dissertation
Mina Brajović (Author), Lijana Zaletel-Kragelj (Mentor), Igor Švab (Thesis defence commission member), Genc Burazeri (Thesis defence commission member), Jerneja Farkaš-Lainščak (Thesis defence commission member), Mark Bellis (Co-mentor)

Abstract

Background. Adverse childhood experiences (ACEs) represent a common pathway to increased risk of unhealthy behaviours, disease, disability and premature mortality. The aim of the study was to estimate the prevalence of the ACEs in the observed SEE countries and compare it among them; to develop composite indicator/s for measuring ACEs to be used in analysis of health inequalities, and to define multivariate models by which relationship between health-related outcomes and ACEs, adjusted to selected confounding factors could be explained. Methods. The data were collected in 2010-2012 in cross-sectional studies in Montenegro and Romania. The international ACE Study Questionnaires were used as a base for study instruments. Association between ACEs and suicidal behaviour (SB), alcohol use (AU), drug use (DU), smoking and physical inactivity (PIA) was assessed,, adjusted to confounders (country, participants’ gender and age, and participants’ parents’ education level and employment status). The main method used for univariate and multivariate analysis was logistic regression. Results. Prevalence of individual ACEs ranged considerably. In the child maltreatment group the highest share of respondents reported they were victims of physical abuse as they were frequently spanked (34.6%), while in the household dysfunction group the most reported ACE was life with a problematic drinker or alcoholic (17.2%). Only 971/2575 (37.7%) participants didn’t experience any ACE type. The study confirmed some individual ACEs are more relevant as magnitude of their negative effect on health is more powerful compared to others. Consequently, cumulative effect of multiple ACEs is heavily determined also by nature of the individual ACEs and not only by their number. Conclusion. The observed health harmful behaviours are more prevalent in victims of early childhood adversities compared to those who were not exposed to ACE. Impact of exposure to ACEs in terms of all observed harmful behaviours, persist into emerging adulthood. Harmful impact of early adversities on respondents’ health measured through harmful behaviours and its strength varies considerably. The study also confirmed that the more ACE types that respondents experienced, the greater their risks of harmful behaviours. Some individual adverse childhood experiences are more relevant as magnitude of their negative impact on health is more powerful compared to others. Outcomes are strongly related to intensity of ACEs or some unique combinations and not only to total number of exposure. Consequently, weight of cumulative effect of multiple ACEs is heavily determined by nature of the individual ACEs and not only by the number.

Keywords

javno zdravje;otroštvo;trpinčenje otrok;mladi odrasli;tvegano vedenje;samomorilno vedenje;odvisnosti;telesna neaktivnost;Črna gora;Romunija;

Data

Language: English
Year of publishing:
Typology: 2.08 - Doctoral Dissertation
Organization: UL MF - Faculty of Medicine
Publisher: [M. Brajović]
UDC: 343.62-053.2:613.97(4-12)(043.3)
COBISS: 19783171 Link will open in a new window
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Downloads: 302
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Other data

Secondary language: Slovenian
Secondary title: Vpliv neugodnih izkušenj v otroštvu na zdravje mladih odraslih v Jugovzhodni Evropi
Secondary abstract: Background. Adverse childhood experiences (ACEs) represent a common pathway to increased risk of unhealthy behaviours, disease, disability and premature mortality. The aim of the study was to estimate the prevalence of the ACEs in the observed SEE countries and compare it among them; to develop composite indicator/s for measuring ACEs to be used in analysis of health inequalities, and to define multivariate models by which relationship between health-related outcomes and ACEs, adjusted to selected confounding factors could be explained. Methods. The data were collected in 2010-2012 in cross-sectional studies in Montenegro and Romania. The international ACE Study Questionnaires were used as a base for study instruments. Association between ACEs and suicidal behaviour (SB), alcohol use (AU), drug use (DU), smoking and physical inactivity (PIA) was assessed,, adjusted to confounders (country, participants’ gender and age, and participants’ parents’ education level and employment status). The main method used for univariate and multivariate analysis was logistic regression. Results. Prevalence of individual ACEs ranged considerably. In the child maltreatment group the highest share of respondents reported they were victims of physical abuse as they were frequently spanked (34.6%), while in the household dysfunction group the most reported ACE was life with a problematic drinker or alcoholic (17.2%). Only 971/2575 (37.7%) participants didn’t experience any ACE type. The study confirmed some individual ACEs are more relevant as magnitude of their negative effect on health is more powerful compared to others. Consequently, cumulative effect of multiple ACEs is heavily determined also by nature of the individual ACEs and not only by their number. Conclusion. The observed health harmful behaviours are more prevalent in victims of early childhood adversities compared to those who were not exposed to ACE. Impact of exposure to ACEs in terms of all observed harmful behaviours, persist into emerging adulthood. Harmful impact of early adversities on respondents’ health measured through harmful behaviours and its strength varies considerably. The study also confirmed that the more ACE types that respondents experienced, the greater their risks of harmful behaviours. Some individual adverse childhood experiences are more relevant as magnitude of their negative impact on health is more powerful compared to others. Outcomes are strongly related to intensity of ACEs or some unique combinations and not only to total number of exposure. Consequently, weight of cumulative effect of multiple ACEs is heavily determined by nature of the individual ACEs and not only by the number.
Secondary keywords: Otroci;Disertacije;Travmatične izkušnje;Zdravstvene posledice;Odrasli;Zdravje;Adverse childhood experiences;Epidemiology;Adverse effects;Health behavior;Young adults;Child;Child abuse;Primary prevention;Secondary prevention;Suicidal ideation;Alcoholism;Substance abuse detection;Smoking;Exercise;Travmatične izkušnje iz otroštva;Epidemiologija;Škodljivi učinki;Vedenje povezano z zdravjem;Mladi odrasli;Otrok;Zloraba otrok;Primarna preventiva;Sekundarna preventiva;Samomorilnost;Alkoholizem;Odkrivanje zlorabe drog;Kajenje;Telesna vadba;South East Europe;Jugovzhodna Evropa;
Type (COBISS): Dissertation
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Medicinska fak.
Pages: IX, 150 f.
ID: 11396888