Assessing adverse childhood experiences and mental health status in diverse and underrepresented young people: advancing Inclusive research

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Bhui, K., Kirk, M., Butcher, I., Fazel, M., Ma, M., Cooke, P., Farahar, C., Foster, A., Harris, K., Sansoy, H., Havers, L., Shaughnessy, N., Hugh-Jones, S., Allder, L., & Mankee-Williams, A. (2026). Assessing adverse childhood experiences and mental health status in diverse and underrepresented young people: advancing Inclusive research [Preprint]. openRxiv. https://doi.org/10.64898/2026.07.21.26358568

Publication date: 22 Jul 2026 Added to AutiHub: 9 Aug 2026 Type: Preprint Article language: English
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Authors

Publication authors
15
Publication authors identified as autistic
2 / 15 (13.3%)
  1. Kamaldeep Bhui
  2. Megan Kirk
  3. Isabelle Butcher
  4. Mina Fazel
  5. Minhua Ma
  1. Paul Cooke
  2. Chloe Farahar *
  3. Annette Foster *
  4. Kier Harris
  5. Harsimran Sansoy
  1. Laura Havers
  2. Nicola Shaughnessy
  3. Siobhan Hugh-Jones
  4. Luke Allder
  5. Anna Mankee-Williams

Abstract

Abstract Background Young people impacted by adverse childhood experiences (ACEs) are often underrepresented in mental health research. Aims This paper aims to advance inclusive research on ACEs by 1) describing co-designed recruitment and engagement methods in a national project on ACEs (Attune), 2) characterising a highly marginalised cohort of young people using identity descriptors co­designed with participants, and 3) reporting associations between ACEs, identity characteristics and mental health outcomes. Methods A trauma-aware approach to engage under-represented young people was co­developed with a national youth advisory group, lived experience researchers, and trusted community partners. Our co-created purposive sampling strategy recruited 74 young people, aged 10-24 years, across England, seeking representation by age, sex, gender identity, sexual orientation, ethnicity, neurodivergence, and geographic location. Participants completed validated self-report measures of ACEs, life events, and mental health. Descriptive, correlational and regression analyses examined cohort characteristics and associations between ACEs, identity characteristics, and mental health measures. Results The final cohort included participants identifying as non-White British (39.5%), non- binary/other gender (25%), and neurodivergent (30%). Half of participants reported exposure to at least one ACE. Analyses identified patterns consistent with prior literature. In addition, ACEs and barriers related to being neurodivergent were associated with increased depression and anxiety symptom severity. Non-binary gender identity was associated with anxiety. We did not observe associations of ACEs or mental health measures, with sex or ethnicity. Conclusions Under-represented groups can be reached via co-created engagement methods informed by lived experience. We identified important associations between ACEs, identities, and mental health outcomes.

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Cited references
25
With a DOI
23
Without a DOI, from raw bibliography text
2
0 / 25 (0.0%) cited references include at least one author identified as autistic.
References with data to complete
5 / 25 (20.0%)
References with detected author names
20 / 25 (80.0%)
Without detected author names
5
Without a structured title
4
Without a stable identifier
2
References with raw author names still to review
0
References with external metadata lookup issues
2
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Author names detected in the cited bibliography
131
From DOI or external metadata
131
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
6
8 / 131 (6.1%) names are linked to an author already present in AutiHub. 123 / 131 (93.9%) names are not yet linked.
Names linked to a person identified as autistic
0 / 131 (0.0%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 0 / 8 (0.0%). Distinct people identified as autistic: 0 / 127 (0.0%).
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