Examining the latent structure of adverse childhood experiences in a sample of adults from the United States using exploratory structural equation modelling

Background: A considerable amount of research has been conducted to determine the detrimental impacts that adverse childhood experiences (ACEs) can have on physical and mental health. Many studies have used ACE questionnaires to measure these events; however, there is some debate regarding the proper theoretical model for ACEs. This study was conducted to evaluate the most commonly used 10-item ACE questionnaire to determine the latent structure of ACEs in the context of psychological wellbeing and internalizing psychopathology. Methods: A representative sample of adults (n = 1839) in the United States completed self-report measures. Exploratory Structural Equation Modelling (ESEM) was utilized to explore the latent structure of ACEs in the presence of negative and positive mental health outcomes and controlling for sex and race/ethnic categories. Results: A one-factor model of the ACEs questionnaire provided reasonable fit to sample data and was deemed the most interpretable solution. The ACEs latent variables were positively correlated with internalizing psychopathology (β = 0.52) and negatively associated with psychological wellbeing (β = −0.44). Females had higher ACE scores and several racial/ethnic group differences were evident. Conclusion: The optimal representation of the latent structure of the ten ACE items is a unidimensional structure. Implications for assessment and research are discussed.