Adverse Childhood Experiences and Adult Mental Health Outcomes

This cohort study investigates the association of adverse childhood experiences with adult psychiatric disorders after adjusting for familial confounding.


Type of ACE Item
Family violence When you were young, before age 18, did you ever see physical violence between family members?For example, hitting, kicking or punching?
Emotional neglect/abuse Have you ever been emotionally abused or neglected -for example, being frequently shamed, embarrassed, ignored, or repeatedly told that you were "no good"?

Physical neglect
Have you ever been physically neglected -for example, not fed, not properly clothed, or left to take care of yourself when you felt you were too young or ill?

Physical abuse
Have you ever been physically abused -for example, hit, choked, burned, or beaten, or severely punished, for example, locked up in a closet, tied up, or chained -by someone you knew well such as a parent, sibling, boyfriend or girlfriend?

Associations between ACE subtypes and depression symptoms in the full cohort and within exposure discordant twin-pairs.
used to identify psychiatric disorders.Associations between the number of ACEs and any psychiatric disorder in the full cohort, stratified by sex.Associations between the number of ACEs and symptoms of depression in the full cohort and within exposure discordant twin-pairs Number of twin individuals in full twin-pairs, number of exposed twin individuals and number of exposure discordant twins.Associations between the number of ACEs and any diagnosed psychiatric disorder in the full cohort and within exposure discordant twin-pairs in the STAGE and YATSS cohorts (excluding CATSS).Associations between the number of ACEs and any adult psychiatric disorder in the full cohort and within exposure discordant twinpairs in the YATSS and CATSS cohorts (excluding STAGE).Associations between the number of ACEs and any adult psychiatric disorder in the full cohort and within exposure discordant twinpairs in the STAGE cohort.Associations between the number of ACEs and any adult psychiatric disorder, additionally including dispensed psychotropic medications as an indication for mild psychiatric disorder not attended by specialist care, in the full cohort and within exposure discordant twinpairs.Associations between the number of ACEs and any adult psychiatric disorder in the full cohort and within exposure discordant twinpairs, excluding twins diagnosed with any psychiatric disorder before age 19 years.Associations between the number of ACEs and any diagnosed psychiatric disorder in the full cohort and within exposure discordant twin-pairs, excluding twins diagnosed with any psychiatric disorder before answering the web-based survey with the ACE assessment.Models were adjusted for age and sex; Estimates are given as the percentage increase in depression symptoms, comparing exposed vs. non-exposed twins; 95% CIs are based on Note.Based on the Swedish version of the ICD version 8, 9 and 10 codes for the identification of diagnosis.©2024Daníelsdóttir HB et al.JAMA Psychiatry.eTable 3. ACEs = adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; CI = Confidence Interval.Models were adjusted for age and sex; Estimates are given as the percentage increase in depression symptoms, for every one-unit increase in ACEs; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; b exp(β) for every additional ACE.© 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 5. © 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 6. ACEs = adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; OR = Odds Ratio; CI = Confidence Interval.Models were adjusted for age and sex; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Any adult psychiatric disorder b Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; c OR for every additional ACE.© 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 7. ACEs = adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; OR = Odds Ratio; CI = Confidence Interval.Models were adjusted for age and sex; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Any adult psychiatric disorder b Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; c OR for every additional ACE.© 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 8. ACEs = Adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; OR = Odds Ratio; CI = Confidence interval.Models were adjusted for age and sex; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Any adult psychiatric disorder; b Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; c OR for every additional ACE.© 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 9. ACEs = Adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; OR = Odds Ratio; CI = Confidence interval.Models were adjusted for age and sex; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Any adult psychiatric disorder; b Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; c OR for every additional ACE.© 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 10. © 2024 Daníelsdóttir HB et al.JAMA Psychiatry.eTable 11.ACEs = adverse childhood experiences; DZ = Dizygotic twins; MZ = Monozygotic twins; OR = Odds Ratio; CI = Confidence Interval.Models were adjusted for age and sex; 95% CIs are based on robust SEs, calculated using generalized estimating equations; a Any adult psychiatric disorder b Exposure discordant twins, the number of individual twins from exposure discordant twin pairs in the analysis; c OR for every additional ACE.eFigure 3.