Beyond Cumulative Risk: How Patterns of Adverse Childhood Experiences Shape Emotion Regulation Difficulties In Adolescents

Background: Adolescence is a critical period for developing emotion regulation, driven by rapid physiological and psychological changes (Silvers, 2021). Difficulties in emotion regulation are a central issue shared across various forms of psychopathology and serve as a fundamental mechanism that contributes to a general vulnerability to mental health problems (Dragan, 2018). With adolescent mental health issues surging at unprecedented rates (Keyes et al., 2019), a deep understanding of emotion regulation is critical for effective prevention and intervention strategies. Research indicates that adverse childhood experiences (ACEs) are linked to difficulties in emotion regulation (Mares, 2024). However, there is a scarcity of studies exploring how different ACEs co-occurrence patterns, particularly those at community and structural levels, affect adolescents' ability to regulate emotions (Thurston et al., 2018). Thus, we used a person-centered approach to examine how ACEs profiles are associated with adolescent difficulties in emotion regulation.

Method: Data were from the Adolescent Brain and Cognitive Development Study (Gravan et al., 2018; N = 9,868, 45.2% Female, 52.8%Male, and 2% Non-binary). We ran latent class analysis on 13 measures of original and expanded ACEs measured at either baseline or 1-year follow-up (ages 9-11), then examined how these latent classes were associated with the measure of difficulties in emotion regulation (Gratz & Roemer, 2004) at the 3-year follow-up (ages 12-13). Data analysis was conducted by Latent Gold 6.0 and missing data were handled by Full information maximum likelihood (FIML) estimation.

Results: Based on model fit indices and interpretability, we identified a 5-class model comprising: a Low ACEs class (54.9%); a Material Hardship and Community Violence class (16.4%); a Parental Mental Health, Material Hardship, and Community Violence class (11.6%); a Parental Mental Health and Substance Use class (9.1%); and a Multiple ACEs class, marked by extensive family dysfunction—including parental mental health and substance use issues, household violence, criminal justice involvement—and structural and community-level ACEs (8%).

Class membership significantly predicted difficulties in emotion regulation. Adolescents in the Parental Mental Health, Material Hardship, and Community Violence class, as well as those in the Multiple ACEs class, demonstrated notably greater difficulties in emotion regulation compared to those in the Low ACEs class. Additionally, these two classes exhibited significantly higher risks of emotion regulation difficulties than adolescents in the Material Hardship and Community Violence class and the Parental Mental Health and Substance Use class.

Conclusions and Implications: Our findings inform targeted, trauma-informed interventions by clarifying how distinct ACE patterns, particularly those that combine family dysfunction with structural and community adversity, disproportionately undermine emotion regulation. These insights carry implications for racial and social justice by highlighting policy approaches that account for compounded hardship among marginalized youth. We further illustrate how person-centered analytic approaches can surface leverage points relevant to policy design, shifting attention from cumulative risk toward actionable profiles that may inform decision-making. From a policy perspective, social work research can contribute to community-engaged efforts to refine screening practices and guide resource allocation in ways that address structural inequities and reduce risks for adolescent mental health disparities.