A latent profile analysis of adverse childhood experiences and adult health in a community sample

Background: Childhood adversity is generally associated with adult mental health problems, but most studies have an insufficient sample size to examine relationships among various aspects of childhood adversity and adult mental health outcomes. Further, past research has predominantly been restricted to a single or limited types of adverse events, which ignores the inherent interdependence among childhood adversity indicators. Objective: The current study explored various configurations of adverse childhood experiences (ACEs) and then examined the relationships among these configurations and various mental health constructs with a person-centered analytic framework. Participants and setting: A sample of 3, 932 adult outpatients was recruited in primary care settings, during regular physician visits. Methods: Participants provided informed consent, demographic information, and then completed validated measure of ACEs (emotional abuse, physical abuse, sexual abuse, physical neglect, emotional neglect, family dysfunction), and a series of validated mental health measures. Results: Latent profile analyses revealed four configurations (or profiles) of ACEs, which were analysed for their relationships with mental health outcomes. The profile with a dominance of physical neglect was associated with the highest levels of anxiety and depression. The profiles with high levels of sexual abuse, either alone or combined with general adversity, had more emotional problems than the profile with low levels of adversity. The profiles characterizing mistreatment did not consistently differ from each other on the mental health outcomes. Conclusions: It is critical to consider ACEs in their complex relationship with each other. Different patterns of ACEs are associated with differential health outcomes in adults.