Association between adverse childhood experiences and risky behaviors

Background: Risky behaviors such as cigarette smoking and excessive alcohol consumption are major contributors to morbidity and mortality in the United States. Adverse childhood experiences (ACEs) represent a child's exposure to negative events. We hypothesize that ACEs may lead to risky behaviors, which may result in adverse health outcomes.

Objective: To determine the association between ACEs and risky behavior using structural equation modeling.

Methods: Data were derived from the Behavioral Risk Factor Surveillance System. Seven indicators were assessed for risky behaviors: heavy drinking, binge drinking, drinking and driving, cigarette smoking, risky sexual behaviors, no physical activity; and lack of sleep. Eleven indicators were assessed for ACEs: living with anyone who was mentally ill, abused alcohol, used/abused drugs, or served time in jail/prison; if parents were separated/divorced; if adults in the home ever abused each other; and if an adult in the home ever physically, psychologically or sexually abused the respondent. Exploratory and confirmatory factor analyses were used to examine the latent structure of the indicators, and path analysis was used to determine associations between ACEs and risky behavior factors.

Results: Bi-dimensional factors for risky behavior and ACEs were identified. The nonsexual ACE factor was significantly associated with chronic and acute risky behavior factors, and the sexual ACE factor was significantly associated with the chronic risky behavior factor.

Discussion: Prevention and early intervention of sexual ACEs and non-sexual ACEs may reduce the prevalence of acute and chronic risky behaviors. Efforts to alleviate ACEs may have long-term benefits for successful aging.