Adverse childhood experiences and adolescent adjustment in the ELSPAC-CZ cohort

Abstract Background Exposure to adverse childhood experiences (ACE) has been associated with mental health problems later in life. However, most previous studies utilized cross-sectional samples with retrospectively collected ACE; this approach is prone to report bias and confounding by other early life factors. Additionally, much previous research come from the United States and the United Kingdom. We tested the association between prospectively measured ACE and adolescent adjustment in a population-based birth cohort in Central Europe. Methods Data were obtained from the Czech part of the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 2,741). ACE score was calculated as a sum of eight intra-familial adversities (i.e., ACE types) assessed prospectively between 6 months and 11 years postpartum. Adolescent internalizing and externalizing problems were measured via Strength and Difficulties Questionnaire (SDQ) at 11 years and were reported by adolescents and their mothers. Results Linear regression models showed that ACE score was associated with adolescent (β = 0.063, 95% CI [0.019, 0.107]) and mother-reported (β = 0.120, 95% CI [0.077, 0.163]) internalizing problems and with adolescent (β = 0.088, 95% CI [0.045, 0.132]) and mother-reported (β = 0.114, 95% CI [0.072, 0.157]) externalizing problems in models adjusted for socio-demographics, birth characteristics and early childhood temperament. Analysis by ACE types revealed that the association was driven particularly by physical and emotional abuse. Conclusions ACE were common in ELSPAC sample (69% of children experienced at least one ACE) and were prospectively associated with adjustment in young adolescents. ACE were associated with later internalizing and externalizing problems, independently from early life sociodemographic characteristics and childhood temperament, suggesting a robust link between ACE and adolescent adjustment. Key messages • ACE exposure was prevalent in the ELSPAC-CZ sample and was linked to increased internalizing and externalizing problems. • The association between ACE and adolescent adjustment was attenuated by adjusting for early childhood temperament.