Adolescent Violence Perpetration: Associations With Multiple Types of Adverse Childhood Experiences

OBJECTIVE: Adverse childhood experiences are associated with significant functional impairment and life lost in adolescence and adulthood. This study identified relationships between multiple types of adverse events and distinct categories of adolescent violence perpetration. METHODS: Data are from 136 549 students in the 6th, 9th, and 12th grades who responded to the 2007 Minnesota Student Survey, an anonymous, self-report survey examining youth health behaviors and perceptions, characteristics of primary socializing domains, and youth engagement. Linear and logistic regression models were used to determine if 6 types of adverse experiences including physical abuse, sexual abuse by family and/or other persons, witnessing abuse, and household dysfunction caused by family alcohol and/or drug use were significantly associated with risk of adolescent violence perpetration after adjustment for demographic covariates. An adverse-events score was entered into regression models to test for a dose-response relationship between the event score and violence outcomes. All analyses were stratified according to gender. RESULTS: More than 1 in 4 youth (28.9%) reported at least 1 adverse childhood experience. The most commonly reported adverse experience was alcohol abuse by a household family member that caused problems. Each type of adverse childhood experience was significantly associated with adolescent interpersonal violence perpetration (delinquency, bullying, physical fighting, dating violence, weapon-carrying on school property) and self-directed violence (self-mutilatory behavior, suicidal ideation, and suicide attempt). For each additional type of adverse event reported by youth, the risk of violence perpetration increased 35% to 144%. CONCLUSIONS: Multiple types of adverse childhood experiences should be considered as risk factors for a spectrum of violence-related outcomes during adolescence. Providers and advocates should be aware of the interrelatedness and cumulative impact of adverse-event types. Study findings support broadening the current discourse on types of adverse events when considering pathways from child maltreatment to adolescent perpetration of delinquent and violent outcomes. Pediatrics 2010; 125: e778-e786