Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the U.S

Child Abuse Negl. 2013 Nov;37(11):917-25. doi: 10.1016/j.chiabu.2013.07.011. Epub 2013 Aug 24.

Abstract

Research has shown that adverse childhood experiences (ACEs) increase the risk of poor health-related outcomes in later life. Less is known about the consequences of ACEs in early adulthood or among diverse samples. Therefore, we investigated the impacts of differential exposure to ACEs on an urban, minority sample of young adults. Health, mental health, and substance use outcomes were examined alone and in aggregate. Potential moderating effects of sex were also explored. Data were derived from the Chicago Longitudinal Study, a panel investigation of individuals who were born in 1979 or 1980. Main-effect analyses were conducted with multivariate logistic and OLS regression. Sex differences were explored with stratified analysis, followed by tests of interaction effects with the full sample. Results confirmed that there was a robust association between ACEs and poor outcomes in early adulthood. Greater levels of adversity were associated with poorer self-rated health and life satisfaction, as well as more frequent depressive symptoms, anxiety, tobacco use, alcohol use, and marijuana use. Cumulative adversity also was associated with cumulative effects across domains. For instance, compared to individuals without an ACE, individuals exposed to multiple ACEs were more likely to have three or more poor outcomes (OR range=2.75-10.15) and four or more poor outcomes (OR range=3.93-15.18). No significant differences between males and females were detected. Given that the consequences of ACEs in early adulthood may lead to later morbidity and mortality, increased investment in programs and policies that prevent ACEs and ameliorate their impacts is warranted.

Keywords: Adverse childhood experiences; Health; Mental health; Substance use.

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • African Americans
  • Chicago / epidemiology
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Health Status*
  • Health Surveys
  • Hispanic Americans
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / ethnology
  • Multivariate Analysis
  • Odds Ratio
  • Poverty Areas
  • Sex Factors
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / ethnology
  • Urban Population*
  • Young Adult