Adverse childhood experiences, family functioning and adolescent health and emotional well being.
OBJECTIVES Adverse childhood experiences (ACEs) have been consistently linked in a strong and graded fashion to a host of health problems in later adulthood but few studies have examined the more proximate effect of ACEs on health and emotional well being in adolescence. STUDY DESIGN Nationally representative cross sectional study. METHODS Using logistic regression on the 2011/12 National Survey of Children's Health, we examined the cumulative effect of total ACE score on the health and emotional well being of US adolescents aged 12 to 17 years. We investigated the moderating effect of family functioning on the impact of ACE on adolescent health and emotional well being. RESULTS Adolescents with higher ACE scores had worse reported physical and emotional well being than adolescents with fewer ACEs net of key demographic and socio economic characteristics. Family functioning moderated the negative impact of cumulative ACE on adolescent health and emotional well being. CONCLUSIONS Adolescent well being has enduring consequences; identifying children with ACE exposure who also have lower functioning family could also help identify those families at particular risk.
Public health