This week, Mad in America examines three studies related to adverse childhood experiences (ACEs) and mental health. The first finds that LGBTQ+ populations are more likely to report ACEs, which in turn are linked to mental health symptoms and risk taking behaviors. The second reports that adolescents entering therapeutic residential care report high rates of ACEs. The third links childhood maltreatment to difficulty understanding, identifying, and speaking about emotions.
Adverse Childhood Experiences More Likely in LGBTQ+ Populations
A new article published in Trauma, Violence, and Abuse finds that LGBTQ+ populations are more likely to report adverse childhood experiences (ACE). This research, led by Audrey-Ann Deneault from the University of Montreal in Canada, also reports that exposure to four or more types of ACEs was more common in gender-diverse compared to sexually-diverse individuals.
The goal of this study was to examine the prevalence of ACEs in an LGBTQ+ indivuduals compared to a reference population and to investigate factors that may be linked to ACEs in an LGBTQ+ population. The authors conducted a narrative review and meta-analysis of previous research to achieve these goals. In total, the authors used data from 52 studies including 24,133 LGBTQ+ and 307,676 non-LGBTQ+ individuals.
The LGBTQ+ population was less likely to report 0 ACEs (15.8% versus 27.5%) and more likely to report four or more ACEs (38.7% versus 24.7%) compared to the non-LGBTQ+ reference group. The LGBTQ+ group was also more likely to report every type of ACE examined in the current work, with psychological violence (17% more likely) and exposure to mental health problems (16% more likely) being the most commonly reported ACEs for LGBTQ+ individuals. Exposure to four or more ACEs was more commonly reported by gender-diverse (43.9%) compared to sexually-diverse (36.1%) individuals. ACEs were linked to higher rates of mental health difficulties such as depression, anxiety, and suicidality, as well as risk taking behaviors in the LGBTQ+ population.
This research had four main imitations. Most of the populations included in this research were from North America. This limits generalizability to other populations, especially in countries that criminalize homosexuality. ACEs were only assessed in terms of how many categories participants experienced. This means the frequency, severity, duration, and escalation were not examined. The ACE measurement relied on self-report surveys, which could be biased due to misremembering or providing socially acceptable rather than accurate information. This research focused on 10 commonly accessed ACE categories, which may have overlooked some adverse childhood experiences.
Adolescents Entering Therapeutic Residential Care Report High Levels of ACEs
A new US study published in the International Journal of Social Science Research finds that adolescents entering therapeutic residential care (TRC)report higher levels of ACEs compared to the national average. This study, led by Kenneth M. Coll from the University of Nevada, also finds that emotional and physical neglect were the ACEs most linked to psychiatric hospitalization and suicidal behavior.
The aim of the current work was to examine connections between ACEs and several other factors, such as having an individualized education plan, suicidal behaviors, Child Protective Services involvement, and psychiatric hospitalization for adolescents entering TRC. The authors used clinical records from two TRC centers in the Rocky Mountain Region of the US to assess ACEs as well as clinical and demographic information.
Adolescents entering TRC were significantly more likely to report ACEs compared to the national average. Forty-eight percent of adolescents entering TRC reported exposure to four or more categories of ACEs compared to the national average of 12.5%, with 50.4% saying they had experienced physical abuse compared to the national average of 28.3%. Adolescents entering TRC were more than 5 times as likely (76% versus 14%) to report emotional and/or physical neglect compared to the national average. Just 2.2% reported no ACEs compared to the national average of 36.1%.
Adolescents referred to TRC through the juvenile justice system were significantly less likely to report abuse or neglect compared to those referred through mental health services. They also had significantly lower ACE scores (3.00 versus 4.83 out of 10). Psychiatric hospitalization was linked to previous experiences of neglect and abuse. Suicidal behavior was linked to previous experiences of neglect.
This study had 3 main limitations. The sample size was small and consisted entirely of high-risk participants. The majority of participants were males of European ancestry, limiting generalizability to minority populations. The data was collected from two TRC facilities in one rural region of the US, further limiting generalizability to other populations.
Emotional Abuse and Neglect in Childhood Linked to Difficulty Understanding and Identifying Emotions
A new Chinese study published in the Journal of Affective Disorders finds that emotional maltreatment during childhood is linked to alexithymia, difficulty in identifying, understanding, and speaking about emotions. This study, led by Yang Liu of Beijing Normal University, also reports that physical abuse and neglect were linked to alexithymia in girls.
The goal of this research was to examine the connections between different types of childhood maltreatment and three aspects of alexithymia: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. The authors collected data from 2,447 Chinese adolescents and young adults (aged 16 – 22) using self-report surveys to access childhood maltreatment and alexithymia.
Overall, emotional maltreatment showed stronger links to alexithymia compared to physical and sexual maltreatment. Emotional abuse and emotional neglect were strongly linked to difficulty identifying feelings, with emotional abuse showing the strongest association. Emotional neglect was also strongly associated with externally oriented thinking. Physical abuse and neglect was more strongly linked to alexithymia in girls.
This study had four main limitations. The design means this data cannot definitively say that childhood maltreatment causes alexithymia, only that they seem linked. The self-report surveys means the data was susceptible to bias due to misremembering and misreporting. The participants were non-clinical. Results may look significantly different in a populations with mental health diagnoses. All the participants were from China, limiting generalizability to other populations.
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Coll, K., Stewart, R., Gutheil, J. S., Day, L., Osmanovic, S., Scholl, S., & Hauser, N. (2026). Adverse childhood experiences associated with common issues entering Therapeutic Residential Care (TRC). International Journal of Social Science Research (IJSSR), 3(1), 287–297. (Link)
Deneault, A.-A., Madigan, S., Beischel, W., Racine, N., Djordjevic, M., MacIsaac-Jones, M., Le, M., Thiemann, R., Salama, H., Lunney, C. A., & Neville, R. D. (2026). Prevalence and correlates of adverse childhood experiences in LGBTQ+ populations: A narrative review and meta-analysis. Trauma, Violence, & Abuse. (Link)
Liu, Y., Liu, S., Preece, D. A., Gross, J. J., Zhao, Z., Qian, J., Gao, M. (Miranda), & Han, Z. R. (2026). Childhood maltreatment and alexithymia: A network analysis. Journal of Affective Disorders, 397, 120876. (Link)