Investigator(s)
| Submitter |
Dendup Dendup Paro Hospital Dendup Dendup 
|
| Principal Investigator |
Dendup Dendup Paro Hospital Dendup Dendup
|
| Co-Investigator(s) |
Nidup Dorji Faculty of Nursing and Public Health (Khesar Gyalpo University of Medical Sciences of Bhutan) Nidup Dorji
|
Title(s) and abstract
| Scientific title | Adverse and Positive Childhood Experiences: Correlation with Substance Use, and Mental Health Symptoms among Patients Seeking Counselling Services in Bhutan |
| Public title | Adverse and positive childhood experiences among Bhutanese seeking counselling services |
| Background | Mental health and substance use disorders are a major global crisis, affecting over a billion people and showing high rates of co-occurrence. A key factor in these adult conditions is early life experience. Adverse Childhood Experiences (ACEs) such as abuse, neglect, and household dysfunction are strongly linked to a higher risk of developing mental health disorders, suicidality, and substance use disorders later in life, with risk increasing alongside the number of ACEs. Conversely, Positive Childhood Experiences (PCEs) like supportive relationships with family and community act as a protective buffer. Evidence shows PCEs can promote resilience and moderate the negative impact of ACEs on mental health and substance use. While this relationship is well-established globally, there is a critical research gap in Bhutan. The country faces a rapidly growing burden of mental health conditions and significant harm from alcohol and substance use, which poses a substantial economic cost. However, empirical studies on ACEs, PCEs, and their connection to mental health and substance use among Bhutan’s population are virtually nonexistent. This study aims to address this gap by investigating the correlation between both adverse and positive childhood experiences and the mental health and substance use of patients seeking |
| Objectives | 1.Assess the prevalence and the type of ACEs among the Bhutanese patients seeking counselling services in the health centers of Bhutan. 2.Assess the prevalence of PCEs among the Bhutanese patients seeking counselling services in the health centers of Bhutan. 3. Find the types and the frequency of substance use among Bhutanese patients seeking counselling services in the health centers of Bhutan. 4. Identify the type of mental health symptoms among Bhutanese patients seeking Counselling in the health centers of Bhutan. 5. Test the association between ACEs, PCEs, substance use, and mental health symptoms among Bhutanese patients seeking counselling services in the health centers of Bhutan. |
| Study Methods | Data will be collected via interviewer-administered questionnaires by trained clinical counselors. The instruments include standardized tools: the Adverse Childhood Experiences International Questionnaire (ACE-IQ), the Benevolent Childhood Experiences (BCEs) scale, the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7), and the WHO-Five Well-Being Index (WHO-5). A pilot test will be conducted with 28 participants. Data analysis will involve descriptive statistics (frequencies, means) and inferential tests (chi-square, t-tests, correlation, regression) using SPSS version 30.0.0, with a significance level of p< 0.05. Written informed consent will be obtained from all participants, ensuring confidentiality and the right to withdraw. |
| Expected outcomes and use of results | Expected Outcomes: This study will produce the first national data on the prevalence of Adverse and Positive Childhood Experiences (ACEs/PCEs) among adults seeking counseling in Bhutan. It will detail their current mental health and substance use profiles. Critically, it will quantify the association between ACEs/PCEs and these adult conditions, testing if positive experiences buffer the impact of adversity. Use of Results: The findings are designed for direct application. They will inform the Ministry of Health and The Pema in strengthening national mental health and substance use policies, advocating for trauma-informed care. For clinicians, the results will guide the development of screening protocols and resilience-focused interventions. For prevention, the data will support public health campaigns to promote safe childhoods. Ultimately, this evidence will help shift Bhutan’s care system towards more effective, preventative, and compassionate approaches. |
| Keywords | Adverse Childhood Experiences, Positive Childhood Experiences, Mental Health, Substance Use Disorder |
Research Details
| Student research | No |
| Start Date | 01-Jan-2026 |
| End Date | 31-Oct-2026 |
| Key Implementing Institution | Self |
| Multi-country research | No |
| Nationwide research | No |
| Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan, Bhutan | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Other (Mental Health) |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |