Are different types of childhood adversities correlated within and across time? A comparison of data on adversity co-occurrence from three longitudinal birth cohort studies

Madison E Bigler; Isabel K Schuurmans; Yiwen Zhu; Nitasha Siddique; Nadia Hoffman; Nastassja Koen; Heather J Zar; Dan J Stein; Charlotte A M Cecil; Erin C Dunn

doi:10.1016/j.chiabu.2025.107315

Are different types of childhood adversities correlated within and across time? A comparison of data on adversity co-occurrence from three longitudinal birth cohort studies

Child Abuse Negl. 2025 Apr 30:107315. doi: 10.1016/j.chiabu.2025.107315. Online ahead of print.

Authors

Affiliations

¹ Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States. Electronic address: mbigler@mgh.harvard.edu.
² Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands. Electronic address: i.schuurmans@erasmusmc.nl.
³ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: yiwenzhu@mail.harvard.edu.
⁴ Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States. Electronic address: nitashas@alumni.princeton.edu.
⁵ South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Electronic address: nadia.hoffman@uct.ac.za.
⁶ South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Electronic address: nastassja.koen@uct.ac.za.
⁷ South African Medical Research Council (SAMRC) Unit on Child and Adolescent Health, Department of Pediatrics & Child Health, University of Cape Town, Cape Town, South Africa. Electronic address: heather.zar@uct.ac.za.
⁸ South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Electronic address: dan.stein@uct.ac.za.
⁹ Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: c.cecil@erasmusmc.nl.
¹⁰ Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center on the Developing Child, Harvard University, Cambridge, MA, USA. Electronic address: edunn2@mgh.harvard.edu.

PMID: 40312228
DOI: 10.1016/j.chiabu.2025.107315

Abstract

Background: Existing research on adverse childhood experiences (ACEs) emphasizes that ACEs tend to co-occur, both at specific timepoints and across development. However, these conclusions are often drawn from cross-sectional data, retrospective reports, and high-risk samples. Patterns of ACE co-occurrence have yet to be investigated longitudinally using repeated, time-specific measures of ACE exposure.

Objective: Assess patterns of ACE co-occurrence across development and compare findings from three longitudinal birth cohorts.

Participants and setting: Data came from the Avon Longitudinal Study of Parents and Children (ALSPAC; U.K.), the Generation R Study (GenR; The Netherlands), and the Drakenstein Child Health Study (DCHS; South Africa).

Method: ACEs were measured repeatedly from birth to age 10 using prospective caregiver reports. Cohort-level tetrachoric correlations were estimated to characterize associations within and between ACE types and by timepoints.

Results: ACEs were only moderately correlated within and across time, with correlation estimates under r = 0.5 at most timepoints, even for the most prevalent exposures. In all cohorts, ACEs capturing direct victimization had the highest co-occurrence with each other. ACEs capturing household dysfunction tended to persist over time but were less likely to co-occur with other ACEs. ACEs were most prevalent in DCHS and had the highest co-occurrence in ALSPAC.

Conclusions: Variation exists in patterns of ACE co-occurrence by ACE type, developmental timing, and sample. Given these results, researchers and clinicians should challenge the assumption that all ACEs consistently co-occur. Instead, ACE exposure when measured via parent or participant self report - may need to be assessed repeatedly across development to better understand patterns of ACE co-occurrence and inform targeted interventions.

Keywords: ACE co-occurrence,; ALSPAC; Adverse Childhood Experiences (ACEs); DCHS; Early adversity,; GenR.