting ACE data directly from adolescents at the state level provides actionable data for prevention and mitigation.

中文翻译：

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青少年童年不良经历的普遍性。


目的 不良童年经历 （ACE） 是可预防的、具有潜在创伤性的事件，具有终生的负面影响。青少年 ACE 的人群水平数据历来依赖于父母的报告，并排除了与虐待相关的 ACE。我们介绍了美国高中生大量人群样本中自我报告的 ACE 患病率。方法 使用来自 16 个州的横断面、具有州代表性的数据，这些数据包括其 2021 年青少年风险行为调查中的核心 ACE 问题，我们估计了 8 个人（终生情感、身体或性虐待、身体忽视、目睹亲密伴侣暴力、家庭药物使用、家庭心理健康状况不佳、父母或监护人被监禁）和累积 ACE（0、1、2-3、 ≥4） 在基于人口的大型青少年样本中，总体和人口特征（性别、种族和民族、年龄、性取向）。结果 情感虐待 （65.8%） 、家庭心理健康状况不佳 （36.1%） 和身体虐待 （32.5%） 的发生率最高。ACE 非常常见，80.5% 的青少年至少经历 1 次 ACE，22.4% 的青少年经历≥ 4 次 ACE。女性 （27.7%）、非西班牙裔多种族 （33.7%）、非西班牙裔美洲印第安人或阿拉斯加原住民 （27.1%）、男同性恋或女同性恋 （36.5%）、双性恋 （42.1%） 或以其他方式描述其性身份或不确定其性身份（质疑）（36.5%）的青少年中经历 ≥4 ACE 最高。结论 青少年自我报告的 ACE 估计值超过了以前发表的父母报告的估计值。ACE 的分布并不均匀，按人口统计特征划分的单个 ACE 和累积 ACE 存在重要差异。 直接从州一级的青少年那里收集 ACE 数据为预防和缓解提供了可操作的数据。