Adverse Grownup Experiences (AGEs): Prevalence, Origins, and Consequences

Background and Purpose:  The adverse childhood experiences (ACEs) literature has helped to illuminate the origins of dysfunction, disorder, and disease.  Yet, there has been limited research on cumulative adversity in adulthood or the pathways through which childhood adversity begets subsequent adversity and dysfunction.  Therefore, this study used data from the Families and Children Thriving (FACT) Study to answer the following research questions:

1. What is the prevalence of adverse grownup experiences (AGEs) in a sample of low-income women?
2. Is there an association between the number of ACEs and the number of AGEs reported?
3. Does greater exposure to ACEs and to AGEs increase the risk of adult mental health problems?
4. Do AGEs mediate the association between ACEs and adult mental health problems?

Methods:  The FACT Study is a panel investigation that tracks the health and well-being of low-income families in Wisconsin that have received home visiting services.  The present study includes 737 women that completed the Childhood Experiences Survey, a 19-item measure of ACEs, and the Adult Experiences Survey, a parallel, 19-item measure of AGEs.  Five types of child maltreatment and five types of household dysfunction were summed to form a 10-item ACE score.  A similar AGE score was constructed based on self-report of 10 adult adversities (e.g., partner abuse; crime victimization; homelessness).  Participants also completed well validated measures (abbreviations in parentheses) of four mental health problems: depression (PHQ-9); anxiety (GAD-7); posttraumatic stress (PC-PTSD); anger (DAR-5). 

For research question 1, descriptive analyses were conducted to document the prevalence of ACEs and AGEs.  For research question 2, we specified a multivariate negative binomial regression model with a log link function.  Research questions 3 and 4 were tested using a path model where mental health outcomes were regressed on ACEs with AGEs included as a mediator.  Path analyses were performed in Mplus 7.4.  All other analyses were performed using SPSS 22.  All multivariate models controlled for maternal age, race/ethnicity, and education status.

Results:  On average, participants reported 3.5 AGEs.  The most prevalent AGEs were partner emotional abuse (47.9%), partner incarceration (46.9%), and partner physical abuse (40.7%).  There was a significant association between the number of ACEs and AGEs reported (p < .001).  Results confirmed that there was a dose-response relationship between ACE scores and total scores for depression, anxiety, posttraumatic stress, and anger (all p < .001).  Results revealed comparably robust associations between AGE scores and mental health problems (all p < .001).  Mediation analyses demonstrated that the measure of AGEs partly mediated the association between ACEs and all mental health outcomes, with percent reduction estimates ranging from 51% to 66%.

Conclusions and Implications:  While generalizability is restricted primarily to low-income women in home visiting programs, the findings suggest that AGEs may be as prevalent and consequential as ACEs.  ACEs may precipitate mental health problems, in part, because they increase the risk of further adversity in adulthood.  Implications for theory, direct practice, and social policy will be discussed.