Childhood Adversity Phenotypes and Risky Health Behaviors among Chinese Adolescents: Extending the Concept of Adversity.

OBJECTIVE

To present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China.

METHODS

Totally, 5,726 adolescents aged 12-18 years were investigated about their ACEs in the family, peer, school, and personal domains and the occurrence of six types of risky health behaviors (i.e., smoking, drinking, sexual intercourse, self-harm, and suicidal ideation and attempts). Latent class analysis (LCA) was used to explore the ACE patterns.

RESULTS

Six latent classes of ACEs were identified, including low adversity, school adversity, school adversity and peer victimization, peer victimization, maltreatment and peer victimization, and high adversity, and associated with risky health behaviors in adolescents. Being physically punished by a teacher, experiencing sexual abuse, and experiencing family trauma most strongly differentiated from the six ACE classes and were correlated with an increased risk for risky adolescent health behaviors.

CONCLUSION

This study supports a positive association between ACEs and risky adolescent health behaviors. Peer victimization, school adversity and associated contexts need to be considered in future ACE studies.