Measurement of Adverse Childhood Experiences: It Matters.

Autor: Reidy DE; School of Public Health, Georgia State University, Atlanta, Georgia; Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia. Electronic address: dreidy@gsu.edu., Niolon PH; Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Estefan LF; Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Kearns MC; Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., D'Inverno AS; Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Marker CD; College of Health Professions, Mercer University, Atlanta, Georgia., Merrick MT; Prevent Child Abuse America, Chicago, Illinois.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2021 Dec; Vol. 61 (6), pp. 821-830. Date of Electronic Publication: 2021 Sep 04.
DOI: 10.1016/j.amepre.2021.05.043
Abstrakt: Introduction: Alternative measurement approaches for adverse childhood experiences (i.e., count score versus individual adverse childhood experiences measured dichotomously versus individual adverse childhood experiences measured ordinally) can alter the association between adverse childhood experiences and adverse outcomes. This could significantly impact the interpretation of adverse childhood experiences research.
Methods: Data were collected in 2018 (analyzed in 2020) via Amazon's Mechanical Turk and from people incarcerated in 4 correctional facilities (N=1,451). Included adverse childhood experience questions measured the following: physical, emotional, and sexual abuse; physical and emotional neglect; household mental illness, substance use, domestic violence, and incarceration; and exposure to community violence before age 18 years. A total of 19 measured outcomes spanned 4 domains of functioning: general functioning, substance use, psychopathology, and criminal behavior.
Results: Regression models using the count score explained the least amount of variance in outcomes, whereas multivariable regression models assessing adverse childhood experiences on a continuum explained the most variance. In many instances, the explained variance increased by 2-5 times across the predictive models. When comparing regression coefficients for multivariable regression models that measured adverse childhood experiences as binary versus ordinal, there were notable differences in the effect sizes and in which adverse childhood experiences predicted outcomes. Disparities in results were most pronounced among high-risk populations that experience a disproportionate amount of adverse childhood experiences.
Conclusions: Alternative methods of measuring adverse childhood experiences can influence understanding of their true impact. These findings suggest that the deleterious effects of imprecise measurement methods may be most pronounced in the populations most at risk of adverse childhood experiences. For the sake of prevention, the measurement of adverse childhood experiences must evolve.
(Copyright © 2021 American Journal of Preventive Medicine. All rights reserved.)
Databáze: MEDLINE
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