Kristopher M Goodrich, Arianna Trott, Monique N Rodríguez, Martha Waller, Elizabeth Lilliott
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引用次数: 1
Abstract
The study of Adverse Childhood Experiences (ACEs) has consistently demonstrated a strong relationship with poor behavioral health outcomes. Further research is needed to understand if a specific ACE, or subcategorizations of ACEs, matter more for behavioral health outcomes. A study of the association between ACEs and problem gambling involving a racially mixed sample (13,217 participants) in New Mexico is presented to illustrate how certain ACEs may have a larger impact on behavioral health outcomes. The researchers examined: 1.) the impact that each individual ACE have on participant's reported problem gambling; 2) which group (abuse or household challenges) had a greater odds ratio and marginal impact on participant's self-reported gambling; and 3) which BRFSS subcategories (emotional abuse, physical abuse, sexual abuse, IPV, substance abuse, mental illness, parental separation or divorce, and incarcerated household member) had a greater odds ratio and marginal impact on participant's self-reported gambling. The results of this study indicate ACEs had a significant influence on problem gambling, and data suggests that when BRFSS data is examined in groups or subcategories there is a difference in the influence that ACEs have on problem gambling. In particular, we found that odds ratio to be significant when participants reported mental health problems in the home (OR = 1.34, 95% CI [1.02, 1.76], p < 0.04), living with incarcerated household members (OR = 1.75, 95% CI [1.28, 2.41], p < 0.001), how often adults hit each other (OR = 1.29, 95% CI [1.10, 1.52], p < 0.001), and how often anyone at least 5 years older than them forced them to have sex (OR = 1.42, 95% CI [1.10, 1.82], p < 0.01) In relation to types of abuse, There was a significant difference in self-reported problem gambling for individuals who reported sexual abuse (OR = 1.64, 95% CI [1.10, 2.46], p < 0.016), as well as participants reporting living with an incarcerated household member (OR = 2.08, 95% CI [1.34, 3.22], p < 0.001); approaching significant results also included individuals who witnessed their parents act violent towards one another (OR = 1.52, 95% CI [.99, 2.33], p < 0.055), and having parents who were separated or divorced (OR = 0.68, 95% CI [0.46, 1.00], p < 0.053). Finally, there was a significant difference in self-reported problem gambling for individuals who reported abuse (OR = 1.36, 95% CI [1.11, 1.66], p < 0.003), while participants reporting household challenges did not quite reach statistical significance (OR = 1.49, 95% CI [0.99, 1.33], p < 0.062. These findings show us that the way we ask questions about the precedence and outcomes of risky behavior matter and warrant further attention.
不良童年经历(ace)的研究一直表明其与不良行为健康结果密切相关。需要进一步的研究来了解特定的ACE或ACE的子分类是否对行为健康结果更重要。一项涉及新墨西哥州种族混合样本(13,217名参与者)的ace和问题赌博之间关系的研究表明,某些ace如何对行为健康结果产生更大的影响。研究人员检查了:1)每个ACE对参与者报告的问题赌博的影响;2)哪一组(虐待或家庭挑战)对参与者自述的赌博行为有更大的优势比和边际影响;3)哪些BRFSS子类别(情感虐待、身体虐待、性虐待、IPV、药物滥用、精神疾病、父母分居或离婚、监禁家庭成员)对参与者自我报告的赌博有更大的优势比和边际影响。本研究结果表明,ace对问题赌博有显著影响,数据表明,当BRFSS数据被分组或子类别检查时,ace对问题赌博的影响是不同的。特别是,我们发现,当参与者报告家中有心理健康问题时,优势比显著(OR = 1.34, 95% CI [1.02, 1.76], p