Adverse Childhood Experience‐Related Conditions and Substance Use in Adolescents: A Secondary Analysis of Cross‐Sectional Survey Data

Abstract

ABSTRACTBACKGROUNDAdverse childhood experiences (ACEs) cluster within children. In addition to standardized ACE measures, there exist “ACE‐related” measures that are either directly or indirectly related to the standardized ACE constructs. This study aimed to identify ACE‐related latent classes of adolescents and describe past‐month substance use in each class by sex and race/ethnicity.METHODSData from the 2018 Indiana Youth Survey (N = 70,703), which is a repeated self‐administered, cross‐sectional survey, were used. Latent class analysis was conducted using ACE‐related family (parent incarceration, insulting/yelling within family, inability to discuss personal problems) and school (hate being in school, feeling unsafe, inability to talk to teachers one‐on‐one) items. Dependent variable combined past 30‐day use‐frequency of 17 substances. Two‐way analysis of variances examined ACE by sex and race/ethnicity interaction.RESULTSFour ACE‐related classes emerged: “Family‐Only” (11.2%), “School‐Only” (16.5%), “Family‐School” (8.0%), and “No‐ACE” (64.3%). Substance use was highest in “Family‐School” (mean = 0.67); lowest in “No‐ACE” (mean = 0.21). Significant race/ethnicity (F = 27.06; p < .0001), ACE * sex interaction (F = 12.13; p < .0001) and ACE * race/ethnicity interaction (F = 4.57; p < .0001) effects emerged. Within each ACE‐related class, substance use was lowest for Asians and highest for Hispanics.CONCLUSIONSAdverse childhood experience‐related items cluster within children across school and family environments and clustering differs by race/ethnicity, but not by sex. Incorporating ACE‐related items into school surveys enhances the ability to implement interventions that target relationships between ACEs and substance use.