Understanding the role of caregiver factors on ACE changes between male and female adolescents in Kinshasa, DRC: A...

Adverse Childhood Experiences (ACEs) are traumatic events occurring from ages 0-17 with adolescence a particularly vulnerable period for increased ACEs exposure.

This study examines the role of caregivers in shaping ACE changes over time and how these influences differ by sex.

Data were drawn from 1450 adolescents (1083 in-school, 367 out-of-school) in two under-resourced communes of Kinshasa, Democratic Republic of Congo. Adolescents were aged 10-14 at baseline (2017) and followed through 2022.

ACEs were assessed by count (0,1,2,3,4+) and type (emotional, physical, sexual, witnessing domestic violence, household dysfunction) at Waves 1 (W1) and 5 (W5). Three caregiver factors from Wave 1 were included as confounders/effect modifiers. Weighted, ordered logistic regression and generalized estimating equations analyzed associations, stratified by gender.

There was a significant change in ACEs between W1 and W5 (OR: 0.4, 95 % CI: 0.4-0.5). For males, caregiver closeness during W1 protected against physical maltreatment during W5 (OR: 0.7, 95 % CI: 0.6-0.99), and caregiver comfort during W1 was protective for domestic violence exposure during W5 (OR: 0.6, 95 % CI: 0.4-0.9). Additionally, lower caregiver monitoring at W1 was associated with greater ACEs change during W5 compared to higher caregiver monitoring. For females, caregiver comfort protected against household disruption (OR: 0.7, 95 % CI: 0.6-0.97).

There was reduced odds of experiencing ACEs during W5 relative to W1, with caregiver factors playing a key role. Gender-stratified analyses highlight the need for tailored, strengths-based family interventions to mitigate ACEs and support adolescent well-being.