Comparison of person-centred and cumulative risk approaches in explaining the relationship between adverse childhood experiences and behavioural and emotional problems

Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centred approach offers another approach to operationalise the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of UK children, examine their relationship with emotional and behavioural problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the UK Household Longitudinal Study (N = 601). Seven items characterised ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, and child-report parental educational disinterest, bullying victimisation, and adverse neighbourhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behaviour. Latent class analysis resulted in a 3-class solution: low ACEs, household challenges, community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behaviour. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centred model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centred and cumulative risk approaches can capture this relationship well. Specifically, the person-centred approach demonstrated how co-occurring risks factors in the community challenges class produced particularly poor internalising outcomes.