Associations of the ten original Adverse Childhood Experiences (ACEs) with mental health impairments after controlling for the other ACEs (meta-analysis)
| Type of Work | Meta-analyse |
This meta-analyse in full text is readable here as a PDF File.
The Geman version of the meta-analyse is here:
< https://www.ipce.info/de/library/web-article/schuster-metaanalyse-zusammenhaenge-ace-mentalen-gesundheit >
Some quotes from the meta-analyses are here:
< https://www.ipce.info/library/web-article/quotes-schuster-meta-analysis >
Some links to the references that are easy to find on Ipce's website are here:
< https://www.ipce.info/library/web-article/schulte-meta-analysis-some-links >
Here below is the Abstract:
Background:
The ten original ACEs (including emotional, physical, and "sexual abuse") are associated with mental impairment among the people affected in countless studies. The corresponding bivariate associations are to a considerable extent confounding bias. The extent of the causal relationships is unresolved.
Methods:
A systematic literature search was conducted to search for studies that determined the associations of each of the ten original ACEs with mental impairment in "minors" or adults after controlling for each of the nine other original ACEs (and other ACEs, if applicable).
Fourteen studies met the inclusion criterion. For the ten different original ACEs, the median of the available individual results was determined for each of three types of associations with mental impairment (bivariate, after controlling for each of the nine other original ACEs and after additionally controlling for further ACEs).
Furthermore, the median of the ten medians in each case was determined for the three types of associations. The effect size of the meta-analysis is the Pearson correlation coefficient r.
Results:
The magnitude of the bivariate associations between the ten original ACEs and mental health impairments is typically medium across studies (median r=0.22), typically very small (r=0.07) after controlling for the nine other original ACEs, and even smaller (r=0.05) after controlling for additional ACEs.
The ACEs incarceration of a household member (r=-0.01) and witnessing violence against the mother/parents (r=0.01) are not associated with mental health impairments after controlling for more than each of the nine other original ACEs.
These associations are also very low for the ACEs "sexual abuse", divorce/separation of parents, and alcohol/drug problem of a household member (r=0.04 each).
Conclusions:
The causal relationships between the ten original ACEs and mental health impairments are smaller than widely suspected. In the case of several original ACEs, long-term important negative health consequences are not to be assumed. The ACEs concept should be fundamentally reconsidered.
Limitations:
Also, because of the many uncontrolled confounding variables
(including genes and other ACEs), the associations identified by the metaanalysis
are not precise causal effect sizes.
