Behavioural health problems among Keralite youth: Relationship with family risk factors and adverse childhood experiences

Preventing adverse childhood experiences (ACEs) is very critical for assuring the healthy development of children. Substantial research shows a robust, dose–response relationship between ACEs and subsequent adverse outcomes. The current study examines the prevalence of ACEs, family risk factors, and Behavioural Health Problems (BHPs) and, the risk of BHPs in relation to family risk factors while considering the influential role of ACEs. A Demographic proforma and Childhood Experiences of Care and Abuse Questionnaire-2 were used to gather data from 613 youth, selected through multi-stage stratified sampling from selected educational institutions in Kerala, South India. Descriptive and inferential statistics (Chi-square test and Binary Logistic regression) were used for analysis. Keralite youth have exposure to multiple ACEs and family risk factors. Various ACEs were highly prevalent (14%-69%) and a quarter of youth had four or more ACEs, with more exposure in males. Neglect, antipathy, and psychological abuse were the common types. Family risk factors, domestic violence (8%), and parental substance abuse (10%) were significant predictors for loss, antipathy and sexual abuse, and the ACEs score. Youth with family risk factors were more likely to have ACEs and those with ACEs exposure were more likely to have BHPs. Parental substance abuse increased the likelihood of depression irrespective of ACEs exposure. This evidence suggests that the exposure to family risk factors and ACEs increases the likelihood of the risk of BHPs in youth and their interrelatedness needs to be addressed in preventing the negative outcomes in later life.