Adverse Childhood Experiences among Adolescent Girls in Residential Treatment: Relationship with Trauma Symptoms, Substance Use, and Delinquency.

Adverse childhood experiences (ACEs) are negative events during childhood or adolescence, including abuse and maltreatment. ACEs are associated with negative life outcomes, and the risk of such outcomes increases when polyvictimization (i.e., multiple types of ACEs) occurs. This study identified patterns in ACEs among girls in a residential treatment program (RTP) and examined how these patterns were associated with trauma symptoms, substance use, and delinquent behavior. Data were coded from psychological assessment records for girls ages 13 to 18 who entered the RTP between 2017 and 2021 ( = 256). Adolescents identified as 43.0% White, 20.9% Biracial/Multiethnic, 16.7% Black, 12.5% Hispanic/Latina, 4.2% Native American/Indigenous Peoples, and 2.7% Middle Eastern/North African descent. Participants reported an average of 5.08 adverse experiences ( = 2.47). Four distinct classes were identified through latent class analysis: polyvictimization (endorsing all 10 ACEs), abuse and non-support (maltreatment and lack of parental support), household dysfunction (parental separation, incarceration, substance use), and low adversity (exposure to only parental separation). The polyvictimization class and the abuse and non-support class reported higher levels of trauma symptoms compared to the low adversity class. The polyvictimization class reported higher substance use compared to the low adversity class. The household dysfunction class reported higher substance use and higher delinquent behaviors compared to the low adversity class. These findings provide a deeper understanding of adolescent girls' experiences of ACEs and mental health and behavioral concerns when entering residential treatment, which helps to inform prevention, intervention, and policy.