Association Between Adverse Childhood Experiences And Murder-Related Psychological Behaviors In Chinese Adolescents: The Serial Mediating Effects Of Borderline Personality Features And Aggression

ObjectiveThe purpose of this study was to describe the epidemic characteristics of adverse childhood experiences(ACEs)and murder-related psychological behaviors in adolescents,reveal the relationships between the type,number and phenotypic patterns of ACEs and murder-related psychological behaviors in adolescents,and explore the serial mediating effects of borderline personality features(BPF)and aggression in the relationship between ACEs and murder-related psychological behaviors in adolescents.MethodsA total of 5 724 junior high school students were randomly selected from Huaibei City,Hefei City and Xuancheng City in Anhui Province by multistage random cluster sampling method to conduct a self-reported questionnaire survey.The content of the survey is based on the “Health Questionnaire for Middle School Students in Anhui Province”,which mainly includes demographic characteristics,BPF,aggression,ACEs and the murder-related psychological behaviors.Chi Square test was used to compare the differences of ACEs and murder-related psychological behaviors among adolescents with different demographic characteristics;Latent class analysis(LCA)was implemented to explore the phenotypic patterns of ACEs;Multivariate logistic regression analysis was applied to examine the relationship between ACEs of different types,numbers and phenotypic patterns and murder-related psychological behaviors.Structural equation model and Bootstrapping analysis were used to examine the serial mediating effects of BPF and aggression between ACEs and murder-related psychological behaviors in adolescents.The significance level was set as P<0.05(two sides).ResultsThis study investigated 8 different types of ACEs,of which the highest reported rate was verbal bullying(20.1%),and the prevalence rates of physical abuse,emotional abuse,sexual abuse,physical neglect,emotional neglect,physical bullying and relational bullying were 9.6%,19.3%,7.1%,7.3%,7.2%,7.6% and 17.9%,respectively.The prevalence rates of murderous ideation,murderous plans,murderous preparation and muederous attempts were 11.7%,4.3%,1.9% and 0.6% respectively.There was no statistical difference in the four murder-related psychological behaviors between sexes(P>0.05).Compared with the students who have not suffered from ACEs,the students who had suffered from ACEs present higher scores of BPF and aggression.In addition,the scores of BPF and aggression of students who reported murder-related psychological behaviors were higher than those who did not report murder-related psychological behaviors(P<0.001).Multivariate logistic regression showed that after controlling the confounding factors,different types of ACEs were positively associated with murder-related psychological behaviors(all Ps<0.001),and the odds ratio between sexual abuse and four types of murder-related psychological behaviors was the largest.There was a dose-response relationship between the number of ACEs and murder-related psychological behaviors.The risk of murderous ideation,murderous plans,murderous preparation and muederous attempts increased by 2.67(95%CI: 2.38～2.99),2.96(95%CI: 2.47～3.56),4.37(95%CI: 3.24～5.90)and 5.94(95%CI: 3.34～10.59)for each type of ACEs increased.LCA fitting determined four optimal ACEs phenotypic patterns: low adverse experience group(71.9%),peer bullying group(9.7%),abuse and neglect group(9.0%)and high adverse experience group(3.4%).Low adverse experience group as the control group,peer bullying group,abuse and neglect group and high adverse experience group significantly increased the risk of murder-related psychological behaviors(all P<0.05).The results of indirect effects analysis showed that the serial mediating effects of ACEs on murderous ideation(indirect effect=0.062,95%CI: 0.043～0.078),murderous plans(indirect effect=0.052,95%CI: 0.026～0.078),murderous preparation(indirect effect=0.045,95%CI: 0.004～0.087)and murderous attempts(indirect effect=0.065,95%CI: 0.006～0.130)through BPF and aggression was statistically significant.In addition,in the ACEs patterns,compared with the low adverse experience group,BPF and aggression play a serial-mediation role in the relationship between the abuse and neglect group,peer bullying group and high adverse experience group and murderous ideation and murderous plans(P<0.01),while the serial mediating effect in murderous preparation and murderous attempts was not significant(P>0.05).ConclusionsACEs are the risk factors of murder-related psychological behaviors among adolescents.Different types,numbers and phenotypic patterns of ACEs are related to an increase risk of murder-related psychological behaviors.BPF and aggression play a serial mediation role in the association between ACEs and murder-related psychological behaviors.ACEs may increase the risk of BPF and further show high aggression,thus increasing the risk of murder-related psychological behaviors.In the future,it is necessary to carry out early and targeted psychological intervention for adolescents who show BPF and high aggression,so as to prevent the occurrence of murder violence.