Measuring Adverse Childhood Experiences: Comparing Individual, Composite, Score-based and Latent Profile-based Scoring Schemas Among Gay, Bisexual, and Other Men Who Have Sex with Men.

Adverse childhood experiences (ACEs; e.g., neglect, sexual abuse) among gay, bisexual, and other men who have sex with men (GBM) may not occur in isolation, but may be connected and occur in clusters. Most studies have measured ACEs individually, hierarchically, additively, or in a binary fashion (presence or absence of ACEs), rather than treating them as connected and clustered. This study examined these competing approaches of scoring ACEs and their relative power at predicting health outcomes. We examined abuse (sexual, physical, and emotional) and neglect (physical and emotional) experiences among a non-random sample of 470 Toronto GBM using the Childhood Trauma Questionnaire Short Form subscales. We compared five scoring schemas: (1) five individual scores for each form of maltreatment; (2) a composite score summing all of the maltreatment scores; (3) a hierarchical regression model with sexual abuse entered first then followed by physical abuse, emotional abuse, physical neglect, and emotional neglect; (4) a severity-based categorization; and (5) a latent profile-based categorization. Experiences of abuse and neglect were not uncommon (22-33%) and some participants experienced multiple forms of abuse and neglect (r = .33-.65, df = 464-467; p < .001; shared variance, r2 = 11-43%). Results show the dose-response effects of ACEs and highlight the importance of examining ACEs in clusters rather than individually. Latent profile analysis identified GBM who experienced multiple and frequent ACEs, and also identified the types of ACEs they experienced: crucial information that was obscured in score-based or severity-based approaches.

Early family adversity, stability and consistency of institutional care and infant cognitive, language and motor development across the first six months of institutionalization.

This study extends research on the effects of institutionalization-by examining the trajectories of cognitive, language and motor development of 64 Portuguese infants and toddlers across the first six months of institutionalization, while determining whether pre-institutional adversities and the stability and consistency of institutional care predict children's development. At time of enrollment, 23.4%, 32.8% and 31.3% of the children were moderately to severely delayed, respectively, in their cognitive, linguistic and motor functioning. Developmental problems persisted after six months of institutionalization. The accumulation of early pre-institutional adversities predicted cognitive and motor limitations at admission to the institutions, but not variation in subsequent development. The stability and consistency of institutional care also failed to predict developmental growth and change. Children who had never lived with their families of origin showed a better language development at enrollment than their counterparts who had lived with their families of origin before institutionalization. Such advantage was followed by a deceleration in language growth after six months of institutional placement. Results are discussed in terms of short- vs. longer-term effects of institutionalization.