Cumulative risk, factor analysis, and latent class analysis of childhood adversity data in a nationally representative sample

Associations Between PTSD and Depressive Symptoms and Victimization Among Female College Students: A Latent Class Analysis

Research on subgroups of female college students who share similar experiences of childhood maltreatment (CM) and intimate partner violence (IPV) victimization is sparse. The primary aims of the current study are: (a) to identify subgroups of victims related to experience of psychological, physical, and sexual CM and IPV and (b) to test the association between subgroups and depressive and post-traumatic stress disorder (PTSD) symptom severity. Survey data was collected from 327 female students at a public university in the Northeast. Three distinct subgroups, that is, victimization classes, were found using Latent Class Analysis: A lifetime victimization class, comprised of females reporting high rates of CM and IPV across types (19.0% of the sample), a childhood victimization class (26.9%); and a low victimization class (54.1%). Depressive symptom severity was positively associated with lifetime and childhood, relative to low, victimization class membership. PTSD symptom severity was associated with the childhood victimization class relative to both lifetime and low victimization class. Subgroups of institutions of higher education (IHE) females who share CM and IPV victimization experiences are discernable. The co-occurrence of IPV and CM in female college students is not uncommon. PTSD symptom severity may be more related to CM than IPV in IHE female students.

Childhood adversity is associated with anxiety and depression in older adults: A cumulative risk and latent class analysis

BACKGROUND

The long-lasting influence of childhood adversity on mental health is well documented; however empirical research examining how this association extends into older adults is limited. This study operationalises adversity using cumulative risk and latent class analysis (LCA) models to assess how adversity exposure and typologies may predict anxiety and depression in older adults.

METHODS

Data came from the Personality and Total Health (PATH) Through Life Project (N = 2551, age 60-66). Participants retrospectively reported their childhood experiences of domestic adversity on a 17-item scale. Mental health was measured using four validated questionnaires of depression and anxiety.

RESULTS

Linear and generalised additive models (GAM) indicated a dose-response relationship, where a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. LCA identified a four-class solution; with high adversity and high parental dysfunction being associated with poorer mental health outcomes while moderate parental dysfunction and low adversity groups scored at healthy levels. Women reported higher overall anxiety than men, but no notable interactions between ACEs and gender were observed. Patterns revealed by LCA were similar to patterns shown by the cumulative risk model.

LIMITATIONS

There is a large time gap from childhood to assessment, making our study susceptible to recall bias. Also, our findings were based on cross-sectional data, limiting causal inferences.

CONCLUSION

Childhood adversity had independent and additive contributions to depression and anxiety in older adulthood, and both cumulative risk and person-centred approaches captured this relationship.

Patterns of adverse childhood experiences and associations with lower mental well-being among university students

BACKGROUND

University students report high levels of adverse childhood experiences (ACEs), which can lead to severe mental health problems. Understanding how ACEs impact well-being in this population is essential, yet research to date is limited.

OBJECTIVE

To explore ACE patterns and their association with lower well-being in university students.

PARTICIPANTS AND SETTING

1023 Spanish students (71.6 % female) aged between 18 and 64 years old (M = 20.10, SD = 3.93) completed a self-report questionnaire.

METHODS

This study used a cross-sectional design. The ACE International Questionnaire (ACE-IQ) and the Short Warwick-Edinburgh Mental Well-being Scale were used to assess, respectively, childhood adversities and mental well-being. Latent Class Analysis and regression modeling were conducted to analyze the link between ACEs and lower mental well-being, considering the covariates of age, country of origin, sexual orientation, and mental illness.

RESULTS

Four ACE classes were identified: Low ACEs (49.5 %), Dysfunctional Household (12.3 %), Household and Peer Abuse (31.0 %), and High ACEs (7.2 %). The regression analysis (F(3, 1007) = 19.2, p < .001, R2adj = 0.054) successfully predicted well-being scores based on ACE classes. When compared with the Low ACE class, all other classes exhibited lower levels of well-being. Age, sexual orientation, and mental illness were also related to lower well-being, with mental illness having the strongest negative effect (β = -0.635, t(1015) = -6.49, p < .001).

CONCLUSIONS

These findings underscore the relationship between childhood adversity and mental health, offering insights for future prevention efforts and enriching our understanding of ACEs and their impact on well-being.

Patterns of adverse childhood experiences and their associations with mental distress, substance use and sexual risk behaviors in Sub-Saharan Africa

BACKGROUND

Multiple adverse childhood experiences (ACEs) are associated with poor sexual and mental health outcomes in low- and middle-income countries (LMICs). Less well understood is how discrete and gendered clustering of ACEs may influence health.

OBJECTIVE

To assess how multiple ACEs co-occur and how dominant patterns of co-occurrence are associated with mental distress, substance use, and sexual risk behaviors among young women and men in Sub-Saharan Africa.

PARTICIPANTS AND SETTING

We used pooled data of young men and women aged 19-24 from comparable, nationally representative Violence Against Children and Youth Surveys (VACS) conducted in Cote d'Ivoire, Kenya, Lesotho, Mozambique, and Namibia (nf = 7183; nm = 2207).

METHODS

We estimated sex-disaggregated latent classes of six ACEs among young women and men. We ran Bolck-Croon-Hagenaars (BCH) distal outcome analysis to test the sex-stratified relationships between ACEs latent classes and health outcomes.

RESULTS

A six class solution best fit the female data. Classes included witnessing violence and experiencing physical violence (PV); experiencing PV; high ACEs; witnessing community violence; orphanhood; and low ACEs exposure. Among males, the best-fitting three-class solution included experiencing PV and witnessing community violence; high ACEs; and low ACEs exposure. Membership in the high ACEs class was associated with mental distress among females and males, and substance use among males. No differences in sexual risk behavior were identified by class membership among either females or males.

CONCLUSIONS

Discrete clusters of co-occurring ACEs are associated with elevated odds of mental distress among females, and mental distress and substance use among males. Preventing ACEs may improve mental health among young women and men in LMICs in Sub-Saharan Africa.

A Scoping Review on Adverse Childhood Experiences Studies Using Latent Class Analysis: Strengths and Challenges

Adverse childhood experiences (ACEs) studies reveal the profound impacts of experiencing trauma and hardships in childhood. However, the cumulative risk approach of treating ACEs obscures the heterogeneity of ACEs and their consequences, making actionable interventions impossible. latent class analysis (LCA) has increasingly been used to address these concerns by identifying underlying subgroups of people who experience distinctive patterns of co-occurring ACEs. Though LCA has its strengths, the existing research produces few comparable findings because LCA results are dependent on ACEs measures and indicators, which vary widely by study. Therefore, a scoping review of ACEs studies using LCA that focuses on ACEs measures, indicators, and findings is needed to inform the field. Following Arksey and O'Malley's five-stage scoping review methodological framework, we first identified 211 articles from databases of EBSCOhost, PubMed, and Scopus using "adverse childhood experiences" for title search and "latent class analysis" for abstract search. Based on the inclusion criteria of peer-reviewed articles written in English published from 2012 to 2022 and the exclusion criteria of nonempirical studies and the LCA not analyzing ACEs, we finally selected 58 articles in this scoping review. Results showed LCA has been increasingly endorsed in the ACEs research community to examine the associations between ACEs and human health and well-being across culturally diverse populations. LCA overcame the limitations of the traditional methods by revealing specific ACEs clusters that exert potent effects on certain outcomes. However, the arbitrary nature of selecting ACEs indicators, measures, and the limited use of theory impedes the field from moving forward.

Leveraging multivariate approaches to advance the science of early-life adversity

Since the landmark Adverse Childhood Experiences (ACEs) study, adversity research has expanded to more precisely account for the multifaceted nature of adverse experiences. The complex data structures and interrelated nature of adversity data require robust multivariate statistical methods, and recent methodological and statistical innovations have facilitated advancements in research on childhood adversity. Here, we provide an overview of a subset of multivariate methods that we believe hold particular promise for advancing the field's understanding of early-life adversity, and discuss how these approaches can be practically applied to explore different research questions. This review covers data-driven or unsupervised approaches (including dimensionality reduction and person-centered clustering/subtype identification) as well as supervised/prediction-based approaches (including linear and tree-based models and neural networks). For each, we highlight studies that have effectively applied the method to provide novel insight into early-life adversity. Taken together, we hope this review serves as a resource to adversity researchers looking to expand upon the cumulative approach described in the original ACEs study, thereby advancing the field's understanding of the complexity of adversity and related developmental consequences.

Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022

BACKGROUND

Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022).

METHODS

Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277).

RESULTS

Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide.

LIMITATIONS

These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings.

DISCUSSION

Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.

Associations Between Configurations of Childhood Adversity and Adult Mental Health Disorder Outcomes

The life course perspective and cumulative inequality theory suggest that childhood adversity, occurring during a sensitive period of the life course, can have long-term consequences for adult mental health and well-being. Yet, the long-term influence of adversity on adult outcomes may depend on both the features of adverse childhood experiences (e.g., the number, type, and co-occurrence of adversities) as well as the outcome assessed. Using latent class analysis applied to several waves of prospective data from the Great Smoky Mountain Study (GSMS; N=1,420) we identify subpopulations that are similar in their adversity experiences before age 18. We then predict adult internalizing and substance use disorder diagnoses by adversity experience. Results reveal five distinct classes of adversity, with unique risks for specific diagnoses in adulthood.

The Association Between Adverse Childhood Experiences (ACEs), Bullying Victimization, and Internalizing and Externalizing Problems Among Early Adolescents: Examining Cumulative and Interactive Associations

Both adverse childhood experiences (ACEs) and bullying victimization are linked with mental health problems in adolescents. However, little is known about the overlap between the two factors and how this impacts adolescent mental health problems (i.e., internalizing and externalizing problems). The current study analyzed data from 8,085 participants (47.7% female; 44.1% racial/ethnic minority) in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Regression analyses were used to estimate associations between ACEs, bullying victimization and mental health problems, respectively, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site. The findings showed that both ACEs and bullying victimization were independently associated with higher internalizing and higher externalizing problems. However, no significant interaction was found between ACEs and bullying victimization. Overall, the results align with the cumulative risk model of adversity, linking cumulative ACEs and bullying victimization to internalizing and externalizing problems in early adolescents.

The influence of childhood trauma and chronotype on suicide attempts in Chinese emerging adults with severe depressive symptoms

BACKGROUND

Studies have investigated how adults with severe depressive symptoms are more likely to attempt suicide, and these adults often have traumatic experiences and chaotic sleep/wake rhythms. Thus, this study using Latent class analysis aimed to investigate the relationship between childhood trauma class, chronotype, and suicide attempts among emerging adults with severe depressive symptoms.

METHODS

This study was conducted among emerging adults with severe depressive symptoms covering 63 Universities in Jilin Province, China. A total of 1,225 emerging adults (mean age = 19.6 ± 1.78) constructed the final sample. In addition to measuring socio-demographic characteristics, the Childhood Trauma Questionnaire-Short Form, the Single-Item Chronotyping, and a single item for suicide attempts were used to evaluate childhood trauma, chronotype, and suicide attempts, respectively. Latent class analysis was applied to identify the classes of childhood trauma within emerging adults who had severe depressive symptoms. Hierarchical logistic regression models were run to investigate the effects of socio-demographic characteristics, chronotype, and childhood trauma class on suicide attempts.

RESULTS

Three latent classes were identified: the Low-risk for childhood trauma class, the Neglect class, and the High-risk for childhood abuse class. Those who suffered sexual, emotional, and physical abuse at the same time were divided into the High-risk for childhood abuse class, and were significantly more likely to experience suicide attempts than those in the Neglect class (OR = 1.97, 95%CI = 1.34-2.89, p < 0.001) and the Low-risk for childhood trauma class (OR = 2.28, 95% CI = 1.50-3.46, p < 0.001). In terms of chronotype, the results showed that the chaotic type was a risk factor for suicide attempts when compared with the evening type (OR = 0.46, 95%CI = 0.27-0.78, p < 0.01), the moderately active type (OR = 0.53, 95%CI = 0.31-0.89, p < 0.05), and the daytime type (OR = 0.42, 95%CI = 0.21-0.86, p < 0.05). Overall, the significant risk factors for suicide attempts included being female, living in an urban area, having experienced sexual, emotional, and physical abuse simultaneously, and having a chaotic chronotype.

CONCLUSION

Emerging adults suffering sexual, emotional, and physical abuse at the same time and identifying with chaotic chronotype showed a higher risk of attempting suicide. The findings provided a clinical reference to quickly identify those at high risk of suicide attempts among emerging adults with severe depressive symptoms.

Testing an integrated dimensional model of adverse childhood experiences: Associations with COVID-19 outcomes

BACKGROUND

Adverse childhood experiences (ACEs) are a salient risk factor for a myriad of negative outcomes. Extant theoretical and empirical models traditionally quantify the impact of ACEs using cumulative representations. Recent conceptualizations challenge this framework and theorize that the types of ACEs children are exposed to differentially impacts their future functioning.

OBJECTIVE

The current study tested an integrated ACEs model using parent-report of child ACEs across four aims: (1) characterize heterogeneity in child ACEs using a latent class analysis (LCA); (2) examine mean level class differences in COVID specific and COVID non-specific environmental factors (i.e., COVID impact, ineffective parenting, effective parenting) and internalizing and externalizing problems during the COVID pandemic; (3) test interactions between COVID impact and ACEs classes in predicting outcomes, and (4) compare a cumulative risk approach to a class membership approach.

PARTICIPANTS AND SETTING

A nationally representative sample of U.S. parents (N = 796; 51.8 % fathers, M age = 38.87 years, 60.3 % Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021.

METHOD

Measures of child's ACEs history, COVID impact, effective and ineffective parenting, and children's internalizing and externalizing problems were completed by parents.

RESULTS

A LCA demonstrated three distinct classes of ACEs reflecting low-risk, trauma-risk, and environmental-risk classes. In general, the trauma-risk class had more negative COVID-19 outcomes than the other classes (small to large effect sizes).

CONCLUSIONS

The classes differentially related to outcomes, providing support for dimensions of ACEs and emphasizing the distinct types of ACEs.

Adversity effects on nonword repetition skills: A proxy measure of language and reading ability

BACKGROUND

Children exposed to adversity are at increased risk for underachievement in reading; however, how early that risk appears and the mechanisms underlying that risk are unclear.

OBJECTIVE

Identify whether individual variation in nonword repetition-a clinical indicator of language and reading ability-can be captured in early childhood (three- to five-years-old) and how various features of adversity exposure (e.g., dosage, severity) are associated with performance.

PARTICIPANTS AND SETTING

Community-based sample of children between the ages of three- and five-years-old who were exposed to significant adversity (n = 92) and living in a major Midwestern metropolitan area.

METHODS

Participants completed a nonword repetition task, and their parent completed a comprehensive adversity questionnaire to report on the child's cumulative lifetime adversity exposure.

RESULTS

Over a third of the participants (34.78 %) did not meet age expectations on the nonword repetition task; however, nonword repetition performance did not significantly associate with the features of the adverse experience (i.e., dosage, severity, frequency, chronicity).

CONCLUSIONS

Risk for underachievement in reading appears early in the preschool years for children exposed to adversity; however, the underlying mechanisms remain unclear since the features of the children's adverse experiences did not associate with their performance. Implications for prevention and early identification within the learning context are discussed.

Cross-time comparison of adverse childhood experience patterns among Kenyan youth: Violence Against Children and Youth Surveys, 2010 and 2019

BACKGROUND

Adverse childhood experiences (ACEs) are a global public health concern. Many children experience multiple ACEs. Patterning of multiple ACEs may change over time.

OBJECTIVE

To assess latent classes of ACEs among male and female youth in Kenya and evaluate whether ACEs latent classes changed between surveys conducted in 2010 and 2019.

PARTICIPANTS AND SETTING

We used data from Kenya Violence Against Children and Youth Survey, a repeated nationally representative survey of male and female youth aged 13-24: 2010 (nf = 1227; nm = 1456) and 2019 (nf = 1344; nm = 788).

METHODS

Latent class analysis was used to estimate clustering of seven ACEs: orphanhood, experiencing physical intimate partner violence, physical violence by a parent/caregiver, physical violence by an adult community member, forced first sex, emotional (EV) and sexual violence (SV), stratified by sex and time.

RESULTS

For females in 2010, identified classes included (1) SV only, (2) household and community physical violence (PV), EV and SV, (3) household and community PV only, (4) low ACEs, and (5) EV only. In 2019, classes included (1) SV only, (2) household and community PV only, and (3) low ACEs. Among males in 2010, the four-class model included (1) household and community PV with EV, (2) low ACEs, (3) household and community PV with SV, and (4) household and community PV only. In 2019, identified classes included (1) orphanhood and SV, (2) orphanhood and PV, (3) low ACEs, and (4) household and community PV only. For both males and females, across the two survey years, some classes demonstrated continuity (low ACEs and caregiver and community PV for both males and females, and SV for females). Orphanhood emerged as relevant to the ACEs latent class structure in 2019 compared to 2010 among males.

CONCLUSION

Prevalence and changes in latent classes between 2010 and 2019 can point toward priority areas and subgroups for violence prevention and response in Kenya.

Adverse childhood experiences and adult outcomes using a causal framework perspective: Challenges and opportunities

BACKGROUND

Research on the effect of adverse childhood experiences (ACEs) on adult outcomes has typically relied on retrospective assessment of ACEs and cumulative scores. However, this approach raises methodological challenges that can limit the validity of findings.

OBJECTIVE

The aims of this paper are 1) to present the value of directed acyclic graphs (DAGs) to identify and mitigate potential problems related to confounding and selection bias, and 2) to question the meaning of a cumulative ACE score.

RESULTS

Adjusting for variables that post-date childhood could block mediated pathways that are part of the total causal effect while conditioning on adult variables, which often serve as proxies for childhood variables, can create collider stratification bias. Because exposure to ACEs can affect the likelihood of reaching adulthood or study entry, selection bias could be introduced via restricting selection on a variable affected by ACEs in the presence of unmeasured confounding. In addition to challenges regarding causal structure, using a cumulative score of ACEs assumes that each type of adversity will have the same effect on a given outcome, which is unlikely considering differing risk across adverse experiences.

CONCLUSIONS

DAGs provide a transparent approach of the researchers' assumed causal relationships and can be used to overcome issues related to confounding and selection bias. Researchers should be explicit about their operationalization of ACEs and how it is to be interpreted in the context of the research question they are trying to answer.

Disruptive behaviors, antisocial attitudes, and aggression in young offenders: Comparison of Adverse Childhood Experience (ACE) typologies

BACKGROUND

Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young offenders' antisocial attitudes, disruptive behaviors and aggression, risk factors for delinquency and reoffending.

OBJECTIVE

This study examined ACE patterns and their association with the above factors in young offenders.

PARTICIPANTS AND SETTING

1130 youth offenders (964 males; M_age = 17.57 years), provided self-reports on ACEs, antisocial attitudes, disruptive behavior ratings and aggression.

METHOD

Latent Class Analysis was performed on 12 self-reported ACEs, followed by Analyses of Covariance on each of the measures.

RESULTS

Four classes - Low ACE, Indirect Victims, Abusive Environment, and Polyvictimized - were identified. Polyvictimized youths had the highest levels of conduct problems (M = 70.35, ps < .05) and proactive aggression (M = 0.45, ps < .05) but did not differ from youths in Abusive Environment in reactive aggression (M = 1.02, p = .69), oppositional problems (M = 65.15, p = .18), and antisocial attitudes (M = 26.95, p = .21). Indirect Victims had lower levels of conduct problems (M = 64.80, p < .05) and antisocial attitudes (M = 24.35, p < .05) than Polyvictimized youths but higher levels of these outcomes than the Low ACE group.

CONCLUSIONS

Our findings showed that ACEs patterns vary in their effects on antisociality and disruptive behaviors. The novel finding was that childhood victimization does not have to be direct, as indirect victimization significantly impacted factors important to delinquency and reoffending.

Comparison of adverse childhood experience analytic approaches and associations with emotional and behavioral problems: A nationwide study among Chinese middle school students

BACKGROUND

Adverse childhood experiences (ACEs) are demonstrated to be strongly associated with many health related problems, which have aroused extensive public attention. But the variety of analytic approaches of ACEs has limited researchers to differentiate those approaches across the outcomes.

METHODS

A total of 22,686 middle school students were surveyed, and their ACEs and health related behaviors were collected. Four different analytic approaches were used to compare the effects of ACEs on four outcomes (non-suicidal self-injury, suicidal ideation, depression and anxiety symptoms). Logistic regression models were applied to verify the associations of adversities and four outcomes. R² and the areas under the Receiver Operator Characteristic (ROC) curve were computed to compare the effects of four approaches.

RESULTS

It was suggested that four measures of ACEs were significantly associated with all the outcomes in both the unadjusted and adjusted models (Ps all <0.05). R² and areas under ROC curve showed that the contributions of four analytical approaches to different outcomes were diverse in this study. ACEs were more impactive to girls than to boys.

CONCLUSION

ACEs are profound influencing factors of emotional and behavioral problems among middle school students. The selection of analytic approaches of ACEs depends on the need of research, and our study contributes to the choice of suitable analytic methods for future research of ACEs.

Empirically-derived dimensions of childhood adversity and cumulative risk: associations with measures of depression, anxiety, and psychosis-spectrum psychopathology

Background: Investigating different approaches to operationalizing childhood adversity and how they relate to transdiagnostic psychopathology is relevant to advance research on mechanistic processes and to inform intervention efforts. To our knowledge, previous studies have not used questionnaire and interview measures of childhood adversity to examine factor-analytic and cumulative-risk approaches in a complementary manner.Objective: The first aim of this study was to identify the dimensions underlying multiple subscales from three well-established childhood adversity measures (the Childhood Trauma Questionnaire, the Childhood Experience of Care and Abuse Interview, and the Interview for Traumatic Events in Childhood) and to create a cumulative risk index based on the resulting dimensions. The second aim of the study was to examine the childhood adversity dimensions and the cumulative risk index as predictors of measures of depression, anxiety, and psychosis-spectrum psychopathology.Method: Participants were 214 nonclinically ascertained young adults who were administered questionnaire and interview measures of depression, anxiety, psychosis-spectrum phenomena, and childhood adversity.Results: Four childhood adversity dimensions were identified that captured experiences in the domains of Intrafamilial Adversity, Deprivation, Threat, and Sexual Abuse. As hypothesized, the adversity dimensions demonstrated some specificity in their associations with psychopathology symptoms. Deprivation was uniquely associated with the negative symptom dimension of psychosis (negative schizotypy and schizoid symptoms), Intrafamilial Adversity with schizotypal symptoms, and Threat with depression, anxiety, and psychosis-spectrum symptoms. No associations were found with the Sexual Abuse dimension. Finally, the cumulative risk index was associated with all the outcome measures.Conclusions: The findings support the use of both the empirically-derived adversity dimensions and the cumulative risk index and suggest that these approaches may facilitate different research objectives. This study contributes to our understanding of the complexity of childhood adversity and its links to different expressions of psychopathology.

Adverse childhood experiences, sexual orientation, and depressive symptoms among Chinese college students: An ecological framework analysis

BACKGROUND

Extensive evidence has demonstrated that adverse childhood experiences (ACEs) predict a high risk of negative health and behavioral outcomes in later life. However, the influence of individuals' psychosocial characteristics and environmental stressors have been mostly omitted in previous research.

OBJECTIVE

This study aimed to examine the prevalence of ACEs among LGB (lesbian, gay, and bisexual) and heterosexual emerging adults, and the associations between different patterns of ACE exposure and depressive symptoms after adjusting for factors at different levels.

PARTICIPANTS AND SETTING

A representative sample of 928 college students in Xiamen city, China was recruited.

METHODS

Latent class analysis was applied to identify the patterns of ACEs. A series of regression analyses were conducted to examine the associations between ACEs and depression and whether ACEs interacted with sexual identity to influence depression, after controlling for individual characteristics, family, school, and society-level factors.

RESULTS

Over 35 % of the participants reported they had experienced at least one type of moderate to extreme childhood maltreatment, and those who identified as LGB reported a higher level of ACE exposure. Higher levels of ACE exposure based on score and clustering approaches were associated with higher risks of depression among Chinese emerging adults. However, the associations between ACEs and depression were not significantly moderated by sexual identity.

CONCLUSIONS

The findings highlighted the importance of early screening for ACEs particularly among sexual minorities and of delivering tailored interventions based on ecological backgrounds. Both the traditional scoring approach and a data-driven approach can be effective in detecting the cumulative effect of ACEs.

The more developmental assets, the less internet gaming disorder? Testing the cumulative effect and longitudinal mechanism during the COVID-19 pandemic

The COVID-19 pandemic has triggered the dramatical development and prosperity of online games, while worldwide people are suffering from it. Considering the high prevalence, serious impacts, and huge development potential of internet gaming disorder (IGD), it is extremely necessary to develop a protective model to prevent and intervene with it among young people. Based on the developmental assets theory, the present study adopted a two-wave longitudinal design to evaluate the cumulative effects of developmental assets on IGD, as well as the underlying mechanisms during this specific period. Data were collected from a sample of 1023 adolescents in Hubei province, Central China through self-report questionnaires. The results indicated that (1) developmental assets were negatively associated with adolescents' IGD concurrently and longitudinally; (2) the overall developmental assets had cumulative effects in linear patterns on adolescents' IGD, concurrently and longitudinally; and (3) internal developmental assets mediated the relationship between external developmental assets and adolescents' IGD longitudinally. Theoretically, the present study supports the developmental assets theory and expands the literature about developmental assets and IGD in younger generations. Practically, the present study provides guidance for prevention and intervention of IGD among adolescents during and after the COVID-19 pandemic. Comprehensive measures should be taken to assist in developing positive internal and external resources to promote youth thriving.

Latent Classes of Adverse and Benevolent Childhood Experiences in a Multinational Sample of Parents and Their Relation to Parent, Child, and Family Functioning during the COVID-19 Pandemic

Adverse Childhood Experiences (ACEs) are known to contribute to later mental health. Conversely, Benevolent Childhood Experiences (BCEs) may buffer against mental health difficulties. The importance of ACEs and BCEs for mental health of both parents and children may be most obvious during periods of stress, with potential consequences for functioning of the family. Subgroups of ACEs and BCEs in parents during the COVID-19 pandemic were investigated and validated in relation to indices of parent, child, and family well-being. In May 2020, ACEs/BCEs were assessed in 547 parents of 5-18-year-old children from the U.K., U.S., Canada, and Australia. Subgroups of parents with varying levels of ACEs and BCEs were identified via latent class analysis. The subgroups were validated by examining associations between class membership and indices of parent and child mental health and family well-being. Four latent classes were identified: low-ACEs/high-BCEs, moderate-ACEs/high-BCEs, moderate-ACEs/low-BCEs, and high-ACEs/moderate-BCEs. Regardless of the extent of BCEs, there was an increased risk of parent and child mental health difficulties and family dysfunction among those reporting moderate-to-high levels of ACEs. Parents' history of adversity may influence the mental health of their family. These findings highlight the importance of public health interventions for preventing early-life adversity.

Heterogeneous adverse childhood experiences and cognitive function in an elderly Chinese population: a cohort study

OBJECTIVE

To identify the heterogeneity of adverse childhood experiences (ACEs) as well as their association with cognitive function in an elderly Chinese population.

DESIGN

A retrospective cohort study.

PARTICIPANTS

The data were from the latest wave of the China Health and Retirement Longitudinal Study and a total of 7222 participants aged ≥60 were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

Latent class analysis was used to identify the classes characterised by 11 types of ACEs. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined by education-specific threshold MMSE scores. Logistic models were constructed to examine the relationship between ACE classes and cognitive impairment. Several childhood and adulthood confounding factors were considered.

RESULTS

Three ACE latent classes were identified. Of them, 76.09% were in the 'Low ACEs' class, 15.43% were in the 'Household dysfunction' class and 8.49% were in the 'Child maltreatment' class. The people in the 'Low ACEs' class seemed to have better childhood family financial situations and higher education levels. The population in the 'Household dysfunction' class tended to live in rural areas and have a higher proportion of men, whereas people in the 'Child maltreatment' class showed a significantly higher proportion of women and higher levels of chronic diseases. 'Child maltreatment' was related to a higher risk of cognitive impairment (OR=1.37, 95% CI: 1.12 to 1.68), while the risk of 'Household dysfunction' was not significantly different from that of the 'Low ACEs' participants (OR=1.06, 95% CI: 0.90 to 1.26).

CONCLUSIONS

The findings supported differences in cognitive function in elderly Chinese people exposed to different types of ACEs.