Exploring the Impact of Adverse Childhood Experiences on Adolescent Health and Behavior: Implications for Adverse Childhood Experience-informed Policies and Practices

Introduction:This study delves into the association between adverse childhood experiences (ACEs) and the development of health issues and behavior in adolescents. The objective is to refine our understanding of the trajectory of health problems associated with ACE exposure among this demographic.Methods:Data from the 2022 round of the Bangkok Behavior Surveillance Survey were scrutinized in this cross-sectional study. Participants, comprising 5740 students from 36 educational institutions in Bangkok, responded to an online questionnaire. The questionnaire, consisting of 15 items, explored various ACEs. Multiple regression analysis was employed to examine the relationship between ACE exposure levels and health indicators.Results:Findings revealed that 78.1% of participants reported at least one ACE, with a higher prevalence among females. ACE exposure (0 [ref], 1, 2, 3, 4, 5+) was associated with various health and behavioral indicators compared to no ACE, including substance use (conventional cigarettes odds ratio [OR] 1.94-4.51, e-cigarettes OR 2.16-2.80, alcohol OR 1.46-3.44, marijuana OR 2.18-3.09, Kratom OR 2.05-3.93, illicit drugs OR 2.61-3.01), engagement sexual activity OR 1.55-3.26, and mental health concerns (anxiety OR: 2.39-10.11, depression OR: 1.98-14.26, suicidal thoughts OR: 2.03-13.21, self-harm OR: 2.98-8.09, and stress OR: 1.65-6.88). Female students with ACE histories exhibited poorer mental health, whereas male students demonstrated a higher propensity for substance abuse.Conclusion:This study underscores a compelling correlation between ACE exposure levels and a spectrum of negative health effects and risky behaviors among adolescents. Those reporting five or more ACE exposures exhibited heightened vulnerability to adverse health conditions.