Childhood Adversity and Health in Emerging Adulthood

Abstract

Key Points Question How are conventional and community-level adverse childhood experiences associated with mental health, substance use, interpersonal violence, and educational outcomes during emerging adulthood? Findings In this cohort study of 1850 emerging adults, higher adverse childhood experience exposure was associated with elevated rates of depression, posttraumatic stress disorder, suicidality, interpersonal violence, lower academic achievement, and use of narcotics, opioids, and other illicit substances. Both adverse childhood experience types contributed to risk; however, specific domains—particularly emotional abuse, sexual abuse, witnessing domestic violence, and discrimination—demonstrated more consistent associations. Meaning In this study, adversity across households and communities showed graded associations with functioning, underscoring the need for prevention strategies addressing cumulative burden and high-impact adversities, including structural conditions.