J.LIU1, E.ABDIN1, J.A.VAINGANKAR1, S.VERMA1, C.Y.Z.TANG1, S.A.CHONG1, M.SUBRAMANIAM1
Institute of Mental Health1
Adverse childhood experiences vary across culture and their heterogenous impact on health is understudied. The present study determined latent classes of adverse childhood experiences, examined socio-demographic variations between identified classes, and elucidated the interactions between class membership and psychological resources (i.e., positive mental health and perceived social support) on high-risk behaviours (i.e., smoking, binge drinking, and suicidality), chronic physical disorders, and mental disorders.
4441 adult Singapore residents were recruited in this nationwide epidemiological study. Lifetime mental disorders and suicidality were assessed on structured clinical interviews, while adverse childhood experiences, chronic physical disorders, smoking, binge drinking, perceived social support, and positive mental health were self-reported.
Latent class analysis identified three distinct classes; a multiple adversities class endorsing elevated levels of abuse and violence (6.1%), an emotionally neglected and bullied class (7.6%), and a low adversities class (86.2%). The multiple adversities class was associated with younger age, female gender, lower education status, more high-risk behaviours and physical/mental disorders. A three-way interaction was observed between profiles of childhood adversities, social support, and positive mental health on suicidality; high (+1 SD) social support and positive mental health were associated with lower risk for suicidality in the multiple adversities class (OR = 0.41, 95% CI 0.21 to 0.79, p < 0.0073).
Our results suggest that increasing positive mental health and social support are points of intervention to reduce suicidality. A person-centred approach via latent class analysis supports the early identification of high-risk profiles of adverse childhood experiences, which may guide the dosage of trauma-focused interventions.