Intergenerational associations of adverse childhood experiences and adolescent engagement in high-risk behaviors


Authors: Sarah A Ray, Austin Yoders, Megan Quinn, Kylee Phalen, Maria Demma Cabral, Mahesh Shrestha, and David Wood
Page Range: 185-194
Published in: International Journal of Child and Adolescent Health, 16#3 (2023)
ISSN: 1939-5930

Table of Contents


While the association between adverse childhood experiences (ACEs) and negative health outcomes in adulthood is well established, very few studies have examined the cumulative impact of ACEs across generations (intergenerational ACEs – caregiver and youth) on health outcomes in adolescence. The purpose of this study is to examine whether intergenerational ACEs are associated with an increased likelihood of participation by youth in high-risk behaviors including tobacco use, vaping, alcohol use, engagement in sexual activity, or result in higher rates of affective disorders such as depression. 234 caregiver-youth dyads were recruited via a convenience sample from pediatric clinics at East Tennessee State University and Western Michigan University Homer Stryker MD School of Medicine. Participant dyads completed a survey assessing both caregiver and youth ACEs, youth depression, and youth participation in high-risk behaviors. Caregiver-youth dyads were sorted into an ACEs matrix with the following groups: low caregiver-low youth ACEs (LC-LY), low caregiver-high youth ACEs (LC-HY), high caregiver-low youth ACEs (HC-LY), and high caregiver-high youth ACEs (HC-HY). HC-HY dyads were 11.4 times more likely to report moderate to severe depression compared to LC-LY dyads (p < 0.01). HC-HY dyads were 4.5, 3.3, and 7.5 times more likely to have youth participate in alcohol use (p < 0.05), vaping (p < 0.05), and sexual activity (p < 0.01), respectively, compared to LC-LY dyads. Intergenerational ACEs exposure was related to greater youth engagement in high-risk behaviors and risk of depression. Assessing both caregiver and youth ACEs would better identify youth at risk for alcohol use, vaping, sexual debut, and depression. Keywords: Adverse childhood experiences, alcohol use, tobacco use, sexual activity, depression, United States

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