Gender differences in adverse childhood experiences, collective violence, and the risk for addictive behaviors among university students in Tunisia.

Journal: Preventive medicine

Volume: 99

Issue: 

Year of Publication: 2018

Affiliated Institutions:  Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "SP", Tunisia. Electronic address: sanaelmhamdi@gmail.com. Duluth Global Health Institute, University of Minnesota, USA. Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia; University Hospital of Monastir, Research Laboratory "SP", Tunisia.

Abstract summary 

Adverse childhood experiences (ACE) have been linked to a variety of addictive behaviors. The recent adaptation of the ACE measure by the World Health Organization (WHO) allows for the assessment of the negative role of additional adverse experiences, such as extra-familial violence. To date, the relationship between extra-familial violence and addictive behaviors has not been assessed. We report the contribution of ACEs, including the new scales for extra-familial violence, on the risk for mental health problems and addictive behaviors by gender in a sample of young adults in Tunisia. We conducted a cross sectional study in Tunisia during 2014, where we recruited 1200 young university adults who completed the validated Arabic version of the WHO ACE questionnaire in a university setting. Results indicated that intra-familial adversities were associated with increased risk for addictive behaviors, particularly in males. ACEs were also associated with increased risk for mental health problems with women showing more difficulties than men. Exposure to peer, community and collective violence was higher in males than in females and logistic regression confirms that exposure to extra-familial violence increased the risk for addictive behaviors both in male and females by two to three-fold. Mental health problems were associated with peer violence and substance abuse in males, but not in females. Results demonstrate for the first time the contribution of exposure to extra-familial violence on risk for addictive behaviors. Results highlight the need for addressing mental health and addiction in a community with high burden of adversity and violence.

Authors & Co-authors:  El Mhamdi Sana S Lemieux Andrine A Bouanene Ines I Ben Salah Arwa A Nakajima Motohiro M Ben Salem Kamel K al'Absi Mustafa M

Study Outcome 

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Statistics
Citations : 
Authors :  7
Identifiers
Doi : 10.1016/j.ypmed.2017.02.011
SSN : 1096-0260
Study Population
Male,Males,Women,Females
Mesh Terms
Adolescent
Other Terms
Study Design
Cross Sectional Study,
Study Approach
Country of Study
Tunisia
Publication Country
United States