Adverse Childhood Experiences and Disability in U.S. Adults

作者：Sophia Miryam Schüssler‐Fiorenza Rose, Dawei Xie, Margaret G. Stineman · 发表于：PM&R · 年份：2014 · DOI：10.1016/j.pmrj.2014.01.013 · 被引用次数：122 · 研究领域：Child Abuse and Trauma、Child Abuse and Related Trauma、Elder Abuse and Neglect

OBJECTIVE: To assess relationships between adverse childhood experiences and self-reported disabilities in adult life. DESIGN: Cross-sectional, random-digit-dialed, state-population-based survey (Behavioral Risk Factor Surveillance System). SETTING: Fourteen states and the District of Columbia. PARTICIPANTS: Noninstitutionalized adults ages ≥18 years surveyed in 2009 and/or in 2010 (n = 81,184). METHODS: The Behavioral Risk Factor Surveillance System Adverse Childhood Experience (ACE) Module asks about abuse (physical, sexual, emotional), family dysfunction (exposures to domestic violence, living with mentally ill, substance abusing, or incarcerated family member(s), and/or parental separation and/or divorce) that occurred before age 18 years. The ACE score sums affirmed ACE categories (range, 0-8). We controlled for demographic characteristics (age, race, education, income, and marital status) and self-reported physical health conditions (stroke, myocardial infarction, diabetes, coronary heart disease, asthma). Five states asked participants about mental health conditions (anxiety, depression). A subset analysis of participants in these states evaluated the effect of adjusting for these conditions. MAIN OUTCOME MEASUREMENTS: The primary outcome was disability (self-reported activity limitation and/or assistive device use). RESULTS: More than half of participants (57%) reported at least 1 adverse childhood experience category, and 23.2% reported disability. The odds ratio (95...