Rachel Kidman1, Dylan Smith2, Luciane R Piccolo3, Hans-Peter Kohler4. 1. Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States. Electronic address: rachel.kidman@stonybrookmedicine.edu. 2. Program in Public Health and Department of Family, Population and Preventive Medicine, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States. 3. Program in Public Health, HSC Level 3, Stony Brook University (State University of New York), Stony Brook, NY 11794, United States. 4. Department of Sociology and Population Studies Center, University of Pennsylvania, 3718 Locust Walk (272 McNeil Building), Philadelphia, PA 19104-6298, United States.
Abstract
BACKGROUND: Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). OBJECTIVE: In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. PARTICIPANTS AND SETTING: Four hundred and ten adolescents (age 10-16 years old) from Malawi. METHODS: The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). RESULTS: Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01). CONCLUSION: Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.
BACKGROUND: Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). OBJECTIVE: In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. PARTICIPANTS AND SETTING: Four hundred and ten adolescents (age 10-16 years old) from Malawi. METHODS: The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). RESULTS: Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities ("last year" in addition to "ever") modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01). CONCLUSION: Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.
Authors: Maxia Dong; Robert F Anda; Vincent J Felitti; Shanta R Dube; David F Williamson; Theodore J Thompson; Clifton M Loo; Wayne H Giles Journal: Child Abuse Negl Date: 2004-07
Authors: Shanta R Dube; Vincent J Felitti; Maxia Dong; Daniel P Chapman; Wayne H Giles; Robert F Anda Journal: Pediatrics Date: 2003-03 Impact factor: 7.124
Authors: Shanta R Dube; Jacqueline W Miller; David W Brown; Wayne H Giles; Vincent J Felitti; Maxia Dong; Robert F Anda Journal: J Adolesc Health Date: 2006-04 Impact factor: 5.012
Authors: Adam J Zolotor; Desmond K Runyan; Michael P Dunne; Dipty Jain; Helga R Péturs; Clemencia Ramirez; Elena Volkova; Sibnath Deb; Victoria Lidchi; Tufail Muhammad; Oksana Isaeva Journal: Child Abuse Negl Date: 2009-10-25
Authors: Francis B Annor; Leah K Gilbert; Evelyn P Davila; Greta M Massetti; Howard Kress; Dennis Onotu; Obinna Ogbanufe Journal: Child Abuse Negl Date: 2020-05-21
Authors: Scholastic Ashaba; Bernard Kakuhikire; Charles Baguma; Emily N Satinsky; Jessica M Perkins; Justin D Rasmussen; Christine E Cooper-Vince; Phionah Ahereza; Patrick Gumisiriza; Justus Kananura; David R Bangsberg; Alexander C Tsai Journal: SSM Ment Health Date: 2022-01-29
Authors: Emily N Satinsky; Bernard Kakuhikire; Charles Baguma; Justin D Rasmussen; Scholastic Ashaba; Christine E Cooper-Vince; Jessica M Perkins; Allen Kiconco; Elizabeth B Namara; David R Bangsberg; Alexander C Tsai Journal: PLoS Med Date: 2021-05-12 Impact factor: 11.069
Authors: Katherine LeMasters; Lisa M Bates; Esther O Chung; John A Gallis; Ashley Hagaman; Elissa Scherer; Siham Sikander; Brooke S Staley; Lauren C Zalla; Paul N Zivich; Joanna Maselko Journal: BMC Public Health Date: 2021-02-25 Impact factor: 3.295