# Patterns of Adverse Childhood Experiences from a Longitudinal South African Community Sample: A Latent Class Analysis

## TL;DR

This study identifies patterns of childhood adversity in South African adolescents, showing that context-specific factors like parental AIDS-affectedness are more influential than traditional measures.

## Contribution

The study introduces contextually sensitive ACEs and applies latent class analysis to South African adolescents, revealing distinct patterns influenced by local conditions.

## Key findings

- Five distinct classes of ACE exposure were identified, with context-specific ACEs playing a stronger role than conventional ACEs.
- Adolescents in higher ACE classes were more likely to be girls, older, and from poorer backgrounds.
- Regional differences were observed, with specific provinces associated with distinct ACE patterns.

## Abstract

South African children have a high risk of experiencing multiple adverse childhood experiences (ACEs) compared to children living in high-income countries. In a low- and middle-income context with high levels of deprivation and crime, we should consider expanded ACEs (ACE-E) that are contextually sensitive, alongside conventional ACEs (ACEs-C). Latent class analysis was used to explore patterns of 14 ACEs measured in a sample of 3,401 South African adolescents (56.42% girls). Data were collected in 2010/2011 and 2011/2012. We assessed the association between class membership and demographic covariates of poverty, location (rural vs. urban), gender, age, and province. 5 classes emerged based on model fit indices and theory: “Low ACEs,” “High Parental AIDS-Affectedness and Parental Death,” “High Parental AIDS-Affectedness and Parental Sickness,” “Moderate Multi-Type Abuse,” and “Highest Multi-type ACEs.” ACEs-E played a stronger role in shaping latent classes than ACEs-C. Compared to the low ACE class, adolescents in other classes lived in greater poverty, were older, and more likely to be girls. Children in “High Parental AIDS-Affectedness and Parental Death” were more likely to be in the Mpumalanga province and children in “Moderate Multi-Type Abuse” were more likely to be in Western Cape. South African adolescents are at risk of multiple ACE exposure and contextually sensitive ACEs mattered most when characterising patterns of ACEs. Research should continue to focus on person-centred approaches to ACEs for understanding the complexity and multiplicative effects of ACEs in low-resource settings.

The online version contains supplementary material available at 10.1007/s42448-025-00231-5.