The Effects of Adverse Childhood Experiences on Externalizing Behaviors Among Adolescents: A Longitudinal Study

Introduction: Current research reveals that adolescents exposed to psychological trauma (i.e. physical violence, verbal abuse, or neglect) may be at high risk for internalizing and externalizing behaviors (Douglas et al., 2010; Duke, Pettingell, McMorris, & Borowsky, 2009; Schilling, Aseltine, & Gore, 2007). Specifically, early exposure to psychological trauma during childhood places adolescents at elevated risk for mood disorders, substance use problems, or delinquency later in life (Douglas et al., 2010). However, previous studies have either been cross-sectional or have examined mood disorders and/or co-occurring risk outcomes separately. To address this gap in the literature, the present study will provide a longitudinal conceptual model that incorporates depressive symptoms and three risk outcomes; delinquency, Inter Personal Violence (IPV), and substance use. We hypothesize that depressive symptoms will significantly mediate the association between Adverse Childhood Experiences (ACEs) and externalizing behaviors. Additionally, it is important to highlight adolescents who do not engage in delinquency, IPV, or substances. Current studies reveal that increased levels of self-control may reduce risk behavior among adolescents (Romer, Duckworth, Sznitman, & Park, 2010). Therefore, the protective effect of self-control will be used as a moderator.

Methods: Using a prospective, 4-year longitudinal study of protective factors for teen dating violence perpetration, adolescents completed self-administrated surveys in a large group setting. Data was collected from six school districts who were selected from a purposive sample stratified by community risk factors. At baseline, 1,236 youth completed surveys, 1,110 at Time 2, 999 at Time 3, and 886 at Time 4 with approximately 12 months occurring between each time point. Baseline levels of all variables; grade, risk level of the school, gender, and race were included as controls.

Results: Our study findings show depressive symptoms significantly mediated the association between ACEs and IPV, delinquency, and substance use. Additionally, self-control moderated the association between (a) adverse childhood experiences and depressive symptoms and (b) depressive symptoms and IPV.

Conclusions: Findings have implications for prevention. This study highlights depressive symptoms as a significant mediator of ACEs and risk behaviors. Additionally, self-control was identified as a protective factor against depressive symptoms. Therefore, when tailoring programs for at-risk adolescents focusing on increasing self-control and processing feelings of depression may better equip adolescents to be resilient in the face of adverse childhood experiences.