Projects / Programmes
Prevalence and long-term effects of adverse childhood experiences on adult functioning
| Code |
Science |
Field |
Subfield |
| 5.09.00 |
Social sciences |
Psychology |
|
| Code |
Science |
Field |
| B680 |
Biomedical sciences |
Public health, epidemiology |
| Code |
Science |
Field |
| 5.01 |
Social Sciences |
Psychology and cognitive sciences |
adverse experience, abuse, neglect, health, resilience, protective and risk factors, questionnaire, focus groups, early interventions
Researchers (6)
| no. |
Code |
Name and surname |
Research area |
Role |
Period |
No. of publicationsNo. of publications |
| 1. |
14076 |
PhD Zalka Drglin |
Sociology |
Researcher |
2018 - 2020 |
555 |
| 2. |
14633 |
Ada Hočevar Grom |
Public health (occupational safety) |
Researcher |
2018 - 2020 |
423 |
| 3. |
19176 |
PhD Helena Jeriček Klanšček |
Public health (occupational safety) |
Researcher |
2018 - 2020 |
403 |
| 4. |
22286 |
PhD Metka Kuhar |
Psychology |
Head |
2018 - 2020 |
631 |
| 5. |
24373 |
PhD Nina Mešl |
Criminology and social work |
Researcher |
2018 - 2020 |
376 |
| 6. |
39636 |
PhD Gaja Zager Kocjan |
Psychology |
Researcher |
2018 - 2020 |
117 |
Organisations (2)
Abstract
An increasing number of foreign studies show that experiences (both positive and adverse) in childhood strongly affect a person’s physical and mental health as well as socioeconomic status during their lifetime and/or even several generations. There even exist financial calculations of how expensive the consequences of adverse events are for a state, in terms of both taxes from individuals as well as healthcare and social security funds. Awareness of what early adverse experiences and their consequences are and primarily recognition of this phenomenon and ensuring of support aimed at reducing the risk factors and damage are among the key social and public health tasks. Adverse life experiences can be ranked within a continuum from subtle to obvious, from minor to serious, from one-off events to years of abuse, neglect etc. There are experiences that a person finds extremely distressing and threatening, too intense to tolerate and/or cope with in conventional ways. Early adverse experiences have particularly negative and long-term effects on health and different aspects of functioning.
The bulk of data on the prevalence of adverse experiences in childhood and research evidence about the correlations between them and various outcomes in adulthood stem from the globally recognised Adverse Childhood Experience Study, also known as the ACE study. This study was conducted for the first time in the 1995–97 period in the USA and is still conducted every year in all US states. It was also conducted in many other countries, e.g. England, Wales, Scotland; recently also in Romania, Macedonia, Serbia, Lithuania, Latvia, Albania, Turkey, Montenegro, the Russian Federation, the Czech Republic, Poland, Norway, Canada, Brazil, China, the Philippines, Jordan etc. Despite the multitude of countries that have already conducted the ACE study, Slovenia is not one of them.
Individual ACE studies always show important connections between the quantity of adverse experiences in childhood and health, psycho-social welfare and socioeconomic situation in adulthood. In the ACE studies, usually more than three-quarters of those surveyed report at least one highly adverse experience in childhood (in the original study 87% of the subjects reported more than one out of ten), whereas one-tenth to one-sixth of subjects report even four or more such experiences. These rates are higher in marginalised groups of population and in populations with a lower socioeconomic status. The highest probability that a person develops poor physical or mental health and/or other adverse outcomes is with those people who had four or more adverse experiences in childhood and adolescence.
Foreign research also shows that early adverse experiences are an extremely important public health issue. In Slovenia some data on potentially adverse experiences are collected more or less systematically, e.g. about the level of risk of poverty and social exclusion (Statistical Office of the RS), different indicators of physical and mental health in children (e.g. European School Survey Project on Alcohol and Other Drugs – ESPAD, Health Behaviour in School-aged Children – HBSC), adults (e.g. European Health Interview Survey) and the elderly (e.g. the Survey on Health, Ageing and Retirement in Europe – SHARE). However, none of the studies conducted so far has offered an insight into the prevalence of adverse experiences nor enabled research of early adverse experiences on health and other psychosocial outcomes in adulthood. Although such research is supported by the WHO and, in 2010, an initiative was launched to globally monitor this phenomenon and its consequences on public health, Slovenia has so far been excluded from comprehensive, exhaustive and systematic research of these important topics.
Our study aims to acquire data on the prevalence of adverse experiences in childhood, most frequent adverse experiences in childhood, their correlation with health and psychosocial outcomes in adulth
Significance for science
No studies have yet been conducted in Slovenia on the influence of adverse experiences in childhood on outcomes in adulthood, although there are already many studies on this subject in other countries and this segment of public health is very topical. The studies that were conducted and repeated several times in other countries contributed substantially to development of knowledge and approaches to working with people in childhood and adulthood (e.g. Chartier, Walker & Naimark, 2010; Steele & Kuban, 2011; Leitch, 2017).
Although many scientific sources exist on the results already obtained in other countries (Baban, Cosma, Balazsi et al., 2013; Bellis, Hughes, Leckenby et al., 2014; Bellis, Lowey, Leckenby et al., 2014; Bellis, Ashton, Hughes et al., 2015; Couper & Mackie, 2016; Hughes, Lowey, Quigg & Bellis, 2016 etc.), we believe that only based on systematically collected results for the Slovenian area it is possible to reasonably develop an understanding and appropriate responses by different professions that correspond to life circumstances of the Slovenian population. The first such study in Slovenia will contribute to acquisition of data on the prevalence of adverse experiences as well as to systematic and comprehensive understanding of the influence of adverse experiences on various types of outcomes (physical and mental health, socioeconomic outcomes). The obtained data will be an important starting point for understanding people’s current problems in a broader life context, which is relevant for the development of different expert areas (healthcare, school and social security systems etc.).
For the purpose of this study, we will acquire data on the prevalence of adverse experiences and their influences on human life, however, our research endeavours will also focus on other relevant and topical issues that can support the development of different scientific disciplines. Given the fact that protective factors are increasingly gaining ground in the domain of public health, our study will place special emphasis on researching their importance (sources of support, resilience). In view of the ACE studies conducted so far, our analysis will be (more) comprehensive. Apart from correlations between adverse experiences and different concrete outcomes in the area of physical and mental health (this has so far been most widely discussed), we will touch upon the relations between such experiences and socioeconomic outcomes and resilience. Moreover, we will be interested in the original socioeconomic context/disadvantage and sources of support in childhood. The study will encompass a broader set of adverse events (including those in adulthood). Moreover, we plan to broaden adverse experiences by including the subtler aspect of unfavourable family dynamics. Such broadly and profoundly designed survey will enable complex analyses (which also consider the socioeconomic aspect and protective factors – both within the meaning of the context and outcomes) as well as explanatory models that will help deepen the understanding of the theme.
We have assessed that this study will contribute to the establishment of the diagnostic theory of “extreme stress” or “complex trauma”, which has been proposed for quite some time. Since the beginning of the 1990s (e.g. Herman Lewis, 1992) efforts have been invested in introducing a special diagnostic category that would cover a great number of consequences which are currently not included in the definition of post-traumatic stress disorder (PTSD) in the DSM-5 manual or other diagnostic categories. When the DSM-5 (2013) was prepared, a new category was proposed, i.e. DESNOS (Disorders of Extreme Stress – Van der Kolk, Roth, Pelcovitz, Sunday & Spinazzola, 2005).
Through our research of different adverse experiences, we will also subject to criticism the existing definition of PTSM, which is associated with a few events and reactions of a limitedly specified timing, and/or call for expansion o
Significance for the country
Ensuring healthy development of children is of key importance for achieving the health, economic and social potentials of adults and individual society as well as for a thriving economy. As mentioned before, many ACE studies show that usually more than three-quarters of the surveyed report at least one highly adverse experience in childhood, whereas from one-tenth to one-sixth of subjects had even four or more such experiences (e.g. Felitti et al., 1998; Finkelhor, Turner, Ormrod & Hamby, 2009). Correlations between adverse experiences and subsequent outcomes in adulthood have been proven (e.g. Anda, Whitfield, Felitti et al., 2002; Felitti et al., 1998; Kessler, Avenevoli, McLaughlin et al., 2012; Longden & Read, 2016; Read, 2013; Varese, Smeets, Drukker et al., 2012). Based on the already known results we can thus claim that living in an environment where a child is exposed to adverse experiences represents a high risk for his or her future life. These data place responsibility on adults to respond appropriately and develop supportive environments for children and adults so that they can develop their health, social and economic potentials. Protective factors must thus be strengthened and adverse experiences prevented, while also addressing their consequences which are visible in the course of life and often pass from one generation to the next.
To design more suitable and comprehensive programmes and policies, data are first needed on the prevalence of adverse events and negative outcomes and/or correlations between the two, as well as a more complex understanding of the role of risk factors and protective factors. Financial calculations were already made of how expensive the consequences of adverse events are for a state, in terms of both taxes from individuals as well as healthcare and social security funds (Fang, Brown, Florence & Mercy, 2012). The authors (ibidem) cite precise financial calculations of economic burdens resulting from child abuse and neglect, with particular emphasis on the costs of children’s and adults’ healthcare, judicial expenses, costs of education, costs related to lost work productivity etc. They conclude that abuse in childhood, compared to other health problems, is also a great burden in economic terms, which underlines the importance of research of the prevalence of child abuse and neglect as well as development of preventive programmes. It is important to provide appropriate response and to focus, among others, on breaking off the transfer of adverse experiences between generations. Citizens with fewer adverse events and/or citizens with developed resilience have been proven, according to foreign studies conducted so far, to be more efficient in economic terms i.e. at work (higher income, less unemployment, less absenteeism etc.).
Our research will focus on the abovementioned issues: it will provide a better insight into the prevalence of adverse events in childhood and their consequences in adulthood. The acquired data will underpin further research and preparation of guidelines for suitable responses in childhood and adulthood that will help reduce the negative consequences as well as strengthen protective factors and people’s resilience. Thus we can influence the fact that adverse experiences in childhood can indirectly be reflected in lower efficiency at work in adulthood, as well as positively influence the economy by means of appropriate support programmes.
The awareness that healthy workers are the most efficient will additionally contribute to a more continued promotion of occupational health which could, in the future, include mitigation of the consequences of adverse experiences in childhood and development of occupational health promotion programmes supporting both male and female workers who had adverse experiences in their childhood. In Slovenia, these approaches have not yet been established and developed, which is why, after the study is concluded and evidence obtained, they
Most important scientific results
Final report
Most important socioeconomically and culturally relevant results
Annual report
2018,
2019,
final report
