Advancing Research On Adverse Childhood Experiences
Although epidemiological research has shown that ACEs increase the risk of morbidity and mortality, few studies have analyzed risk and protective factors that may compound or buffer against the effects of ACEs. Likewise, the mechanisms that effectuate the long-term consequences of early adversity are not well understood. This symposium presents new empirical research using multiple datasets and diverse samples to examine the consequences of ACEs along with potential moderating and mediating paths of effect.
Methods: The first paper uses data gathered from the Behavioral Risk Factor Surveillance System (BRFSS) in Wisconsin to explore health-related consequences of exposure to ACEs and the potential moderating effects of race and income. The second paper uses BRFSS data from Washington to investigate indicators of socioemotional functioning and health-related behaviors that may promote positive adaptation in response to ACEs. The third paper uses data from the Chicago Longitudinal Study (CLS) to examine linkages between ACEs and comorbidity among tobacco use, depression, and anxiety. The final paper also uses CLS data to explore whether the ACE-crime connection is mediated by low educational attainment.
Results: Paper 1 uncovered complex ACE-health connections suggesting that race and income act as moderators, and that ACEs may have differential (i.e., threshold) effects within income strata. Paper 2 demonstrated the impacts of ACEs on psychological health, and it revealed protective and suppressive effects associated with select indicators of positive functioning. Paper 3 found that greater exposure to ACEs increased the risk of tobacco use, effects that only emerged when concomitant depressive symptoms or anxiety were present. Paper 4 demonstrated that, controlling for juvenile offending and other background risks, dropping out of high school fully or partially mediated the connection between ACEs and various indicators of adult crime.
Conclusions/Implications: While confirming that ACEs are associated with diverse and long-lasting consequences, these papers generate novel insights into circumstances under which ACE effects may vary, for whom, and why. This evidence will contribute to the development of the ACE framework and its application to population surveillance, risk assessment, prevention and intervention. In turn, these studies advance toward a second generation of ACE research that can be more readily translated into service response and policy applications.