Adverse childhood experiences and health risk behaviours by gender among Tunisian adolescents

Abstract

Abstract Background Adverse Childhood Experiences (ACEs) have become an alarming phenomenon exposing individuals at a great risk of developing mental health issues. To date, there remains a lack of adequate researches on ACEs especially among adolescents. This survey aimed to describe the prevalence of childhood adversities and to determine their role in developing risky behaviours amongst Tunisian youth. Methods We conducted a cross sectional study among schooled adolescents in the governorate of Mahdia (Tunisia) from January to February 2020. Exposure to violence was assessed using the validated Arabic version of the WHO ACE questionnaire. The Internet Addiction Test (IAT) and the Hospital Anxiety and Depression scale (HAD) were used as a screening tool for internet addiction, anxiety and depression. Results A total of 1940 adolescents were recruited. The majority of them (97.5%) reported experiencing at least one ACE. Emotional neglect (83.2%) and witnessing community violence (73.5%) were the most reported ACE categories. According to gender, males had higher rates of exposure to physical abuse and social violence than females. The most common risky behaviour was internet addiction (50%) followed by substance use (16.6%). After adjustment for anxiety and depression, the dose-response association between ACE and risky behaviours was well established. Conclusions These results among youth have both public health and societal implications. Key messages The prevalence of exposure to adverse childhood experiences as well as risky behaviors are alarming among Tunisian adolescents. Screening addictive behaviors among youth with a history of childhood adversities is needed.