Prevalence, distribution and attributable risks of adverse childhood experiences in different family types: A survey of young adults in Botswana

Abstract

Background: Although adverse childhood experiences (ACEs) are often associated with poor outcomes in adulthood, little is known about its distribution in various family types, especially in low- and middle-income countries.

Objective: We assessed the prevalence, distribution, and attributable risks of ACEs in different family types in early adults.

Methods: Using data from 483 young adults (18-25 years of age), we assessed the prevalence and distribution of ACEs and employed binary logistic regressions to quantify the attributable risk of ACEs in different family types: nuclear (reference), single-mother, separated/divorced, and extended family types. We compared respondents without reports of ACEs (reference) to those reporting different numbers of ACEs (1 or more, 2 or more, 3 or more, 4 or more and 5 or more) to assess attributable risks of ACEs in different family types.

Results: Out of the 483 participants, (female = 262 [53.3%]), 26.7% reported no ACEs, 21.1% reported 1 ACE, 13.3% reported 2 ACEs, and 38.9% reported 3 or more ACEs. Two hundred thirty-two (48%) and 153 (31.7%) students reported that they were from a nuclear and single-mother family types, respectively. Overall, there were higher densities of ACEs in single-mother and separated/divorced compared to nuclear family type. Compared to nuclear family type, the attributable risks of ACEs for single-mother family type ranged from 2.85 (95% Confidence Intervals (CI) 1.65) to 4.13 (95% CI: 1.92-8.91) and for separate/divorced family type ranging from 3.69 (95% CI: 1.72) to 6.32 (95% CI: 2.40-16.64).

Conclusions: The odds of ACEs differ with family types and were markedly pronounced in single-mother and separated/divorced compared to nuclear family types. Interventions to mitigate the effects of ACEs should be targeted at family types with a high density of ACEs. Professionals should design programmes targeting single-mother, separated/divorced and extended family types to alleviate the negative effects of childhood adversity.

Keywords: Adverse childhood experiences; Botswana; Family types; Young adults.