Adverse childhood experiences: Examining latent classes and associations with physical, psychological, and risk-related outcomes in adulthood

Abstract

BackgroundAdverse childhood experiences (ACEs) are a public health crisis, affecting nearly half of children in the United States. Long-term effects of ACEs on psychological well-being, engagement in risk behaviors, and physical health have been observed. Moreover, many individuals exposed to ACEs are also affected by an accumulation of stressors due to broader structural inequities. ObjectiveThe current study examined heterogeneity in patterns of ACEs, explored how these patterns varied based on race/ethnicity, biological sex, and socioeconomic status, and assessed how ACE patterns were associated with physical health, mental health, and risk-related outcomes in adulthood. ParticipantsDrawing on the Add Health dataset, survey data from Waves I, III, IV (n = 12,288) were analyzed. Mean age of participants was 28.3 (SD = 1.9), more than half were female (54.4%), and a little less than half identified as youth of color (46.7%). MethodMultigroup latent class analysis explored heterogeneity in ACE exposure and variations based on structural inequities. Latent class regression assessed associations between ACE classes and outcomes. ResultsA four-class solution was identified. Class sizes and latent structures differed by biological sex. Among males and females, the low adversity class had more positive physical health, mental health, and risk-related outcomes compared to all classes, while the childhood maltreatment and high adversity/community violence classes engaged in more risk-related behaviors. Very small to medium effects were observed. ConclusionFindings highlight the importance of examining heterogeneity in ACE exposure, and how patterns of ACEs may differentially affect outcomes in adulthood.