Adverse childhood experiences: Impact upon intimate partner violence, depression, and suicide attempt among adults in a sample of Southwest tribes

Adverse Childhood Experiences (ACE) refer to multiple types of abuse and neglect during childhood. Studies show links between ACE and behavioral health manifestations in adulthood such as Intimate Partner Violence (IPV), depression, and suicide in the United States. This association has not been explored in American Indian populations despite the fact American Indians experience the highest burden of mental illness, IPV, and suicide. Face-to-face Behavioral Risk Factor Surveillance System (BRFSS) interviews were conducted with 663 adults in a sample of southwest tribes from 2008-2010. The instrument included an 8-item ACE module and measures of suicide, IPV, and depression. To measure the cumulative effects of ACE, a four level scale (1, 2, 3, 4+) was used assigning one point for each ACE occurrence. The burden of ACE ranged from 7% to 51% for each ACE type. 32% reported no ACE, and 22%, 16%, 9%, and 21% reported ACE scores of 1, 2, 3, 4+ respectively. 20% of adults experienced IPV, 15% reported depression, and 9% attempted suicide. Results showed statistically significant relationships (p<0.05) between ACE and adult behavioral health outcomes. Adults with high ACE scores (4+) were 3.5-7.2 times more likely to experience depression, suicide, or IPV than adults with low ACE scores. These findings demonstrate that ACE is a serious public health concern for American Indians. The need for culturally appropriate interventions to prevent ACE exposure and strengthen resiliency among American Indian youth is critical, and may beneficially mitigate behavioral health concerns in adulthood such as suicide, IPV, and depression.