{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T07:20:36Z","timestamp":1780816836216,"version":"3.54.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:00:00Z","timestamp":1693612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Disciplines of Excellence, West China Hospital, Sichuan University","award":["ZYYC21005"],"award-info":[{"award-number":["ZYYC21005"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Adverse childhood experiences (ACEs) have been well recognized as risk factors for various adverse outcomes. However, the impacts of ACEs on psychological wellbeing among Chinese children and adolescents are unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In total, 27\u200a414 participants (6592 Grade 4\u20136 and 20\u200a822 Grade 7\u201312 students) were included and information on ACEs and various psychosocial outcomes was collected. We identified subgroups with distinct psychosocial statuses using cluster analysis and logistic regression was applied to measure the associations of ACEs [individual, cumulative numbers by categories or co-occurring patterns identified by using multiple correspondence analysis (MCA)] with item- and cluster-specific psychosocial difficulties.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three and four cluster-based psychosocial statuses were identified for Grade 4\u20136 and Grade 7\u201312 students, respectively, indicating that psychosocial difficulties among younger students were mainly presented as changes in relationships\/behaviours, whereas older students were more likely featured by deviations in multiple domains including psychiatric symptoms and suicidality. Strongest associations were found for threat-related ACEs (e.g. bullying experiences) with item- or cluster-based psychosocial difficulties (e.g. for cluster-based difficulties, the highest odds ratios\u2009=\u20091.72\u20132.08 for verbal bullying in Grade 4\u20136 students and 6.30\u201312.81 for cyberbullying in Grade 7\u201312 students). Analyses on cumulative numbers of ACEs and MCA-based ACE patterns revealed similar risk patterns. Additionally, exposure patterns predominated by poor external environment showed significant associations with psychosocial difficulties among Grade 7\u201312 students but not Grade 4\u20136 students.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Chinese adolescents faced different psychosocial difficulties that varied by age, all of which were associated with ACEs, particularly threat-related ACEs. Such findings prompt the development of early interventions for those key ACEs to prevent psychosocial adversities among children and adolescents.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyad117","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T20:00:20Z","timestamp":1693684820000},"page":"1887-1897","source":"Crossref","is-referenced-by-count":11,"title":["Association of childhood adversities with psychosocial difficulties among Chinese children and adolescents"],"prefix":"10.1093","volume":"52","author":[{"given":"Yuchen","family":"Li","sequence":"first","affiliation":[{"name":"Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University , Chengdu, China"},{"name":"Med-X Center for Informatics, Sichuan University , Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Shang","sequence":"additional","affiliation":[{"name":"School of Health Management, Xihua University , Chengdu, China"},{"name":"West China Biomedical Big Data Center, West China Hospital, Sichuan University , Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Yang","sequence":"additional","affiliation":[{"name":"Med-X Center for Informatics, Sichuan University , Chengdu, China"},{"name":"West China Biomedical Big Data Center, West China Hospital, Sichuan University , Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Hou","sequence":"additional","affiliation":[{"name":"Med-X Center for Informatics, Sichuan University , Chengdu, China"},{"name":"West China Biomedical Big Data Center, West China Hospital, Sichuan University , Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huazhen","family":"Yang","sequence":"additional","affiliation":[{"name":"Med-X Center for Informatics, Sichuan University , Chengdu, 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