A Gender-Specific Analysis of Adverse Childhood Experiences and Vicarious Trauma Among Social Workers in Taiwan

Background and purpose:

Vicarious trauma represents a common occupational hazard for social workers engaging with traumatized clients. Previous studies have found that social workers have experienced adverse childhood experiences (ACEs), and these experiences constitute a significant risk factor for vicarious trauma. However, few studies have explored gender differences in this relationship. In order to better understand the association between cumulative ACEs scores and vicarious trauma among social workers in Taiwan, as well as potential gender differences, we conducted gender-specific analyses. We hypothesized that Taiwanese social workers who experienced more ACEs would have a greater risk of high levels of vicarious trauma, with gender differences observed.

Methods:

From July to October 2024, we conducted a cross-sectional online survey using a convenience sample in Taiwan, 360 questionnaires were collected. Survey questions included socio-demographic characteristics (such as gender, age, educational attainment, monthly income, field of practice, employment status and traumatic work frequency), adverse childhood experiences (6 items, including physical abuse, emotional abuse, emotional neglect, sexual abuse, mother or stepmother treated violently and bullying), and vicarious trauma. Multivariable logistic regression analyses were conducted separately for males and females to estimate the association between cumulative ACEs scores and vicarious trauma, controlling for socio-demographic characteristics.

Results:

Among participants, majority were female (77.5%), were aged 30-39 years (40.4%), had a college degree (76.4%), reported monthly income of 40,001-50,000 NTD (54.7%), had social work experience of 4 years or less (41.9%), 70% reported worked in protective fields, 95.3% employed full-time, and 74.7% reported the frequency of trauma work were “frequent to almost daily”. The prevalence for each value of the cumulative ACEs score was: no ACEs (37.8%), one ACEs (19.2%), two ACEs (17.2%), three ACEs (11.4%), and 14.4% for four or more ACEs. Furthermore, 43.6% reported high levels of vicarious trauma.

Multivariate logistic regression analysis indicated that among males, the odds of high levels of vicarious trauma do not elevate until the individual experienced four or more ACEs, with those who experienced four or more ACEs having nearly 13.69 times the odds of high levels of vicarious trauma (AOR= 13.69, CI =1.50-124.55, p<0.05) compared to those with no ACEs. For females, compared to those with no ACEs, those who experienced two ACEs (AOR= 2.31, CI = 1.13-4.72, p<0.05), three ACEs (AOR= 3.11, CI = 1.38-7.00, p<0.01), and 4+ ACEs (AOR= 4.51, CI = 2.09-9.74, p<0.001) having higher odds of high levels of vicarious trauma.

Conclusions and implications:

Our findings suggest that Taiwanese social workers have a graded relationship between cumulative ACEs scores and high levels of vicarious trauma, and this relationship varies by gender. These results may have implications for social work practice in Taiwan. As ACEs are prevalent among social workers, and such experiences are associated with increased levels of vicarious trauma, we recommend that social work practice should increase trauma-informed training may help social workers develop strategies for addressing vicarious trauma. Future studies should further explore the gender-specific associations between ACEs and mental health related to vicarious trauma among social workers.