A Person-Centered Approach to Identifying At-Risk US Army Soldiers-in-Training Based on Adverse Childhood Experiences

Military service members are confronted with numerous stressors as they progress through their career. Given the military's desire to maintain mission readiness, it is imperative to identify areas of early intervention to promote optimal functioning and health. This study used the stress process framework and a person-centered approach to identify subgroups of soldiers-in-training based on adverse childhood experiences (ACEs). Specifically, two questions were addressed: (a) Are there distinct profiles of ACEs among soldiers-in-training, and (b) who are the most at-risk soldiers-in-training? The sample consisted of 30,836 soldiers-in-training from the Army study to Assess Risk and Resilience in Servicemembers. Five subgroups were identified using latent profile analysis: low adversity, moderate emotional adversity, elevated emotional adversity, moderate structural adversity, and high cumulative adversity. Results from a multivariate and univariate analyses of variance indicated significant small main effects of profile membership in anxiety, depression, posttraumatic stress disorder, and resilient mindset. Those with high cumulative adversity and elevated emotional adversity appeared to be the most at-risk regarding mental health, yet those with high cumulative adversity had similar levels of resilient mindset as the lower adversity groups. Those with elevated emotional adversity had the lowest levels of resilient mindset. Findings provide a more holistic understanding of unique combinations of ACEs among individuals' as they enter military service. ACEs profiles may help providers identify those who may benefit from targeted supports (e.g., trauma-informed mental health providers) prior to or during service for those who may be most vulnerable to poor outcomes.