Understanding the role of caregiver factors on ACE changes between male and female adolescents in Kinshasa, DRC: A five-wave linked longitudinal panel study

Background

Adverse Childhood Experiences (ACEs) are traumatic events occurring from ages 0–17 with adolescence a particularly vulnerable period for increased ACEs exposure.

Objectives

This study examines the role of caregivers in shaping ACE changes over time and how these influences differ by sex.

Participants & setting

Data were drawn from 1450 adolescents (1083 in-school, 367 out-of-school) in two under-resourced communes of Kinshasa, Democratic Republic of Congo. Adolescents were aged 10–14 at baseline (2017) and followed through 2022.

Methods

ACEs were assessed by count (0,1,2,3,4+) and type (emotional, physical, sexual, witnessing domestic violence, household dysfunction) at Waves 1 (W1) and 5 (W5). Three caregiver factors from Wave 1 were included as confounders/effect modifiers. Weighted, ordered logistic regression and generalized estimating equations analyzed associations, stratified by gender.

Results

There was a significant change in ACEs between W1 and W5 (OR: 0.4, 95 % CI: 0.4–0.5). For males, caregiver closeness during W1 protected against physical maltreatment during W5 (OR: 0.7, 95 % CI: 0.6–0.99), and caregiver comfort during W1 was protective for domestic violence exposure during W5 (OR: 0.6, 95 % CI: 0.4–0.9). Additionally, lower caregiver monitoring at W1 was associated with greater ACEs change during W5 compared to higher caregiver monitoring. For females, caregiver comfort protected against household disruption (OR: 0.7, 95 % CI: 0.6–0.97).

Conclusion

There was reduced odds of experiencing ACEs during W5 relative to W1, with caregiver factors playing a key role. Gender-stratified analyses highlight the need for tailored, strengths-based family interventions to mitigate ACEs and support adolescent well-being.