Comparison of three models of adverse childhood experiences: Associations with child and adolescent internalizing and externalizing symptoms.

Abstract

Exposure to adverse childhood experiences (ACEs) is prevalent and confers risk for psychopathology later in life. Approaches to understanding the impact of ACEs on development include the independent risk approach, the Dimensional Model of Adversity and Psychopathology (DMAP) distinguishing between threat and deprivation events, and the cumulative risk approach. The present research provides an empirical confirmation of DMAP and a comparison of these three approaches in predicting internalizing and externalizing symptoms in youth. In Study 1, mental health professionals (N = 57) rated ACEs as threat or deprivation events. These ratings were used to create composites to represent the DMAP approach in Study 2. With cross-sectional and longitudinal data from children and adolescents in state custody (N = 23,850), hierarchical linear regression analyses examined independent risk, DMAP, and cumulative risk models in predicting internalizing symptoms, disinhibited externalizing symptoms. and antagonistic externalizing symptoms. All three approaches produced significant models and revealed associations between exposure to ACES and symptoms. Individual risk accounted for significantly more variance in symptoms than cumulative risk and DMAP. Cumulative risk masked differential associations between ACES and psychological symptoms found in the individual risk and DMAP approaches.