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Adverse childhood experiences and developmental outcomes in adolescents in residential care: A comparison of cumulative and person-based approaches

Maneiro L, López-Romero L, Llerena N · 9 Oct 2026

Abstract

Abstract Exposure to adverse childhood experiences (ACEs) has detrimental effects on developmental outcomes, particularly among adolescents in residential care. However, previous evidence suggests that the analytic approach used to study ACEs may influence findings and shape our understanding of their impact. This study addressed this limitation by examining both cumulative and person-centred approaches and their impact on developmental outcomes across two time points in a sample of 161 adolescents (46.6% boys, 49.7% girls, 3.7% non-binary; aged 12–18, M  = 15.22, SD  = 1.59) placed in 24 residential facilities, of whom 47.8% were followed up eight months later. Group care workers reported on seven ACEs (family substance use, family mental health problems, family criminality, exposure to domestic violence, physical/psychological abuse, physical neglect, psychological neglect) and trauma-related symptoms, while adolescents self-reported internalizing and externalizing problems. Overall, a higher number of ACEs was associated with more negative outcomes, yet a closer examination revealed a more nuanced pattern. Latent profile analysis identified three profiles, namely Low ACEs, Moderate ACEs–High Neglect, and High ACEs–Low Neglect, with the latter two linked to more adverse outcomes than the Low ACEs group. Comparing approaches highlighted the importance of considering not only the accumulation but also the type and severity of ACEs. Findings underscore the value of combining cumulative and person-centred approaches to advance understanding of how early adversities shape adolescent development.