Prevalence of Adverse Childhood Experiences in the First Decade of Life: A Study in the Portuguese Cohort, Generation XXI

Int J Environ Res Public Health. 2022 Jul 8;19(14):8344. doi: 10.3390/ijerph19148344.


Adverse childhood experiences (ACEs) are a modifiable risk factor for diseases throughout life. This study estimates the prevalence of ACEs in children, addressing associated sociodemographic characteristics and examining the relationship of ACEs with the child's health and behaviors. We used information on 5295 participants at 10 years old, of the birth cohort Generation XXI, established in Porto, Portugal. Children answered a self-administered questionnaire on ACEs, based on the original ACEs study. Principal component analysis was used to group correlated ACEs, and a score was computed to assess their cumulative effect. Overall, 96.2% of children reported having been exposed to at least one ACE. The most prevalent ACE was a household member shouting, yelling, or screaming at the child (57.7%). Boys were more likely than girls to report "abuse", "school problems", and "death/severe disease". Low parental education, income, and unemployment were associated with an increased risk of "school problems", "death/severe disease", and "household dysfunction". We observed that the dimensions of ACEs could be identified at 10 years of age. A disadvantaged socioeconomic environment was associated with dimensions of ACEs. These data illustrate the natural history of dimensions of ACEs and their potential social patterning.

Keywords: adverse childhood experiences; childhood; violence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adverse Childhood Experiences*
  • Child
  • Child Abuse*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Portugal / epidemiology
  • Prevalence

Grants and funding

This work was supported by the European Regional Development Fund (ERDF) through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology (FCT), Portuguese Ministry of Science, Technology and Higher Education under the projects “BioAdversity: How childhood social adversity shapes health: The biology of social adversity” (POCI-01-0145-FEDER-016838; PTDC/DTP-EPI/1687/2014), “HIneC: When do health inequalities start? Understanding the impact of childhood social adversity on health trajectories from birth to early adolescence” (POCI-01-0145-FEDER-029567; PTDC/SAU-PUB/29567/2017) and “STEPACHE: The pediatric roots of amplified pain: from contextual influences to risk stratification” (POCI-01-0145-FEDER-029087; PTDC/SAU-EPI/29087/2017). It is also supported by the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UIDB/04750/2020) and Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR) (LA/P/0064/2020), Administração Regional de Saúde Norte (Regional Department of Ministry of Health) and Fundação Calouste Gulbenkian; PhD Grant SFRH/BD/144503/2019 (to AA) funded by FCT through Fundo Social Europeu (FSE) and CEECIND/01516/2017 (to SF).