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Kim -

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Children and Youth Services Review





There has been increasing attention to adverse childhood experiences (ACEs) among adolescents in the U.S because ACEs may result in severe mental health issues. Although associations between ACEs and mental health have been explored, research on how different types or combinations of ACEs render different impacts on adolescents is limited. Therefore, this study aims to (a) examine latent classes of ACEs among adolescents who have experienced at least one ACE and (b) investigate associations of each latent group of ACEs with mental health problems, depression and anxiety.


Questionnaires on ACEs and depression/anxiety from the 2016 National Survey of Children’s Health (NSCH) were used, and a total of 11,437 adolescents aged 10–17 years were included in this study. For analyses, latent class analysis (LCA) was implemented to identify the number and types of classes, which are pertinent to represent the heterogenous combinations of ACEs. Moreover, chi-square tests and ordinal regression were performed to investigate the associations of class memberships within ACEs with depression/anxiety.


The LCA found four class memberships within ACEs: Multiple High-Risk, Broken Family, Income Hardship, and Multiple Low-Risk. These classes displayed differences in depression/anxiety. For both pre-existing and current conditions of depression/anxiety, the most prominence has been found in the Multiple High-Risk, followed by the Multiple Low-Risk, the Broken Family, and the Income Hardship, in order.


These differences among the classes indicate that understanding of ACEs and interventions should be based on considering latent classes of ACEs.


This is an Accepted Manuscript of an article published by Elsevier in Children and Youth Services Review on February 14, 2020 , available online:

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.