Patterns of Adverse Childhood Experiences and Differences in Mental Health and Social Support in Young Adulthood

Background: Research on adverse childhood experiences (ACEs) directed significant attention toward how stressful experiences affect long-term development. While many studies have used summative scores of ACEs, newer literature examines specific patterns of ACEs. Though such patterns have differential effects on child development, it remains less clear whether and how associations may persist into young adulthood for males and females. To address these gaps, this study examines the association between patterns of early childhood ACEs with mental health and social support in young adulthood.

Methods: We drew data from the Fragile Families and Child Well-being Study, which followed parent-child dyads from birth to twenty-two years. Latent class analysis was used to analyzed ten types of ACEs at age three, including eight original ACEs, financial difficulty and neighborhood disorganization. LCA was conducted separately for males and females. Young adult mental health and social support were measured at age twenty-two using the Beck Depression and Anxiety Inventories, UCLA Loneliness Scale, and the Interpersonal Support Evaluation List.

Results:

LCA indicated five classes for females (n=2329, LMR-LRT = .084): low ACEs (45.7%), parental separation (24.7%), financial difficulty (14.6%), chaotic home (6.6%), and child maltreatment (8.3%). For females, early childhood ACEs patterns had no significant associations with depression, anxiety, loneliness or social support.

In contrast, six classes were identified for males (n=2568, LMR-LRT-.006); these included low-ACES (38.8%), parent separation (25.6%), financial difficulty (8.76%), chaotic home (3.5%) classes, along with a fifth distinctly high physical abuse class (8.3%) and a sixth high-ACEs class (3.9%) with both physical and emotional abuse.

Counter to hypotheses, financial difficulty and chaotic home classes often fared as well as the low-ACES class. There were no significant differences in anxiety between the male classes. For depression, the chaotic home class had significantly lower depression scores than parental separation (p = .02) or physical abuse (p = .03) classes. For perceived stress, the high ACEs class had significantly higher perceived stress than financial difficulty (p = .009), chaotic home (p =.03) and low ACEs (22.9, p = .014); the physical abuse class had higher stress than the financial difficulty class (p =.027). For loneliness, financial difficulty class reported lower loneliness than physical abuse (p < .001), high ACEs (p = .017), parental separation (p = .005), and low ACEs (p < .001). Lastly, physical abuse had the lowest overall social support, while financial difficulty class reported higher social support than high ACEs (p = .007), parental separation (p = 001), physical abuse (p < .001) and low ACEs (p = .028) classes; low ACEs also had higher social support than parental separation (p = .04) or physical abuse (p = .012) classes.

Conclusions and Implications: Findings support both the need to examine not just summative ACES scores but sex-specific patterns of ACEs, and the utility of LCA to do so. The results raise questions about females’ ability to adjust over the life-course, as compared to the longer-lasting associations in males. Such findings likewise have implications for social work practice and policy addressing trauma.