Associations among Childhood Household Income, Latent Classes of Early Adverse Childhood Experiences, and Adolescent Mental Health.

Adverse Childhood Experiences (ACEs) and low household income are associated with adolescent mental health challenges, and children from lower-income households experience more ACEs. Less is known about how ACEs may cluster for sub-groups of individuals (e.g. those with differing household incomes) or if different ACE clusters are associated with differential mental health outcomes. Using data from the Future of Families and Child Wellbeing Study ( = 2,524) and seven ACE indicators (harsh physical discipline; emotional/verbal abuse neglect; parent mental illness, problematic substance use, incarceration, and intimate partner violence), we conducted latent class analysis to identify distinct combinations of early childhood ACE exposure (ages 0-5). Then we tested associations between household income (relative to needs; at birth) and ACE class membership, as well as ACE class membership and adolescent depression and anxiety symptoms. We identified three distinct latent classes characterized as: "Low ACEs", "Physical/Emotional Abuse," and "High ACEs." Household income at birth was associated with early childhood ACE class membership and ACE class membership was associated with differential adolescent mental health outcomes. Future research and interventions must consider how different ACE combinations (beyond the simple count of ACEs) uniquely impact health/wellbeing, and the role that household income has in the patterning of ACEs.