Keyword: confounding

Schuster, Filip; Associations of the ten original Adverse Childhood Experiences (ACEs) with mental health impairments after controlling for the other ACEs (meta-analysis)
The ten original ACEs (including emotional, physical, and "sexual abuse") are associated with mental impairment among the people affected in countless studies. The corresponding bivariate associations are to a considerable extent confounding bias. The extent of the causal relationships is unresolved. [...]
Methode: A systematic literature search was conducted to search for studies that determined the associations of each of the ten original ACEs with mental impairment in "minors" or adults after controlling for each of
the nine other original ACEs (and other ACEs, if applicable). [...]
Conclusions: The causal relationships between the ten original ACEs and mental health impairments are smaller than widely suspected. In the case of several original ACEs, long-term important negative health consequences
are not to be assumed. The ACEs concept should be fundamentally
reconsidered.
Limitations: Also, because of the many uncontrolled confounding variables (including genes and other ACEs), the associations identified by the metaanalysis are not precise causal effect sizes.