Adverse childhood experiences among youth from high-achieving schools: Appraising vulnerability processes toward fostering resilience.

Abstract

Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n ϭ 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n ϭ 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4ϩ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4ϩ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4ϩ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. Public Significance StatementYouth at high-achieving schools are known to be an "at-risk" group, and this article shows links between adverse childhood experiences (ACEs) and elevated risk for psychiatric disorders in adulthood. Most strikingly, individuals with four or more ACEs had 12 times greater odds of developing diagnoses of depression or anxiety, as compared with those with no ACEs. Results carry substantive implications for future prevention and intervention, as many of this demographic of youth and parents can be reluctant to seek help for burgeoning distress.

High-achieving schools connote risks for adolescents: Problems documented, processes implicated, and directions for interventions.

“…More recent evidence, based on multiple high-achieving schools assessed between 2015 and 2019, reflects convergent findings (Luthar, 2019). The latter report presents new data on nine cohorts, including independent boarding, independent day, and public high schools, with a total sample of over 7,500 students.…”

“…Findings showed that across all nine schools and among both male and female students, rates of clinically significant anxious and depressed symptoms in particular were elevated, with a median value that was 6–7 times those in national norms. Rates of serious withdrawn–depressed and somatic symptoms were also high, with median values 3.5–5 times rates in nationally representative samples (Luthar, 2019).…”

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention

“…Consequences commonly include post-traumatic stress disorder (PTSD) [ 25 ], obesity and eating disorders [ 26 – 28 ], alcohol and drug problems [ 29 – 33 ], poor school achievement [ 34 ], depression [ 35 , 36 ], dissociation [ 37 ], social impairment [ 38 ], antisocial behaviour, anxiety [ 39 ], self-harm and suicide [ 40 , 41 ], and increased chance of revictimization [ 42 , 43 ]. In students from high-achieving schools, ACEs were associated with between two and five-fold increases in adult psychiatric diagnoses, depending on the extent of exposure to ACEs [ 44 ]. Reviews have highlighted the high rates of insecure disorganised and dissociative attachment styles in situations of severe and ongoing maltreatment [ 45 ].…”

Science, practice, and policy related to adverse childhood experiences: Framing the conversation.

“…Veterans, particularly female veterans, are an important and understudied population and serve as the focus for study by Blosnich et al (2021) about the associations between ACEs and suicidal ideation. Luthar et al (2021) looks beyond more traditional target populations to examine a recently identified Group at risk for ACEs—youth from high-achieving schools.…”