How adverse childhood experiences relate to single and multiple health risk behaviours in German public university students: a cross-sectional analysis

• Published in: BMC public health 2018-08, Vol.18 (1), p.1005-1005, Article 1005
• Main Authors: Wiehn, Jascha, Hornberg, Claudia, Fischer, Florian
• Format: Article
• Language: English
• Subjects: Adverse childhood experiences; Analysis; Child abuse & neglect; Child maltreatment; Childhood; Childhood factors; Children; Children & youth; College students; Colleges & universities; Cross-sectional studies; Domestic violence; Dose-response effects; Families & family life; Feasibility studies; Health; Health behavior; Health promotion; Health risk assessment; Health risks; Households; Imprisonment; Life expectancy; Medical screening; Mental disorders; Mental health care; Morbidity; Protective factors; Psychological aspects; Psychosomatic disorders; Public health; Regression analysis; Risk analysis; Risk behavior; Risk factors; Risk taking; Risky behaviours; Sex crimes; Sociodemographics; Socioeconomic status; Socioeconomics; Stress-related trauma; Students; Surveys; Systematic review; Trauma; University students; Violence
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-018-5926-3

Adverse childhood experiences (ACEs) have been shown to be linked to health risk behaviours (HRBs). This study aims to identify risk factors for ACEs and to examine the associations between ACEs and single and multiple HRBs in a sample of university students in Germany. An online-based cross-sectional study was conducted among public university students (N = 1466). The widely applied ACE questionnaire was used and extended to operationalise 13 categories of childhood adversity. First, variables for each type of ACE and HRB were dichotomised (single ACEs and single HRBs), and then used for cumulative scores (multiple ACEs and multiple HRBs). Frequencies were assessed, and (multinomial) logistic regression analyses were performed. Prevalence rates of ACEs ranged from 3.9 to 34.0%, depending on the type of childhood adversity. Sociodemographic risk and protective factors for single/multiple ACEs varied strongly depending on the outcome. In particular, a high family socioeconomic status seemed to be a consistent protective factor for most ACEs. After adjusting for sociodemographic characteristics, both single and multiple HRBs were associated with single events of ACEs. Moreover, dose-response relationships between multiple ACEs and various single and multiple HRBs were found. The study provides strong evidence that ACEs are associated with HRBs. The number of ACEs may play a role in single or multiple HRBs. Reducing the number of ACEs could thus decrease HRBs, which account for many of the leading causes of morbidity and death. The findings highlight the importance of trauma-informed health interventions designed to prevent the occurrence of ACEs, and build capacity among children and adults.