The Influence of Adverse Childhood Experiences (ACEs) on the Functional Impairment of Justice-Involved Adolescents: A Comparison of Baseline to Follow-Up Reports of Adversity

Date01 October 2021
Published date01 October 2021
Subject MatterArticles
The Influence of Adverse
Childhood Experiences (ACEs)
on the Functional Impairment
of Justice-Involved Adolescents:
A Comparison of Baseline to
Follow-Up Reports of Adversity
Jacquelynn F. Duron
, Abigail Williams-Butler
Feng-Yi Y. Liu
, Danielle Nesi
, Kathleen Pirozzolo Fay
and Bo-Kyung Elizabeth Kim
Adverse childhood experiences (ACEs) have long been recognized for negatively influencing indi-
vidual outcomes such that each additional ACE exposure increases the risk for negative health and
behavioral outcomes. Little is known, however, about how the more recent accumulation of ACEs
occurring in follow-up periods influence global functioning considering the past accumulation of
ACEs reported at baseline by justice-involved adolescents. Participants were 851 adolescents who
completed the Northwestern Juvenile Project (NJP), a longitudinal survey. OLS regression models
were used to examine the influence of follow-up and baseline ACEs on the functional impairment of
youth. Results indicate that both follow-up and baseline ACEs were associated with worse func-
tioning over time with baseline ACEs demonstrating a greater effect. This study highlights the
importance of assessing accumulations of ACEs over time for adolescents in the juvenile justice
system and considering how youth of different characteristics and experiences may differently
encounter functional impairment. Implications for offering trauma-informed services to disrupt the
effects of adversity on adolescents’ functioning are discussed.
childhood adversity, justice-involved youth, functional impairment, psychiatric diagnosis
School of Social Work, Rutgers The State University of New Jersey, New Brunswick, NJ, USA
Department of Psychology, Loyola University Chicago, Chicago, IL, USA
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
Corresponding Author:
Jacquelynn F. Duron, School of Social Work, Rutgers The State University of New Jersey, 390 George St., Suite 713, New
Brunswick, NJ 08901, USA.
Youth Violence and JuvenileJustice
2021, Vol. 19(4) 384-401
ªThe Author(s) 2021
Article reuse guidelines:
DOI: 10.1177/15412040211016035
Exposure to traumatic adversities among justice-involved youth is high (Abram et al., 2004; Charak
et al., 2018; Ford et al., 2013). In a recent study of lifetime exposure to adversities, nearly 93%of
justice-involved youth reported experiencing four or more types of adversity (Charak et al., 2018).
Many of these adversities include personal experiences of maltreatment or family experiences of
difficulty. The adverse childhood experiences (A CEs) study is well-known for establishing the
measurement of childhood adversities that reflect an individual’s prior experience in 10 key areas;
these areas include abuse (physical, sexual, and emotional), neglect (physical and emotional), and
household dysfunction (mother who experienced domestic violence, parental abandonment, house-
hold member who experienced substance abuse, mental illness or incarceration) during the first
18 years of life (Anda et al., 1999). Conceptualized as a cumulative risk model, higher ACE scores
denote higher levels of adversity with previous research indicating that greater exposure to ACEs
early in life is associated with greater risk of mortality, many forms of morbidity, mental health
difficulties, and behavioral health problems over the life course (Felitti et al., 1998; Gilbert et al.,
2010; Kessler, et al., 2010; Timmermans et al., 2010). While it is widely recognized that each
additional ACE increases personal risk (Flaherty et al., 2013; Grasso et al., 2016; Wolff et al.,
2017), the influence of early and later accumulations of risk on overall functioning has not been
well documented among justice-involved adolescents. This paper examines the cumulative effect of
follow-up ACEs (ACEs accumulated during the course of the study and later in the adolescent’s life)
and baseline ACEs (ACEs accumulated prior to the study and earlier in the adolescent’s life) among
a sample of justice-involved youth to discover how more recent ACEs and past ACEs influence
global functioning. Global functioning, related to functional impairment, is measured in this study
by an overall assessment of the presence of symptoms that disturbs personal and social well-being.
Cumulative Adversities: A Strain on Development
Much of the ACEs research has considered how cumulative stressful or traumatic events in child-
hood are significant risk factors for unhealthy development from childhood to adulthood. Robust
findings have indicated that multiple relative to single risk exposures have worse developmental
consequences (Gutman & Flouri, 2017; Rutter, 1979, 1981; Sameroff, 2006; Sameroff et al., 2004).
This is particularly concerning for justice-involved youth who experience greater rates of trauma
exposures than youth in the community (Dierkhising et al., 2013). In a previous study of youth
involved in the Northwestern Juvenile Project (NJP), youth reported an average of 14.6 traumas with
93%of detained youth reporting at least one trauma and 84%reporting more than one trauma
(Abram et al., 2004). These high rates of adverse exposure are related to poor personal outcomes,
including higher rates of post-traumatic stress disorder (PTSD) that exceed the lifetime estimates of
PTSD in community samples (Abram et al., 2004). Justice involved youth with high trauma expo-
sure experience brain and personality disruptions that interfere with self-regulation (Ford et al.,
2007) and many internalizing (Finkelhor et al., 2011) and externalizing problems (Dierkhising et al.,
2013). Furthermore, research indicates that childhood adversities are associated with an increased
likelihood of offending behavior (Teague et al., 2008) and reoffending behavior (Wolff et al, 2017).
The association of childhood adversities to delinquency and recidivism has implications for how
juvenile justice systems engage with youth (Baglivio et al., 2015; Barrett et al., 2014).
Research has also found that risks for symptomatic outcomes may vary based on the age when
traumas are experienced (Schoedl et al., 2010). Studies related to timing of adversities or sensitive
periods of exposure have produced mixed results. A recent study focusing on accumulation, timing,
and duration found that intermitte nt adversity had the strongest rela tionship to later childhood
behavior problems (Schroeder et al., 2020). Contrarily, in a study examining DNA methylation—
an epigenetic mechanism—adverse exposures before 3 years of age produced the most variability in
altering gene expression (Dunn et al., 2019). Bosch et al. (2012) similarly found that pre and
Duron et al. 385

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