Prevalence of adverse childhood experiences (ACEs) and association with dating violence and symptoms of mental illness among adolescents in the Dominican Republic

Background: Adolescent dating violence (ADV) and mental illness are highly prevalent, interrelated public health priorities. Increasingly, scholars are looking to adverse childhood experiences (ACEs) to explain risk for these health concerns. Objectives: Determine prevalence of ACEs, ADV perpetration and victimization, and anxiety and depression symptoms among adolescents in the Dominican Republic (DR). Evaluate the association of ACEs with these ADV and mental health outcomes. Participants and setting: Cross-sectional survey data were collected from 142 adolescents at middle and high schools in the DR. Methods: We assessed ACEs using the Childhood Experiences Survey, ADV using the Conflict in Dating Relationships Inventory, and depression/anxiety symptoms using Patient-Reported Outcomes Measurement Information System scales. Linear and logistic regressions were performed to test dose-response relationships between a cumulative ACE score and ADV and mental health outcomes while adjusting for age, gender, and rural/urban residence. Results: 80.6% of students reported at least one ACE. The most prevalent ACEs reported were physical abuse (49%) and witnessing domestic violence (48%). After adjusting for covariates, cumulative ACE scores were significantly associated with depression symptoms, anxiety symptoms, physical and emotional ADV perpetration, and physical and emotional ADV victimization. Conclusions: Structural and community-based interventions to prevent ADV and promote mental health for adolescents in the DR should address ACEs.