title: 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.
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.
authors: Jane Addams College of Social Work, University of Illinois at Chicago, 1040 W. Harrison St., Chicago, IL 60607, USA.
authors: J P
authors: JP
authors: Mersky
authors: J
authors: J
authors: Topitzes
authors: A J
authors: AJ
authors: Reynolds
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001741:Black or African American; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D015999:Multivariate Analysis; D016017:Odds Ratio; D011204:Poverty Areas; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D014505:Urban Population; D055815:Young Adult
keywords: Adverse childhood experiences; Health; Mental health; Substance use
references: Future Child. 2009 Fall;19(2):119-46
references: 19719025
references: Child Abuse Negl. 1994 May;18(5):409-17
references: 8032971
references: Arch Gen Psychiatry. 2010 Feb;67(2):113-23
references: 20124111
references: J Abnorm Child Psychol. 2007 Jun;35(3):475-95
references: 17333363
references: JAMA. 1997 Aug 27;278(8):637-43
references: 9272895
references: Psychosom Med. 2009 Feb;71(2):243-50
references: 19188532
references: PLoS One. 2013;8(1):e54691
references: 23372755
references: Am J Public Health. 2008 May;98(5):946-52
references: 18381992
references: J Consult Clin Psychol. 2004 Jun;72(3):500-510
references: 15279533
references: Am J Prev Med. 1998 May;14(4):245-58
references: 9635069
references: Arch Gen Psychiatry. 2004 Aug;61(8):807-16
references: 15289279
references: JAMA. 1999 Nov 3;282(17):1652-8
references: 10553792
references: JAMA. 1962 Jul 7;181:17-24
references: 14455086
references: Addict Behav. 2002 Sep-Oct;27(5):713-25
references: 12201379
references: J Clin Epidemiol. 2004 Mar;57(3):229-36
references: 15066682
references: Eur Arch Psychiatry Clin Neurosci. 2006 Apr;256(3):174-86
references: 16311898
references: Arch Gen Psychiatry. 2005 Jun;62(6):617-27
references: 15939839
references: BMC Public Health. 2007 Mar 07;7:30
references: 17343754
references: Child Abuse Negl. 2004 Jun;28(6):623-43
references: 15193852
references: Am J Psychiatry. 1963 Oct;120:386-7
references: 14069465
references: Am J Prev Med. 2008 May;34(5):396-403
references: 18407006
references: Arch Pediatr Adolesc Med. 2007 Aug;161(8):730-9
references: 17679653
references: Circulation. 2004 Sep 28;110(13):1761-6
references: 15381652
references: Arch Womens Ment Health. 2004 Apr;7(2):111-21
references: 15083346
references: Depress Anxiety. 1999;9(4):169-74
references: 10431682
references: Child Dev. 2004 Sep-Oct;75(5):1435-56
references: 15369524
references: Am J Prev Med. 2005 Jun;28(5):430-8
references: 15894146
references: Psychol Bull. 2007 Mar;133(2):183-204
references: 17338596
references: J Affect Disord. 2004 Oct 15;82(2):217-25
references: 15488250
references: Lancet. 2007 Sep 8;370(9590):859-77
references: 17804063
references: Child Abuse Negl. 1990;14(1):19-28
references: 2310970
references: Am J Public Health. 2006 Oct;96(10):1849-53
references: 17008582
references: Clin Psychol Rev. 2009 Jun;29(4):328-38
references: 19371992
references: Lancet. 2005 May 21-27;365(9473):1786-93
references: 15910951
references: Child Dev. 2003 Jan-Feb;74(1):3-26
references: 12625433
references: J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9
references: 20855043
references: Child Abuse Negl. 2011 Jun;35(6):408-13
references: 21652073
references: Am J Public Health. 2008 Feb;98(2):296-303
references: 17538060
references: J Obstet Gynecol Neonatal Nurs. 2011 Mar-Apr;40(2):157-65
references: 21314710
references: Pediatrics. 2003 Mar;111(3):564-72
references: 12612237
references: Psychol Med. 2012 Sep;42(9):1997-2010
references: 22273480
references: Pediatr Clin North Am. 2009 Apr;56(2):389-403
references: 19358923
references: Prev Sci. 2009 Mar;10(1):1-12
references: 19160053
references: BMC Public Health. 2013 Jan 09;13:17
references: 23302300
references: Child Abuse Negl. 1998 Nov;22(11):1065-78
references: 9827312
references: J Prev Interv Community. 2012;40(4):278-90
references: 22970781
references: Am J Public Health. 1997 Feb;87(2):249-55
references: 9103105
references: Arch Intern Med. 2003 Sep 8;163(16):1949-56
references: 12963569
references: Child Abuse Negl. 2004 Jul;28(7):771-84
references: 15261471
references: BMC Public Health. 2013 Jan 03;13:3
references: 23286392
references: Arch Pediatr Adolesc Med. 2009 Dec;163(12):1135-43
references: 19996051
references: Psychol Bull. 2002 Mar;128(2):330-66
references: 11931522