Emerging adults around age 19 who experience four or more adverse childhood experiences report substantially higher rates of depression, suicidal ideation, hard drug use, and interpersonal violence than peers with no reported childhood adversity, according to a study published in JAMA Network Open.
Childhood Adversity Rates and Specific Triggers
The research team measured adverse childhood experiences among 1,850 emerging adults utilizing the Philadelphia ACEs survey. This 21-item scale captures both conventional events and community-level childhood adversity. The survey looks at conventional events such as emotional or physical neglect, emotional or physical abuse, sexual abuse, witnessing domestic violence, household mental illness, household substance abuse, or having an incarcerated family member. Community-level events encompass witnessing violence, experiencing discrimination, being bullied, or feeling unsafe in a neighborhood.
Among these categories, emotional abuse, sexual abuse, discrimination, and witnessing domestic violence showed the strongest and most consistent associations with poor health and other negative outcomes. Jeff Temple, PhD, first author and professor alongside associate dean for clinical research at UTHealth Houston School of Behavioral Health Sciences, pointed out a distinct dose-response trend where negative effects generally grew more severe as the cumulative quantity of adverse events rose.
Did you know? The Philadelphia ACEs survey expands traditional trauma screening by incorporating neighborhood safety and discrimination alongside household-level challenges.
Why Emerging Adulthood Is a Critical Intervention Window
Temple emphasized that the findings are notable because participants were assessed relatively close in time to the childhood adversity they reported, unlike many previous studies that rely on adults who are several decades removed from childhood. According to Temple, emerging adulthood represents a vital developmental period defined by identity development and risky behavior where experiences carry profound implications for health, relationships, and education.
“Emerging adults who are still relatively close in time to these experiences are already showing substantial differences in mental health, relationships, substance use, and educational outcomes,” Temple said. Additional authors on the study, all based at UTHealth Houston, include Elizabeth Baumler, PhD; Leila Wood, PhD; and Leslie Taylor, PhD.
Prevention Strategies and Trauma-Informed Support
The study highlights a dual need for preventing adversity earlier in childhood while actively intervening during emerging adulthood. Temple pointed out that while primary prevention remains the ultimate goal, the transitional years of young adulthood offer a distinct window to intervene before behavioral and mental health patterns become deeply entrenched.
Effective intervention strategies require identifying young people who have experienced significant trauma and connecting them directly with trauma-informed supports. At the same time, public health initiatives must address broader systemic factors, including neighborhood safety and discrimination, that contribute to ongoing risk during this life stage.
Frequently Asked Questions
What specific traumas were measured in the study?
Researchers used the Philadelphia ACEs survey, which covers conventional childhood adversities like abuse and household dysfunction, alongside community-level events such as discrimination, bullying, and neighborhood violence.
How does this study differ from previous research on adverse childhood experiences?
Unlike earlier studies that evaluated adults decades after their youth, this research assessed emerging adults with an average age of 19 who were much closer in time to the reported events.
Which types of adversity had the strongest impact?
According to the research team, emotional abuse, sexual abuse, discrimination, and witnessing domestic violence showed the strongest and most consistent links to negative health and behavioral outcomes.