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Adverse Childhood Experiences, Mental Health, and Risk Behaviors in Adulthood: Exploring Sex, Racial, and Ethnic Group Differences in a Nationally Representative Sample

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Abstract

This study examined sex, racial, and ethnic differences in the short- and long-term associations between adverse childhood experiences (ACEs), mental health, and risk behaviors in a nationally representative sample. Analysis was based on the National Longitudinal Study of Adolescent to Adult Health, a longitudinal cohort of U.S. adolescents followed in five waves of data collection from adolescence to adulthood. Analysis included design-based regression models to examine the associations between ACEs and proximal and distal outcomes (i.e., depression, suicidal ideation, number of sexual partners, binge drinking, current smoker) assessed in the transition to adulthood (mean age 21; 2001–2002) and adulthood (mean age 38; 2016–2018). Sex, racial, and ethnic interactions were included in regression models to examine effect modification in the association of ACEs, mental health, and risk behaviors. In this analytical sample (N = 9,690), we identified a graded association between ACEs and depression, suicide ideation, and current smoker status at both time points (i.e., mean age 21 and 38). Sex moderated the relationship between ACEs and depression at mean age 21, while race (i.e., American Indian versus White) moderated the relationship between ACEs and number of sexual partners at mean age 38. A greater number of cumulative traumatic experiences in childhood may amplify adverse health outcomes among women and adults of American Indian descent in particular.

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Availability of Data and Material

Access to Add Health restricted-use data were obtained through the University of North Carolina at Chapel Hill.

Code Availability

Upon request.

Notes

  1. Item was reverse coded.

  2. Item was reverse coded.

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Acknowledgements

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. No direct support was received from grants P01-HD31921 for this analysis.

Funding

This study was supported by the Moore Center for the Prevention of Child Sexual Abuse, Johns Hopkins Bloomberg School of Public Health.

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Authors and Affiliations

  1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD, 21231, USA

    Luciana C. Assini-Meytin, Rebecca L. Fix, Reshmi Nair & Elizabeth J. Letourneau

  2. Department of Behavioral and Community Health, School of Public Health, University of Maryland, 2242 Valley Dr, College Park, MD, 20742, USA

    Kerry M. Green

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  1. Luciana C. Assini-Meytin
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  2. Rebecca L. Fix
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  3. Kerry M. Green
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Correspondence to Luciana C. Assini-Meytin.

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Assini-Meytin, L.C., Fix, R.L., Green, K.M. et al. Adverse Childhood Experiences, Mental Health, and Risk Behaviors in Adulthood: Exploring Sex, Racial, and Ethnic Group Differences in a Nationally Representative Sample. Journ Child Adol Trauma 15, 833–845 (2022). https://doi.org/10.1007/s40653-021-00424-3

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