Adverse Childhood Experience-Related Conditions and Substance Use in Adolescents: A Secondary Analysis of Cross-Sectional Survey Data

BACKGROUND: Adverse childhood experiences (ACEs) cluster within children. In addition to standardized ACE measures, there exist "ACE-related" measures that are either directly or indirectly related to the standardized ACE constructs. This study aimed to identify ACE -related latent classes of adolescents and describe past -month substance use in each class by sex and race/ethnicity. METHODS: Data from the 2018 Indiana Youth Survey (N = 70,703), which is a repeated self-administered, cross-sectional survey, were used. Latent class analysis was conducted using ACE -related family (parent incarceration, insulting/yelling within family, inability to discuss personal problems) and school (hate being in school, feeling unsafe, inability to talk to teachers one-on-one) items. Dependent variable combined past 30 -day use -frequency of 17 substances. Two-way analysis of variances examined ACE by sex and race/ethnicity interaction. RESULTS: Four ACE -related classes emerged: "Family-Only"(11.2%), "School-Only"(16.5%), "Family-School"(8.0%), and "No-ACE"(64.3%). Substance use was highest in "Family -School'' (mean = 0.67); lowest in "No-ACE"(mean = 0.21). Significant race/ethnicity (F = 27.06; p < .0001), ACE* sex interaction (F = 12.13; p < .0001) and ACE* race/ethnicity interaction (F = 4.57; p < .0001) effects emerged. Within each ACE -related class, substance use was lowest for Asians and highest for Hispanics. CONCLUSIONS: Adverse childhood experience -related items cluster within children across school and family environments and clustering differs by race/ethnicity, but not by sex. Incorporating ACE -related items into school surveys enhances the ability to implement interventions that target relationships between ACEs and substance use.