Adverse childhood experiences: impacts on adult mental health and social withdrawal.

Background: Adverse childhood experiences (ACEs) have been found to negatively impact adult mental health outcomes. Numerous studies have highlighted on ACEs in family and community settings. However, few have examined the impact of ACEs in school settings, despite the potential influence on social participation. Hikikomori, characterized by severe social withdrawal, was first studied in Japan and has gained recognition in recent years. The present study aims to present the concept of ACEs specific to schools and investigate the impact of both school ACEs and traditional ACEs on adult mental health and Hikikomori. Methods: A total of 4,000 Japanese adults, aged 20-34, were recruited through an Internet survey form. All data were obtained in October 2021. Participants answered questions regarding their ACEs in the family (10 items), school ACEs (five teacher-related items and two bullying-related items), depressive/anxiety symptoms, and Hikikomori (remaining at home for more than 6 months). Results: A significant association with depressive/anxiety symptoms was shown in both ACEs and school ACEs. An increase of one point in the ACE scores was associated with a 24% increase in the risk of depressive/anxiety symptoms. School ACE scores also demonstrated a significant association with depressive/anxiety symptoms, with an increase of one point associated with a 44% increase in the risk of these symptoms. As for Hikikomori, a significant association was shown in the school ACEs only: a 29% increased risk of Hikikomori for every one-point increase in school ACE scores. Both school ACE scores for teacher-related and bullying-related factors revealed a significant association with Hikikomori; the rates of increased risk were 23 and 37%, respectively. Conclusion: These results suggest that school ACEs, rather than ACEs in the family, are associated with the risk of Hikikomori. School ACEs are important for social adaptation, and reducing traumatic experiences in school settings may have the potential to prevent problems in later life, specifically in terms of social participation.

Mental health status of children who use foreign languages at home in Japan.

Aim: Little is known about the mental health status of children in Japan whose roots are in foreign countries. The differences in language that are used every day may be a factor that makes adaptation difficult for these children. The aim of the present study, therefore, was to examine the mental health status of children who use foreign languages at home via a cross-sectional survey in a large cohort. Methods: The survey was conducted among children who attended public elementary and junior high schools in a large city in Japan. Data were received from 20,596 elementary school-aged (above 4th grade) and 19,464 junior high school-aged children. We compared mental health status evaluated by the Patient Health Questionnaire-4 in the group based on language usage at home (only Japanese, only foreign languages, and both languages). Results: We found that children who used foreign languages at home exhibited worse mental health status than children who used only Japanese at home. In addition, mental health status was slightly better among junior high school-aged children who used only foreign languages at home than among elementary school-aged children. This tendency was not observed in the group of children who used both languages at home. Conclusion: Our results suggest that children in Japanese society who use foreign languages at home have worse mental health, therefore there is a need for support for these children living in Japan.