Citation

Mitani H, Kondo N, Amemiya A, Tabuchi T. BMJ Open 2024; 14(6): e082134.

Copyright

(Copyright © 2024, BMJ Publishing Group)

DOI

10.1136/bmjopen-2023-082134

PMID

38925696

Abstract

OBJECTIVE: Although adverse childhood experiences (ACEs) are associated with poor health in adulthood, positive childhood experiences (PCEs) can reduce the risk of negative health outcomes. This study aimed to investigate whether PCEs in the community (CPCEs, ie, trusted adults other than parents, supportive friends, belongingness to school, or community traditions) would have an independent effect on better health outcomes and moderate the association between ACEs and adult illnesses.

DESIGN: Cross-sectional survey. SETTING: Data were gathered from a nationwide, cross-sectional internet survey conducted in Japan in 2022. PARTICIPANTS: This study included 28 617 Japanese adults aged 18-82 years (51.1% female; mean age=48.1 years). PRIMARY AND SECONDARY OUTCOME MEASURES: The associations among self-reported ACEs, CPCEs before the age of 18 years and current chronic diseases (eg, cancer and depression) were investigated using multivariable logistic regression models.

RESULTS: CPCEs were associated with lower odds of adult diseases (such as stroke, chronic obstructive pulmonary disease (COPD), chronic pain, depression, suicidal ideation and severe psychological distress) after adjusting for ACEs. More CPCEs weakened the association between ACEs and adult diseases. Specifically, among those with ACEs, ≥3 CPCEs (vs 0-2 CPCEs) lowered the adjusted prevalence by ≥50% for stroke (2.4% to 1.2%), COPD (2.2% to 0.7%) and severe psychological distress (16.4% to 7.4%).

CONCLUSION: CPCEs could reduce ACE-related risk of poor physical and mental health in later life. Early-life interventions that enhance PCEs in schools and/or neighbourhoods are recommended.

Language: en

Keywords

Humans; Cross-Sectional Studies; Adult; Aged; Female; Logistic Models; Male; Middle Aged; social interaction; Adolescent; mental health; epidemiology; Young Adult; Aged, 80 and over; Chronic Disease; chronic disease; *Adverse Childhood Experiences/statistics & numerical data; Japan/epidemiology; stress, psychological