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Abstract Purpose. Adverse childhood experiences (ACEs) are associated with poor health outcomes in adulthood; However, the mechanisms linking early adversity to quality of life have often been examined in isolation. Guided by Life Course Theory, this study examined the direct and indirect associations between ACEs and adult quality of life, both as latent variables through obesity, physical activity, physical health, and emotional support. Methods. Data from 21,362 adults across five U.S. states and territories, drawn from the 2024 Behavioral Risk Factor Surveillance System, were used in this study. ACEs were modeled as a higher-order latent construct comprising three subdomains: household dysfunction, emotional/physical abuse, and sexual abuse. Quality of life was specified as a multidimensional latent factor indicated by mental health, general health, cognitive functioning, life satisfaction, and loneliness. Structural equation modeling in Mplus version 8.10 was conducted, using WLSMV estimation, adjusting for age, sex, race/ethnicity, education, and relationship status. Results. The final model demonstrated excellent fit. Higher ACE exposure was directly associated with lower quality of life in adulthood. ACEs were associated with a higher likelihood of obesity, poorer physical health, and less received social-emotional support, though not with physical activity. Indirect effects showed that the association between ACEs and quality of life was primarily mediated by physical health and social-emotional support. Conclusion. Study findings highlighted how childhood adversity is associated with adult quality of life, with physical health and receiving social-emotional support as key areas for intervention that may improve long-term well-being.
Jahanaray et al. (Tue,) studied this question.