Exposure to Different Patterns of Adverse Childhood Experiences and Subsequent Behavioral and Mental Health Outcomes Among Young Adults

Excessive alcohol use and tobacco smoking are major health problems among young adults and modifiable risk factors impacting long-term health. Adverse childhood experiences (ACEs) such as child maltreatment and household dysfunction have been strongly linked with subsequent substance use and related psychological symptoms. Recent research on ACEs has argued that measurement of childhood adversities can be improved by considering a wider range of potentially concomitant adversities and victimization experiences. Understanding associations between patterns of ACEs and adulthood addictive behaviors and psychological symptoms has important implications for preventing and remedying long-term health and behavioral outcomes. The aims of this study were to identify latent classes of ACEs and examine the relationship between victimization classes with young adults’ alcohol and tobacco use, and psychological symptoms.

Data for the current study were collected from young adults ages 18 to 25 (N=335) recruited from the community. Slightly more than half were female (51.8%) and 55.7% were White. Participants completed an hour-long structured interview. Latent class analysis (LCA) was performed in Mplus (version 7.3) to identify homogenous subgroups of young adults who experienced similar patterns of ACEs. The following 12 ACEs indicators were evaluated: childhood emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, witnessing intimate partner violence, household alcohol abuse, household drug abuse, household mental health, household incarceration, property victimization, and gang violence. Following the LCA, group differences across the latent classes were examined using a multivariate one-way analysis of covariance (one-way MANCOVA) with participant age, gender, and racial majority/minority status as covariates, and the following variables as dependent variables: alcohol-related problems measured by the Rutgers Alcohol Problem Index; number of daily cigarettes; and psychological symptoms measured by the Brief Symptom Inventory.

LCA evaluation using a variety of fit statistics (e.g., AIC, BIC, BLRT, MLRT) suggested that the three-class solution was optimal. Class 1 (“Poly-victimized Group”) comprised 24% of the sample (n=80); participants in this group had high rates of multiple victimization types. Class 2 (“Emotional Victimization” Group) was distinguished by high rates emotional abuse and neglect and comprised 16% (n= 54) of the sample. The third class (“No Maltreatment/Low Family Malfunctioning”) consisted of 60% of the sample and was characterized by low family malfunctioning, and low to no direct childhood maltreatment experiences (n= 201). Results of the one-way MANCOVA demonstrated that these classes differed significantly on the outcome variables (Pillai's F (6, 580) = 12.88, p < .001, partial η²= .12), with Class 1 having the highest rates of alcohol-related problems, number of cigarettes used daily, and psychological symptoms.

Our findings confirm that for many young people, ACEs occur as multiple rather than single experiences. The present study also suggests that distinct profiles of childhood individual and family risks are differently associated with young adult outcomes. If our goals are to prevent adverse behavioral and mental health outcomes among young adult victims of ACEs, future research must develop empirically sound explanations of how exposure to certain patterns of ACEs relate to increased risk of later substance use and mental health problems.