Salud Mental

Relationship between adverse childhood experiences and the physical and mental health in Mexican adults

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Blanca Patricia Nevárez-Mendoza
Gerardo Ochoa-Meza

Resumen

Introducción. Las experiencias adversas en la infancia (EAI) se refieren a la exposición durante la niñez a sucesos potencialmente perjudiciales para la salud. Estos incluyen: maltrato físico, psicológico, sexual y negligencia, así como algunas formas de disfunción familiar.

Objetivo. Examinar la frecuencia de las EAI y su relación con la salud mental y física de adultos en Ciudad Juárez.

Método. 389 personas de entre 18 y 65 años, en un estudio transversal con muestra incidental y participación voluntaria. Los instrumentos empleados fueron: PHQ-9 para depresión, GAD-7 para ansiedad y PHQ-15 para síntomas psicosomáticos.

Resultados. El 75% reportó al menos un tipo de adversidad y el 31.4% tres o más. Reportar 3+ EAI estuvo asociado con un incremento en Odds Ratio para depresión (OR = 5.04, 95% IC [2.38, 10.68]), ansiedad (OR = 3.33, 95% IC [1.09, 6.99]), severidad psicosomática (OR = 4.58, 95% IC [2.53, 8.29]), obesidad (OR = 2.08, 95% IC [1.21, 3.59]) y limitaciones por malestares físicos o emocionales (OR = 5.90, 95% IC [2.88, 12.09]). Una mayor ansiedad se asoció con abuso sexual (OR = 2.12 95% IC [.92, 4.85]) y haber sido testigo de violencia (OR = 5.09, 95% IC [1.04, 24.77]). Mayor riesgo de severidad psicosomática se presentó si se reportaba abuso sexual (OR = 1.94 95% IC [1.06, 3.54]) y negligencia (OR = 1.84, 95% IC = [1.02, .32]).

Discusión y conclusión. Las EAI están asociadas con dificultades de salud mental y psicosomatización. Se confirma relación entre los distintos tipos de adversidad y la salud.
Palabras clave:
Experiencias adversas en la infancia, depresión, ansiedad, síntomas psicosomáticos, salud

Referencias

Anda, R. F., Butchart, A., Felitti, V. J., & Brown, D. W. (2010). Building a framework for global surveillance of the public health implications of Adverse Childhood Experiences. American Journal of Preventive Medicine, 39(1), 93-98. doi: 10.1016/j.amepre.2010.03.015

Benjet, C. (2010). Childhood adversities of populations living in low-income countries: Prevalence, characteristics, and mental health consequences. Current Opinion in Psychiatry, 23(4), 356-362. doi: 10.1097/YCO.0b013e32833ad79b

Benjet, C., Borges, G., & Medina-Mora, M. E. (2010). Chronic childhood adversity and onset of psychopathology during three life stages: Childhood, adolescence and adulthood. Journal of Psychiatric Research, 44(11), 732-740. doi: 10.1016/j.jpsychires.2010.01.004

Bryan, R. H. (2019). Getting to Why: Adverse Childhood Experiences’ Impact on Adult Health. Journal for Nurse Practitioners, 15(2), 153-157.doi: 10.1016/j.nurpra.2018.09.012

Campbell, J. A., Walker, R. J., & Egede, L. E. (2016). Associations between Adverse Childhood Experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50(3), 344-352. doi: 10.1016/j.amepre.2015.07.022

Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217-225. doi: 10.1016/j.jad.2003.12.013

Chiang, J. J., Taylor, S. E., & Bower, J. E. (2015). Early adversity, neural development, and inflammation. Developmental Psychobiology, 57(8), 887-907. doi: 10.1002/dev.21329

Cohen-Cline, H., Jones, K. G., Kulkarni-Rajasekhara, S., Polonsky, H. M., & Vartanian, K. B. (2019). Identifying underlying constructs of childhood adversity in a low-income population. Child Abuse & Neglect, 91, 1-11. doi: 10.1016/j.chiabu.2019.02.005

Danese, A., & Baldwin, J. R. (2017). Hidden Wounds? Inflammatory Links Between Childhood Trauma and Psychopathology. Annual Review of Psychology, 68, 517-544. doi: 10.1146/annurev-psych-010416-044208

Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology & Behavior, 106, 29-39. doi: 10.1016/j.physbeh.2011.08.019

Dong, M., Anda, R., Felitti, V., Dube, S., Williamson, D., Thompson, T., ... Giles, W. (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child, Abuse and Neglect, 28(7), 771-84. doi: 10.1016/j.chiabu.2004.01.008

Dube, S. R., Anda, R. F., Felitti, V. J., Croft, J. B., Edwards, V. J., & Giles, W. H. (2001). Growing up with parental alcohol abuse: exposure to childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect, 25(12), 1627-1640. doi: 10.1016/S0145-2134(01)00293-9

Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. Journal of Adolescent Health, 38(4), 444.e1-10. doi: 1016/j.jadohealth.2005.06.006

Familiar, I., Ortiz-Panozo, E., Hall, B., Vieitez, I., Romieu, I., Lopez-Ridaura, R., & Lajous, M. (2015). Factor structure of the Spanish version of the Patient Health Questionnaire-9 in Mexican women. International Journal of Methods in Psychiatric Research, 24(1), 74-82. doi: 10.1002/mpr.1461

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245-258. doi: 10.1016/S0749-3797(98)00017-8

Flores-Torres, M. H., Comerford, E., Signorello, L., Grodstein, F., Lopez-Ridaura, R., de Castro, F., … Lajous, M. (2020). Impact of adverse childhood experiences on cardiovascular disease risk factors in adulthood among Mexican women. Child Abuse & Neglect, 99, 104175. doi: 10.1016/j.chiabu.2019.104175

Forster, M., Grigsby, T. J., Rogers, C. J., & Benjamin, S. M. (2018). The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. Addictive Behaviors, 76, 298-304. doi: 10.1016/j.addbeh.2017.08.037

Garner, A. S., Forkey, H., & Szilagyi, M. (2015). Translating developmental science to adress childhoold adversity. Academic Pediatrics, 15(5), 493-502. doi: 10.1016/j.acap.2015.05.010

Gutiérrez Amparán, J. R. (2016). Los derechos de las niñas y niños huérfanos por situación de violencia: víctimas de la guerra en la frontera norte de México. Revista Internacional de Derechos Humanos, 6(6), 33-51.

Hajat, A., Nurius, P., & Song, C. (2020). Differing trajectories of adversity over the life course: Implications for adult health and well-being. Child Abuse & Neglect, 102, 104392. doi: 10.1016/j.chiabu.2020.104392

Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., … Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356-e366. doi: 10.1016/S2468-2667(17)30118-4

Instituto Nacional de Estadística y Geografía. (20 de jan de 2020). INEGI - Household and Income Expenditure. Retrieved from https://en.www.inegi.org.mx/temas/ingresoshog

Jones, T. M., Nurius, P., Song, C., & Fleming, C. M. (2018). Modeling life course pathways from adverse childhood experiences to adult mental health. Child Abuse & Neglect, 80, 32-40. doi: 10.1016/j.chiabu.2018.03.005

Kalmakis, K. A., & Chandler, G. E. (2014). Adverse childhood experiences: towards a clear conceptual meaning. Journal of Advanced Nursing, 70(7), 1489-1501. doi: 10.1111/jan.12329

Khrapatina, I., & Berman, P. (2017). The impact of Adverse Childhood Experiences on health in college students. Journal of Child & Adolescent Trauma, 10(3), 275-287. doi: 10.1007/s40653-016-0093-0

Loxton, D., Forder, P. M., Cavenagh, D., Townsend, N., Holliday, E., Chojenta, C., & Melka, A. S. (2021). The impact of adverse childhood experiences on the health and health behaviors of young Australian women. Child Abuse & Neglect, 111, 104771. doi: 10.1016/j.chiabu.2020.104771

McKee-Lopez, G., Robbins, L., Provencio-Vasquez, E., & Olvera, H. (2019). The relationship of childhood adversity on burnout and depression among BSN students. Journal of Professional Nursing, 35(2), 112-119. doi: 10.1016/j.profnurs.2018.09.008

McLaughlin, K. A., Peverill, M., Gold, A. L., Alves, S., & Sheridan, M. A. (2015). Child maltreatment and neural systems underlying emotion regulation. Journal of the American Academy of Child & Adolescent Psychiatry, 54(9), 753-762. doi: 10.1016/j.jaac.2015.06.010

McLaughlin, K. A., Weissman, D., & Bitrán, D. (2019). Childhood adversity and neural development: A systematic review. Annual Review of Developmental Psychology, 1(1), 277-312. doi: 10.1146/annurev-devpsych-121318-084950

Merrick, M. T., Ports, K. A., Ford, D. C., Afifi, T. O., Gershoff, E. T., & Grogan-Kaylor, A. (2017). Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse & Neglect, 69, 10-19. doi: 10.1016/j.chiabu.2017.03.016

Monnat, S. M., & Chandler, R. F. (2015). Long-term physical health consequences of Adverse Childhood Experiences. Sociological Quarterly, 56(4), 723-752. doi: 10.1111/tsq.12107

Nevárez-Mendoza, B., & Ochoa-Meza, G. (In press). Adaptation of the Adverse Childhood Experiences Questionnaire in Mexican samples. Revista de Psicología y Salud. Retrieved from https://psicologiaysalud.uv.mx/index.php/psicysalud

Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The Long-Term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9(11).1001349. doi: 10.1371/journal.pmed.1001349

Porter, C., Palmier-Claus, J., Branitsky, A., Mansell, W., Warwick, H., & Varese, F. (2020). Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatrica Scandinavica, 141(1), 6-20. doi: 10.1111/acps.13118

Ports, K. A., Ford, D. C., Merrick, M. T., & Guinn, A. S. (2020). Chapter 2 - ACEs: Definitions, measurement, and prevalence. In Adverse Childhood Experiences (pp. 17-34). Elsevier. doi: 10.1016/b978-0-12-816065-7.00002-1

Riedl, D., Lampe, A., Exenberger, S., Nolte, T., Trawöger, I., & Beck, T. (2020). Prevalence of adverse childhood experiences (ACEs) and associated physical and mental health problems amongst hospital patients: Results from a cross-sectional study. General Hospital Psychiatry, 64, 80-86. doi: 10.1016/j.genhosppsych.2020.03.005

Ros Montalbán, S., Comas Vives, A., & García-García, M. (2010). Validación de la versión española del cuestionario PHQ-15 para la evaluación de síntomas físicos en pacientes con trastornos de depresión y/o ansiedad: estudio DEPRE-SOMA. Actas Españolas de Psiquiatría, 38(6), 345-357.

Scott, K. M., von Korff, M., Angermeyer, M. C., Benjet, C., Bruffaerts, R., de Girolamo, G., … Kessler, R. C. (2011). Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions. Archives of General Psychiatry, 68(8), 838-844. doi: 10.1001/archgenpsychiatry.2011.77

Secretaría de Salud. (2004). Modelo integrado para la prevención y atención de la violencia familiar y sexual. Manual operativo. México: Centro Nacional de Equidad de Género y Salud Reproductiva.

Sheffler, J. L., Stanley, I., & Sachs-Ericsson, N. (2020). Chapter 4 - ACEs and mental health outcomes. In: Adverse Childhood Experiences (pp. 47-69). Elsevier. doi: 10.1016/b978-0-12-816065-7.00004-5

Shonkoff, J. P. (2016). Capitalizing on advances in science to reduce the health consequences of early childhood adversity. JAMA Pediatrics, 170(10), 1003-1007. doi: 10.1001/jamapediatrics.2016.1559

Solis, J. M., Shadur, J. M., Burns, A., & Hussong, A. M. (2012). Understanding the diverse needs of children whose parents abuse substances. Current Drug Abuse Reviews, 5(2), 135-147. doi: 10.2174/1874473711205020135

Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. doi: 10.1001/archinte.166.10.1092

Subramaniam, M., Abdin, E., Seow, E., Vaingankar, J. A., Shafie, S., Shahwan, S., … Chong, S. A. (2020). Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental illnesses: Results from the Singapore Mental Health Study. Child Abuse & Neglect, 103, 104447. doi: 10.1016/j.chiabu.2020.104447

UNICEF. (2019). Panorama estadístico de violencia contra niños, niñas y adolescentes en México. México: UNICEF.

Vig, K. D., Paluszek, M. M., & Asmundson, G. J. G. (2020). Chapter 5 - ACEs and physical health outcomes. In Adverse Childhood Experiences (pp. 71-90). Elsevier. doi: 10.1016/b978-0-12-816065-7.00005-7

Vitriol, V., Cancino, A., Leiva-Bianchi, M., Serrano, C., Ballesteros, S., Potthoff, S., … Asenjo, A. (2017). Depresión adulta y experiencias infantiles adversas: evidencia de un subtipo depresivo complejo en consultantes de la atención primaria en Chile. Revista Médica de Chile, 145(9), 1145-1153. doi: 10.4067/s0034-98872017000901145

Wade, R., Cronholm, P. F., Fein, J. A., Forke, C. M., Davis, M. B., Harkins-Schwarz, M., … Bair-Merritt, M. H. (2016). Household and community-level Adverse Childhood Experiences and adult health outcomes in a diverse urban population. Child Abuse & Neglect, 52, 135-145. doi: 10.1016/j.chiabu.2015.11.021

Waikamp, V., & Barcellos Serralta, F. (2018). Repercusiones del trauma en la infancia en la psicopatología de la vida adulta. Ciencias Psicológicas, 12(1), 137-144. doi: 10.22235/cp.v12i1.1603