The Long Shadow of Adverse Childhood Experiences (ACEs): 1. Mental Health Outcomes in a Community Sample


Keith Stephen Dobson, Lauren Allan, Gina Marandola, Dennis Pusch

Background: Research has consistently linked adverse childhood experiences (ACEs) to negative mental and physical health outcomes later in life. The present study replicated the landmark ACE study in the United States, but within a Canadian adult primary care population (N=3,924). Methods: Participants completed an Adverse Childhood Experiences Questionnaire and a self-report measure for the diagnoses of a variety of mental health problems. Using age and socioeconomic status as covariates, odds ratios were calculated with multivariate logistic regression separately for males and females. Results: Approximately 30.3% of the sample had an ACE score of 0, while the scores for 1, 2, 3 and 4+ACEs were 23.1%, 16.4%, 10.5% and 12.9%, respectively. As the number of ACEs increased, the odds of either a previous or current mental health problem generally also increased in a dose-response manner. This relationship was particularly strong for the DSM-V categories of depressive disorders, anxiety disorders, obsessive-compulsive disorders, bipolar and related disorders, substance-related and addictive disorders, and neurodevelopmental disorders. Similar patterns of results were observed for both males and females. Conclusion: This research replicates results from population-based studies that have examined relationships between ACEs and mental health problems. A better understanding of the factors that underlie the risk for mental disorders is critical to develop prevention and early intervention models. The implications for ACEs screening and intervention within primary care populations are discussed.