Abstract
Most studies rely on cross-sectional retrospective reports from adult samples to collect information about adverse childhood experiences (ACEs) to examine relationships with adult outcomes. The problems associated with these reports have long been debated, with only a few studies determining their reliability and validity and fewer still reaching consensus on the matter. This paper uses repeat prospective and retrospective reports of adverse childhood experiences from two respondent sources in the South African Birth to Twenty Plus (Bt20+) cohort to explore agreement and concordance in the prospective reporting of ACEs by caregivers and respective children as adolescents and then as young adults. The findings demonstrate little overall agreement between prospective and retrospective accounts of childhood experiences, with 80% of kappa values below the moderate agreement cutoff (k = .41). The highest levels of agreement were found between prospective and retrospective reporting on parental and household death (kappas ranging from .519 to .944). Comparisons between prospective caregiver reports and retrospective young adult reports yielded high concordance rates on sexual and physical abuse and exposure to intimate partner violence (91.0%, 87.7% and 80.2%, respectively). The prevalence of reported ACEs varied with the age of the respondent, with adolescents reporting much higher rates of exposure to violence, physical and sexual abuse than are reported retrospectively or by caregivers. This variation may partly reflect actual changes in circumstances with maturation, but may be influenced by developmental stage and issues of memory, cognition and emotional state more than has been considered in previous analyses. More research, across disciplines, is needed to understand these processes and their effect on recall. Long-term prospective studies are critical for this purpose. In conclusion, methodological research that uses a range of information sources to establish the reliability and validity of both retrospective and prospective reports ‒ recognizing that the two approaches may fundamentally answer different questions ‒ should be encouraged.
Highlights
Made familiar by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente’s Adverse Childhood Experiences (ACE) study [1], retrospective adult reports of childhood experiences of abuse, neglect and household dysfunction have been linked to a range of adverse social and health outcomes in later life [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21], studied predominantly in high-income countries
Blank spaces indicate that questions on this ACE were not asked at a particular age
The aim of this study was to explore the levels of agreement between three accounts of reporting on ACEs - prospective caregiver reports on the period between 5 and 11 years in a child’s life, prospective adolescent reports on the period between 11 and 18 years and retrospective young adult reports of experiences before the age of 18 years
Summary
Made familiar by the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente’s Adverse Childhood Experiences (ACE) study [1], retrospective adult reports of childhood experiences of abuse, neglect and household dysfunction have been linked to a range of adverse social and health outcomes in later life [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21], studied predominantly in high-income countries. In recent years a number of South African studies have assessed the impact of childhood adversity on health and wellbeing [25, 26], including one longitudinal prospective study of cumulative adverse childhood experiences [27]. High levels of inequality and unemployment, along with a generalized HIV epidemic adding another dimension to the experience of adversity [10, 16, 25], present conditions where exposure to multiple and concurrent adverse childhood experiences is prevalent around the country [27]
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