Adverse Childhood Experiences and Alcohol Use and Misuse: Testing the Impact of Traditional and Expanded Adverse Childhood Experiences Among Racially/Ethnically Diverse Youth Transitioning Into Adulthood

Objective: Traditional adverse childhood experiences (T-ACEs), such as abuse and neglect, have been associated with an increased risk of youth alcohol use and misuse. This study aims to compare associations of T-ACEs and expanded ACEs (E-ACEs), an expanded set of ACEs that encompass community-level adversities, with alcohol use and misuse by race/ethnicity. Method: Data came from a three-wave (1998-1999, 1999-2000, 2004-2005) community-based study in Houston, including youth transitioning into adulthood. We compared associations between ACEs at Wave 1 and past-year alcohol use, abuse, and dependence at Wave 3. Results: Participants (2,391) included White (908), Black (898), and Latinx (585) youth (M [SD] = 14.00 [2.04]) transitioning into young adulthood (M [SD] = 19.77 [2.34]). T-ACEs were associated with higher odds of alcohol use, abuse, and dependence (OR = 1.15, 1.18, 1.24, respectively) while E-ACEs increased the odds of alcohol dependence (OR = 1.23) in the total sample. No significant differences by race/ethnicity were found. Racial/ethnic differences in increased alcohol risk were observed for some ACE items, such as bullying and use for Latinx youth (OR = 2.13) and poverty and dependence for White youth (OR = 2.01). Conclusions: T-ACEs and E-ACEs increase the risk of alcohol use and misuse. Results highlight the importance of preventing ACE exposure as a risk factor for youth alcohol use and misuse. Public policies must also focus on preventing ACEs through multilevel interventions aimed at reducing violence, bullying, and financial instability.