Multiple childhood traumas tied to worse young adult outcomes

Jeff Temple, PhD, professor and associate dean for clinical research at UTHealth Houston School of Behavioral Health Sciences. (Photo by UTHealth Houston)

Emerging adults with an average age of 19 who experienced four or more adverse childhood experiences had substantially higher rates of depression, suicidal ideation, hard drug use, and interpersonal violence than those who reported no childhood adversity.

Experiencing emotional abuse, sexual abuse, discrimination, and witnessing domestic violence had the strongest and most consistent associations with poor health and other negative outcomes, according to the team. 

The study was published today in JAMA Network Open.

First author Jeff Temple, PhD, professor and associate dean for clinical research at UTHealth Houston School of Behavioral Health Sciences, said the team’s findings are notable because, unlike many previous studies, participants were assessed relatively close in time to the childhood adversity they reported. Other studies are typically conducted among adults who are several decades removed from childhood, Temple said. 

“There are few transitions in life—tween to teen and then teen to young adult—that really define who we are in terms of identity development and risky behavior,” said Temple, who is the Betty and Rose Pfefferbaum Chair in Child Mass Trauma and Resilience at McGovern Medical School at UTHealth Houston. “Emerging adulthood is a particularly important developmental period, and what happens during these years can have implications for health, relationships, and education well into adulthood.” 

Temple’s study was also unique in that it assessed both conventional adverse childhood experiences and community-level childhood adversity. 

The team measured adverse childhood experiences among 1,850 emerging adults using the Philadelphia ACEs survey, a 21-item scale that captures both conventional and community-level childhood adversity. 

Conventional events in the survey include emotional or physical abuse, sexual abuse, emotional or physical neglect, witnessing domestic violence, household substance abuse, household mental illness, or having an incarcerated family member. Community-level events include witnessing violence, experiencing discrimination, being bullied, or feeling unsafe in your neighborhood. 

“Emerging adults who are still relatively close in time to these experiences are already showing substantial differences in mental health, relationships, substance use, and educational outcomes,” Temple said. “And there was a clear pattern—as the number of adverse childhood experiences increased, outcomes generally became worse.” 

The findings point to the importance of both preventing adversity earlier in childhood and intervening during emerging adulthood, Temple said.

“We obviously want to prevent these experiences from happening in the first place, but emerging adulthood also gives us an important window to intervene before these patterns become more entrenched,” Temple said. “That means identifying young people who have experienced significant adversity and connecting them with trauma-informed supports, while also addressing broader factors such as neighborhood safety and discrimination that contribute to risk.”

Additional authors, all with UTHealth Houston, include Elizabeth Baumler, PhD; Leila Wood, PhD; and Leslie Taylor, PhD.