Relationship between adverse childhood experiences and homelessness and the impact of Axis I and II disorders

L.E. Roos, N. Mota, T.O. Afifi, L.Y. Katz, J. Distasio and J. Sareen

American Journal of Public Health, 2013, vol. 103, issue S2, S275-S281

Abstract: Objectives. We investigated the links between homelessness associated with serious mental and physical healthy disparities and adverse childhood experiences (ACEs) in nationally representative data, with Axis I and II disorders as potential mediators. Methods. We examined data from the National Epidemiologic Survey of Alcohol and Related Conditions in 2001-2002 and 2004-2005, and included 34 653 participants representative of the noninstitutionalized US population who were 20 years old or older. We studied the variables related to 4 classes of Axis I disorders, all 10 Axis II personality disorders, a wide range of ACEs, and a lifetime history of homelessness. Results. Analyses revealed high prevalences of each ACE in individuals experiencing lifetime homelessness (17%-60%). A mediation model with Axis I and II disorders determined that childhood adversities were significantly related to homelessness through direct effects (adjusted odd ratios = 2.04, 4.24) and indirect effects, indicating partial mediation. Population attributable fractions were also reported. Conclusions. Although Axis I and II disorders partially mediated the relationship between ACEs and homelessness, a strong direct association remained. This novel finding has implications for interventions and policy. Additional research is needed to understand relevant causal pathways.

Keywords: adult; age; aged; article; family relation; female; health status; homelessness; human; male; mental health; middle aged; personality disorder; risk assessment; risk factor; socioeconomics; statistics; violence; homelessness; Personality Disorders; statistics and numerical data, Adult; Age Factors; Aged; Family Relations; Female; Health Status; Homeless Persons; Humans; Male; Mental Health; Middle Aged; Personality Disorders; Risk Assessment; Risk Factors; Socioeconomic Factors; Violence, Adult; Age Factors; Aged; Family Relations; Female; Health Status; Homeless Persons; Humans; Male; Mental Health; Middle Aged; Personality Disorders; Risk Assessment; Risk Factors; Socioeconomic Factors; Violence (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301323_5

DOI: 10.2105/AJPH.2013.301323

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