Methods: We use the National Longitudinal Study of Adolescent and Adult Health (ADD Health) data collected from a nationally representative adolescents. The final analysis sample includes 5,747 females and 4.938 males. For the latent class of ACEs, we use 12 observed indicators of the following exposures: physical abuse, physical neglect, emotional abuse, emotional neglect, sexual abuse, parental divorce/separation, living with a household adult(s) with a problem of alcohol, incarceration, or mental illness, a victim or witness of community violence, and poverty. We identify the profiles of ACES using a Latent Class Analysis (LCA) for each gender. Next, we run multinomial logistic regressions separately for each gender group to examine the associations between the ACEs and sociodemographic/health characteristics (e.g., age, gender, race/ethnicity, education, household income, public assistance use, health status, and depressive symptoms). All analyses employ sampling weights to account for the complex survey design and non-response bias.
Results: The LCA analysis identifies gender-specific profiles of ACEs. Females have four classes: global adversity (6.3%), child maltreatment (15.5%), household dysfunction (19.3%), and low adversity (58.9%). Females in the global adversity class are highly exposed to multiple adversities (physical neglect, physical abuse, emotional abuse, parental divorce/separation, poverty, and household adult with issues of alcohol or incarceration). Males have four classes but slightly different ones: community violence (7.4%), child maltreatment (13.3%), household dysfunction (14.2%), and low adversity (65.1%). Males in the community violence class are estimated to very likely have witnessed community violence or been a victim to a great degree (over 90%). The multinomial regressions generally suggest that early adversities predict socioeconomic disadvantages in both gender groups. For females, the low adversity class reports significantly better health status than the three classes of ACEs; lower rates of public assistance use in young adulthood than household dysfunction and global adversity classes. Black males are more likely to be exposed to the classes of child maltreatment, household dysfunction, and community violence than their White counterparts.
Conclusion and Implications: This study provides empirical evidence that the latent construct of ACEs varies by gender. While child maltreatment, household dysfunction, low adversity classes are commonly identified, females have a distinct class of global adversity, and males have a separate class of community violence. The findings support that researchers and practitioners should address the needs of gender-specific understandings and interventions for trauma-informed care.