Childhood Adversity, Resilience, and Mental Health: A Sequential Mixed-Methods Study of Chinese Young Adults

Grace W.K. Ho, A.C.Y. Chan Chan, M Shevlin, Thanos Karatzias, P.S. Chan, D.S. Leung

Research output: Contribution to journalArticle

Abstract

Resilience is a key health protective factor for those with adverse childhood experiences (ACEs), but little research has explored how it manifests in early adulthood or across cultures. The purpose of this study was to generate a fuller understanding of resilience and its contribution to the relationships between mental health problems and ACEs among Chinese young adults in Hong Kong. Using a sequential explanatory mixed-methods design, 433 Chinese young adults aged 18-24 years were surveyed online to examine the relationships between ACEs, resilience, and mental health problems (depression, anxiety, maladjustment, and post-traumatic stress symptoms). Among them, 34 participants with ACEs were purposively selected and interviewed to explore cultural factors that influenced their resilience. Quantitative data were analyzed
using multiple hierarchical regression analyses; qualitative data were analyzed using a qualitative descriptive approach.
Higher cumulative ACE exposure was associated with higher severity of adjustment disorder and odds for screening positive for post-traumatic stress disorders, but not for symptoms of depression or anxiety. Resilience significantly contributed to explaining variances across all mental health outcomes over and beyond ACEs and in a protective fashion. Four themes emerged from qualitative interviews: (1) Privacy, emotional restraint, and “saving face”; (2) Conforming to preserve harmony; (3) A will to excel; and (4) Viewing adversity as a matter of luck. These findings suggest Chinese young adults’ resilience was influenced by cultural norms of restraint, conformity, competition, and superstition. The present study provides a model for future studies using a mixed-methods design to deeply examine resilience among younger people exposed to early adversities within sociocultural, historical, or geographical contexts.
LanguageEnglish
JournalJournal of Interpersonal Violence
Publication statusAccepted/In press - 13 Aug 2019

Fingerprint

Young Adult
Mental Health
Anxiety
Superstitions
Depression
Adjustment Disorders
Privacy
Hong Kong
Post-Traumatic Stress Disorders
Regression Analysis
Interviews
Health
Research
Protective Factors

Keywords

  • Adverse childhood experiences
  • resilience
  • young adulthood
  • Chinese culture

Cite this

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title = "Childhood Adversity, Resilience, and Mental Health: A Sequential Mixed-Methods Study of Chinese Young Adults",
abstract = "Resilience is a key health protective factor for those with adverse childhood experiences (ACEs), but little research has explored how it manifests in early adulthood or across cultures. The purpose of this study was to generate a fuller understanding of resilience and its contribution to the relationships between mental health problems and ACEs among Chinese young adults in Hong Kong. Using a sequential explanatory mixed-methods design, 433 Chinese young adults aged 18-24 years were surveyed online to examine the relationships between ACEs, resilience, and mental health problems (depression, anxiety, maladjustment, and post-traumatic stress symptoms). Among them, 34 participants with ACEs were purposively selected and interviewed to explore cultural factors that influenced their resilience. Quantitative data were analyzedusing multiple hierarchical regression analyses; qualitative data were analyzed using a qualitative descriptive approach.Higher cumulative ACE exposure was associated with higher severity of adjustment disorder and odds for screening positive for post-traumatic stress disorders, but not for symptoms of depression or anxiety. Resilience significantly contributed to explaining variances across all mental health outcomes over and beyond ACEs and in a protective fashion. Four themes emerged from qualitative interviews: (1) Privacy, emotional restraint, and “saving face”; (2) Conforming to preserve harmony; (3) A will to excel; and (4) Viewing adversity as a matter of luck. These findings suggest Chinese young adults’ resilience was influenced by cultural norms of restraint, conformity, competition, and superstition. The present study provides a model for future studies using a mixed-methods design to deeply examine resilience among younger people exposed to early adversities within sociocultural, historical, or geographical contexts.",
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author = "Ho, {Grace W.K.} and Chan, {A.C.Y. Chan} and M Shevlin and Thanos Karatzias and P.S. Chan and D.S. Leung",
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Childhood Adversity, Resilience, and Mental Health: A Sequential Mixed-Methods Study of Chinese Young Adults. / Ho, Grace W.K.; Chan, A.C.Y. Chan; Shevlin, M; Karatzias, Thanos; Chan, P.S.; Leung, D.S.

In: Journal of Interpersonal Violence, 13.08.2019.

Research output: Contribution to journalArticle

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T1 - Childhood Adversity, Resilience, and Mental Health: A Sequential Mixed-Methods Study of Chinese Young Adults

AU - Ho, Grace W.K.

AU - Chan, A.C.Y. Chan

AU - Shevlin, M

AU - Karatzias, Thanos

AU - Chan, P.S.

AU - Leung, D.S.

PY - 2019/8/13

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AB - Resilience is a key health protective factor for those with adverse childhood experiences (ACEs), but little research has explored how it manifests in early adulthood or across cultures. The purpose of this study was to generate a fuller understanding of resilience and its contribution to the relationships between mental health problems and ACEs among Chinese young adults in Hong Kong. Using a sequential explanatory mixed-methods design, 433 Chinese young adults aged 18-24 years were surveyed online to examine the relationships between ACEs, resilience, and mental health problems (depression, anxiety, maladjustment, and post-traumatic stress symptoms). Among them, 34 participants with ACEs were purposively selected and interviewed to explore cultural factors that influenced their resilience. Quantitative data were analyzedusing multiple hierarchical regression analyses; qualitative data were analyzed using a qualitative descriptive approach.Higher cumulative ACE exposure was associated with higher severity of adjustment disorder and odds for screening positive for post-traumatic stress disorders, but not for symptoms of depression or anxiety. Resilience significantly contributed to explaining variances across all mental health outcomes over and beyond ACEs and in a protective fashion. Four themes emerged from qualitative interviews: (1) Privacy, emotional restraint, and “saving face”; (2) Conforming to preserve harmony; (3) A will to excel; and (4) Viewing adversity as a matter of luck. These findings suggest Chinese young adults’ resilience was influenced by cultural norms of restraint, conformity, competition, and superstition. The present study provides a model for future studies using a mixed-methods design to deeply examine resilience among younger people exposed to early adversities within sociocultural, historical, or geographical contexts.

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SN - 0886-2605

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