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

• Date: 01 October 2021
• Published date: 01 October 2021
• DOI: 10.1177/15412040211016035
• Subject Matter: Articles

Article

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

1

, Abigail Williams-Butler

1

,

Feng-Yi Y. Liu

1

, Danielle Nesi

2

, Kathleen Pirozzolo Fay

1

,

and Bo-Kyung Elizabeth Kim

3

Abstract

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.

Keywords

childhood adversity, justice-involved youth, functional impairment, psychiatric diagnosis

1

School of Social Work, Rutgers The State University of New Jersey, New Brunswick, NJ, USA

2

Department of Psychology, Loyola University Chicago, Chicago, IL, USA

3

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.

Email: jduron@ssw.rutgers.edu

Youth Violence and JuvenileJustice

2021, Vol. 19(4) 384-401

ªThe Author(s) 2021

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/15412040211016035

journals.sagepub.com/home/yvj

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