Moore Chelsea R, Stoddard Sarah A
School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI, 48109-5482.
School of Nursing University of Michigan, 400 North Ingalls, Ann Arbor, MI, 48109-5482.
J Sch Health. 2025 Feb;95(2):162-171. doi: 10.1111/josh.13527. Epub 2024 Oct 27.
Adverse childhood experiences (ACEs) are associated with behavioral health challenges and high school dropout, and behavioral health is associated with high school dropout. Less is known about the role of behavioral health challenges in the relationship between ACEs and high school dropout.
Using data from the Panel Study of Income Dynamics (2013) and its 2014 Childhood Retrospective Circumstances Study supplement, the current study conducts mediational path analysis to examine the direct and indirect effects of cumulative ACEs on high school dropout via adolescent depression, anxiety, and substance use.
Experiencing more ACEs was associated with depression, anxiety, and substance use. Only depression and substance use were associated with high school dropout. There was a significant direct effect between increased ACEs and high school dropout and significant indirect effects via depression and substance use, but not anxiety.
Adolescent behavioral health interventions to address the long-term effects of ACEs may also support academic achievement. School-based interventions, particularly those aligned with trauma-sensitive school frameworks and engaging various school personnel, including school nurses, should be considered. Community- and policy-level interventions aimed at primary prevention of ACEs are also needed.
童年不良经历（ACEs）与行为健康挑战及高中辍学有关，且行为健康与高中辍学有关。关于行为健康挑战在ACEs与高中辍学之间的关系中所起的作用，人们了解较少。
利用收入动态面板研究（2013年）及其2014年童年回顾情况研究补充数据，本研究进行中介路径分析，以检验累积ACEs通过青少年抑郁、焦虑和物质使用对高中辍学的直接和间接影响。
经历更多的ACEs与抑郁、焦虑和物质使用有关。只有抑郁和物质使用与高中辍学有关。ACEs增加与高中辍学之间存在显著的直接影响，且通过抑郁和物质使用存在显著的间接影响，但通过焦虑不存在。
旨在解决ACEs长期影响的青少年行为健康干预措施也可能有助于学业成就。应考虑以学校为基础的干预措施，特别是那些与创伤敏感学校框架相一致并让包括学校护士在内的各种学校工作人员参与的干预措施。还需要旨在对ACEs进行一级预防的社区和政策层面的干预措施。
