Adverse Childhood Experiences (ACEs) Among Black Men: Associations with IPV Perpetration and Excess Alcohol Use

Background and Purpose: Research has consistently shown an association between ACEs and subsequent mental and behavioral health outcomes, including IPV perpetration and alcohol use. Although higher rates of ACEs are found in racial/ethnic minority populations, there is a paucity of research examining ACES, alcohol use and IPV among Black men. This study identified latent classes of ACEs among Black men to understand how patterns of ACEs influence adult alcohol use and IPV perpetration outcomes.

Methods: The sample of Black men (n=2,326) were obtained from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC: Wave 2). Ten items were used to measure ACEs: physical and emotional neglect; physical, emotional, and sexual abuse; witnessing mother/caregiver being abused; having a household member with a mental illness, drug and/or alcohol problem, or who was incarcerated. Unhealthy alcohol use was measured as exceeding weekly (14 standard drinks) or daily (4 standard drinks) drinking limits in the last 12 months. Five questions measured perpetration of physical violence in adulthood. Latent class analyses (LCA) were estimated in Mplus based on ACEs and survey logistic regressions were run in STATA with LCA classes as independent variables predicting adult alcohol use and IPV perpetration.

Results: Sixty eight percent of the sample endorsed ACEs. Of this amount, 20%, 16%, 13%, and 19% reported exposure to 1, 2, 3, and ≥4 ACEs, respectively. The most common ACEs were emotional and physical abuse and physical neglect. Six percent of the sample reported perpetrating IPV in the past year, and 50% exceeded weekly/daily drinking limits.

LCA revealed three classes: (1) “Severe ACEs” (i.e., high physical and emotional neglect, sexual abuse, witnessing mother being abused, having a parent/caregiver with mental illness, who was incarcerated, and with alcohol and/or drug problem); (2) “Physical/Emotional Abuse” (i.e., high levels of physical or emotional maltreatment but lower levels of other ACES), and (3) “Low ACEs” (i.e., low exposure to all ACE factors).

Men in the “Severe ACEs” (OR=4.36, p<.001), and “Physical and Emotional Abuse” (OR=2.28, p<.001) classes had increased risk for IPV perpetration (ref: “Low ACEs class”). Those in the “Severe ACEs” class had slightly greater odds (OR=1.31, p<.001) of unhealthy alcohol use when compared to those in the “Low ACEs” class.

Conclusions and Implications: Depending on pattern of ACEs exposure (i.e. latent class), risk for unhealthy alcohol use and IPV perpetration varied. Black men in the “Severe ACEs” and “Physical/Emotional Abuse” classes were more likely to perpetrate IPV. However, only “Severe ACEs” class membership was associated with excess alcohol use. Families with an IPV history may transmit risk intergenerationally as children witness and are victims of violence and then display IPV in adulthood. For unhealthy alcohol use, observational learning may combine with familial risk to influence adult drinking habits. Our findings highlight the need for inventions aimed at addressing ACEs among Black boys as they increase risk for multiple negative outcomes in adulthood.