• Lucinda R Grummitt, Katherine M Keyes, Sonali Rajan, Erin V Kelly, Emma L Barrett, and Nicola C Newton.
• The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia. Electronic address: lucinda.grummitt@sydney.edu.au.
• Am J Prev Med. 2022 Sep 1; 63 (3): 331-340.

IntroductionChildhood adversities are risk factors for subsequent mental health problems. Research commonly focuses on adverse childhood experiences, despite evidence that other exposures, such as neighborhood violence or peer victimization, co-occur with adverse childhood experiences and are associated with similar mental health outcomes. This study explored the clustering of these exposures and examined the associations with mental health.MethodsData were a nationally representative sample of U.S. children aged 10-17 years (N=1,959), collected in 2013-2014. Latent class analysis was conducted on 22 types of childhood adversity. Regression models examined associations with mental health and substance use. These secondary analyses were conducted in 2021.ResultsA total of 5 classes were identified: Low all (59% of the sample), Abuse (29%), High multiple adversities (5%), Peer adversity (4%), and Neighborhood violence (4%). All classes had poorer mental health and a higher prevalence of substance use than Low all, with particularly harmful levels in High multiple adversities. Neighborhood violence was not significantly different from High multiple adversities on mental health symptoms and showed a greater proportion of past-year substance use than all other classes except High multiple adversities. Peer adversity and Abuse classes did not differ significantly in any outcomes.ConclusionsFindings highlight the particularly deleterious impact of neighborhood violence and highly co-occurring adversity types on mental health and substance use. It is important to extend our conceptualization of adverse childhood experiences to include peer adversity and neighborhood violence and shift from a siloed approach to examining all these exposures.Copyright © 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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