Measuring Adverse Child Experiences Among Young Adolescents Globally: Relationships With Depressive Symptoms and Violence Perpetration

Purpose: The purpose of the study was to develop a measure of ACEs applicable for young adolescents in low- and middle-income countries (ACEs) and to analyze the relationships of ACEs against two outcomes: depressive symptoms and violence perpetration. There is a paucity of research on the consequences of adverse child experiences (ACEs) on adolescent health and behavior from low- and middle-income countries and virtually no multinational studies. Methods: As part of the Global Early Adolescent Study, an 11-item measure of ACEs was developed and piloted with 1,284 adolescents aged 10-14 years in 14 urban communities in an equal number of countries. With one exception where interviewers were used, data were self-reported anonymously using tablets. Results compared a summative ACEs index score and latent class analysis. Results: Findings show high rates of ACEs exposure experienced by young adolescents in resource-poor neighborhoods in low- and middle-income countries; disproportionate exposures of boys and strong associations between ACEs and both depressive symptoms and violence perpetration. Latent class analysis provided modest refinement over a summed ACEs score. Conclusion: While interventions tend to focus on behavioral outcomes, evidence suggests that ACEs exposure is a strong antecedent related to both depressive symptoms and violence perpetration. (C) 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc.