A Bifactor Model of Childhood Adversity in a Longitudinal South African Birth Cohort Study

Early exposure to violence can elicit a toxic-stress response in children. However, not all exposures to violence exert the same negative impact. This study aimed to develop a bifactor model of childhood adversity by integrating two established measures, the Child Exposure to Community Violence questionnaire and the Pediatric Emotional Distress Scale. The Adversity Exposure-Response Model was created using caregiver-proxy report data from children aged 3.5 and 4.5 years (<i>N</i> = 801) in a South African birth cohort from two high-risk, low-income communities. A bifactor model best fit the data, with the newly formed composite serving as a statistically significant predictor of exposure to traumatic events (β = .34, <i>p</i> < .001). As predicted, this bifactor model provided a holistic approach to childhood adversity, challenging the assumption that all adverse events result in uniformly negative outcomes. It offers a comprehensive screening tool to identify at-risk children early, facilitating targeted interventions in high-risk settings.