Mind the Gap: Adolescent/Caregiver Adverse Childhood Experience Reporting Differences and Association With Adolescent Mental Health.

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with poor mental health outcomes, yet little is known about discrepancies between adolescent and caregiver reports of ACE exposure. This study examines differences between adolescent self-reported and caregiver-reported ACEs and evaluates how reporting discrepancies are associated with depressive and anxiety symptoms among hospitalized adolescents.

METHODS

We recruited 250 adolescent-caregiver dyads from an inpatient adolescent unit in Bronx County, New York. Adolescents and caregivers independently completed ACE questionnaires, assessing traditional (eg, abuse, neglect) and nontraditional (eg, community violence, discrimination) ACEs experienced by the adolescent. Adolescent self-reported depression and anxiety were measured using the Patient Health Questionnaire Modified for Adolescents and Generalized Anxiety Disorder-7, respectively. Descriptive statistics and Pearson correlations were used to analyze the data.

RESULTS

Adolescents reported higher mean ACE scores than caregivers for both traditional (1.66 vs 1.24, P < .001) and nontraditional (1.36 vs 0.89, P < .001) ACEs. Discrepancies in reporting were positively correlated with adolescent depression (r = 0.357, P < .001) and anxiety (r = 0.241, P < .001). Gender-diverse adolescents reported the highest ACE scores, and larger score differences were noted among Hispanic and multiracial and multiethnic dyads.

CONCLUSION

These findings highlight discrepancies between adolescent and caregiver reports of adolescent adversity and underscore the importance of adolescent self-report in clinical assessment. Future research should focus on evaluating interventions that support caregiver awareness, particularly in diverse populations.