Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences.
OBJECTIVE
We sought to determine the fractions of psychiatric disorders and suicide ideation and attempts in a general population sample attributable to childhood physical abuse, sexual abuse, and witnessing domestic violence.


METHODS
Data were obtained from the US National Comorbidity Survey Replication. Population attributable fractions were calculated to determine the proportion of psychiatric disorders and suicide ideation and attempts attributable to adverse childhood experiences. The analysis was stratified by gender.


RESULTS
The estimated attributable fractions for psychiatric disorders attributable to having experienced any adverse childhood event ranged from 22% to 32% among women and 20% to 24% among men. Having experienced any adverse event accounted for a substantial proportion of suicide ideation and attempts among women (16% and 50%, respectively) and men (21% and 33%, respectively). Substantial proportions of poor mental health outcomes were also attributable to increasing number of adverse events.


CONCLUSIONS
The estimated proportions of poor mental health outcomes attributed to childhood adversity were medium to large for men and women. Prevention efforts that reduce exposure to adverse childhood events could substantially reduce the prevalence of psychopathology and suicidal behavior in the general population.
Afifi
Tracie O
TO
Department of Community Health Sciences at the University of Manitoba, PZ-430771 Bannatyne Ave, Winnipeg, Manitoba, Canada R3E 3N4. toafifi@exchange.hsc.mb.ca
Enns
Murray W
MW
Cox
Brian J
BJ
Asmundson
Gordon J G
GJ
Stein
Murray B
MB
Sareen
Jitender
J
D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000209:etiology*; D015995:Prevalence; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology