Adverse childhood experiences: separate and cumulative effects on adolescent health and emotional well-being

Purpose

Adverse childhood experiences (ACE) have been consistently linked in a strong and graded fashion to a host of health problems in later adulthood but few studies have examined the more proximate effect of ACE on health and emotional well-being in adolescence.

Methods

Using logistic regression on the 2011/12 National Survey of Children’s Health, we assessed the separate and cumulative effects of ACE on the health and emotional well-being of US adolescents ages 12 through 17. We also investigated the moderating role of family functioning on ACE’s effect on adolescent health and emotional well-being.

Results

Over half of U.S. youths experienced at least one ACE by adolescence, and given exposure to one adverse experience, they were at greater risk of experiencing others. Economic hardship and experiencing discrimination increased the odds of poor adolescent health, while parental divorce and neighborhood violence increase the odds of adolescent emotional problems. Mental illness in the home increased the risk of both poor adolescent health and emotional problems. Family functioning moderated the negative impact of cumulative ACE on adolescent emotional well-being.

Conclusions

Adolescent well-being has enduring consequences; identifying children with ACE exposure who also have lower-functioning family could also help identify those families at particular risk. Our findings have implications for policy and intervention before at-risk children reach adulthood. Results also highlight the value of assessing multiple measures of health and well-being.