Asociación de experiencias adversas en la infancia con síntomas de asma en niños. Revisión bibliográfica / Association of adverse childhood experiences with asthma symptoms in children. A literature review

Las experiencias adversas en la infancia (EAI) tienen un impacto considerable en la salud física y mental de los niños y adolescentes. Esta revisión bibliográfica se centra en la asociación entre estas experiencias y la incidencia de síntomas asmáticos, así como en las alteraciones inmunológicas en la población pediátrica. Los estudios revisados muestran una correlación significativa entre la exposición a EAI y el asma, destacando la importancia de un enfoque biopsicosocial para su manejo. Además, se discuten las implicancias clínicas y las precauciones necesarias al interpretar estos hallazgos.

Adverse childhood experiences (ACEs) have a significant impact on the physical and mental health of children and adolescents. This literature review focuses on the association between these experiences and the incidence of asthma symptoms, as well as immunological alterations in the pediatric population. The reviewed studies show a significant correlation between ACE exposure and asthma, highlighting the importance of a biopsychosocial approach for its management. Additionally, the clinical implications and necessary precautions when interpreting these findings are discussed.

Profiles of childhood trauma: epidemiological survey results of an educated young community cohort

Background: Childhood trauma is a major threat to the welfare and prosperity of any society. Young adult population is vulnerable due to increasing adverse childhood experiences and the likelihood of serious implications in educational performance and mental health. This survey was aimed to observe the proportion of various types of childhood traumas and their association with different socio-demographic characteristics among young university students of Karachi, Pakistan. Methods: This cross-sectional study was conducted among 300 young university students, during August-December 2023. Initially, cluster sampling was done deemed to the epidemiological survey. Afterwards, from the selected clusters, students from different universities were approached using non-probability convenient sampling technique. Self-reported data were collected through a questionnaire comprising of socio-demographic characteristics along with the types of traumas experienced during their childhood. SPSS Version 26.0 was used to analyse data. Results: Of the 300 university students with a mean age of 22.14±2 years, 55.3% were females. Overall, 63.6% of the participants experienced trauma before 18 years age. The most common trauma types reported were physical/verbal abuse (81%), unlawful touch/sexual abuse (45%), parents separated/divorced (31%) abandoned by parents (20%), lived with an alcoholic/drug addict (18%) or with a mentally ill adult (14%). There were no statistically significant findings between childhood trauma experience and socio-demographic traits. Conclusions: Various profiles of childhood trauma were found prevalent in young university level individuals. Current research does suggest a way forward to prevent this public health issue that can have detrimental consequences on an individual’s mental and physical health and stress reactivity.

Implementación de intervenciones que aborden las experiencias adversas en la infancia en atención primaria: una revisión exploratoria

Introducción: La vivencia de experiencias adversas en la infancia (EAI) se asocia a mayor riesgo de presentar conductas de riesgo y enfermedades crónicas a largo plazo. A nivel mundial, se han comenzado a pesquisar y abordar en las atenciones de salud. Sin embargo, en Chile aún no existe una sugerencia a nivel nacional para incorporarlo. El fin de este artículo es proveer de información y recomendaciones a la práctica clínica. Métodos: Se realizó una revisión exploratoria en PubMed, LILACS y PsycInfo usando el marco metodológico del Joanna Briggs Institute para identificar la literatura disponible sobre implementación de intervenciones en detección y abordaje de EAI dentro de un sistema de salud, con foco en atención infantil ambulatoria. Resultados: Se encontraron 34 estudios atingentes al tema, los que muestran que implementar mecanismos de detección y abordaje de EAI es factible y aceptable, tanto para el personal de salud como para los usuarios, pero debe ser realizado dentro de un modelo de cuidado que incorpore a las familias y comunidad, además de trabajar con los equipos en capacitación, gestión del cambio, implementación y evaluación. Conclusiones: La Atención Primaria de Salud (APS) resulta ser un lugar privilegiado para su implementación dada la cercanía y relación de confianza que se establece con las familias. Este estudio muestra que es posible implementar un modelo de detección y abordaje de EAI en APS, lo que resulta crucial dentro de su rol preventivo-promocional si se quiere generar un impacto en la salud de niños, niñas y adolescentes ahora y en el futuro.

Introduction: Adverse childhood experiences (ACEs) are associated with an increased risk of developing risky health behaviors and chronic diseases in the long term. Screening for ACEs is beginning to be implemented worldwide in healthcare settings due to their known impact on present and future health. However, in Chile, there are no recommendations to incorporate ACEs screening into usual care. Methods: A scoping review was conducted using the Joanna Briggs Institute methodological framework to identify available literature on the implementation of interventions aimed at the detection and management of ACEs within a health system, specifically pediatric primary care. The search included PubMed, LILACS, and PsycInfo databases. Results: A total of 34 studies were included. They show that screening for ACEs is feasible and acceptable for both health care providers and users. However, it must be implemented as a part of a model of care that considers families and communities, besides working with health teams in training, change management, implementation, and evaluation. Conclusions: Primary Health Care (PHC) is a privileged setting for screening implementation because of the longitudinal and trust relationships established with families. This study concludes that it is possible to implement a model for detecting and managing ACEs in PHC, which will be crucial for its promotional and preventive role if there is a desire to generate an impact on infant and adolescent health now and in the future.

Research progress on physical pain and social pain in non-suicidal self-injury and their influencing factors / 中国神经精神疾病杂志

Non-suicidal self-injury is a prevalent pathological behavior in clinical settings,significantly impacting both physical and mental health.Non-suicidal self-injury is closely associated with the abnormal perception of pain.Pain can be classified as physiological pain and social pain.In contrast to healthy people,individuals engaging in non-suicidal self-harm exhibit lower sensitivity to physiological pain but higher sensitivity to social pain.Their physiological pain thresholds are elevated,while their social pain thresholds are reduced.The alterations in pain sensitivity led them to alleviate emotions through a"pain to counter pain"approach.The abnormalities in pain sensitivity among individuals who engage in non-suicidal self-injury are closely linked to their social and psychological factors.Self-criticism,depressive symptoms,and adverse childhood experiences are all associated with the pain sensitivity of non-suicidal self-harm patients.

Stress level and quality of life following pediatric cataract surgery / Avaliação do nível de estresse e de qualidade de vida em crianças submetidas à cirurgia de catarata

ABSTRACT Purpose: To evaluate the quality of life and stress level related to visual function following pediatric cataract surgery in a Brazilian public hospital. Methods: This prospective study analyzed children aged 6-14 years old who underwent cataract surgery. The Childhood Stress Scale and Children's Visual Function Questionnaire (CVFQ) were used to assess stress levels and quality of life, respectively. Both instruments were applied by two psychologists before and after the surgery. Eye examination was performed by two ophthalmologists. Preoperative and postoperative data were compared. Results: In total, 23 children (32 eyes) were enrolled in the study, of which 9 had bilateral cataracts. The average age group at the time of surgery was 9.65 ± 2.26 (6-14) years old. One month after the surgery, the spherical equivalent was -0.90 ± 1.66D, and the corrected distance visual acuity was 0.13 ± 0.10 (0-0.3) LogMAR in bilateral cases and 0.50 ± 0.39 (0-1.3) LogMAR in unilateral cases (p<0.01). According to the Childhood Stress Scale, 77.7% of the bilateral cases and 57.1% of the unilateral cases had stable stress levels, and 34.7% of the children improved their stress level. The analysis of the CVFQ was based on scores for general health, general vision health, competence, personality, and treatment. After cataract surgery, 78.2% of the patients had improved or maintained CVFQ scores in the general health domain; 82.6%, general vision health; 95.6%, competence; 56.5%, personality; and 78.2%, treatment. Conclusion: Pediatric cataract surgery improves the visual function and the quality of life even in patients undergoing surgical procedures, without increasing the stress levels.

RESUMO Objetivo: Avaliar a qualidade de vida e o nível de estresse relacionada à função visual após a cirurgia de catarata pediátrica em um hospital público brasileiro. Métodos: Estudo prospectivo em crianças de seis a 14 anos submetidas à cirurgia de catarata. A Escala de Stresse Infantil e o Questionário de Função Visual em Crianças foram usados para avaliar o nível de estresse e a qualidade de vida, respectivamente. Ambos os instrumentos foram aplicados por duas psicólogas antes e após a cirurgia. O exame oftalmológico foi realizado por dois oftalmologistas. Os dados coletados no pré e pós-operatório foram comparados. Resultados: Vinte e três crianças (32 olhos) foram incluídas no estudo, nove delas apresentavam catarata bilateral. A média de idade na cirurgia foi de 9,65±2,26 (6 a 14) anos. Um mês após a cirurgia, o equivalente esférico foi de -0,90 ± 1,66D e a acuidade visual corrigida a distância foi de 0,13 ± 0,10 (0-0,3) LogMAR em casos bilaterais e 0,50 ± 0,39 (0-1,3) LogMAR em casos unilaterais (p<0.01). De acordo com a Escala de Stresse Infantil, 77,7% dos casos de catarata bilaterais, e 57,1% dos casos unilaterais mantiveram o nível de estresse e 34,7% das crianças melhoraram o nível de estresse. A análise do Questionário de Função Visual em Crianças foi baseada em pontuações para saúde geral, saúde geral da visão, competência, personalidade e tratamento. Após a cirurgia de catarata, 78,2% dos pacientes melhoraram ou mantiveram o escore do Questionário de Função Visual em Crianças na saúde geral, 82,6% na saúde geral da visão, 95,6% na competência, 56,5% na personalidade e 78,2% no tratamento. Conclusão: A cirurgia de catarata pediátrica melhora a função visual e a qualidade de vida em pacientes submetidos a procedimento cirúrgico, sem aumentar o nível de estresse.

Association between childhood trauma and postpartum depression among Brazilian puerperal women / Asociación entre traumas en la infancia y depresión posparto en puérperas brasileñas / Associação entre trauma na infância e depressão pós-parto em puérperas brasileiras

Objective: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. Method: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. Results: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. Conclusion: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up.

Objetivo: evaluar la asociación entre diferentes formas de traumas en la infancia y depresión posparto en puérperas brasileñas. Método: en este estudio transversal se incluyó a 253 puérperas que fueron evaluadas con la Edinburgh Postnatal Depression Scale y el Childhood Trauma Questionnaire . Se realizaron análisis de regresión logística multivariados para verificar la asociación de diferentes tipos de trauma y la coocurrencia de formas de abuso y negligencia con la depresión posparto. Resultados: se identificó depresión posparto en 93 mujeres (36,8%; intervalo de confianza del 95%: 30,8-42,7). Todas las formas de traumas en la infancia que se evaluaron (abuso emocional, negligencia emocional, abuso físico, negligencia física y abuso sexual) estuvieron asociadas de manera independiente con la depresión posparto después de ajustar por variables de confusión. El abuso emocional siguió estando asociado con la depresión posparto cuando se analizó la coocurrencia de todas las formas de traumas en la infancia. Conclusión: los resultados sugieren una asociación entre las diferentes formas de traumas en la infancia y la depresión posparto. En este sentido, los traumas en la infancia son un indicador para que los profesionales de Enfermería detecten factores de riesgo para la depresión posparto en los controles obstétricos.

Objetivo: avaliar a associação entre diferentes formas de trauma na infância e depressão pós-parto em puérperas brasileiras. Método: estudo transversal incluiu 253 puérperas que foram avaliadas pela Edinburgh Postnatal Depression Scale e pelo Childhood Trauma Questionnaire . Análises multivariadas de regressão logística foram realizadas para verificar a associação entre diferentes tipos de trauma e a coocorrência de formas de abuso e negligência com depressão pós-parto. Resultados: a depressão pós-parto foi identificada em 93 mulheres (36,8%; Intervalo de Confiança de 95%: 30,8-42,7). Todas as formas de trauma na infância avaliadas (abuso emocional, negligência emocional, abuso físico, negligência física e abuso sexual) foram independentemente associadas à depressão pós-parto após ajuste para variáveis de confusão. O abuso emocional permaneceu associado à depressão pós-parto quando foi analisada a coocorrência de todas as formas de trauma na infância. Conclusão: os resultados sugerem associação entre as diferentes formas de trauma na infância e depressão pós-parto. Nesse sentido, o trauma na infância é um indicador para os profissionais de Enfermagem rastrearem fatores de risco de depressão pós-parto durante o acompanhamento obstétrico.

Socioeconomic inequalities in health problems in the first two years of life: Pelotas (Brazil) birth cohort, 2015 / Desigualdades socioeconômicas em problemas de saúde nos primeiros dois anos de vida: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2015 / Desigualdades socioeconómicas en problemas sanitarios en los dos primeros años de vida: cohorte de nacimientos de Pelotas, Rio Grande do Sul, Brasil, 2015

Abstract: Brazil is characterized by an unfinished agenda of health inequalities, which impact health problems in the childhood. This study aimed to evaluate the socioeconomic inequalities of health problems in the early childhood. This is a prospective study, using data from the birth cohort carried out in the city of Pelotas (Rio Grande do Sul State, Brazil) in 2015. The outcomes were health problems presented at 12 and 24 months: cough, breathing difficulty, diarrhea, ear pain, pneumonia, urinary infection, hospitalization, and other health problems. Socioeconomic inequalities were measured applying the slope index of inequality (SII) and the concentration index (CIX), with wealth index and maternal schooling being the socioeconomic variables. The inequalities in the number of health problems were evaluated by Poisson regression. The perinatal sample comprised 4,275 children. At 12 months approximately 74% of the children presented 1 or more health problems, while at 24 months, approximately 44% presented 2 or more health problems. For all period, the mean number of health problems was 2.9 (standard deviation = 2.0). Higher frequencies were observed for children belonging to the poorest income quintile and with lower maternal education, except for 1 or more health problems at 24 months. The greatest absolute and relative inequality was observed for 2 or more health problems at 12 months (SII: -0.23, 95%CI: -0.29; -0.18 and CIX: -0.19, 95%CI: -0.25; -0.14). There is an opposite dose-response relation for the risk of accumulation of health problems according to maternal schooling (1.07, 95%CI: 1.04; 1.09) and wealth categories (1.03, 95%CI: 1.01; 1.04), in the full adjusted models. The study confirms inequalities due to health problems in Brazilian children, especially in the first year of life.

Resumo: O Brasil é marcado por uma agenda inacabada em relação às desigualdades na saúde, impactando os problemas de saúde da infância. O objetivo deste estudo foi avaliar as desigualdades socioeconômicas relacionadas aos problemas de saúde da primeira infância. Este é um estudo prospectivo com base na coorte de nascimentos realizado na cidade de Pelotas (Rio Grande do Sul, Brasil) em 2015. Os desfechos foram problemas de saúde apresentados aos 12 e 24 meses de idade: tosse, dificuldade para respirar, diarreia, dor de ouvido, pneumonia, infecção urinária, hospitalização e outros problemas de saúde. As desigualdades socioeconômicas foram aferidas usando o índice de desigualdade absoluta (SII, acrônimo em inglês) e o índice de concentração (CIX, acrônimo em inglês), considerando o índice de riqueza e escolaridade materna como variáveis socioeconômicas. A regressão de Poisson foi utilizada para avaliar as desigualdades no número de problemas de saúde. Um total de 4.275 crianças foram incluídas na análise. Aos 12 e 24 meses, aproximadamente 74% e 44% apresentaram 1 ou mais e 2 ou mais problemas de saúde, respectivamente. Para todo o período, o número médio de problemas de saúde foi de 2,9 (desvio padrão = 2.0). Maiores frequências foram observadas para crianças no quintil de renda mais baixa e com menor escolaridade materna, exceto para 1 ou mais problemas de saúde aos 24 meses. A maior desigualdade absoluta e relativa foi observada para 2 ou mais problemas de saúde aos 12 meses (SII: -0,23, IC95%: -0,29; -0,18 e CIX: -0,19, IC95%: -0,25; -0,14). Com base nos modelos ajustados, foi encontrada uma relação dose-resposta oposta para o acúmulo de problemas de saúde com base na escolaridade materna (1,07, IC95%: 1,04; 1,09) e nas categorias de riqueza (1,03, IC95%: 1,01; 1,04). Portanto, o estudo confirma as desigualdades relacionadas aos problemas de saúde em crianças brasileiras, especialmente no primeiro ano de vida.

Resumen: Las desigualdades sanitarias en Brasil afectan a la salud infantil. El objetivo de este estudio fue evaluar las desigualdades socioeconómicas de los problemas sanitarios de la primera infancia. Este es un estudio prospectivo de una cohorte de nacimientos realizada en la ciudad de Pelotas (Rio Grande do Sul, Brasil) en 2015. Los desenlaces fueron problemas sanitarios de niños de 12 y 24 meses de edad como tos, dificultad para respirar, diarrea, dolor de oído, neumonía, infección del tracto urinario, hospitalización, entre otros problemas. Las desigualdades socioeconómicas se midieron con el índice de desigualdad absoluta (SII, por sus siglas en inglés) y el índice de concentración (CIX, por sus siglas en inglés). El índice de ingresos y nivel educativo de la madre fueron las variables socioeconómicas. Las desigualdades en el número de problemas sanitarios se evaluaron mediante la regresión de Poisson. La muestra perinatal fue conformada por 4.275 niños. A los 12 y 24 meses, aproximadamente el 74% y el 44% de los niños tenían uno o más y dos o más problemas de salud, respectivamente. Durante el período, el número promedio de problemas sanitarios fue de 2,9 (desviación estandar = 2.0). Se observaron frecuencias más altas para los niños pertenecientes al quintil de ingresos más pobres y con el nivel educativo de la madre más bajo, a excepción de uno o más problemas de salud a los 24 meses. La mayor desigualdad absoluta y relativa se observó en dos o más problemas sanitarios a los 12 meses (SII: -0,23, IC95%: -0,29; -0,18 e CIX: -0,19, IC95%: -0,25; -0,14). Con base en los modelos ajustados, se encontró una relación dosis-respuesta opuesta para la acumulación de problemas sanitarios en cuanto al nivel educativo de la madre (1,07, IC95%: 1,04; 1,09) y a los ingresos (1,03, IC95%: 1,01; 1,04). Este estudio confirma las desigualdades por problemas sanitarios de niños brasileños, especialmente en el primer año de vida.

Experiencias infantiles adversas y síndrome metabólico en adultos de una unidad de medicina familiar en Michoacán, México / Adverse childhood experiences and metabolic syndrome in adults in a family medicine unit Michoacán, Mexico

Introducción: las experiencias infantiles adversas (EIA) aumentan el riesgo de enfermedades metabólicas en la edad adulta; no obstante, esta relación ha sido poco estudiada en la población mexicana Objetivos: determinar la frecuencia de experiencias infantiles adversas (EIA) y su relación con el síndrome metabólico en personas mayores de 19 años de edad en una unidad de medicina familiar urbana en Michoacán, México. Metodología: se realizó un estudio observacional, retrospectivo, transversal y analítico en 127 participantes mayores de 19 años. Se evaluaron sus medidas antropométricas, y cuantificamos los niveles de glucosa en ayuno, triglicéridos y colesterol HDL en sangre. Aplicamos el cuestionario internacional de experiencias infantiles adversas (ACE-IQ). Utilizamos estadística descriptiva y la prueba de Chi cuadrada. Resultados: el 95% de la muestra reportó al menos una EIA, y la más frecuente fue la violencia doméstica. El 45% de los individuos presentaron síndrome metabólico. No se encontró asociación entre el síndrome metabólico ni los componentes con la exposición a las EIA. No obstante, observamos que el divorcio o pérdida de uno de los padres fue más frecuente en los participantes con síndrome metabólico (p = 0.03). Conclusiones: la frecuencia de EIA fue mucho más alta que lo previamente reportado, pero no se observó una asociación con el síndrome metabólico... (AU)

Introduction: Adverse childhood experiences (ACE) increase the risk of metabolic diseases in adulthood; however, this relationship has been scarcely studied in the Mexican population. Objective: To determine the frequency of adverse childhood experiences and their relationship to metabolic syndrome in an urban Primary Care Unit from Michoacán, México. Methods: An observational, retrospective, cross-sectional and analytical study was performed in 127 participants older than 19 years. Their anthropometric measurements were evaluated, and we quantified the blood levels of fasting glucose, triglycerides, and HDL cholesterol. The Adverse Childhood Experiences International Questionnaire (ACE-IQ) was utilized. We used descriptive statistics and the Chi square test. Results: 95% of the sample reported at least one EIA, and the most frequent was domestic violence. 45% of individuals presented metabolic syndrome. No association was found between the metabolic syndrome or its components with the exposure to EIA. However, we observed that divorce or loss of one of the parents was more frequent in the participants with metabolic syndrome (p = 0.03). Conclusions: The frequency of EIA was much higher than previously reported, however, we did not observe an association of ACE with metabolic... (AU)

Violencia sexual en el departamento del Huila (Colombia): un problema de salud pública, 2016-2020 / Sexual violence in the department of Huila (Colombia): a public health problem, 2016-2020

RESUMEN Objetivo: Describir el comportamiento de la violencia sexual en el departamento del Huila (Colombia) durante el quinquenio 2016-2020. Materiales y métodos: Investigación cuantitativa, tipo descriptivo de corte transversal; universo de 4988 casos de violencia sexual, cuya fuente fue el Sistema de Vigilancia Epidemiológica (SIVIGILA). Resultados: La violencia sexual presentó una tendencia creciente entre 2016 y 2019, pero un decremento de cuatro puntos porcentuales para 2020. Los municipios con mayor número de casos de violencia sexual fueron Neiva, Pitalito, La Plata y Garzón. En el análisis sociodemográfico de la víctima, la mayoría se hallaban en los ciclos de vida de adolescencia, infancia y primera infancia. Las mujeres presentaron la más alta frecuencia, con una razón de 7,3 mujeres víctimas de violencia sexual por cada hombre. En cuanto a la modalidad, el abuso sexual fue la más relevante, seguido de violación, acoso sexual y actos sexuales. Respecto al perfil del agresor, el género masculino fue el que presentó más alta frecuencia, con una razón de 26,2 agresores de género masculino por 1 del femenino. Conclusiones: La violencia sexual en el Huila evidenció una gran vulnerabilidad en adolescentes, infancia y primera infancia y principalmente en mujeres. Urge abordar aspectos como las desigualdades sociales, económicas, las violencias de género, los comportamientos abusivos, las crisis sociales en las políticas públicas locales.

ABSTRACT Objective: Describe the behavior of sexual violence in the department of Huila (Colombia) during the five-year period 2016 to 2020. Materials and methods: Quantitative research, descriptive cross-sectional type, universe of 4,988 cases of sexual violence, whose source was the Epidemiological Surveillance System (SIVIGILA). Results: Sexual violence presented an increasing trend between 2016 and 2019, but a decrease of four percentage points for the year 2020. The municipalities with the highest number of cases of sexual violence were Neiva, Pitalito, La Plata, and Garzón. In the sociodemographic analysis of the victim, the majority were in the life cycles of adolescence, infancy, and early childhood. Women presented the highest frequency; with a ratio of 7.3 women victims of sexual violence for each man. Regarding the modality, sexual abuse was the most relevant, followed by rape, sexual harassment, and sexual acts. Regarding the profile of the aggressor, it was the male gender that presented the highest frequency, with a ratio of 26.2 male aggressors to one female. Conclusions: Sexual violence in Huila showed a great vulnerability in adolescents, childhood, and early childhood and mainly in women. It is urgent to address aspects such as social and economic inequalities, gender violence, abusive behavior, social crises in local public policies.

Experiências adversas na infância: um estudo com autores de agressão sexual / Experiencias infantiles adversas: un estudio con perpretadores de agresiones sexuales / Adverse childhood experiences: a study addressing the perpetrators of sexual violence

This study aimed to describe the Adverse Childhood Experiences (ACE) of perpetrators of sexual violence of children and adolescents and their relationship with the abusers' personal and situational factors (n = 30). Hence, a database composed of the transcripts of interviews was analyzed using content analysis, from which thematic categories emerged as proposed by the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Physical abuse was the most frequently reported (70%). Sexual abuse was reported by almost half of the sample, which presented an increased risk in the face of the death and/or divorce of parents (RR = 4.21) and emotional neglect (RR = 3.2). In addition, the participants with higher ACE-Scores abused children more recurrently and less frequently consumed alcohol or other drugs. The interpretation of the results in light of the literature reinforces the hypothesis that the consequences of adversities during childhood are associated with a higher likelihood of becoming a victim throughout life and manifesting risky behaviors, such as aggressive sexual behavior. Future studies are suggested to apply the ACE-IQ to larger samples and implement a post-test to contribute to more effective interventions to treat this population.

Este estudio tuvo como objetivo analizar las Experiencias Adversas en la Infancia por parte de los perpetradores de agresión de niños y niñas y la asociación con factores personales y situacionales identificados. (n = 30). Para ello, se utilizó el instrumento de cribado del Cuestionario Internacional de Experiencias Adversas en la Infancia (ACE-IQ) para el análisis de los datos. El maltrato físico fue reportado con mayor frecuencia (70%) y el abuso sexual fue mencionado por casi la mitad de la muestra, con su riesgo aumentado ante la muerte y/o divorcio de los padres (RR = 4,21) y negligencia emocional (RR = 3.2). Participantes con ACE-Scores más altos han agredido repetidamente a sus víctimas y con menos necesidad de consumir alcohol y/o otras drogas. Los resultados muestran que las consecuencias de la exposición a la adversidad en la infancia están asociadas no solo a la probabilidad de convertirse en víctima a lo largo de la vida, sino también a caminos de transitar permeados por conductas de riesgo y criminalidad. Se sugiere que más estudios puedan aplicar el ACE-IQ a muestras más grandes, con la realización de una prueba posterior, lo que puede contribuir a intervenciones más efectivas al servicio de esta población.

Este estudo objetivou descrever Experiências Adversas na Infância (EAI) relatadas por autores de agressão sexual de crianças e adolescentes e sua relação com fatores pessoais e situacionais identificados (n = 30). Para tanto, utilizou-se um banco de dados formado por transcrições de entrevistas previamente realizadas, cuja análise de conteúdo considerou categorias temáticas retiradas do Adverse Childhood Experiences International Questionnaire (ACE-IQ). O abuso físico foi o mais relatado (70%) e o abuso sexual mencionado por quase metade da amostra, tendo seu risco aumentado diante da morte e/ou separação dos pais (RR = 4.21) e negligência emocional (RR = 3.2). Participantes com maiores ACE-Scores agrediram de forma mais recorrente e com menor uso de álcool e/ou outras drogas. A interpretação dos resultados à luz da literatura da área reforça a hipótese de que as consequências da exposição à adversidade na infância estão relacionadas tanto à probabilidade de tornar-se vítima ao longo da vida quanto de vir a manifestar comportamentos de risco, como a conduta sexual agressiva. Estudos posteriores poderão aplicar o ACE-IQ diretamente e em amostras maiores, com a realização de pós-teste, o que favorecerá a promoção de intervenções mais eficazes no atendimento a essa população.

Echoes of early-life stress on suicidal behavior in individuals with substance use disorder / Ecos del estrés en la vida temprana en el comportamiento suicida en personas con trastorno por uso de sustancias

Introduction: Psychoactive substances abuse is considered a problematic social factor due its likelihood to cause harmful, self-destructive behaviors to the subjects and the overall society. Stress in an individual's early life may also be a contributing factor to substance abuse as well as suicide attempts. There is a lack of studies examining these factors in people with substance-use disorder. Aim: to identify the relationship between early-life stress and suicide attempts in drug-dependent adults. Methods: This is a predictive correlational study with a cross-sectional approach. The convenience sample consisted of 105 individuals treated at an outpatient unit for addiction treatment. The participants were assessed using the Mini-international Neuropsychiatric Interview, a Childhood Trauma Questionnaire to measure the severity of the different types of early life stress; the Beck Scale for Suicide Ideation was also used. The data were analyzed using descriptive and inferential statistics through univariate and multivariate logistic regression. Results: The analyzed sample included 33 (31.4%) individuals who attempted suicide and were significantly more likely to suffer from emotional, physical, or sexual abuse than those who had never attempted suicide (p <0,05). Conclusions: Different forms of early-life stress are related to attempted suicide in people with substance-use disorder. Further studies are needed to understand the effects of early-life stress on suicide attempts in drug-dependent people.

Introducción: El abuso de sustancias psicoactivas se considera un factor social problemático cuando se producen conductas autodestructivas perjudiciales para el sujeto y la sociedad. El estrés en la vida temprana de una persona también puede ser un factor que contribuya a las situaciones de abuso de sustancias, así como a los intentos de suicidio. Hay una falta de estudios que examinen estos factores en personas con trastorno por uso de sustancias. Objetivo: Identificar la relación entre estrés en la vida temprana y los intentos de suicidio en personas adultas con trastorno por uso de sustancias. Métodos: Estudio correlacional, predictivo, transversal. La muestra de conveniencia consistió en 105 personas tratadas en una unidad ambulatoria para el tratamiento de adicciones. Las personas se evaluaron por medio de la Mini-Entrevista Neuropsiquiátrica Internacional, el Cuestionario de Trauma Infantil para medir la gravedad de los diferentes tipos de estrés en la vida temprana y la Escala de Beck para Ideación Suicida. Los datos se analizaron mediante estadística descriptiva e inferencial mediante regresión logística univariante y multivariante. Resultados: De la muestra analizada, 33 (31,4%) habían intentado suicidarse y tenían una exposición significativamente mayor al abuso emocional, físico y sexual (p<0,05) en comparación con las personas que nunca habían intentado suicidarse. Conclusiones: Diferentes formas de estrés en la vida temprana están relacionadas con el intento de suicidio en personas con trastorno por consumo de sustancias. Se necesitan más estudios para comprender los efectos del estrés en la vida temprana sobre los intentos de suicidio en una persona con dependencia.

Introdução: O uso abusivo de substâncias psicoativas é considerado um fator social problemático quando ocorrem comportamentos autodestrutivos prejudiciais ao sujeito e à sociedade. O estresse no início da vida de um indivíduo também pode ser um fator que contribui para situações de abuso de substâncias, bem como tentativas de suicídio. Há uma falta de estudos examinando esses fatores em pessoas com transtorno por uso de substâncias. Objetivo: Identificar a relação entre o estresse no início da vida e as tentativas de suicídio em adultos com transtorno de uso de substâncias. Métodos: Estudo correlacional preditivo com abordagem transversal. A amostra por conveniência foi composta por 105 indivíduos atendidos em uma unidade ambulatorial para tratamento de dependências e foi avaliada por meio do Mini-International Neuropsychiatric Interview, do Childhood Trauma Questionnaire para medir a gravidade de diferentes tipos de estresse precoce e da Escala de Beck para Ideação Suicida. Os dados foram analisados por meio de estatística descritiva e inferencial por meio de regressão logística univariada e multivariada. Resultados: Da amostra analisada, 33 (31,4%) já haviam tentado suicídio e tiveram exposição significativamente maior a abusos emocionais, físicos e sexuais (p <0,05) em comparação com os participantes que nunca tentaram suicídio. Conclusões: Diferentes formas de estresse no início da vida estão relacionadas à tentativa de suicídio em indivíduos com transtorno por uso de substâncias . Mais estudos são necessários para compreender os efeitos do estresse precoce nas tentativas de suicídio de uma pessoa com dependência.

Resilience, adverse childhood experiences, and mental health in Health Science students during the COVID-19 pandemic / Resiliencia, eventos adversos en la infancia y salud mental en estudiantes de Ciencias para la Salud en la pandemia por COVID-19

Abstract Introduction A steady rise in mental problems has been observed in the university population, particularly in the area of health, related to the COVID-19 pandemic. Protective factors such as resilience and risk factors such as adverse events in childhood have been associated with mental health outcomes. Objective Describe psychiatric symptoms and their association with adverse childhood experiences and resilience in first-semester students in the three undergraduate programs of the Faculty of Health Sciences of the University of Caldas, Colombia in 2020. Method Descriptive, cross-sectional, correlational study, using a virtual survey including the SRQ (Self Reporting Questionnaire), Wagnild and Young's Resilience Scale and questions on adverse childhood experiences. Results A total of 108 students with a mean age of 19.6 years participated in the study. Affective symptoms were found in 6.4% of subjects. The most frequent level of resilience was medium, while the most commonly reported adverse event was child abuse. An association was found between being exposed to adverse childhood experiences and the presence of symptoms that compromise mental health and alter one of the domains of resilience. A link was also found between the presence of these symptoms and the alteration of domains of resilience. Discussion and conclusion It was possible to identify a risk of mental health disorders in students, and to establish an association between adverse events in childhood and resilience.

Resumen Introducción Se ha descrito un aumento progresivo de problemas mentales en la población universitaria, especialmente en el área de la salud, relacionado con la pandemia por COVID-19. Factores protectores como la resiliencia y factores de riesgo como eventos adversos en la infancia, se han relacionado con desenlaces en la salud mental. Objetivo Describir síntomas psiquiátricos y su asociación con eventos adversos en la infancia y resiliencia, en estudiantes de primer semestre de los tres programas de pregrado de la Facultad de Ciencias para la Salud de la Universidad de Caldas, Colombia en 2020. Método Estudio descriptivo, transversal, correlacional, mediante una encuesta virtual incluyendo el SRQ (Self Reporting Questionnaire), escala de resiliencia de Wagnild y Young y preguntas relacionadas con eventos adversos en la infancia. Resultados Participaron 108 estudiantes con edad media de 19.6 años. Hubo presencia de síntomas afectivos en 6.4%. El nivel de resiliencia más frecuentemente encontrado fue "medio" y el evento adverso en la infancia más comúnmente reportado fue el maltrato. Se demostró asociación entre haber estado expuesto a eventos adversos en la infancia tanto con presencia de síntomas que comprometen la salud mental como con afectación de uno de los dominios de resiliencia. Asimismo, hubo asociación entre presencia de dichos síntomas con afectación de los dominios de la resiliencia. Discusión y conclusión Se pudo identificar riesgo de alteraciones de la salud mental en los estudiantes, resaltando la asociación con eventos adversos en la infancia y la resiliencia.

Reliability and validity of the Chinese version of adverse childhood experiences international questionnaire in parents of preschool children / 北京大学学报(医学版)

OBJECTIVE@#To test the reliability and validity of the Chinese version of adverse childhood experiences international questionnaire (ACE-IQ) in Chinese parents of preschool children.@*METHODS@#The parents of preschool children in 6 kindergartens in Tongzhou District of Beijing were selected by stratified random cluster sampling, and the Chinese version of ACE-IQ after translation and adaptation was used for survey online. The collected data were randomly divided into two parts. One part of the data (n=602) was used for exploratory factor analysis (EFA), to screen items and evaluate structural validity, and then form the final Chinese version of ACE-IQ. The other part of the data (n=700) was used for confirmatory factor analysis (CFA), criterion validity analysis and reliability analysis. At the same time, experts investigation method was used to evaluate the content validity of the final Chinese version of ACE-IQ.@*RESULTS@#After deleting four items of collective violence, the Chinese version of ACE-IQ with twenty-five items indicated good structural, criterion and content validity. Analysis results showed that the Chinese version of ACE-IQ presented a seven-factor model dimension, namely emotional neglect, physical neglect, family dysfunction, family violence, emotional and physical abuse, sexual abuse and violence outside the home, and the total score of the binary version of ACE-IQ Chinese version was positively correlated with the total score of childhood trauma questionaire-28 item short form (CTQ-SF, r=0.354, P < 0.001) and the center for epidemiological studies depression scale (CES-D, r=0.313, P < 0.001) respectively. Results from five experts showed that the item-level content validity index (I-CVI) of 25 items was between 0.80 and 1.00, and the average of all I-CVIs on the scale (S-CVI/Ave) of the scale was 0.984. At the same time, the internal consistency (Cronbach's α coefficient) of the whole scale was 0.818, and the split-half reliability (Spearman-Brown coefficient) was 0.621, which demonstrated good reliability.@*CONCLUSION@#This study has formed a Chinese version of ACE-IQ with 25 items and 7 dimensions, which has good reliability and validity among the parents of preschool children in China. It can be used as an evaluation instrument for measuring the minimum threshold of the adverse childhood experiences in the parents of preschool children in the cultural background of China.

How adverse and benevolent childhood experiences influence depression and suicidal ideation in Chinese undergraduates: a latent class analysis

BACKGROUND@#There has been minimal research on the role of benevolent childhood experiences (BCEs) and how such events may offer protection from the insidious effects of adverse childhood experiences (ACEs) or later in life.@*OBJECTIVES@#This research aims to learn how BCEs and ACEs interact to affect adolescents' psychological distress.@*METHODS@#Cross-sectional survey was conducted in three cities (Xuzhou, Nanjing, and Wuhan) in China from March 2021 to May 2021. Latent class analysis (LCA) was used to classify the patterns of ACEs and BCEs. We adopted hierarchical multivariable regression to examine the influences of ACEs and BCEs on depression and suicidal ideation.@*RESULTS@#To explore the relationship between childhood experience and suicidal ideation and depression, LCA revealed three patterns of ACEs: (1) emotional abuse (10.57%); (2) high ACEs (0.55%); and (3) low ACEs classes (88.88%). Adolescents with emotional abuse (depression: OR = 3.82, 95%CI = 2.80-5.22, P < 0.001; suicidal ideation: OR = 5.766, 95%CI = 3.97-8.38, P < 0.001) and high ACEs class (suicidal ideation: OR = 5.93, 95%CI = 1.19-29.66, P < 0.05) had an increased risk of psychological distress (reference: low ACEs). LCA revealed four patterns of BCEs: (1) relationship support (14.54%); (2) low BCEs (4.85%); (3) high BCEs (55.34%); and (4) high quality of life classes (25.28%). Adolescents with a high quality of life (depression: OR = 0.09, 95%CI = 0.05-0.16, P < 0.001; suicidal ideation: OR = 0.22, 95%CI = 0.12-0.40, P < 0.001) and high BCEs (depression: OR = 0.05, 95%CI = 0.03-0.09, P < 0.001; suicidal ideation: OR = 0.15, 95%CI = 0.09-0.26, P < 0.001) protected the mental health of adolescents (reference: low BCEs).@*CONCLUSIONS@#High ACEs and emotional abuse classes were significantly associated with poorer mental health symptoms, including suicidal ideation and depression. In contrast, high BCEs and high quality of life classes were associated with better mental health. These findings point out that it is more necessary to identify and support victims of ACEs, and it is urgent to increase BCEs in early childhood.

Could children exposed to intimate partner violence against their mother have more functional gastrointestinal disorders?

Abstract Objective: To analyze the association between child exposure to intimate partner violence (CEIPV) committed against their mother and functional gastrointestinal disorders (FGIDs) in school-age children. Methods: A prospective cohort study was carried out that evaluated 626 mother-child pairs living in a poor urban area in the Northeast of Brazil. The mothers were asked about their children's exposure to intimate partner violence. Holden's classification was used, which investigates ten types of CEIPV from prenatal care. The number of exposures, age of onset, and the perpetrator of the exposure were also verified. The FGIDs in children were identified from the mother's responses to the questionnaire about pediatric gastrointestinal symptoms, Roma III version parent-report, translated and cross-culturally adapted into Brazilian Portuguese. Results: FGIDs were more frequent among children exposed to violence than those not exposed (OR: 1.64; 95% CI: 1.04-2.58; p = 0.03). Likewise, in children who suffered four or more types of exposure (OR: 1.81; 95% CI: 1.10-2.96; p = 0.01), in which the exposure started in the first two years of life (OR: 1.93; 95% CI: 1.08-3.47; p = 0.02) and in those whose biological father was the perpetrator of the violence (OR; 1.62; 95% CI: 1, 05-2.48; p = 0.02). Conclusion: Corroborating the proposal of the biopsychosocial model, CEIPV increases the chance of occurrence of FGIDs in school-age children. Therefore, early identification and proposals for appropriate interventions are suggested both for the prevention of CEIPV and for the prevention and follow-up of FGIDs.

Adverse childhood experiences and psychopathology in adolescents from northern Chile: the moderating role of the attachment style

Abstract Background Identifying the underlying mechanisms through which adverse childhood experiences affect (ACEs) the mental health of adolescents is of paramount importance for disease prevention in later stages of life. Objective The present study examines the relationship between ACEs and psychopathology in adolescents from northern Chile and how attachment style (abandonment anxiety and intimacy avoidance) may moderate this relationship. A total of 154 schooled adolescents aged 12 to 17 (M = 15.08, SD = 1.64) completed a series of self-report questionnaires including the Adverse Childhood Experience Questionnaire (ACEs), Experiences in Close Relationships-Relationship Structures (ECR-RS), and Youth Self Report (YSR-18). Results The data analysis was carried out using SPSS version 25, which included descriptive analysis, one-way ANOVA, and Spearman correlation analysis. To address moderation analysis, the PROCESS macro extension version 4.1 was employed. In this process, the bootstrap method was applied to construct confidence intervals, and the pick-a-point approach was used to define the levels of the moderating variable. According to the results, 80.3% of the sample experienced one or more ACEs, and 16.4% reported experiencing at least three. Furthermore, the variables under study exhibited significant correlations with each other, except for intimacy avoidance, which showed no correlation with ACEs (rho = −0.10; p = 0.273). When considering abandonment anxiety as a moderating variable, the direct effect of ACEs on externalizing symptoms showed statistically significant changes (β = 0.60, p = 0.03). No other moderating effects were found according to the proposed models. Conclusion In childhood, the accumulation of ACEs is associated with the development of psychopathology in adolescents from northern Chile, specifically with the presence of internalizing and externalizing symptoms. These findings suggest that lower levels of abandonment anxiety could mitigate the effects of ACEs on adolescent psychopathology, while higher levels of abandonment anxiety could exacerbate these effects on psychopathology.

Scurvy and food selectivity in childhood: a case report

ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

Childhood trauma subtypes may influence the pattern of substance use and preferential substance in men with alcohol and/or crack-cocaine addiction

Objective: To compare the prevalence and subtypes of childhood maltreatment (CM) between individuals with and without substance use disorder (SUD) and investigate the influence of different traumas on the preferential use of substances and the severity of dependence. Methods: The sample consisted of 1,040 men with SUD (alcohol users [n=315], crack-cocaine users [n=406], multiple-substance users [n=319]) and 201 controls. The Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index-6 (ASI-6) were used to assess CM and drug-use patterns. Results: Individuals with SUD had a higher prevalence of CM than controls (63.4 vs. 28.1%, respectively). Exposure to physical trauma was associated with alcohol use disorder and severity of alcohol use. In contrast, emotional trauma was associated with use of multiple substances and severity of drug use in crack-cocaine users. Conclusions: This study corroborates the association of CM with SUD susceptibility. Our results suggest that the type of CM may influence preferential substance use and addiction severity. In this sense, physical traumas are more associated with alcohol use, while emotional and sexual traumas favor use of multiple drugs, especially crack cocaine. These findings may help the development of tailored prevention and intervention strategies.

Relationship between adverse childhood experiences and the physical and mental health in Mexican adults / Relación entre las experiencias adversas en la infancia y la salud física y mental en adultos mexicanos

Abstract Introduction Adverse childhood experiences (ACEs) are potentially traumatic events that people may experience during early life, including physical, psychological, and sexual abuse; neglect; and household dysfunction. Objective To evaluate the frequency of ACEs and their relationship with the mental and physical health of Mexican adults. Method 389 people between 18 and 65 years old were included in a cross-sectional study with an incidental sample and voluntary participation. Subjects responded to the ACEs questionnaire, the PHQ-9, the GAD-7, and the PHQ-15. Logistic regression models were used to evaluate the association between ACEs and adult health conditions. Results 75% reported at least one type of adversity, and 31.4% reported three or more. Reporting three or more ACEs was associated with an increased odds ratio for depression (OR = 5.04, 95% CI [2.38, 10.68]), anxiety (OR = 3.33, 95% CI [1.09, 6.99]), psychosomatic severity (OR = 4.58, 95% CI [2.53, 8.29]), obesity (OR = 2.08, 95% CI [1.21, 3.59]), and limitations due to physical or emotional discomfort (OR = 5.90, 95% CI [2.88, 12.09]). Higher anxiety was associated with sexual abuse (OR = 2.12 95% CI [.92, 4.85]) and witnessing violence (OR = 5.09, 95% CI [1.04, 24.77]). The probability of psychosomatic severity was higher if reported sexual abuse increased (OR = 1.94 95% CI [.06, 3.54]) and emotional neglect (OR = 1.84, 95% CI [1.02, 3.32]). Discussion and conclusion ACEs are associated to mental health difficulties and psychosomatic symptoms. The relationship between different types of adversity and health is confirmed.

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.

Prevalence and factors associated with adverse early childhood experiences: a population-based study in Ceará, Brazil / Prevalência e fatores associados a experiências adversas na primeira infância: um estudo de base populacional no Ceará, Brasil

ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0-2, 3-5, and 6-9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7-90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures.

RESUMO Objetivo: Estimar a prevalência de experiências adversas na infância e identificar fatores associados. Métodos: O estudo transversal de base populacional compreendeu os dados de uma amostra de 3.200 domicílios com 3.566 crianças menores de seis anos, representativa do estado do Ceará, Brasil. Foi utilizado um processo de amostragem multiestágio, com estratificação entre a capital do estado, Fortaleza, e os 28 municípios do interior, nos quais foram sorteados 160 setores censitários, cada qual com um conglomerado de 20 domicílios. A variável desfecho foi estruturada com base nas situações de experiências adversas na infância sugeridas pelo grupo Centers for Disease Control and Prevention, de acordo com o número de situações a que a criança foi exposta: 0-2, 3-5 e 6-9. O modelo multivariado de regressão logística ordinal foi utilizado para avaliar as associações. Resultados: Das 3.566 crianças estudadas, 89,7% (intervalo de confiança — IC95% 88,7-90,7) foram expostas a pelo menos uma experiência adversa, sendo as mais prevalentes negligência e abuso emocional/físico. Os principais fatores associados às experiências adversas na infância foram a idade materna mais elevada e o tabagismo materno, a ausência paterna, a baixa escolaridade do chefe da família, a insegurança alimentar e a falta de rede de apoio social. Conclusão: O estudo encontrou alta ocorrência de experiências adversas na primeira infância, principalmente entre crianças nascidas de mães de idade mais elevada e tabagistas, sem a presença paterna, e em situação de vulnerabilidade social e econômica, como a insegurança alimentar, que deve ser alvo prioritário de medidas de prevenção e controle.