The Prevalence and Consequences of Adverse Childhood Experiences in the German Population

Multiple studies have shown a link between cumulative adverse experiences in childhood and a wide variety of psychosocial problems in later life. There have not been any pertinent representative studies of the German population until now. The goal of this study is to determine the frequency of adverse childhood experiences (ACE), the extent to which they manifest themselves in patterns of co-occurrence, and their possible connection to psychosocial abnormalities in the German population.

2531 persons (55.4% female) aged 14 years and up (mean [M] = 48.6 years, standard deviation [SD] = 18) were retro- spectively studied for ACE and psychosocial abnormalities by means of the Patient Health Questionnaire-4 (PHQ-4) and further questions on aggressiveness and life satisfaction. The frequency of ACE and their cumulative occurrence were analyzed in de- scriptive terms. Patterns of simultaneously occurring types of ACE were studied with latent class analysis. Associations between ACE and psychosocial abnormalities were tested with logistic regression analyses.

43.7% of the respondents reported at least one ACE; 8.9% reported four or more. The most commonly reported ones were parental separation and divorce (19.4%), alcohol consumption and drug abuse in the family (16.7%), emotional neglect (13.4%), and emotional abuse (12.5%). Four ACE patterns were identified by latent class analysis: no/minimal ACE, household dysfunction, child maltreatment, and multiple ACE. In the cumulative model, the high-risk group with four or more ACE displayed a significantly elevated risk for depressiveness (odds ratio [OR] = 7.8), anxiety (OR = 7.1), physical aggressiveness (OR = 10.5), and impaired life satisfaction (OR = 5.1).

Adverse childhood experiences are common, and their cumulation is associated with markedly increased negative sequelae for the affected persons. Preventive approaches are needed that extend beyond the area of child maltreatment alone and address other problems in the parental home, such as mental illness in the parents. Data acquisition by self-reporting is a limitation of this study.