Exposure frequencies of single adverse childhood experiences and their association with psychological distress: evidence from a cohort study among emerging Swiss adults

Abstract Background Adverse childhood experiences (ACE) are significant transdiagnostic risk factors for impaired psychosocial functioning throughout life. Most research on ACE has relied on composite scores, limiting conclusions about specific adverse experiences. The aim of the present study was to describe in detail the exposure frequencies of a wide range of single adverse experiences (SACEs) and investigate their association with psychological distress among emerging adults at the individual and the population levels. Methods A total of 2528 emerging Swiss adults aged 18 to 22 years from a random population sample participated in the first wave of a cohort study. ACE measures included 39 specific experiences covering neglect (emotional, physical), abuse (emotional, physical, sexual), witnessing violence, peer maltreatment and parental psychopathology. ANOVA models estimated bivariate associations between SACE exposure frequencies and psychological distress. Results The most frequently reported child maltreatment subtypes were emotional neglect and abuse (38.4% resp. 30.8%). Regarding SACEs, more than 75% reported “witnessing the parents arguing fiercely” and verbal maltreatment by peers. SACEs were strongly associated with psychological distress in emerging adulthood, though the strength varied by type and frequency of exposure. Physical and sexual abuse experiences were strongly associated with psychological distress even when experienced only rarely. In contrast, SACEs in the domains of emotional abuse, emotional neglect and verbal abuse by peers correlated with psychological distress primarily at higher exposure frequencies. At the population level, frequently occurring SACEs, such as verbal abuse by family, explained the largest proportion of variance in psychological distress. Conclusions The impact of adverse childhood experiences on psychological distress among emerging adults depends on the type of SACE and their exposure frequency. These findings highlight the importance of analyzing single adversities and their frequencies alongside dimensional and pattern-based approaches in ACE research. Trial registration NCT05122988; November 17, 2021.