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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.120253v1 98/5/946    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Afifi, T. O. Articles by Sareen, J. Search for Related Content PubMed PubMed Citation Articles by Afifi, T. O. Articles by Sareen, J. Related Collections Community Health Epidemiology Mental Health Prevention

Tracie O. Afifi, MSc, Murray W. Enns, MD, Brian J. Cox, PhD, Gordon J.G. Asmundson, PhD, Murray B. Stein, MD, MPH and Jitender Sareen, MD

Tracie O. Afifi is with the Department of Community Health Sciences at the University of Manitoba, Winnipeg. Murray W. Enns and Jitender Sareen are with the Departments of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg. Brian J. Cox is with the Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg. Gordon J. G. Asmundson is with the Anxiety and Illness Behaviors Laboratory and Traumatic Stress Group, University of Regina, Regina, Saskatchewan. Murray B. Stein is with the Departments of Psychiatry, and Family and Preventive Medicine, University of California, San Diego.

Correspondence: Requests for reprints should be sent to Tracie O. Afifi, MSc, PZ-430 771 Bannatyne Ave, Winnipeg, Manitoba, Canada R3E 3N4 (e-mail: toafifi{at}exchange.hsc.mb.ca).

Objectives. We sought to determine the fractions of psychiatric disorders and suicide ideation and attempts in a general population sample attributable to childhood physical abuse, sexual abuse, and witnessing domestic violence.

Methods. Data were obtained from the US National Comorbidity Survey Replication. Population attributable fractions were calculated to determine the proportion of psychiatric disorders and suicide ideation and attempts attributable to adverse childhood experiences. The analysis was stratified by gender.

Results. The estimated attributable fractions for psychiatric disorders attributable to having experienced any adverse childhood event ranged from 22% to 32% among women and 20% to 24% among men. Having experienced any adverse event accounted for a substantial proportion of suicide ideation and attempts among women (16% and 50%, respectively) and men (21% and 33%, respectively). Substantial proportions of poor mental health outcomes were also attributable to increasing number of adverse events.

Conclusions. The estimated proportions of poor mental health outcomes attributed to childhood adversity were medium to large for men and women. Prevention efforts that reduce exposure to adverse childhood events could substantially reduce the prevalence of psychopathology and suicidal behavior in the general population.

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