Patterns of Adverse Childhood Experiences Across Multiple States: A Latent Class Analysis

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2020

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University of Hawaii at Manoa

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Adverse childhood experiences (ACEs) have been shown to be associated with many negative psychosocial outcomes, including depression, lower quality of life, and substance use. Importantly, the associations between ACEs and negative outcomes have been shown to have a dose response relationship with many of these outcomes, such that higher numbers of ACEs endorsed has been associated with worse outcomes across a variety of domains. However, much of the previous research on this topic has focused solely on the number of types of ACEs experienced, rather than the severity and patterns of these experiences. Although some studies have attempted to explore in this direction, there has not yet been a clear consensus on how best to investigate patterns of ACEs. The current study assessed patterns of ACEs in a sample of individuals across multiple U. S. states using latent class analysis and found a 6-class solution: 1) High Trauma, 2) Substance Use, 3) Abuse and Conflict, 4) Moderate Level of Household Dysfunction, 5) Emotional Abuse, and 6) Low Trauma. The ideal class structure for each of the individual states included in the study was then determined, with multiple differences between the overall sample’s classes and individual states’ classes found for the Substance Use, Abuse and Conflict, and Emotional Abuse classes. All of the elevated risk categories were found to be associated with significantly worse perceived emotional and social support, life satisfaction, and health-related quality of life in adulthood than the Low Trauma class. Some of these elevated risk classes were also differentially related to outcomes when compared to each other. These findings underscore the importance of patterns of ACEs, above and beyond the raw number of ACEs domains experienced and have potentially useful implications for prevention and screening efforts.

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Clinical psychology

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