Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (3): 408-414. doi: 10.19723/j.issn.1671-167X.2023.03.004

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Reliability and validity of the Chinese version of adverse childhood experiences international questionnaire in parents of preschool children

Xiao-yi MI1,Shan-shan HOU2,Zi-yuan FU1,Mo ZHOU1,Xin-xuan LI3,Zhao-xue MENG2,Hua-fang JIANG4,Hong Zhou1,*()   

  1. 1. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
    2. Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101101
    3. School of Health Humanities, Peking University, Beijing 100191, China
    4. Weifang Maternal and Child Health Hospital of Shandong, Weifang 261000, Shandong, China
  • Received:2023-03-01 Online:2023-06-18 Published:2023-06-12
  • Contact: Hong Zhou E-mail:hongzhou@bjmu.edu.cn

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Abstract:

Objective: To test the reliability and validity of the Chinese version of adverse childhood experiences international questionnaire (ACE-IQ) in Chinese parents of preschool children. Methods: The parents of preschool children in 6 kindergartens in Tongzhou District of Beijing were selected by stratified random cluster sampling, and the Chinese version of ACE-IQ after translation and adaptation was used for survey online. The collected data were randomly divided into two parts. One part of the data (n=602) was used for exploratory factor analysis (EFA), to screen items and evaluate structural validity, and then form the final Chinese version of ACE-IQ. The other part of the data (n=700) was used for confirmatory factor analysis (CFA), criterion validity analysis and reliability analysis. At the same time, experts investigation method was used to evaluate the content validity of the final Chinese version of ACE-IQ. Results: After deleting four items of collective violence, the Chinese version of ACE-IQ with twenty-five items indicated good structural, criterion and content validity. Analysis results showed that the Chinese version of ACE-IQ presented a seven-factor model dimension, namely emotional neglect, physical neglect, family dysfunction, family violence, emotional and physical abuse, sexual abuse and violence outside the home, and the total score of the binary version of ACE-IQ Chinese version was positively correlated with the total score of childhood trauma questionaire-28 item short form (CTQ-SF, r=0.354, P < 0.001) and the center for epidemiological studies depression scale (CES-D, r=0.313, P < 0.001) respectively. Results from five experts showed that the item-level content validity index (I-CVI) of 25 items was between 0.80 and 1.00, and the average of all I-CVIs on the scale (S-CVI/Ave) of the scale was 0.984. At the same time, the internal consistency (Cronbach's α coefficient) of the whole scale was 0.818, and the split-half reliability (Spearman-Brown coefficient) was 0.621, which demonstrated good reliability. Conclusion: This study has formed a Chinese version of ACE-IQ with 25 items and 7 dimensions, which has good reliability and validity among the parents of preschool children in China. It can be used as an evaluation instrument for measuring the minimum threshold of the adverse childhood experiences in the parents of preschool children in the cultural background of China.

Key words: Adverse childhood experiences, Parents of preschool children, Reliability, Validity

CLC Number: 

  • R179

Table 1

Results of EFA for binary version of ACE-IQ Chinese version"

Items Factor loading
Emotional neglect Physical neglect Family dysfunction Family violence Emotional and physical abuse Sexual abuse Violence outside the home
ACE01 0.878 0.043 0.010 0.076 -0.013 0.031 0.018
ACE02 0.872 0.049 -0.014 -0.036 0.049 0.047 -0.095
ACE03 0.039 0.703 -0.002 0.086 -0.056 0.043 -0.028
ACE04 -0.075 0.649 0.035 0.178 0.116 -0.089 0.006
ACE05 0.134 0.775 -0.038 -0.115 0.123 0.126 0.053
ACE06 -0.037 0.001 0.873 0.054 -0.107 -0.003 0.048
ACE07 -0.038 -0.035 0.909 0.009 -0.035 0.001 0.034
ACE08 0.007 -0.067 0.919 -0.021 0.005 0.005 -0.012
ACE09 0.154 0.022 0.735 -0.003 0.182 -0.046 -0.013
ACE10 -0.059 0.046 0.572 0.009 0.071 0.020 -0.057
ACE11 0.017 0.156 0.020 0.569 0.380 0.062 0.232
ACE12 0.040 0.095 -0.016 0.824 0.148 0.015 0.123
ACE13 -0.005 0.001 0.037 0.768 0.031 0.134 0.014
ACE14 0.100 0.078 0.038 0.210 0.709 0.054 0.180
ACE15 -0.045 0.126 0.034 -0.009 0.610 0.105 0.130
ACE16 0.084 -0.018 0.021 0.162 0.732 0.054 0.173
ACE17 -0.055 -0.026 0.020 0.025 0.618 0.153 -0.088
ACE18 0.090 0.081 0.049 0.153 0.211 0.607 0.096
ACE19 0.042 -0.043 -0.030 -0.015 0.110 0.818 0.069
ACE20 -0.025 -0.012 -0.023 0.065 0.028 0.849 0.024
ACE21 -0.005 0.072 -0.013 0.025 0.078 0.840 -0.003
ACE22 -0.054 0.084 0.092 0.128 0.212 0.186 0.403
ACE23 -0.057 -0.008 -0.021 0.168 0.255 0.050 0.608
ACE24 0.016 -0.013 -0.018 0.048 -0.065 -0.016 0.824
ACE25 -0.008 -0.016 -0.053 -0.016 0.090 0.024 0.793
Eigenvalue 1.627 1.608 3.326 1.803 2.230 2.597 2.031
Variance contribution/% 6.510 6.431 13.302 7.210 8.921 10.390 8.124

Figure 1

Item factor loading of binary version of ACE-IQ Chinese version by CFA"

Table 2

Correlation among the scores of total scale and each subscale of ACE-IQ evaluated by binary version and CTQ-SF and CES-D"

Items CTQ-SF CES-D
r P r P
ACE-IQ total score 0.354 < 0.001 0.313 < 0.001
Emotional neglect 0.246 < 0.001 0.131 0.001
Physical neglect 0.227 < 0.001 0.173 < 0.001
Family dysfunction 0.139 < 0.001 0.108 0.004
Family violence 0.249 < 0.001 0.193 < 0.001
Emotional and physical abuse 0.286 < 0.001 0.221 < 0.001
Sexual abuse 0.132 < 0.001 0.115 0.002
Bullying and community violence 0.111 < 0.001 0.244 < 0.001
1 World Health Organization. Adverse childhood experiences international questionnaire[EB/OL]. (2020-01-28)[2022-03-20]. https://www.who.int/publications/m/item/adverse-childhood-experiences-international-questionnaire-(ace-iq).
2 McGrath JJ , McLaughlin KA , Saha S , et al. The association between childhood adversities and subsequent first onset of psychotic experiences: A cross-national analysis of 23 998 respondents from 17 countries[J]. Psychol Med, 2017, 47 (7): 1230- 1245.
doi: 10.1017/S0033291716003263
3 Lotto CR , Altafim ERP , Linhares MBM . Maternal history of childhood adversities and later negative parenting: A systematic review[J]. Trauma Violence Abuse, 2023, 24 (2): 662- 683.
doi: 10.1177/15248380211036076
4 Geng F , Zou J , Liang Y , et al. Associations of positive and adverse childhood experiences and adulthood insomnia in a community sample of Chinese adults[J]. Sleep Med, 2021, 80, 46- 51.
doi: 10.1016/j.sleep.2021.01.022
5 Wang X , Yin G , Guo F , et al. Associations of maternal adverse childhood experiences with behavioral problems in preschool children[J]. J Interpers Violence, 2022, 37 (21/22): NP20311- NP20330.
6 McDonald SW , Madigan S , Racine N , et al. Maternal adverse childhood experiences, mental health, and child behaviour at age 3: The all our families community cohort study[J]. Prev Med, 2019, 118, 286- 294.
doi: 10.1016/j.ypmed.2018.11.013
7 Gupta RC , Randell KA , Dowd MD . Addressing parental adverse childhood experiences in the pediatric setting[J]. Adv Pediatr, 2021, 68, 71- 88.
doi: 10.1016/j.yapd.2021.05.003
8 Le-Scherban F , Wang X , Boyle-Steed KH , et al. Intergenerational associations of parent adverse childhood experiences and child health outcomes[J]. Pediatrics, 2018, 141 (6): e20174274.
doi: 10.1542/peds.2017-4274
9 Schickedanz A , Halfon N , Sastry N , et al. Parents' adverse childhood experiences and their children's behavioral health problems[J]. Pediatrics, 2018, 142 (2): e20180023.
doi: 10.1542/peds.2018-0023
10 Greene CA , Haisley L , Wallace C , et al. Intergenerational effects of childhood maltreatment: A systematic review of the parenting practices of adult survivors of childhood abuse, neglect, and violence[J]. Clin Psychol Rev, 2020, 80, 101891.
doi: 10.1016/j.cpr.2020.101891
11 Kidman R , Smith D , Piccolo LR , et al. Psychometric evaluation of the adverse childhood experience international questionnaire (ACE-IQ) in Malawian adolescents[J]. Child Abuse Negl, 2019, 92, 139- 145.
doi: 10.1016/j.chiabu.2019.03.015
12 Gette JA , Gissandaner TD , Littlefield AK , et al. Modeling the adverse childhood experiences questionnaire-international version[J]. Child Maltreat, 2021, 27 (4): 527- 538.
13 Kim YH . Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students[J]. Child Abuse Negl, 2017, 67, 338- 348.
doi: 10.1016/j.chiabu.2017.03.009
14 Ho G , Bressington D , Karatzias T , et al. Patterns of exposure to adverse childhood experiences and their associations with mental health: A survey of 1346 university students in East Asia[J]. Soc Psychiatry Psychiatr Epidemiol, 2020, 55 (3): 339- 349.
doi: 10.1007/s00127-019-01768-w
15 Almuneef M , Qayad M , Aleissa M , et al. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: A pilot study[J]. Child Abuse Negl, 2014, 38 (11): 1787- 1793.
doi: 10.1016/j.chiabu.2014.06.003
16 Chen W , Yu Z , Wang L , et al. Examining childhood adversities in Chinese Health Science students using the simplified Chinese version of the adverse childhood experiences-international questionnaire (SC-ACE-IQ)[J]. Advers Resil Sci, 2022, 3 (4): 335- 346.
doi: 10.1007/s42844-022-00076-8
17 刘慧. 母亲童年期虐待经历和儿童虐待认知对教养方式的影响[D]. 哈尔滨师范大学, 2018.
18 史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用[J]. 中南大学学报(医学版), 2012, 37 (2): 49- 52.
19 World Health Organization. Adverse childhood experiences international questionnaire (ACE-IQ) guidance for analysing ACE-IQ[EB/OL]. (2020-01-28)[2022-03-20]. https://cdn.who.int/media/docs/default-source/documents/child-maltreatment/ace-iq-guidance-for-analysing.pdf?sfvrsn=adfe12bb_2.
20 World Health Organization. Process of translation and adaptation of instruments[EB/OL]. [2021-12-29]. https://www.who.int/substance_abuse/research_tools/translation/en.
21 Chegeni M , Haghdoost A , Shahrbabaki ME , et al. Validity and reliability of the Persian version of the adverse childhood experiences abuse short form[J]. J Educ Health Promot, 2020, 9, 140.
doi: 10.4103/jehp.jehp_15_20
22 赵幸福. 儿童期虐待问卷的信效度及家庭暴力男性躯体施暴者社会心理和分子生物学研究[D]. 中南大学, 2005.
23 Bellis MA , Hughes K , Ford K , et al. Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: A systematic review and meta-analysis[J]. Lancet Public Health, 2019, 4 (10): e517- e528.
doi: 10.1016/S2468-2667(19)30145-8
24 Tran QA , Dunne MP , Vo TV , et al. Adverse childhood experiences and the health of university students in eight provinces of Vietnam[J]. Asia Pac J Public Health, 2015, 27 (Suppl 8): S26- S32.
25 章婕, 吴振云, 方格, 等. 流调中心抑郁量表全国城市常模的建立[J]. 中国心理卫生杂志, 2010, 24 (2): 139- 143.
26 王媛媛. 医学量表的编制与评价[M]. 北京大学医学出版社, 2020: 114- 118.
27 孙昕霙. 健康调查问卷设计原理与实践[M]. 北京大学医学出版社, 2020: 100- 102.
28 周春燕, 宋炜玲, 李林, 等. 儿童期逆境国际问卷在中学生群体中的信效度分析[J]. 中国临床心理学杂志, 2022, 30 (6): 1329- 1333.
29 Simoes PP , Almeida RM . Maternal mortality and accessibility to health services by means of transit-network estimated traveled distances[J]. Matern Child Health J, 2014, 18 (6): 1506- 1511.
30 Scott K , McMahon S , Yumkella F , et al. Navigating multiple options and social relationships in plural health systems: A qualitative study exploring healthcare seeking for sick children in Sierra Leone[J]. Health Policy Plan, 2014, 29 (3): 292- 301.
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