Association between adverse childhood experiences and adolescent alcohol use

Objective To explore the association between adverse childhood experiences (ACEs) and adolescent alcohol use and to provide evidence for prevention and intervention. Methods A total of 1 550 students from grades 6 to 8 in three public middle schools in a district of Shanghai were selected by stratified cluster sampling method. The baseline and follow-up investigation were conducted by anonymous electronic questionnaire in mobile tablet from November to December in 2017 and 2018, respectively. The latent class analysis (LCA) was applied for the classification of ACEs, while the multivariate generalized estimating Equations (GEE) model was adopted to examine the association between ACEs and adolescent alcohol use. Results The ACEs was divided into 3 classes by LCA: high exposure (8.97%), abuse and neglect (38.97%), low exposure (52.06%). The multivariate GEE model indicates the risk of alcohol drinking among adolescents in high exposure and abuse and neglect classes were significantly higher than their counterparts in low exposure class ( OR = 2.65, 95% CI = 1.72-4.07; OR = 1.50, 95% CI = 1.14-1.96, respectively). Conclusion The effect of ACEs on alcohol use may vary across different latent classes. Supportive childhood environment may contribute to decrease the risk of adolescent drinking behavior. 【摘要】 目的 探究儿童期不良经历(adverse childhood experiences, ACEs)与青少年饮酒的关联, 为青少年饮酒行为的防 控提供指导。 方法 采用分层整群抽样的方法选取上海市某区3所公立初中六至八年级的1 550名学生, 于2017年和 2018年11—12月开展2次匿名电子问卷调査。米用潜类别分析(latent class analysis, LCA)对ACEs进行分类, 利用多因 素广义估计方程(generalized estimating equations, GEE)模型分析ACEs与青少年饮酒的关联。 结果 LCA拟合结果表明, ACEs可分为3个潜类别, 分别定义为髙暴露组(139名, 8.97%)、虐待忽视组(604名, 38.97%) 和低暴露组(807名, 52.06%)。多因素GEE模型结果显示, 相较于低暴露组, 髙暴露组( OR = 2.65, 95% CI = 1.72~4.07)和虐待忽视组( OR = 1.50, 95% CI = 1.14~1.96)研究对象的饮酒风险显著增加( P 值均<0.01)。 结论 不同潜类别的ACEs对饮酒的影响可能存 在差异, 良好的儿童期成长环境可能有助于降低青少年饮酒风险。