Latent class patterns of adverse childhood experiences and mental health among National Guard recruits.

BACKGROUND

Most studies have relied on a cumulative risk approach when examining adverse childhood experiences (ACEs). This approach assumes equal weighting of adversities and fails to consider how the nature, severity, and combination of ACEs may differentially impact outcomes.

OBJECTIVE

Employing a person-centered approach, we identified distinct patterns of ACEs in a sample of Army National Guard recruits and investigated how these patterns relate to internalizing symptoms (i.e., self-reported mental health) and externalizing problems (i.e., substance use and rule-breaking behaviors).

PARTICIPANTS AND

SETTING

Participants were 1201 Army National Guard recruits from the Advancing Research on Mechanisms of Resilience (ARMOR) study.

METHODS

Latent class analysis (LCA) was performed to identify distinct latent classes of recruits with similar ACEs patterns. Associations between classes and mental health and behavioral outcomes of interest were examined using the Bolck-Croon-Hagenaars (BCH) method.

RESULTS

LCA revealed four latent classes of ACEs: (1) low adversity (51.1 %), (2) emotional and physical maltreatment (18.3 %), (3) poly-adversity (16.1 %), and (4) parental separation (14.5 %). There were no significant interclass differences found in internalizing symptoms or substance use. However, the emotional/physical maltreatment and low adversity classes showed significantly higher counts of rule-breaking behaviors than the other classes.

CONCLUSIONS

Findings suggest recruits enter military service reporting distinct patterns of ACEs, which are differentially associated with rule-breaking behaviors but not mental health outcomes or substance use.