Racial/Ethnic Differences in Adverse Childhood Experiences and Mental Health.

INTRODUCTION: Racial/ethnic differences exist in the prevalence of Adverse Childhood Experiences (ACEs). However, few studies have examined racial/ethnic differences in the association between ACEs and poor mental health outcomes in young adulthood.

METHODS: Data on 10 self-reported, recalled ACEs (prior to age 18), and current symptoms of depression, anxiety, PTSD, and sleep problems in early adulthood were collected from 2,020 young adults (age 20-23 years) between January-June 2021 enrolled in a Southern California prospective community-based cohort. Logistic regression models run in 2022-2023 evaluated the association of cumulative (0,1,2,3,4+ ACEs), grouped (abuse, neglect, household dysfunction), and individual ACE exposure with mental health outcomes; interaction models tested for differences by race/ethnicity.

RESULTS: All ACE exposures (cumulative, grouped, individual ACEs) were associated with increased odds of most mental health symptoms. Significant differences by race/ethnicity emerged for individual and grouped (but not cumulative) ACEs. For example, associations of any abuse-related ACE and emotional and physical abuse with depressive symptoms were greater for Hispanic participants than for those of another race/ethnicity. Further, associations of emotional abuse with sleep problems were greater for Hispanic participants than for Asian American and Pacific Islander (AAPI) participants (interaction ps<0.05). Though not significant, the association of familial incarceration with depression symptoms was higher for AAPI participants than for other racial/ethnic groups (interaction p-value=0.06).

CONCLUSIONS: Evaluation of individual and grouped ACEs reveal important racial/ethnic heterogeneity in associations with mental health outcomes. Findings have implications for targeted prevention efforts for racial/ethnic groups at higher risk for poor mental health.