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Cited by 15Child Abuse and TraumaChild and Adolescent Psychosocial and Emotional DevelopmentChild Welfare and Adoption

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Is ACEs Screening for Adolescent Mental Health Accurate and Fair?

Cohen, Joseph R., Choi, Jae Wan·2022·Prevention Science
DOI 10.1007/s11121-022-01391-3
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Abstract

Increasingly, adversity-focused assessment tools are being introduced into preventive mental health screening protocols. However, few studies have explicitly examined whether use of these instruments serves as equitable, clinically useful measures of mental health risk in adolescents. In response, the present study examined whether an adverse childhood experiences (ACEs) measure was accurate and fair as an index of environmental risk for adolescent mental health diagnoses. Secondary data analyses were conducted on the National Comorbidity Survey-Adolescent Supplement. Adolescents (N = 10,148; Age Mean = 15.20; 51.3% male; 65.6% White, 15.1% Black, and 14.4% Hispanic) answered ten questions concerning childhood adversities and completed diagnostic interviews for PTSD, depression, and externalizing disorders. In the overall sample, ACEs showed some clinical utility (e.g., area under the curve (AUCs) ≥ 0.64), diagnostic likelihood ratios (DLRs) > 4.0) and acceptable calibration (i.e., expected/observed indices' confidence intervals included 1) across diagnoses. Within subpopulations, however, predictive validity varied. The AUCs were lower for multiple diagnoses in Black male and Hispanic female adolescents and DLRs suggested greater clinical utility for indexing mental health in White, female adolescents. Finally, models were not well-calibrated between adolescent subpopulations, suggesting recommended ACEs screening can potentially produce biased results when used to inform me…

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Metadata

Authors
Cohen, J. R., & Choi, J. W.
Affiliations
University of Illinois Urbana-Champaign (US)
Corresponding author
Cohen, Joseph R.
ORCID
Venue
Prevention Science
Publisher
Springer Science and Business Media LLC
Published
2022-07-01
Volume
23
Issue
7
Pages
1216-1229
ISSN
  • 1389-4986 (ISSN-L)
  • 1573-6695
DOI
10.1007/s11121-022-01391-3
OpenAlex
W4283739280
Cited by
15
References
8
Citations by year
2026: 3 · 2025: 7 · 2024: 3 · 2023: 1 · 2022: 1
FWCI
2.74
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Prevention Science (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Justice (2018-R2-CX-0022)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Sociology and Political Science › Child Welfare and Adoption
Keywords
adverse childhood experiences, mental health screening, adolescents, predictive validity, diagnostic likelihood ratios, calibration, post-traumatic stress disorder, depression, externalizing disorders, racial and ethnic disparities, mental health prevention
MeSH terms
Adolescent Health, Adverse Childhood Experiences, Adolescent, Female, Hispanic or Latino, Humans, Male, Mental Health

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