Prevalence and profiles of adverse childhood experiences: a French nationwide study using the CONSTANCES cohort

Introduction: Adverse childhood experiences (ACEs) can impact individuals' health later in life. In France, research on the prevalence and patterns of ACEs remains limited. This study aims to estimate the prevalence of different categories and profiles of ACEs in the French general population, and to explore their associations with childhood socioeconomic and demographic factors. Methods: A cross-sectional observational study was conducted using retrospective data from the CONSTANCES cohort, a large population-based cohort study in France, including adults aged 18 to 69 years at enrolment. The analytic sample included 101 071 participants with complete data on ACEs. Prevalence and typology of ACEs was assessed using the Behavioural Risk Factor Surveillance System questionnaire and examined individually, cumulatively and through latent class analysis (LCA) to identify exposure profiles. Associations with socioeconomic and demographic factors were examined using multinomial logistic regression, and all analyses were stratified by sex. Results: Overall, 65% of participants reported experiencing at least one ACE. Females were more likely than males to report certain experiences, including sexual violence. LCA identified three distinct ACE profiles in males (low exposure; physical and emotional violence; unstable family environment), and four in females (similar to males, with an additional class characterised by sexual violence). Class membership was associated with factors such as age, parental socioprofessional category and geographical origin. Conclusions: ACEs are highly prevalent in the French population and differ by sex. These findings emphasise the importance of social determinants, including gender and socioeconomic position, as risk factors.