The Association between Adverse Childhood Experiences and Conduct Disorder among Adolescents: A Case of Shimo La Tewa Borstal Institution in Mombasa County, Kenya

Abstract

Adverse Childhood Experiences (ACEs) are widely recognized as significant predictors of poor behavioural outcomes, including the development of Conduct Disorder (CD) during adolescence. This study investigated the association between ACEs and conduct disorder symptoms and assessed the moderating role of perceived social support among male adolescents confined at Shimo la Tewa Borstal Institution in Mombasa County, Kenya. The specific objectives were to assess the effect of childhood abuse on conduct disorder severity; examine the influence of childhood neglect on conduct disorder symptoms; determine the impact of family dysfunction on conduct disorder severity; and investigate how perceived social support moderates the relationship between ACEs and conduct disorder. The study was guided by attachment theory, social learning theory, and ecological systems theory within a developmental psychopathology framework. The study adopted a quantitative cross-sectional survey design using stratified random sampling to select 140 adolescent boys aged 15–17 years, with strata based on age and length of stay at the institution. Data was collected using standardized tools: Adverse Childhood Experiences Questionnaire, Conduct Disorder subscale of the Adolescent Symptom Inventory, Inventory of Callous–Unemotional Traits, and Multidimensional Scale of Perceived Social Support, supplemented by a demographic questionnaire. The study found that emotional neglect was most prevalent (69.3%), followed by emotional abuse (65.0%), physical abuse (55.5%), physical neglect (48.9%), and sexual abuse (16.8%). Cross-tabulation analysis revealed systematic escalation patterns, with sexual abuse showing the most dramatic increase from 11.5% in mild conduct disorder cases to 33.3% in severe cases. Household dysfunction affected 91.2% of participants at moderate to high levels, with parental separation (66.4%) and substance abuse (65.7%) being most common. Over half (51.8%) of adolescents demonstrated clinically relevant callous-unemotional traits, while 68.6% reported high family support despite documented dysfunction. Statistical analysis confirmed significant associations between ACEs and conduct disorder (p = 0.019), callous-unemotional traits and conduct severity (p = 0.007), and protective effects of social support (p = 0.000). The study concludes that exposure to adverse childhood experiences significantly increases the likelihood and severity of conduct disorder among incarcerated adolescents through cumulative developmental damage that progressively destroys emotional foundations necessary for prosocial behavior. Callous unemotional traits emerged as strong predictors of treatment resistance, while perceived social support demonstrated protective effects despite family dysfunction. The study recommends that the Kenya Prisons Service and State Department for Children Services implement trauma-informed rehabilitation programs, establish systematic trauma assessment protocols, integrate clinical psychologists into institutional teams, and develop family reunification programs. Policy recommendations include standardized trauma-informed care guidelines, dedicated mental health budgets, and mandatory training for correctional officials. Future research should explore gender differences, conduct comparative studies across institutions, and investigate culturally appropriate therapeutic approaches. The key terms used in this study are Adverse Childhood Experiences (ACEs), Conduct Disorder (CD), Callous-Unemotional Traits, Perceived Social Support, Incarcerated Adolescents, Shimo la Tewa Borstal Institution, Kenya.