Associations of Exposure Frequencies of Single Adverse Childhood Experiences with Psychological Distress: Evidence from a Cohort Study among Emerging Adults

Background: Adverse childhood experiences (ACE) are significant transdiagnostic risk factors for impaired psychosocial functioning and mental health conditions throughout life. Most research on ACEs has used composite scores, which precludes specific conclusions about the impact of individual adverse experiences and their frequency of occurrence.Objective: To investigate the association between exposure frequencies of single adverse experiences with psychological distress among emerging adults.Participants and Setting: A total of 2528 emerging Swiss adults aged 18 to 22 years (mean age 19.3) from a random population sample participating in the first wave of a cohort study. Methods: ACE measures were 39 specific experiences for neglect (emotional, physical), abuse (emotional, physical, sexual), witnessing violence, peer maltreatment and parental psychopathology. ANOVA models were used to estimate the associations of exposure frequencies for each adverse experience with psychological distress. Results: Single adverse childhood experiences were strongly associated with psychological distress in emerging adulthood, with considerable differences across experiences and their exposure frequencies. Physical and sexual abuse experiences were associated with psychological distress across all exposure frequencies, including if experienced only rarely. Emotional abuse, emotional neglect and verbal abuse by peers experiences showed associations with psychological distress mainly at higher exposure frequencies. Conclusions: The severe impact of adverse childhood experiences on the mental health of emerging adults varies greatly depending on the specific adverse experience and how often a person had to endure them. Our research underscores the value of analyzing the impact of single adversities and their exposure frequencies alongside dimensional approaches in ACE research. Keywords: Adverse childhood experiences; Emerging adulthood; mental health; Switzerland; psychological distress; peer maltreatment; single adversity approach