Exploring adverse childhood experiences in the wake of system change - A natural experiment comparing East and West Germany.

BACKGROUND

Adverse childhood experiences (ACEs) have negative effects on individuals necessitating examination to discern contributing conditions. The use of quasi-experimental settings, arising from socio-political changes, offers retrospective insight into the macro-level context.

OBJECTIVE

To examine the prevalence of ACEs in the separate macro-systems of both German states, as well as the influence of the socio-political system change due to German unification on ACEs.

METHOD: Data from N = 3'994 participants (age: M = 48.54, SD = 14.37; 50.40% identify as women; 49.42% from East Germany) is analysed using Generalised Additive Models (GAMs). The development of the prevalence of self-reported ACEs is reported and Wilcoxon-Mann-Whitney Tests are conducted between four subsamples, i.e., participants born before and after unification, as well as in the East or West German states.

RESULTS

GAMs reveal differences between East and West German states: Participants born before unification in East Germany report fewer ACEs than participants in West Germany, as well as less ACEs than participants in East Germany after unification. Differences in overall ACEs between East and West German age groups born after 1991 are visually substantial and statistically different for the ACE "substance dependence in the household".

CONCLUSION

Utilising the "natural experiment" of German separation and unification, this study illustrates the impact of socio-political system changes at the individual level. Various cultural, social and economic changes, in particular the high rate of unemployment in the East after unification, are discussed to explain the findings and highlight the importance of considering broader socio-political contexts in understanding and preventing ACEs.