Psychometric evaluation of the Adverse Childhood Experience International Questionnaire (ACE-IQ) in Malawian adolescents

• Published in: Child abuse & neglect Vol. 92; pp. 139 - 145
• Main Authors: Kidman, Rachel, Smith, Dylan, Piccolo, Luciane R., Kohler, Hans-Peter
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2019; Elsevier Science Ltd
• Subjects: ACE; Adolescence; Adolescent; Adolescents; Adult; Adverse Childhood Experiences; Caregivers; Child; Child abuse & neglect; Child Abuse - ethnology; Child Abuse - psychology; Child development; Childhood experiences; Childhood factors; Depressive Disorder - ethnology; Depressive Disorder - etiology; Developing countries; Disruption; Factor Structure; Family Characteristics; Female; Health behavior; HIV; Human immunodeficiency virus; Humans; Income; Intelligence Quotient; Intelligence tests; LDCs; Low Income; Low income groups; Malawi - ethnology; Male; Measures; Mental depression; Middle Aged; Predictions; Predictive validity; Prevalence; Psychometric evaluation; Psychometrics; Quantitative psychology; Questionnaires; Reliability; Reproducibility of Results; Surveys and Questionnaires - standards; Teenagers; Timing; Validity; Young Adult; Malawi; Psychometric evaluation; Adolescence; ACE; HIV; Adverse childhood experiences
• ISSN: 0145-2134; 1873-7757; 1873-7757
• DOI: 10.1016/j.chiabu.2019.03.015

Adverse childhood experiences (ACEs) can have lifelong adverse impacts on health and behavior. While this relationship has been extensively documented in high-income countries, evidence from lower-income contexts is largely missing. In order to stimulate greater research on the prevalence and consequences of ACEs in low-income countries, the World Health Organization (WHO) developed the ACE-International Questionnaire (ACE-IQ). In this paper, we explore the factor structure, validity and reliability of the original ACE-IQ, and evaluate whether potential adaptations improve its predictive validity. Four hundred and ten adolescents (age 10–16 years old) from Malawi. The adolescents answered an adapted version of ACE-IQ and Beck Depression Inventory (BDI). Taken together, our results suggest that (a) the ACE-IQ is structured in three dimensions: household disruption, abuse, and neglect; (b) there is support for the validity of the scale evidenced by the correlation between subdimensions (average across 13 correlations, phi = .20, p < 0,01; across subdomains (phi = .10, p < 0,01); partial agreement among children with the same caregiver (ICC = .43, p < .001) and correlation between ACE and depression (predictive validity; r = .35, p < .001); (c) information on the timing of the adversities (“last year” in addition to “ever”) modestly improved the predictive value of the ACE-IQ in models of depression (from R2 = .12 to .15, p < .001); and (d) additional HIV-related questions showed low endorsement and a modest correlation with BDI (r = .25, p < 0,01). Our findings suggest that the ACE-IQ is appropriate for use among adolescents from a low-income context.