The Association between Adverse Childhood Experiences (ACEs) and the Mental Health of Adolescents with Child Welfare...

Mental health problems are increasing among U.S. adolescents. Numerous studies have linked adverse childhood experiences (ACEs) to these growing concerns. Studies in this rapidly expanding field are calling for the inclusion of contextually and developmentally relevant ACEs, such as discrimination and bullying, alongside conventional ACEs, such as maltreatment. The current study assesses the association between an expanded set of ACEs and mental health functioning among adolescents with child welfare involvement. Participants included 245 racially/ethnically diverse youth (ages 12-15; 60.5% female) and their parents/caregivers. Multi-informant measures of ACEs and adolescent functioning (e.g., internalizing behaviors, dissociative symptoms, social problems) were used. Based on extant literature, 21 candidate ACEs were selected for possible inclusion in an expanded ACE index. Fourteen ACEs were positively associated with at least one mental health variable and included in the index: physical abuse, sexual abuse, physical neglect, witnessing domestic violence, witnessing community violence, termination of parental rights, number of caregiver transitions, number of school changes, peer emotional bullying, peer physical bullying, cyberbullying, physical violence due to discrimination, emotional/relational dating violence, and sexual/physical dating violence. The resulting index was positively associated with all outcome variables. Subgroup analyses examined the association between ACEs and mental health functioning within different sociodemographic groups, finding relatively comparable effects. These results underscore the need to consider ACEs specific to adolescence and population/context. Findings also suggest that some ACEs - although likely still impactful in other ways-may be less influential for adolescent mental health functioning among youth with child welfare involvement.