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Examining the relations between gender, latent classes of adverse childhood experiences (ACEs), and internalizing/externalizing symptoms among Latinx teens


Multiple nationally representative studies in the same time period demonstrate that between 45-63% of all individuals in the United States have lived through at least one adverse childhood experience (ACE; (Felitti et al., 1998; Merrick, Ford, Ports, & Guinn, 2018; Sacks & Murphey, 2018; Sacks, Murphey, & Moore, 2014). ACEs are garnering more attention as more systems (e.g., school, juvenile justice facilities) become aware of their devastating impacts. As more prevention and intervention efforts are funded, it is vital to understand how ACEs interact with one another to influence symptoms and other outcomes (Wolff, Cuevas, Intravia, Baglivio, & Epps, 2018). Some scholars argue in favor of a cumulative risk only approach, however, the importance of an interactional approach, consisting of unique clusters of ACEs, is supported by the developmental trauma disorder framework. The purpose of this study is to investigate whether unique clusters of ACEs exist, and to demonstrate classes utilizing additional ACEs items. Following this, the purpose of the study is to determine whether clusters are practically helpful in real-world clinical settings. Participants consisted of 167 Latinx youth aged 12 – 17 seeking services at a community mental health agency. An ML 3-step LCA (Vermunt, 2010) was used to estimate classes, predict class membership from gender, and predict internalizing/externalizing symptoms from class membership. Due to nearly all fit statistics converging upon either a 2-class or 3-class model, it is likely that both a 2-class model and 3-class model are adequate models to describe co-occurrences of adverse childhood experiences. As there was acceptable support for a 3-class solution, and an examination of item probabilities revealed meaningful differences amongst the three classes, the present study utilized a 3-class model of ACEs. The three typologies of ACEs constellations that emerged were: (1) Interpersonal Victimization with High Community Violence and Low Household Dysfunction, (2) Healthy Interpersonal Relationships with Divorce and Low Household Dysfunction, and (3) Family Interpersonal Victimization with Extreme Household Dysfunction. Significant gender differences were found when predicting class membership in the Healthy Interpersonal Relationships with Divorce and Low Household Dysfunction class, with boys being more likely to be placed in this class than any other class. The Interpersonal Victimization with High Community Violence and Low Household Dysfunction demonstrated the greatest rates of internalizing and externalizing symptoms at intake and demonstrated greater internalizing symptoms than externalizing symptoms. With recent calls for the acknowledgment of expanded ACEs, using clinical samples, examining ACEs in diverse populations, and using person-centered analysis instead of variable-centered analysis to move beyond a cumulative risk framework has opened up novel research opportunities. The chronic stress experienced by these youth is devastating, leaving them at risk for a number of deleterious mental and physical health outcomes (Osório et al., 2017). There must be a global shift toward the understanding of ACEs, and beyond this, into understanding how we help youth and families experiencing ACEs after collecting these data from them (Finkelhor, 2017). These findings contribute to the pre-existing literature suggesting that the way that traumatic experiences intersect with one another might have differential and clinically significant impacts on psychological functioning.

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