(PS6-48) Latent Classes of Adverse Childhood Experiences and Their Association with Mental Health, and Suicidal Ideation in Teenagers

Abstract Text: In the U.S., suicide is the second leading cause of death among adolescents (Hink, 2022). It is pivotal to identify modifiable factors that increase risk for suicidal ideation. Adverse childhood experiences (ACEs), which can disrupt children’s development, are associated with poor adult mental health and poor stress-related coping behaviors (Monnat and Chandler 2015). Individuals with multiple ACEs are four times more likely to experience lifetime mental illness diagnosis, self-harm, suicide attempts, and low mental well-being compared to individuals without ACEs (Ford et al., 2020). However, most studies have measured ACEs by retrospective self-report, which is subject to recall bias, rather than prospectively. To our knowledge, no studies have examined the impact of combinations of prospectively measured ACEs on adolescents’ mental health. The current study used latent class analysis to identify youth with distinct patterns of prospectively measured ACEs between birth and age 14, and examined their association with suicidal ideation, post-traumatic stress (PTS) , and depressive symptoms at age 16.
Participants were 1354 youth from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). LONGSCAN recruited child-caregiver dyads who were at-risk for family violence before child age 4 years. Indicators of whether youth experienced 8 ACEs between birth and age 14 were created. Physical abuse, sexual abuse, emotional maltreatment, family violence, and caregiver substance use were collected from biannual youth and their caregiver interviews and systematic Child Protective Services (CPS) record reviews. CPS records of neglect were also included and caregivers reported about their mental health and family member arrest/incarceration. At age 16, youth reported their depression, PTS symptoms, and whether they “seriously considered suicide” in the past year.
A latent class analysis supported a 4-class solution characterized by (1) relatively low likelihood of all ACEs (N = 464; 35%); (2) high likelihood of all ACEs (N = 460; 34%); (3) high likelihood of neglect and caregiver substance use (N = 299; 22%); and (4) high likelihood of emotional maltreatment, physical and sexual abuse (N = 131; 10%). Wald chi squared tests revealed that youth in the High ACEs (MDep = 4.38, MPTS = 5.32) and High Abuse (MDep = 5.52, MPTS = 6.75) classes had significantly more depression and PTS symptoms than youth in the Low ACEs class (MDep = 2.78, MPTS = 3.76). The High ACEs class also reported significantly higher rates of suicidal ideation than the Low ACEs class (14% vs. 5%).
This study examined differences in adolescent mental health outcomes among groups of youth with distinct patterns of prospectively measured ACEs. In addition to groups of youth with high and low probabilities for all ACEs, we identified more nuanced groups with specific patterns of adverse experiences. Findings suggest that youth with patterns that involved more abusive experiences were at greater risk for suicidal ideation, had more PTS and depressive symptoms, and may have greater need for services to address these symptoms. Given increased attention to ACEs screening, there is a need for increasing cognitive-behavioral intervention availability among youth at-risk for adversity.