The impact of adverse childhood experiences on psychosocial functioning.

Decades of research have established that adverse childhood experiences (ACEs) are associated with psychological wellbeing. There is a need to understand the underlying mechanisms that link ACEs to outcomes years later. However, much of the understanding garnered from research has relied on retrospective data. In Study One (Chapter Two), a systematic review was conducted which focuses on longitudinal research investigating mediating and moderating pathways explaining the relationship between ACEs and psychosocial outcomes. While a general picture of underlying mechanisms was not forthcoming, several methodological issues in the literature were found. First, wide heterogeneity in how multiple ACEs were operationalised made generalisations difficult. Second, the paucity of longitudinal studies that satisfactorily assess important temporal concepts such as stationarity (i.e. the stability of effects over time) precludes understanding of the nature of the relationship between ACEs and psychosocial functioning over time.
Study Two (Chapter Three) and Study Three (Chapter Four) sought to address these limitations using the Understanding Society dataset. In Study Two, two conceptually different operationalisation of multiple ACEs were modelled. The cumulative risk approach and person-centred approach were compared. Findings showed that the cumulative risk approach explained more variance for most outcomes, but the person-centred approach showed the potential of ACE typologies to find highly specified relationships. In Study Three, a series of longitudinal models found that many of the relationships between ACEs and psychosocial outcomes were bidirectional. Additionally, when ACE risks were partitioned by ecology, community risks had a specific effect on internalising problems, whereas household risks affected internalising problems, externalising problems, delinquency, and life satisfaction. Together, these studies shed light on how ACEs are related to psychosocial outcomes.