ImportanceWhile adverse childhood experiences (ACEs) are known to impart significant risk for negative mental health and cognitive outcomes in youth, translation of ACE scores into clinical intervention is limited by poor specificity in predicting negative outcomes. This work expands on the ACE framework using a data-driven approach to identify 8 different forms of traumatic and adverse childhood experiences (TRACEs) and reveal their differential associations with psychiatric risk and cognition across development.ObjectiveBuilding upon the traditional ACEs model, this study aimed to characterize unique components of commonly co-occurring TRACEs and to examine moderation of longitudinal change in mental health and cognitive development during adolescence.Design, Setting, and ParticipantsThis work draws from youth and their caregivers who completed up to 4 annual behavioral assessments from 2016 to 2021 as part of the ongoing Adolescent Brain Cognitive Development (ABCD) study. Data collection was performed at 21 regionally-distributed sites across the United States. Analyses for this work were conducted January 2023 through November 2023.ExposuresYouth participants in the ABCD study’s exposure to 268 different TRACEs, which were distilled into adversity components using nonlinear principal components analysis.Main Outcomes and MeasuresMixed-effects and latent change score models considered TRACEs components as moderators of longitudinal change in internalizing and externalizing mental health problems, as well as longitudinal change in cognitive ability.ResultsData were distilled from 11 876 youth participants, who were grouped into dyads with a caregiver. ABCD study youth participants were 9 to 10 years old at baseline assessment (year 0) and 12 to 13 years old at ABCD year 3. A total of 5679 participants (47.8%) were female. Analyses revealed that TRACEs organized into 8 thematic adversity components (e.g., family conflict, interpersonal violence). At baseline assessment (year 0), exposure to nearly every adversity component was associated with poorer mental health and diminished cognitive ability. Yet across time, it was observed that different forms of adversity were variably linked to both increases and decreases in internalizing and externalizing problems. For example, while peer aggression (t = 5.31) and family conflict (t = 5.67) were associated with increases in both internalizing and externalizing problems over early adolescence, community threat (t = 2.82) and poverty (t = 2.07) were linked to decreased problems, potentially representing adaptive suppression of symptoms. Finally, adversity types related to resource deprivation (eg, poverty, caregiver maladjustment) were associated with declines in cognitive ability over early adolescence.Conclusions and RelevanceIn this cohort study, distinct forms of TRACEs differentially moderated developmental changes in psychiatric risk and cognitive ability in different ways, offering the possibility for precision-based prediction of risk for youth. Such findings could be used in targeted early prevention and intervention strategies for at-risk youth.

中文翻译：

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童年创伤和不良经历以及精神风险的发育差异


重要性虽然已知不良童年经历 （ACEs） 会给青少年带来负面心理健康和认知结果的重大风险，但由于预测负面结果的特异性差，ACE 评分转化为临床干预受到限制。这项工作使用数据驱动的方法扩展了 ACE 框架，以确定 8 种不同形式的创伤和不良童年经历 （TRACE），并揭示了它们与精神病风险和认知在发展过程中的不同关联。目的在传统 ACEs 模型的基础上，本研究旨在表征通常同时发生的 TRACEs 的独特成分，并检查青春期心理健康和认知发展纵向变化的调节。设计、设置和参与者这项工作来自青年及其照顾者，他们在 2016 年至 2021 年期间完成了多达 4 次年度行为评估，作为正在进行的青少年大脑认知发展 （ABCD） 研究的一部分。在美国 21 个区域分布的站点进行数据收集。这项工作的分析于 2023 年 1 月至 2023 年 11 月进行。主要结局和措施混合效应和潜在变化评分模型认为 TRACEs 成分是内化和外化心理健康问题纵向变化以及认知能力纵向变化的调节因子。结果数据是从 11 876 名青年参与者中提取的，他们被分组为与照顾者的二人组。 ABCD 研究青年参与者在基线评估时（第 0 年）为 9 至 10 岁，在 ABCD 第 3 年为 12 至 13 岁。共有 5679 名参与者 （47.8%） 为女性。分析显示，TRACE 分为 8 个主题逆境组成部分（例如，家庭冲突、人际暴力）。在基线评估（第 0 年）时，暴露于几乎所有逆境成分都与较差的心理健康和认知能力下降有关。然而，随着时间的推移，人们观察到不同形式的逆境与内化和外化问题的增加和减少之间存在不同的联系。例如，虽然同伴攻击 （t = 5.31） 和家庭冲突 （t = 5.67） 与青春期早期内化和外化问题的增加有关，但社区威胁 （t = 2.82） 和贫困 （t = 2.07） 与问题减少有关，可能代表症状的适应性抑制。最后，与资源剥夺相关的逆境类型（例如，贫困、照顾者适应不良）与青春期早期认知能力的下降有关。结论和相关性在这项队列研究中，不同形式的 TRACEs 以不同的方式差异性地调节精神风险和认知能力的发育变化，为基于精确度的青少年风险预测提供了可能性。这些发现可用于针对高危青少年的针对性早期预防和干预策略。