Adverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia

doi:10.1016/j.chiabu.2016.09.003

Child Abuse & Neglect

Volume 60, October 2016, Pages 10-17

https://doi.org/10.1016/j.chiabu.2016.09.003 Get rights and content

Abstract

Background

The aim of this study is to determine if ACEs impact the health and risk behavior burden among Kingdom of Saudi Arabia (KSA) adults. Methods: In 2013, a cross-sectional study was conducted across KSA to identify the retrospective prevalence of ACEs and their association with high risk behaviors and chronic diseases. Surveys from 10,156 adults in all 13 Saudi regions were obtained using an Arabic version of the WHO ACE-IQ (KSA ACE-IQ).

Results

Compared to respondents reporting no ACEs, even just one ACE contributed significantly to the odds of experiencing diabetes mellitus (OR = 1.3), depression (OR = 1.32), or anxiety (OR = 1.79) outcomes. Two ACEs were necessary for statistically significant, higher odds to emerge for hypertension (OR = 1.46), mental illness (OR = 1.93), smoking (OR = 1.17), alcohol use (OR = 1.75), and drug use (OR = 1.45). Respondents who reported four or more ACEs had greater odds of coronary heart disease (OR = 1.94), and obesity (OR = 2.25). Compared to those reporting no ACEs, respondents reporting four or more ACEs had over four times the odds of Alcohol or Drug Use, Mental Illness, Depression, and/or Anxiety outcomes and more than twice the odds of diabetes, hypertension, obesity, and/or smoking outcomes.

Conclusion

Findings from this analysis underscore the potential benefit of providing focused preventative approaches to mitigating ACEs in KSA in relation to both the specific and cumulative burden of health and risky behavior outcomes.

Section snippets

Background

Childhood abuse and traumatic stressors have been linked to an increased risk of severe cognitive, behavioral, health, and social problems through the Adverse Childhood Experiences (ACEs) Study (Felitti et al., 1998). To date, relatively few studies have examined ACEs in an international context and their relevance to health and risky behavior outcomes in the Kingdom of Saudi Arabia (KSA) are unknown. This paper provides the first analysis of the impact of Adverse Childhood Experiences (ACEs)

Participants

In 2013, a cross-sectional study of adults aged 18 or older was conducted across Saudi Arabia to identify the retrospective prevalence of adverse childhood experiences and their association with current high risk behaviors and chronic diseases. Surveys were collected from 10,156 adults in all 13 Saudi administrative regions (i.e. entire KSA) and 182 different locations. The cities in which the survey was implemented were randomly selected after stratifying large and small cities within each

Results

Table 1 summarizes the sample’s characteristics. All respondents were Saudi nationals; most were from urban areas and the largest proportion hailed from either Riyadh or Makkah Region (25.6% and 22.5% respectively). Respondents ages ranged from 18 to 88 years old and the median age was 32 years (M = 34, SD = 11). More respondents were male (52.1%), had completed either college, university or graduate studies (41.3%), and were most likely to identify as married (58.7%). Compared to available census

Discussion

This research presents the results of a national survey of over 10,000 Saudi Arabian nationals regarding adverse child experiences (ACEs) and health, mental health and risky behavior. The findings regarding the influence of ACEs on these outcomes suggest that there are important, long-term, and widespread health and especially behavioral health implications associated with childhood maltreatment experiences.

First, as observed in studies elsewhere in the world (Anda et al., 2006; Björkenstam et

Conclusion

Like studies conducted elsewhere in the world, this research reaffirms that as ACEs increase so do adjusted odds of poor physical, mental and behavioral health outcomes. Since ACEs are stressful and have been found to be linked to chronic diseases in adulthood, this study helps to clarify that prevention efforts are needed in order to reduce risk factors associated with child maltreatment in KSA. First, as parents, caregivers, and other relatives are primarily responsible for child

Acknowledgements

This research is supported by a grant from King Abdullah International Medical Research Center (KAIMRC) in Saudi Arabia, the authors would like to thank Ms. Nahrain Quiambao for administrative support and assistance for the preparation of the manuscript.

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Citation Excerpt :
Compared to respondents without ACEs, those who reported even one ACE had significantly amplified probabilities of mental illness, depression, or anxiety. Those reporting four or more ACEs had an increased probability of mental illness of more than four times (Almuneef et al., 2016). ACEs have been implicated in unhealthy behaviors such as alcohol abuse (Anda et al., 2002; Rothman et al., 2008; Almuneef et al., 2014; Allem et al., 2015), and could remarkably boost health expenditures and the risk of debt (Schickedanz et al., 2019).
Numerous people have suffered adverse childhood experiences (ACEs) that can have lasting negative consequences. However, few studies have focused on maternal ACEs' effect on their children's health. This study aimed to evaluate the impact on children's health of ACEs that their mothers experienced.
Data from the China Health and Retirement Longitudinal Study (CHARLS) 2018 combined with the CHARLS 2014 Life History Survey were analyzed. The logistic regression was used to investigate maternal ACEs' impact on their children's health. Based on the stepwise regression model and bias-corrected bootstrap, we estimated the mediating effects.
Maternal ACEs could result in harm to the health of children (P < 0.05). If the types of maternal ACEs increased by one unit, the odds ratio of their children's poor health would rise by 9.6 %. Moreover, if the types of maternal ACEs increased by one unit, the odds ratio of daughters' and sons' poor health would increase by 8.3 % and 10.2 %, respectively. Three mediating mechanisms of mothers' education, physical health, and mental health were confirmed by empirical tests.
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Research articleAdverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia

Abstract

Background

Results

Conclusion

Section snippets

Background

Participants

Results

Discussion

Conclusion

Acknowledgements

Child Abuse Neglect

Child Abuse Neglect

American Journal of Preventive Medicine

American Journal of Preventive Medicine

Child Abuse Neglect

American Journal of Preventive Medicine

Women Health in Saudi Arabia: A review of non-communicable diseases and their risk factors

Pakistan Journal of Medical Sciences

Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression

Psychiatric Services

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European Archives of Psychiatry and Clinical Neuroscience

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Multi-exposure and clustering of adverse childhood experiences, socioeconomic differences and sychotropic medication in young adults

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Research article
Adverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia