The Heterogeneity of Developmental Profiles of Adolescents Experiencing Substantial Adverse Childhood Experiences

Background: Adverse Childhood Experiences (ACEs) studies reveal the profound impacts of experiencing child maltreatment and family dysfunction in childhood. Exposure to four or more ACEs substantially increases an individuals’ health and behavioral risks and suicide attempt; however, human development is multidimensional. Trauma survivors would bear salient consequences of ACEs on certain developmental outcomes but may still thrive in other aspects. Meanwhile, as people at different social locations would receive differential social resources, suggesting that social positions predispose individuals to differential risks, protective factors, and responses to trauma. Depicting the multidimensional developmental profiles and exploring racial disparities in those profiles can contribute to ACEs prevention and intervention.

Methods: We used a high-risk sub-sample of 1,427 adolescents from the Future of Families and Child Wellbeing Study, who experienced at least four ACEs by age 9. ACEs were assessed using ten indicators when the focal child was at ages 3, 5, and 9, including psychological abuse, physical abuse, neglect, witnessing maternal domestic violence, maternal substance use, maternal depression, paternal incarceration, parental separation, family poverty, and maternal low education.

Using Mplus 8, we conducted a three-step latent profile analysis (LPA) to examine the development profile of this study sample during adolescence, focusing on their social skills (measured by the Adaptive Social Behavior Inventory), internalizing and externalizing behaviors (measured by the Child Behavior Checklist), and academic achievement (measured by their grades in English, math, history, and science) at age 15.

We used both fit statistics and interpretability to select the most fitting model. Fit statistics included the Akaike information criterion, Bayesian information criterion, sample size adjusted BIC, the Lo– Mendell–Rubin likelihood ratio test, the bootstrap likelihood ratio test, and model entropy.

Results: Based on the model fit results, the four-profile solution model was the best-fitting model. We identified four distinct profiles for adolescents who experienced high ACEs by age 9. The profile with the highest percentage (68.9%) was defined as a multidimensional resilient group. Adolescents in this group showed the highest social skills and academic achievement but the lowest levels of internalizing and externalizing behaviors. The second large profile (17.0%) was defined as a moderate risk group with relatively low GPA, social skills, and relatively high externalizing behaviors, while internalizing behaviors were relatively low. The third large profile (9.0%) was called the quiet group, as group members exhibited the lowest social skills and highest internalizing behaviors but showed relatively low externalizing behavior and good GPA. Finally, we identified the profile with the smallest percentage (5.1%) named as high risk with resilience group. Adolescents in this group exhibited the highest externalizing behavior, high internalizing behavior, and lowest GPA, but good social skills. Compared to White adolescents, Black and Hispanic adolescents had a lower likelihood of being in the quiet group than the multidimensional resilience group.

Conclusions: Using an innovative LPA, we revealed the heterogeneity of the developmental outcomes among adolescents experiencing substantial ACEs. Our findings suggest that a comprehensive screening of social-cognitive and behavioral development is needed for the trauma-affected population to provide targeted interventions.