DOI: https://doi.org/10.14710/jpki.21.1.9-16

The Association between Adverse Childhood Experiences, Social Support, Body Mass Index, and Physical Activity among Adolescents

*Riza Hayati Ifroh orcid scopus  -  Department of Health Promotion, Faculty of Public Health, Universitas Mulawarman, Indonesia
Muhamad Aziz Rabiautsani  -  School of Psychology, Northeast Normal University, China
Lies Permana  -  Department of Health Promotion, Faculty of Public Health, Universitas Mulawarman, Indonesia
Dhihram Tenrisau  -  Varians Statistik Kesehatan, Indonesia
Open Access Copyright (c) 2026 Authors under http://creativecommons.org/licenses/by-sa/4.0.

Citation Format:
Abstract

association with levels of social support and physical activity, which play a role in adolescents’ future health. This cross-sectional study aimed to examine the associations between ACEs, social support, Body Mass Index (BMI), and physical activity among adolescents in Samarinda, Indonesia.

Method: A sample of 246 participants completed an online self-administered questionnaire. Descriptive statistics, Pearson correlation coefficients, and chi-square tests were used to explore associations among variables. Mediation and moderation analyses were conducted using the PROCESS macro.

Result: The findings revealed that ACEs were negatively associated with perceived social support (β = -0.1949, p < 0.001) and positively associated with physical activity (β = 0.0834, p = 0.0062). Perceived social support was negatively associated with physical activity (β = -0.2002, p = 0.0004) and partially mediated the relationship between ACEs and physical activity, with a significant indirect effect (β = 0.0390, 95% CI [0.0156, 0.0675]). The moderated mediation analysis revealed that BMI did not significantly moderate the direct or indirect effects, although the indirect pathway remained significant across different levels of BMI. The study demonstrated that perceived social support partially mediated the relationship between ACEs and physical activity. This mediation pathway remained significant regardless of BMI level, while BMI did not show a moderating effect. Conclusion these findings suggest that social support partially explains how ACEs influence physical activity, regardless of BMI.

Fulltext View|Download
Keywords: ACEs;social support;physical activity;BMI

Article Metrics:

Article Info
Section: Research Article
Language : EN
Recent articles
Exposure to Electronic Cigarette Advertisements on the Internet and Smoking Behavior in Adolescents Diffusion of Educational Digital Innovation: Implementing The OKY App for Menstrual Education in Junior High Schools The Association between Adverse Childhood Experiences, Social Support, Body Mass Index, and Physical Activity among Adolescents More recent articles
Most cited articles
Faktor Risiko Kejadian Low Back Pain Pada Operator Tambang Sebuah Perusahaan Tambang Nickel Di Sulawesi Selatan Non Disclosure Of HIV Positive Status Of Women To Their Partner : Implication For PMTCT Praktik Inisiasi Menyusu Dini Perbedaan Efektifitas Metode Demonstrasi Dengan Pemutaran Video Tentang Pemberantasan DBD Terhadap Peningkatan Pengetahuan Dan Sikap Anak SD Di Kecamatan Wedarijaksa Kabupaten Pati Faktor Sosial Budaya dalam Praktik Perawatan Kehamilan, Persalinan, dan Pasca Persalinan (Studi di Kecamatan Bangsri Kabupaten Jepara) More cited articles
  1. Pearce J, Murray C, Larkin W. Childhood adversity and trauma: experiences of professionals trained to routinely enquire about childhood adversity. Heliyon. 2019;5(7):e01900
  2. Hadwen B, Pila E, Thornton J. The associations between adverse childhood experiences, physical and mental health, and physical activity: A scoping review. J Phys Act Heal. 2023;13(1):104–16
  3. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Heal. 2017;2(8):e356–66
  4. Goldstein E, Topitzes J, Miller-Cribbs J, Brown RL. Influence of race/ethnicity and income on the link between adverse childhood experiences and child flourishing. Pediatr Res. 2021;89(7):1861–9
  5. Bellis MA, Lowey H, Leckenby N, Hughes K, Harrison D. Adverse childhood experiences: Retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population. J Public Heal (United Kingdom). 2014;36(1):81–91
  6. Gardner R, Feely A, Layte R, Williams J, McGavock J. Adverse childhood experiences are associated with an increased risk of obesity in early adolescence: a population-based prospective cohort study. Pediatr Res. 2019;86(4):522–8
  7. Giano Z, Wheeler DL, Hubach RD. The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health. 2020;20(1):1–12
  8. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006;256(3):174–86
  9. Curtis A, Luchetti M, Prendergast C, Ahern E, Súilleabh SO, Creaven A marie, et al. Social Science & Medicine Adverse childhood experiences and loneliness : A systematic review and. 2025;370(February)
  10. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE)Study. Am J Prev Med. 2019;56(6):774–86
  11. Shalabi KM, Alsharif ZA, Alrowaishd SA, Al Ali RE. Relationship between body mass index and health-related physical fitness: a cross-sectional study. Eur Rev Med Pharmacol Sci. 2023;27(20):9540–9
  12. Marker AM, Steele RG, Noser AE. Physical activity and health-related quality of life in children and adolescents: A systematic review and meta-analysis. Heal Psychol. 2018;37(10):893–903
  13. Santana CCA, Azevedo LB, Cattuzzo MT, Hill JO, Andrade LP, Prado WL. Physical fitness and academic performance in youth: A systematic review. Scand J Med Sci Sport. 2017;27(6):579–603
  14. Donnelly JE, Hillman CH, Castelli D, Etnier JL, Lee S, Tomporowski P, et al. Physical activity, fitness, cognitive function, and academic achievement in children: A systematic review. Med Sci Sports Exerc. 2016;48(6):1197–222
  15. Sibley BA, Etnier JL. The Relationship Between Physical Activity and Cognition in Children: A Meta-Analysis Benjamin. Pediatr Exerc Sci. 2003;2000:243–56
  16. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985 Mar-Apr;100(2):126-31
  17. Oshio T, Umeda M. Gender-specific linkages of parents’ childhood physical abuse and neglect with children’s problem behaviour: Evidence from Japan. BMC Public Health. 2016;16(1):1–8
  18. Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: A unifying theory. Clin Psychol Rev. 2001;21(1):33–61
  19. Erickson KI, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108(7):3017–22
  20. Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: Exercise effects on brain and cognition. Nat Rev Neurosci. 2008;9(1):58–65
  21. Mammen G, Faulkner G. Physical activity and the prevention of depression: A systematic review of prospective studies. Am J Prev Med. 2013;45(5):649–57
  22. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29
  23. Harada M, Guerrero A, Iyer S, Slusser W, Szilagyi M, Koolwijk I. The Relationship Between Adverse Childhood Experiences and Weight-Related Health Behaviors in a National Sample of Children. Acad Pediatr. 2021;21(8):1372–9
  24. Raney JH, Testa A, Jackson DB, Ganson KT, Nagata JM. Associations Between Adverse Childhood Experiences, Adolescent Screen Time and Physical Activity During the COVID-19 Pandemic. Acad Pediatr. 2022;22(8):1294–9
  25. Murphy J, McGrane B, White RL, Sweeney MR. Self-Esteem, Meaningful Experiences and the Rocky Road—Contexts of Physical Activity That Impact Mental Health in Adolescents. Int J Environ Res Public Health. 2022;19(23)
  26. Damme KSF, Vargas TG, Walther S, Shankman SA, Mittal VA. Physical and mental health in adolescence: novel insights from a transdiagnostic examination of FitBit data in the ABCD study. Transl Psychiatry. 2024;14(1):1–8
  27. Evans SE, Steel AL, DiLillo D. Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role? Child Abus Negl. 2013;37(11):934–43
  28. Cheong E Von, Sinnott C, Dahly D, Kearney PM. Adverse childhood experiences (ACEs) and later-life depression: Perceived social support as a potential protective factor. BMJ Open. 2017;7(9):1–12
  29. Karatekin C, Ahluwalia R. Effects of Adverse Childhood Experiences, Stress, and Social Support on the Health of College Students. J Interpers Violence. 2020;35(1–2):150–72
  30. Dorri AA, Stone AL, Salcido R, Russell ST, Schnarrs PW. Sexual and gender minority adverse childhood experiences (SGM-ACEs), perceived social support, and adult mental health. Child Abus Negl. 2023;143(June):106277
  31. Schnarrs PW, Stone AL, Bond MA, Salcido R, Dorri AA, Nemeroff CB. Development and psychometric properties of the sexual and gender minority adverse childhood experiences (SGM-ACEs): Effect on sexual and gender minority adult mental health. Child Abus Negl. 2022;127(February):105570
  32. Gill M, Chan-Golston AM, Rice LN, Roth SE, Crespi CM, Cole BL, et al. Correlates of Social Support and its Association With Physical Activity Among Young Adolescents. Heal Educ Behav. 2018;45(2):207–16
  33. Laird Y, Fawkner S, Niven A. A grounded theory of how social support influences physical activity in adolescent girls. Int J Qual Stud Health Well-being. 2018;13(1)
  34. Mendonça G, Farias Júnior JC de. Physical activity and social support in adolescents: analysis of different types and sources of social support. J Sports Sci. 2015;33(18):1942–51
  35. Hasanah E, Zamroni Z, Dardiri A, Supardi S. Indonesian adolescents experience of parenting processes that positively impacted youth identity. Qual Rep. 2019;24(3):499–512
  36. Wahyuningsih H, Novitasari R, Kusumaningrum FA. Emotional and psychological well-being in Indonesian adolescents: Translation and construct validation of the Stirling Children’s Well-being Scale in a college student sample. Cogent Educ. 2022;9(1)
  37. Davis L, Barnes AJ, Gross AC, Ryder JR, Shlafer RJ. Adverse Childhood Experiences and Weight Status among Adolescents. J Pediatr. 2019;204:71-76.e1
  38. Piaggi P, Vinales KL, Basolo A, Santini F, Krakoff J. Energy expenditure in the etiology of human obesity: spendthrift and thrifty metabolic phenotypes and energy-sensing mechanisms. J Endocrinol Invest. 2018;41(1):83–9
  39. Zhang Y, Li Y, Jiang T, Zhang Q. Role of body mass index in the relationship between adverse childhood experiences, resilience, and mental health: a multivariate analysis. BMC Psychiatry. 2023;23(1):1–13
  40. Center for Reproductive Health UGM Faculty of Medicine Public Health and Nursing. Early Adolescents’ Health in Indonesia: Evidence Base from GEAS-Indonesia Baseline 2019. 2019
  41. Basrowi RW, Wiguna T, Samah K, Djuwita F Moeloek N, Soetrisno M, Purwanto SA, et al. Exploring Mental Health Issues and Priorities in Indonesia Through Qualitative Expert Consensus. Clin Pract Epidemiol Ment Health. 2024;20:e17450179331951
  42. Munira L, Liamputtong P, Viwattanakulvanid P. Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study. Belitung Nurs J. 2023;9(2):110–7
  43. Sumiatin T, Ningsih WT, Su’udi, Aby Yazid Al Busthomy Rofi’i, Roudlotul Jannah, Siti Kotijah. Analysis of Health Behavior of Adolescents in Tuban, Indonesia. Indian J Forensic Med Toxicol. 2021;15(2):3604–9
  44. DP2PA Samarinda. Data Kekerasan Kota Samarinda [Internet]. 2023. Available from https://dp2pasamarinda.com/wp-content/uploads/2024/02/BUKU-DATA-KASUS-KEKERASAN-pada-APLIKASI-SIMFONI-PPA-KOTA-SAMARINDA-TAHUN-2023-1.pdf
  45. World Health Organization. Adverse Childhood Experiences International Questionnaire (ACE-IQ) Rationale for ACE-IQ. In 2011. p. 8
  46. Bi S, Stevens GWJM, Maes M, Boer M, Delaruelle K, Eriksson C, et al. Perceived Social Support from Different Sources and Adolescent Life Satisfaction Across 42 Countries/Regions: The Moderating Role of National-Level Generalized Trust. J Youth Adolesc. 2021;50(7):1384–409
  47. Zimet GD, Dahlem NW, Zimet SG, Farley GK. perceived social support scale Zimet et al. J Pers Assess. 1988;52(1):30–41
  48. Amiri S, Mahmood N, Yusuf R, Ghenimi N, Javaid SF, Khan MAB. Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis. Children. 2024;11(8):1–19
  49. Schlauch KA, Read RW, Neveux I, Lipp B, Slonim A, Grzymski JJ. The Impact of ACEs on BMI: An Investigation of the Genotype-Environment Effects of BMI. Front Genet. 2022;13(March):1–15
  50. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences ( ACE ) Study. Am J Prev Med. 1998;14(4):245–58
  51. Aldomini M, Lee JW, Nelson A, Hwang RS, Alharbi KK, Sinky TH, et al. The moderating role of social support on the impact of adverse childhood experiences on life satisfaction and mental health in adulthood. Clin Epidemiol Glob Heal. 2025;32(February):101933
  52. Li QD, Kuang XM, Qi J. Correlates of Physical Activity of Children and Adolescents with Visual Impairments: A Systematic Review. Curr Pharm Des. 2020;26(39):5002–11
  53. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–75
  54. Al-shoaibi AAA, Iyra P, Raney JH, Ganson KT, Dooley EE, Testa A, et al. Associations Between Adverse Childhood Experiences and Early Adolescent Physical Activity in the United States. Acad Pediatr. 2024;24(4):662–8
  55. Danese A, Tan M. Childhood maltreatment and obesity: Systematic review and meta-analysis. Mol Psychiatry. 2014;19(5):544–54
  56. Reblin M, Uchino BN. Social and emotional support and its implication for health. Curr Opin Psychiatry. 2008;21(2):201–5
  57. Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. Int J Environ Res Public Health. 2022;19(2)

Last update:

No citation recorded.

Last update: 2025-09-09 01:51:25

No citation recorded.