Perceived Negative Effects of Adverse Childhood Experiences: Associations with Internalizing Symptoms in Young Adults

Cumulative exposure to ACEs is associated with internalizing disorders throughout life. Efforts to move beyond the cumulative risk framework call for assessment of various aspects of adversity (e.g., timing) to improve identification of mechanistic outcomes and accuracy in predicting individual health risk following ACEs. Here, we test whether a cumulative ACE score, an average score of perceived negative effect, or their interaction, are associated with internalizing symptoms among young adults. Six hundred undergraduates (Mage = 19.05; 75% female; 69% Black) completed questionnaires related to ACEs, anxiety, and depressive symptoms. The perceived negative effect score was independently associated with anxiety and depressive symptoms, whereas a cumulative ACE score was only associated with depressive symptoms. No interactions were detected. The findings highlight the value in assessing perception as one aspect of exposure to ACEs. Future research should consider other contextual factors, and how they may interact with perception to influence health outcomes.