Trajectories of Adverse Childhood Experiences and Self-Reported Health at Age 18

Richard Thompson*, Emalee G. Flaherty, Diana J. English, Alan J. Litrownik, Howard Dubowitz, Jonathan B. Kotch, Desmond K. Runyan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Objective Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health. Methods The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported health at age 18 were examined using linear mixed models after controlling for earlier health status and demographics. Results The chronic ACEs group had increased self-reported health concerns and use of medical care at 18 but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes. Conclusions In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits.

Original languageEnglish (US)
Article number646
Pages (from-to)503-509
Number of pages7
JournalAcademic Pediatrics
Issue number5
StatePublished - Sep 1 2015


  • adolescent health
  • adverse childhood experiences
  • child abuse and neglect
  • childhood adversities
  • utilization

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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