Toward a Comprehensive Model of the Links between Personality, Adverse Childhood Experiences, and Health

Adverse childhood experiences (ACEs) are linked to poor health outcomes. However, research connecting a broader personality framework with ACEs and health outcomes is underexplored. This study examined associations between ACEs, HEXACOD personality traits—a seven-factor extension of the HEXACO framework, including Disintegration, a trait reflecting proneness to psychotic-like experiences and behaviors—and health outcomes in a nationally representative Serbian sample (N = 2,721). Using multi-group structural equation modeling, we examined the simultaneous contributions of personality and ACEs to predict mental and physical health. Measurement invariance was assessed to test the validity of the model across gender groups. The model demonstrated scalar invariance across gender groups. Disintegration trait was the most robust predictor of poor mental and physical health, followed by high Emotionality and low eXtraversion. ACEs were significantly associated with both health domains, but their predictive power was smaller than that of Disintegration. Our findings underscore the central role of Disintegration in linking early adversity and adult health outcomes. Findings suggest it reflects a broader vulnerability that bridges early adversity, emotional instability, and poor health outcomes across the lifespan. Findings also suggest that certain personality profiles may shape how adversity is experienced and reported.