Outcomes related to adverse childhood experiences in college students: Comparing latent class analysis and cumulative risk

Merians, Addie N.; Baker, Majel R.; Frazier, Patricia A.; Lust, Katherine

doi:10.1016/j.chiabu.2018.07.020

Cited by 99 publications

(92 citation statements)

References 25 publications

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“…Two smaller classes of approximately 6% reported "Abuse and mother's mental health problems" and "Poly adversity." The clusters derived in our study are consistent with those found in other work (Debowska et al, 2017;Ford et al, 2014;Lotzin et al, 2018;Merians et al, 2019;Mersky et al, 2017;Ross et al, 2018), although the key advances of the present study are that we find these classes in a longitudinal sample with mainly prospective data on ACEs. One of the most striking findings with respect to ACE clustering in this study is the co-occurrence of parental mental health problems with other ACEs-most commonly parental separation and parental convictions but also emotional and physical abuse.…”

Section: Summary and Interpretation Of Findingssupporting

confidence: 92%

The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important?

Lacey

Howe

Kelly-Irving

et al. 2020

J Interpers Violence

103

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Previous research has demonstrated a graded relationship between the number of Adverse Childhood Experiences reported (an ACE score) and child outcomes. However, ACE scores lack specificity and ignore the patterning of adversities, which are informative for interventions. The aim of the present study was to explore the clustering of ACEs and whether this clustering differs by gender or is predicted by poverty. Data on 8,572 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. ALSPAC is a regionally representative prenatal cohort of children born between 1991 and 1992 in the Avon region of South-West England. ACEs included parental divorce, death of a close family member, interparental violence, parental mental health problems, parental alcohol misuse, parental drug use, parental convictions, and sexual, emotional, and physical abuse, between birth and 19 years. Latent class analysis was used to derive ACE clusters and associations between poverty, gender, and the derived classes tested using multinomial logistic regression. Five latent classes were identified: “Low ACEs” (55%), “Parental separation and mother’s mental health problems” (18%), “Parental mental health problems, convictions and separation” (15%), “Abuse and mental health problems” (6%), and “Poly adversity” (6%). Death of a close family member and sexual abuse did not cluster with other adversities. The clustering did not differ by gender. Poverty was strongly related to both individual ACEs and clusters. These findings demonstrate that ACEs cluster in specific patterns and that poverty is strongly related to this. Therefore, reducing child poverty might be one strategy for reducing ACEs.

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Section: Summary and Interpretation Of Findingssupporting

confidence: 92%

The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important?

Lacey

Howe

Kelly-Irving

et al. 2020

J Interpers Violence

103

View full text Add to dashboard Cite

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“…Although our study was the first to examine the interrelatedness of adversities for infants, the findings were somewhat consistent with findings reported using BRFSS-ACEs data from adults (Brown et al 2013;Ford et al 2014;Merians et al 2019;Mersky et al 2017) and older children in pediatric visits with parent-reported Kaiser-ACEs (Scott et al 2013).…”

Section: Discussionsupporting

confidence: 87%

“…There is a new, but growing literature that examines the interrelatedness of adult-reported ACEs using personcentered methods. In a study of college students who reported on BRFSS-ACEs, latent class analysis (LCA) identified four classes of individuals: low-risk, household dysfunction, emotional/physical abuse, and a class with high levels of all ACEs (Merians et al 2019). The largest study using BRFSS-ACEs data (N = 117,555) reported more combinations of exposures including (1) low-risk; (2) sexual abuse; (3) emotional abuse and household alcoholism; (4) emotional abuse, household alcoholism, and domestic violence; and (5) high levels of all ACEs (Barboza 2018).…”

Section: Studies Of Interrelated Risks In Adult Samplesmentioning

confidence: 99%

Adverse Childhood Experiences in Infancy: a Latent Class Approach Exploring Interrelatedness of Risks

et al. 2020

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Researchers have documented the ways in which children's parenting and home environments impact their social, emotional, and cognitive skills. There is scientific consensus that certain adverse childhood experiences (ACEs), particularly in the absence of a nurturing caregiver, decrease the likelihood that children will develop optimally. Many ACEs co-occur, thereby increasing the number of adversities children experience. This study examined the interrelatedness of ACEs for 14-month-old children from the Early Head Start Research and Evaluation Project (N = 2361). Using latent class analysis, three classes were identified: ACEslow (N = 1431, 60.6%), ACEs-parent maltreatment (N = 636, 26.9%), and ACEs-household dysfunction (N = 294, 12.5%). Class membership was significantly associated with related parenting constructs. Children in families with greater household dysfunction (ACEs-household dysfunction) had parents with the highest levels of parenting stress and the lowest levels of self-efficacy, but who were knowledgeable of infant development and were observed to be moderately supportive in play with their child. Parents at risk for child maltreatment (ACEs-parent maltreatment) had moderate levels of stress and self-efficacy, but the least knowledge of development and were observed to be the least supportiveness in play. Our study suggests that infants experience constellations of ACEs, which are differentially associated with parenting characteristics and behaviors. Results lend credibility to ACE screening in infancy and could be used to inform intervention efforts and the development of more efficient, sensitive screening methods.

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“…However, even though these modeling choices can result in different conclusions, there is only limited evidence that directly contrasts them. Some exceptions include comparison of a latent class predictor characterization (LCA) to the cumulative risk ACE Score in predicting outcomes in college students [23] which found that LCA performed similarly to the cumulative ACE Score. In contrast, Schilling et al found that a cumulative risk approach produced different predictions than treating the same data with a cluster analysis approach [24].…”

Section: Model Comparisonsmentioning

confidence: 99%

Contrasting cumulative risk and multiple individual risk models of the relationship between Adverse Childhood Experiences (ACEs) and adult health outcomes

LaNoue

George

Helitzer

et al. 2020

BMC Med Res Methodol

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Background A very large body of research documents relationships between self-reported Adverse Childhood Experiences (srACEs) and adult health outcomes. Despite multiple assessment tools that use the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. Alternative conceptual models are rarely used and very limited evidence directly contrasts conceptual models to each other. Also, while a cumulative numeric ‘ACE Score’ is normative, there are differences in the way it is calculated and used in statistical models. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ (MIR) model that enters individual ACE events together into prediction models. We also investigated differences that arise from the use of different strategies for coding and calculating the ACE Score. Methods We merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 outcomes. We compared descriptive model fit metrics and used Vuong’s test for model selection to arrive at best fit models using the cumulative ACE Score (as both a continuous or categorical variable) and the MIR model, and then statistically compared the best fit models to each other. Results The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield different and complementary inferences. Conclusions Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy. Results suggest that investigators working with large srACEs data sources could empirically derive the number of items, as well as the exposure coding strategy, that are a best fit for the outcome under study. A multiple individual risk model could also be considered in addition to the cumulative risk model, potentially in place of estimation of unadjusted ACE-outcome relationships.

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Outcomes related to adverse childhood experiences in college students: Comparing latent class analysis and cumulative risk

Cited by 99 publications

References 25 publications

The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important?

The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important?

Adverse Childhood Experiences in Infancy: a Latent Class Approach Exploring Interrelatedness of Risks

Contrasting cumulative risk and multiple individual risk models of the relationship between Adverse Childhood Experiences (ACEs) and adult health outcomes

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