Multimodal Patterns of Adverse Childhood Experiences in Adolescence: Behavioral, Neuroimaging, and Genetic Moderation Evidence from the ABCD Study

Background Adolescence is a critical development stage, and adverse childhood experiences (ACEs) are important environmental factors influencing behavior. However, the relationship between ACEs, individual behavior, brain mechanisms, and the role of genetic risk remains underexplored. Methods We analyzed data from 9,796 participants aged 9–13 years from the Adolescent Brain Cognitive Development (ABCD) study. Sixty-seven ACE-related variables covering caregiving disruption, family functioning, neighborhood environment, and safety were examined. Sparse canonical correlation analysis (sCCA) and multiple sparse canonical correlation analysis (msCCA) identified multivariate ACE–behavior–brain patterns. Moderated mediation was used to test genetic risk modulation, and a cross-lagged panel model examined longitudinal associations. Results Two robust modes emerged. Mode 1 r eflected parental mental health difficulties linked to child mental health ( r  = 0.576, P _perm < 0.001). Mode 2 represented socioeconomic and family environment factors associated with cognitive performance ( r = -0.272, P _perm < 0.008). Neuroimaging revealed convergent alterations in hippocampal and cerebellar volumes, white-matter integrity, and large-scale functional networks. Polygenic risk for psychiatric disorders significantly moderated ACE–brain–behavior pathways, with effects varying across ancestry groups. Longitudinal analyses showed that parental depression and ADHD strongly predicted youth psychiatric symptoms two years later. Conclusions Two distinct profiles of ACEs influence adolescent behavior through neuroimaging pathways, and these associations are further shaped by genetic risk. Findings advance mechanistic understanding of ACE-related vulnerability and highlight intervention targets for at-risk youth.