Latent classes of adverse childhood experiences and their associations with impulsivity and mental health among adults in Saudi Arabia
AI Summary
Latent class analysis identified two classes among ACE-exposed adults: limited/mixed ACE (36.9% overall) and poly-victimisation (28.0%).
Poly-victimisation class had high probabilities of emotional abuse, physical abuse, witnessed domestic violence, emotional neglect, and household mental illness.
Compared with no-ACE group, poly-victimisation associated with greater negative urgency, lack of perseverance, higher psychiatric diagnosis and perceived health impact; supports cautious pattern-level ACE assessment.
Background: Adverse childhood experiences (ACEs) are associated with later mental-health difficulties, but simple ACE counts can obscure which adversities co-occur within individuals. Person-centred modelling can identify groups of people with similar exposure patterns.Objective: This cross-sectional study identified latent classes of ACEs among adults living in Saudi Arabia and examined their associations with five facets of UPPS-P impulsive behaviour and brief mental-health indicators.Methods: An online convenience sample of 379 adults aged 18-65 years completed the 10-item ACE screener, the Arabic Short UPPS-P Impulsive Behaviour Scale, and single-item measures of lifetime psychiatric diagnosis and perceived health impact. Respondents reporting no ACEs were retained as a structural no-ACE reference group. Latent class analysis was conducted among ACE-exposed participants. Model selection considered information criteria, entropy, average posterior probabilities, class size, and interpretability. Alternative class specifications were examined in sensitivity analyses. False discovery rate (FDR) correction was applied to pairwise outcome tests.Results: Of 379 eligible respondents, 133 (35.1%) reported no ACEs. Among 246 ACE-exposed respondents, a two-class solution was selected and yielded limited/mixed ACE (n = 140, 36.9% of the full sample) and poly-victimisation (n = 106, 28.0%) classes. The poly-victimisation class showed high probabilities of emotional abuse, physical abuse, witnessed domestic violence, emotional neglect, and household mental illness. Compared with the no-ACE group, the poly-victimisation class had higher negative urgency (d = 0.55, q < .001), lack of perseverance (d = 0.43, q = .007), psychiatric diagnosis (42.5% vs 10.5%; OR = 6.27, 95% CI [3.19, 12.31]), and perceived health impact (77.4% vs 21.1%; OR = 12.81, 95% CI [6.91, 23.75]). Family-conflict interactions were exploratory and not statistically robust.Conclusions: A poly-victimisation class was associated with greater emotion-related impulsivity and mental-health burden. The findings support cautious use of pattern-level ACE assessment alongside ACE counts, while recognising the limitations of cross-sectional convenience sampling and brief outcome measures.
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