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Adverse childhood experiences (ACEs) are defined as a broad set of negative and traumatic events that happen in childhood. Most research on ACEs has been conducted in Western settings, with limited studies on non-Western contexts. In Chinese societies, where Confucian values emphasizing traditional gender roles and hierarchical family structures are prevalent, individuals with ACEs and impacts of these experiences may not receive adequate attention. Therefore, the objective of this study is to explore the nature and impacts of ACEs in Chinese adult men and women. The research question is: What are the nature and impacts of ACEs in Chinese adult men and women?
To understand the nature of ACEs, the current study utilizes a 3D poly-victimization theoretical model which argues that the concept of ACEs is better captured by three dimensions, namely invasiveness, exploitativeness, and severity. The model proposes that the victimization of ACEs is multiplicative, meaning that the interaction effect of the ACEs is greater than the cumulative effects of ACEs. Furthermore, to understand the impacts of ACEs, the current study draws on the integrative body-mind-spirit framework, which adopts an Eastern approach to conceptualize holistic well-being. This framework emphasizes a holistic perspective of the human body, mind, and spirit, recognizing that all three dimensions are co-existed and interconnected with each other.
Methods:
The study utilized a 3D river of life oral history approach, an art-based methodological approach, and semi-structured qualitative interview methods to collect data from eight women and eight men receiving services from an anti-domestic violence agency in Hong Kong, China. They were referred by the agency and the sampling method used was convenience sampling. Data were collected with semi-structured and in-person interviews, audio recorded, and transcribed. Each interview lasted for 2 to 5 hours. The participants were aged 20 to 50. About the 3D river of life oral history approach, the participants were asked to draw an image of their life as a river. Additionally, the interview produced 3D shapes in color; one set of shapes is created by the participant to represent key ACEs, the other set is created from questions regarding the theory.
Results:
These two sets of colored 3D shapes were compared, and the findings suggest both the differences and convergences between the participants own representations and theoretical predictions. Their ACEs include abuse (emotional, physical, or sexual), neglect (emotional or physical), and household dysfunction (e.g., witnessing domestic violence, having household members with substance abuse and mental health problems, parental incarceration, and parental separation). Extracts from the interviews, river of life drawings, and the 3D shapes will further be discussed. These findings imply that disentangling the concept of ACEs may guide the development of psychometric measures. Moreover, four main themes about the impacts of ACEs emerged: somatic responses, cognitive transformations, spiritual/religious coping, and the impacts of filial piety beliefs on exacerbating the effects of ACEs.
Conclusions:
These findings highlight the possibility of using trauma-informed and culturally-relevant integrative body-mind-spirit intervention approaches in Chinese people who have ACEs. Theoretical and practical implications will also be discussed.