TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background. Adverse Childhood Experiences (ACEs), defined as potentially traumatic events occurring before the age of 18, include various forms of abuse, neglect, and household dysfunction, and have been shown to significantly affect health, well-being, and life opportunities.

Aim. The aim of study is to explore relationship between categories of different types of abuse and health-risk behaviors, cognitive impairments and academic challenges among students at Ivane Javakhishvili Tbilisi State University (TSU), Georgia.

Methods. The study employed a quantitative research method, distributing an electronic questionnaire to all TSU students in June 2021, which included internationally recognized ACEs-related questions along with additional questions related to health, behaviors, and learning.

Results.The results revealed that a notable proportion of both female and male students experienced physical violence, with male students reporting it more frequently than females. Psychological violence was encountered by a considerable share of students, with slightly higher prevalence among males. Additionally, reports of sexual violence varied significantly by gender, with female students being more affected than their male counterparts. The study examined health-risk behaviors, with 17.2% of students identified as active smokers, 3.2% as drug users, and 10.0% having suicidal thoughts or attempts. Notably, ACEs were strongly associated with increased rates of smoking, drug use, and suicidal behavior, with victims of sexual violence showing the highest prevalence of these behaviors.

Conclusions.The research highlights the significant impact of ACEs on cognitive function and academic performance, with nearly half of the students reporting attention problems, and many victims of violence experiencing difficulties with learning. The findings underscore the need for targeted interventions in educational settings to support students affected by ACEs and promote their long-term well-being.

Sethi D, Bellis MA, Hughes K, Mitis F, Gilbert R, Galea G. European report on preventing child maltreatment. Copenhagen: World Health Organization Regional Office for Europe; 2013.

Felitti VJ, Anda RF, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998 May;14(4):245-58.

Dube SR. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Preventive Medicine, 2003, 37(3):268−277.

Sasaki N, Tabuchi T, Fujiwara T, Nishi D. Adverse childhood experiences and living in the socially deprived areas in adulthood: a cross-sectional study of the nationwide data in Japan. BMC Public Health. 2023 Aug 24;23(1):1616. doi: 10.1186/s12889-023-16557-z. PMID: 37620789; PMCID: PMC10463887.

Fanslow J, Hashemi L, Gulliver P, McIntosh T. Adverse childhood experiences in New Zealand and subsequent victimization in adulthood: Findings from a population-based study. Child Abuse Negl. 2021 Jul;117:105067. doi: 10.1016/j.chiabu.2021.105067. Epub 2021 Apr 18. PMID: 33878644.

Bellis MA, Hughes K, Leckenby N, Jones L, Baban A, Karcheva M et al. Adverse childhood experiences and associations with health-harming behaviours in young adults: surveys in eight eastern European countries. Bull World Health Organ. 92:641–55B. 2014.

Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry 2003; 160: 1453–60.

Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Polyvictimization and trauma in a national longitudinal cohort. Development and Psychopathology, 19(1), 149–166.

Moylan, C. A., Herrenkohl, T. I., Sousa, C., Tajima, E. A., Herrenkohl, R. C., & Russo, M. J. (2010). The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence, 25(1), 53–63

Makaruk K, Włodarczyk J, Sethi D, Michalski P, Szredzińska R, Karwowska P (2017). Survey of adverse childhood experiences and associated health-harming behaviours among Polish students. Copenhagen: WHO Regional Office for Europe

Madigan S, Deneault AA, Racine N, Park J, Thiemann R, Zhu J, Dimitropoulos G, Williamson T, Fearon P, Cénat JM, McDonald S, Devereux C, Neville RD. Adverse childhood experiences: a meta-analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry. 2023 Oct;22(3):463-471. doi: 10.1002/wps.21122. PMID: 37713544; PMCID: PMC10503911.

Elizabeth A. Swedo, Maria V. Aslam, Linda L. Dahlberg, Phyllis Holditch Niolon, Angie S. Guinn, Thomas R. Simon, James A. Mercy. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. CDC, Weekly / June 30, 2023 / 72(26);707–715.

Baban A, Cosma A, Balazsi R, Sethi D, Olsavszky V (2013). Survey of adverse childhood experiences among Romanian university students. Study report from the 2012 survey. Copenhagen: WHO Regional Office for Europe.

Milica Pejović Milovančević and Oliver Tošković. Adverse Childhood Experiences (ACE) Study Research on Adverse Childhood Experiences in Serbia. UNICEF in Serbia, 2019.

Survey on Adverse Childhood Experiences in Montenegro. Institute of Public Health of Montenegro WHO Regional Office for Europe. 2013.

Raleva M, Jordanova Peshevska D, Sethi D, editors (2013). Survey of adverse childhood experiences among young people in the former Yugoslav Republic of Macedonia. Copenhagen: WHO Regional Office for Europe.

Qirjako G, Burazeri G, Sethi D, Miho V. Community survey on prevalence of adverse childhood experiences in Albania. Report. Copenhagen: WHO Regional Office for Europe. 2013.

Victoria Zakhozha, Yulia Sakhno, Dinesh Sethi & Nataliya Korol. Adverse childhood experiences and health-harming behaviours among students in Ukraine Report on survey. WHO Regional Office for Europe. 2018.

Galina Le_Adriana Baban Dinesh Sethi Larisa Boderscova Jana Chihai Andrei Luchian. Adverse Childhood Experiences and associated health-risk behaviours in university students from the Republic of Moldova WHO Regional Office for Europe. 2018.

World Health Organization. Adverse Childhood Experiences International Questionnaire. In Adverse Childhood Experiences International Questionnaire (ACE-IQ): Geneva: WHO, 2018.