Adverse Childhood Experience (ACEs) and Mental Health in Young Adulthood

Background and Purpose: Adverse childhood experiences (ACEs) have significant impacts on mental health outcomes. Previous studies show that early exposure to ACEs increases risks of developing mental health problems in adulthood, such as depression, anxiety, and trauma. The majority of ACEs studies have examined ACEs rather simply by using total frequency scores. Many questions remain unanswered about the natures and consequences of ACEs. This study aims to (1) identify the different patterns of ACEs exposures, and (2) investigate how different patterns of ACEs exposures are associated with mental health outcomes in young adulthood.

Methods: The data came from the National Longitudinal Study of Adolescent and Adult Health Wave 1 (1994-1995) to Wave 4 (2008). The analytic sample consists of 8,443 who responded all four waves. First, we used a latent class analysis (LCA) to identify classes of ACEs on the basis of the patterns and types of ACEs (Model 1). We used nine binary variables indicating each of adverse childhood experiences: physical abuse, physical neglect, emotional abuse, emotional neglect, sexual abuse, growing up with a divorced parent, living with having a family member(s) with partner conflict, incarceration, or suicide attempt. Second, we conducted multinomial logistic regression analysis to compare the identified ACEs latent classes by sociodemographic characteristics (Model 2). Third, we conducted three logistic regression analyses to examine the associations between ACEs class (independent variable) and mental health outcomes (dependent variables). We used three mental health variables: clinically diagnosed mental disorders in depression (Model 3-1), anxiety (Model 3-2), and trauma (Model 3-3) measured during young adulthood. In the logistic regressions, we included control variables: age, gender, race, immigrant status, education, household income, receipt of public assistance before age 18, and general health status.

Results: Based on the evaluation of the fit indices (e.g., AIC and BIC) and substantive criteria, LCA (Model 1) identified three heterogeneous classes of ACEs: (1) Low ACEs (62.41%), (2) Family Dysfunction ACEs (17.58 %), and (3) High/Multiple ACEs (20.00 %). Multinomial logistic regression (Model 2) found that compared to Whites, Hispanics (β=.37 p=.045) and African Americans (β=.52 p<.001) were more likely to be classified as Family Dysfunction ACEs (vs. Low ACEs), and Native American (β=.59 p=.004) were more likely to be in High/Multiple ACEs (vs. Low ACEs). Also, young adults with higher education levels and higher household income were less likely to be in the ACEs group of Family Dysfunction (vs. Low ACEs). Finally, three logistic analyses showed that both groups of Family Dysfunction ACEs (β=.24, p=.049) and High/Multiple ACEs (β=.81, p<.001) were more likely to have depression than Low ACEs (Model 3-1). Also, High/Multiple ACEs group was more likely to report anxiety (β=.56, p<.001, Model 3-2) and trauma (β=.93, p<.001, Model 3-3) respectively.

Discussion and Implications: This study contributes to better understandings of ACEs exposures. Findings demonstrate that different experiences of ACEs are significantly and distinctively associated with mental health disorders in young adulthood. Our findings highlight the importance of considering ACEs exposures for promoting mental health of young adults.