Publication year
2019
Citation Title
The effects of adverse childhood experiences on internalizing versus externalizing outcomes.
Journal Name
Criminal Justice and Behavior
Journal Volume
46
Issue Number
4
Page Numbers
568-589
DOI
10.1177/0093854819826213
Summary
Understanding the impact of youth's adverse childhood experiences (ACEs) on externalizing and internalizing outcomes has important implications for prevention and intervention programs. This study investigated whether specific ACEs are predictive of internalizing outcomes (e.g., anxiety) or externalizing outcomes (e.g., runaway behavior). The findings indicate that many ACEs increase the risk of negative youth outcomes.
Key Findings
Reports of emotional abuse, physical abuse, household violence, household substance abuse, and household member incarceration increased risk of externalizing behavior in youth.
Childhood sexual abuse increased risk of internalizing behavior in youth.
The strongest predictor for externalizing behaviors was emotional abuse.
Physical neglect was the only ACE that did not predict internalizing or externalizing outcomes.
Implications for Military Professionals
Provide workshops to help youth learn about self-management of externalizing and internalizing behavior
Host activities that build systems of support between the community and families with youth who experience ACEs
Implications for Program Leaders
Develop curricula to help youth program staff and educators use early identification strategies for youth with ACEs
Disseminate information to parents regarding common difficulties faced by youth who have experienced ACEs
Implications for Policy Makers
Encourage the development of preventative programs that promote resilience among youth
Support research that investigates the impact of youth programs on youth internalizing and externalizing behavior
Methods
Data were obtained from the Florida Department of Juvenile Justice (FDJJ).
Internalizing and externalizing outcomes were measured using the Positive Achievement for Change Tool (PACT) risk assessment (from the FDJJ data) which included identifying behaviors for internalizing (e.g., depression) and externalizing outcomes (e.g., violence) as well as instances of ACE.
Statistical analyses examined if ACEs predicted youth experiences of internalizing and externalizing behavior.
Participants
This study included 30,909 youth. Male participants comprised 78.3% of the sample.
The ages of the sample were as follows: 24.9% were 12 years old and younger, 53.7% of the sample were between 13 years and 15 years old, and 21.4% of the sample were 16 years old and older.
Most of the sample (61.8%) identified as either Black, Latino, and Asian, while 38.2% identified as White.
Limitations
The sample consisted of youth in the legal system which restricts generalizability of findings to non-incarcerated developing youth.
The Positive Achievement for Change Tool (PACT) risk assessment was not fully intended to explore the impact of ACEs on youth; therefore, it is unknown if the assessment missed key behaviors or outcomes.
Co-occurrence of externalizing and internalizing outcomes was not included within the study, so findings may not be applicable for youth who exhibit both externalizing and internalizing behavior.
Avenues for Future Research
Compare the incidences of ACEs among incarcerated and non-incarcerated youth
Use personality profiling to examine if youth with certain ACEs are more likely to develop externalizing or internalizing behavior
Explore gender differences in the predictors of externalizing and internalizing youth behavior among youth who have experienced ACEs
Focus
Civilian
Target Population
Population Focus
Abstract
This study examines the effects of adverse childhood experiences (ACEs) on the risk of internalizing or externalizing out- comes among juveniles. While myriad research has investigated the impacts of ACEs on internalizing and externalizing outcomes, it is unclear whether ACEs have a stronger link to one outcome over the other when controlling for other factors. Using a sample of 30,909 youth who exclusively exhibited internalizing (n = 1,030) or externalizing problems (n = 29,879), regression techniques and propensity score matching were utilized to evaluate the impact of each ACE on the risk of internalizing versus externalizing outcomes. Results indicate that the most pertinent factor for predicting externalized problems is emotional abuse. Household member incarceration, physical abuse, emotional neglect, and household violence or substance abuse also predicted externalizing outcomes. Sexual abuse was the only ACE predictive of internalizing, while physical neglect and parental mental illness did not have a correlation with either outcome.
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