title: Trajectories of Adverse Childhood Experiences and Self-Reported Health at Age 18.
abstract: OBJECTIVE
  Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health.
  
  
  METHODS
  The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported health at age 18 were examined using linear mixed models after controlling for earlier health status and demographics.
  
  
  RESULTS
  The chronic ACEs group had increased self-reported health concerns and use of medical care at 18 but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes.
  
  
  CONCLUSIONS
  In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits.
authors.affiliation: Richard H. Calica Center for Innovation in Children and Family Services, Juvenile Protective Association, Chicago, Ill. Electronic address: rthompson@juvenile.org.
authors.forename: Richard
authors.initials: R
authors.lastname: Thompson
authors.affiliation: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
authors.forename: Emalee G
authors.initials: EG
authors.lastname: Flaherty
authors.affiliation: School of Social Work, University of Washington, Seattle, Wash.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: English
authors.affiliation: Department of Psychology, San Diego State University, San Diego, Calif.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Litrownik
authors.affiliation: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md.
authors.forename: Howard
authors.initials: H
authors.lastname: Dubowitz
authors.affiliation: Department of Child and Maternal Health, University of North Carolina-Chapel Hill, Chapel Hill, NC.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Kotch
authors.affiliation: Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado School of Medicine, Aurora, Colo.
authors.forename: Desmond K
authors.initials: DK
authors.lastname: Runyan
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D054523:Adult Survivors of Child Abuse; D002648:Child; D002649:Child Abuse; D016241:Child of Impaired Parents; D002675:Child, Preschool; D000066479:Criminal Behavior; D003863:Depression; D000069581:Exposure to Violence; D054541:Family Conflict; D005260:Female; D006304:Health Status; D006801:Humans; D000066511:Intimate Partner Violence; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D057566:Self Report; D019966:Substance-Related Disorders
keywords: adolescent health; adverse childhood experiences; child abuse and neglect; childhood adversities; utilization