Differential Effects in Exposure to Aces and Problematic Drinking: An Examination of Protective Factors


Welch, Timothy Sean (2022). Differential Effects in Exposure to Aces and Problematic Drinking: An Examination of Protective Factors.


Exposure to Adverse Childhood Experiences (ACEs) has been associated with numerous negative developmental outcomes across the lifespan, including problematic drinking. However, not all individuals exposed to ACEs go on to drink problematically. This difference in the effect of exposure to ACEs on drinking use is an example of heterogeneity and is called a differential effect. Relatively little research has examined what factors predict resilience to the harmful effects of ACEs. Most existing research has examined either a single protective factor or examined the total number of protective factors in a cumulative scale. No study has yet to specifically examine differential effects in the context of ACEs and alcohol use. The aim of this study was to examine differential effects in exposure to ACEs and alcohol use to empirically identify a resilient group of individuals. Two research questions drove this study 1) How can heterogeneity in the association between ACEs and alcohol use be characterized? and 2) What factors predict group membership? Using data from the National Longitudinal Study of Adolescent to Adult Health (Add health), two complimentary analytic tools were used to achieve these aims: Regression Mixture Modeling (RMM) and Structural Equation Model Trees (SEM trees).Results from the RMM found evidence of two groups: a resilient group consisting of 72.6% percent of the sample and a harmful effects group consisting of 27.4% percent of the sample. Two factors were positively associated with belonging to the resilient group, school bonding and self-control. One factor, having a mentor, was associated with a lower likelihood of being in the resilient group. Results from the SEM-tree divided the data into three groups based on two variables: self-esteem and having a mentor. In this analysis, higher self-esteem and having a mentor during adolescence were both associated with problematic drinking. Findings from this study provide empirical evidence of a resilient group of individuals for whom there is not an association between exposure to ACEs and alcohol use. Despite testing multiple theoretically based protective factors, only school bonding and problem solving were associated with resilience. This suggests future research should consider additional alternative protective factors. The results suggest therapists and clinicians working with youths exposed to ACEs should work to foster increased levels of school bonding during adolescence and should assess levels of self-control and focus on helping youths develop greater self-control.






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Reference Type



Welch, Timothy Sean

Series Author(s)

Blow, Adrian J.

Year Published





Michigan State University

City of Publication

Ann Arbor





Reference ID