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Published in final edited form as: J Exp Child Psychol. 2024 Sep 26;249:106077. doi: 10.1016/j.jecp.2024.106077

Birth order moderates the association between adverse childhood experiences and externalizing behavior symptoms in adolescence

Marcela Soto a, Lauren Micalizzi b,c,*, Dayna Price b,c, Michelle L Rogers c, Kristina M Jackson b,c
PMCID: PMC12908024  NIHMSID: NIHMS2135951  PMID: 39332240

Abstract

Adverse childhood experiences (ACEs) are associated with externalizing behaviors. Whereas some ACEs affect individual children (i.e., child-specific; e.g., failing a grade), others affect the family unit (i.e., family-wide; e.g., parent losing a job); effects of ACEs on externalizing behavior may manifest differently across groupings of ACEs. Moreover, birth order may modify the association between child-specific and family-wide ACEs and externalizing behavior due to differences in the experience of being a younger versus older sibling. This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for developing externalizing symptoms following familial ACE exposure. Participants were 61 sibling pairs (younger sibling Mage = 11.37 years, 44.1% male; older sibling Mage = 13.1 years, 52.5% male) recruited from six schools in the northeastern United States. Parents rated each child’s externalizing behaviors (e.g., bullying, meanness) and retrospectively reported on each child’s experience of 34 ACEs; two raters categorized ACEs as child-specific (n = 10) or family-wide (n = 24). Multilevel modeling revealed that both child-specific and family-wide ACEs were associated with increased externalizing behaviors. Birth order moderated the effect of family-wide (but not child-specific) ACEs on externalizing behaviors, independent of sex and age. Externalizing behavior was higher for younger siblings as compared with older siblings, particularly when a high number of ACEs (6+) were reported. This research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs and the role of birth order.

Keywords: Adverse childhood experiences (ACEs), Externalizing behavior, Adolescence, Birth order, Siblings

Introduction

Adverse childhood experiences (ACEs) refer to distressing events that occur during childhood and adolescence. ACEs encompass abuse, neglect, and violence as well as more subtle psychological stressors such as parental conflict and divorce (Boullier & Blair, 2018). ACEs are related to increased risk for substance use (Forster et al., 2019; Marchica et al., 2022), incarceration (Baglivio & Epps, 2016; Baglivio et al., 2015), poor health such as obesity, heart disease, and cancer (Felitti et al., 1998; Hughes et al., 2017; Sonu et al., 2019), and negative mental health outcomes such as externalizing (i.e., negative, acting-out) behavior (Anderson et al., 2022; Liming & Grube, 2018; Marchica et al., 2022; Muniz et al., 2019). Externalizing behavior symptoms that follow ACE exposure can present in childhood (Hicks et al., 2020), adolescence (Lowthian et al., 2021; Muniz et al., 2019), and adulthood (Wright & Schwartz, 2021).

The familial nature of ACEs

ACEs inherently transpire within the familial unit. Child-specific ACEs refer to adverse experiences that directly affect individual children within a family such as physical abuse, exposure to violence, and failing a grade. These experiences primarily affect the child who directly experiences them. On the other hand, family-wide ACEs encompass adverse experiences that affect the entire family unit collectively such as parental substance abuse, domestic violence, and parental mental illness. Whereas child-specific ACEs directly affect one child in a family and family-wide ACEs affect all children within a family, the impacts of ACEs on family members are complex (Bzostek & Berger, 2017). According to family systems theory, child-specific experiences, such as ACEs, may disrupt the overall balance and functioning of the family system and thereby influence other family members, such as siblings, who were not directly influenced by the adversity (Bowen, 1978). The family is an interconnected system, and the family members may experience heightened stress, tension, or conflict as they navigate the repercussions of a child’s experiences. For example, if one child fails a grade, a sibling may be affected by the parental reaction to the event.

Moreover, family-wide experiences might not affect all children in a family the same way. Each child in a family is likely to be differentially affected by family-wide ACEs based on constitutional factors, such as temperament/personality, and situational factors, such as where the child was when the event happened. For example, parental incarceration may more negatively affect a sibling living at home versus a sibling living at boarding school. Disentangling individual and familial sources and sequelae of childhood adversity can reveal links to later functioning and allow for targeted prevention and intervention (Morrill et al., 2019).

Differential responses of siblings to ACEs

Provided that many of the outcomes linked to ACEs are heritable, such as criminal offending (Ling et al., 2019) and depressive symptoms (Fernandez-Pujals et al., 2015), one might expect that sibling responses to ACE exposure would be similar (Burt, 2009). In fact, some go as far as to say that the strong connection between childhood abuse by parents and later adverse outcomes is genetically influenced (Wright & Schwartz, 2021). However, non-identical siblings do not share all their genes, and non-shared environmental influences (i.e., environmental factors that are independent across siblings) are also at play; thus, it cannot be assumed that sibling responses to ACEs would manifest similarly (Boisvert & Wright, 2008).

Take, for example, externalizing behavior, which has been linked to ACEs. Externalizing behavior is highly heritable (Gjone & Stevenson, 1997; Towers et al., 2000; Wright & Schwartz, 2021), yet siblings do not always display the same levels of externalizing behaviors. Most research that seeks to understand why siblings differ (i.e., the sources of variation) in externalizing behavior has identified non-shared environmental factors (Boisvert & Wright, 2008; Turkheimer & Waldron, 2000) such as differential levels of harsh parental discipline (McGuire et al., 1995; Meunier et al., 2011), dissimilar negative life events (Button et al., 2008), and deviant peer influences (Boisvert & Wright, 2008). All these factors may explain the differential effects of ACEs on siblings. Other reasons why ACEs may differentially affect sibling manifestation of externalizing behavior are age and birth order.

Sibling age and response to ACEs

Younger siblings are, by definition, younger in age than their older siblings, which may connote greater risk for adverse outcomes following ACE exposure. When siblings experience the same family-wide adversity, younger siblings experience the trauma at a younger age relative to their older siblings. There may be a “window of vulnerability” whereby early exposure to an ACE is associated with greater susceptibility to psychopathology (Finlay et al., 2022; Solís et al., 2015), suggesting that younger siblings may be at greater risk than older siblings simply by being younger at the time of exposure to a given event. Furthermore, ACEs may become less influential on risk behaviors as youths become more autonomous and peer-oriented and less reliant on family ties and parental support (Malone et al., 2004; Sun & Li, 2007). Yet, ACEs may confer differential risks to siblings for reasons other than the chronological age at ACE or the developmental period at which a behavioral outcome is manifested; one of these is birth order.

Birth order and response to ACEs

A scoping review found evidence that older siblings tend to position themselves as protectors of their younger siblings, buffering and reducing the impact of ACEs on younger siblings, yet this “parentification” may be to their detriment (Donagh et al., 2023). For this reason, older siblings may present with worse outcomes relative to their younger siblings following ACEs. However, there are equally compelling reasons to expect that younger siblings may be more negatively affected by ACEs than their older siblings. Younger siblings are raised under different circumstances than their older counterparts. Having older siblings can increase younger siblings’ empathy (Su-Russell & Russell, 2023; Tucker et al., 1999), improve their understanding of false beliefs (Hou et al., 2020), and help them to be more competitive (Okudaira et al., 2015). Having an older sibling can also influence the parenting received by the younger sibling. Some evidence suggests that latter-born children are less responded to, are less stimulated, and experience positive affection less often (Belsky, 1984). Moreover, parents’ experiences with an older sibling can affect their expectations of a younger sibling, changing parental interactions and parenting techniques (Jensen et al., 2023; Mendelson et al., 1997). In addition, ACEs may lead to more severe outcomes for younger siblings due to a potentially lower number of friendships relative to older siblings and weaker/less developed social networks (Wang, 2021). High-quality friendships are associated with well-being and can buffer against negative effects of adverse experiences, potentially through the provision of social support (Berndt, 1989; Bolger et al., 1998). Similarly, harsh home environments are predictive of later victimization by peers, but this holds true only in children who do not have strong social networks (Barker et al., 2008; Bowes et al., 2009). Thus, there is reason to believe that older and younger siblings may be differentially vulnerable to the adverse effects of ACEs, but to our knowledge this has not been explored empirically.

The current study

This study examined the externalizing behavior of siblings in relation to their experiences of child-specific and family-wide ACEs to test the hypothesis that younger siblings are at greater risk for displaying externalizing behavior symptoms following ACE exposure. We expected the younger sibling in a sibling dyad to develop greater externalizing behavior following exposure to the same or similar family-wide ACEs, but not necessarily to child-specific ACEs. Specifically, the two hypotheses were that (1) child-specific and family-wide ACEs would be associated with greater externalizing behavior symptoms in both older and younger children and (2) birth order would moderate the effect of family-wide ACEs on externalizing symptoms, such that younger siblings would have higher externalizing behavior scores following family-wide ACE exposure than their older counterparts.

Method

Procedures

Data for the current study were drawn from a longitudinal study of the progression through sequential drinking milestones among 1023 youths recruited from six Rhode Island middle schools (in the northeastern United States) reflecting mixed urbanicity (one urban, two rural, and three suburban). Participants were enrolled in semi-annual sequential cohorts from 2009 to 2011. Study information was mailed to participants and distributed through schools. Interested youths whose parents/guardians (hereafter referred to as parents) provided consent completed a 2-hr in-person session that included a web-based baseline survey. At the time of enrollment, parents were mailed a paper-and-pencil survey that one parent would self-select to complete (89% were mothers). See Jackson et al. (2021) for a detailed description of the participants and procedure. Based on school-level data, the sample was largely representative of the schools from which they were drawn with respect to sex and grade but was more racially diverse and less economically disadvantaged than the school populations. The study was approved by the institutional review board of Brown University, and a certificate of confidentiality was obtained from National Institutes of Health.

The current study used data from both participant-reported baseline survey data and parent-reported data for all sibling pairs (n = 130 of 1023 participants). Siblings who were twins (n = 12 of 1023) were excluded due to the focus on birth order, as were data from three adopted siblings (n = 3 of 1023). The sample was initially composed of 65 sibling pairs representing 130 individuals. Of these participants, 9 did not have answers for the dependent variable (externalizing behavior). This translates to 4 sibling pairs who did not provide responses plus an additional pair with values available for only 1 sibling. Thus, the final sample was limited to data available from 60 complete dyads and one non-complete dyad, corresponding to 121 individuals plus their parents. Missing data were handled with full information maximum likelihood.

Participants

Demographics are reported in Table 1. Youth demographics were as follows: Mage = 12.25 years, SD = 1.13, range = 10–15; 52.1% female; 17.5% Hispanic or Latino; 10.7% Black, 73.6% White, 15.7% other/mixed race. Parents were 88.4% female; 13.5% Hispanic or Latino; 8.3% Black, 85.1% White, 6.6% other/mixed race; 95% biological parent(s) with a mean age of 41.4 years, SD = 7.6.

Table 1.

Demographics for siblings (by birth order) and parents

Younger n = 60 Older n = 61 Parent n = 61
Mean age in years (SD) 11.4 (0.8) 13.1 (0.7) 41.32 (7.6)
n (%)
 Sex at birth
  Female 34 (56.7%) 29 (47.5%) 54 (88.5%)
 Race
  Black 6 (10.0%) 5 (8.2%) 5 (8.2%)
  White 41 (68.3%) 46 (75.4%) 52 (85.3%)
  Other/mixed 13 (21.7%) 10 (16.4%) 4 (6.6%)
 Ethnicity (% Hispanic or Latino) 11 (18.3%) 10 (16.7%) 8 (13.1%)
 Biological parent 57 (95%) 58 (95.1%) –
 % Reduced-price or free lunch (socioeconomic status) – – 49 (40.5%)
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Measures

Child life events

The Coddington Life Events Scale is a parent-reported set of 34 yes/no items assessing important life events that may have occurred during their children’s lifetime, with the goal of identifying events that can affect child health. The scale was expanded from the 31-item Life Events Record for Elementary Age Group (Coddington, 1972a, 1972b); minor modifications were made to wording, including that “the child’s father and the child’s mother” was changed to “one of my child’s parents” to be more inclusive to non-traditional families and “the child” was changed to “my child” to make the format match other questions that were preceded by “my child”. Three questions were added: (1) “Our family went on welfare”, (2) “There was a delay in receiving child support or alimony payments”, and (3) “There was an increased difficulty managing a chronically ill or disabled family member”. Parents indicated with a yes or no response whether an event had happened to their child. Parents completed this survey separately for each sibling.

Two independent reviewers assigned each life event into one of two categories, child-specific (i.e., events that were specific to one child in the family) or family-wide (i.e., events that directly affected the family unit); reviewers were in complete agreement in their categorization. Of the 34 items, 10 were labeled child-specific and 24 were labeled family-wide (see Table s.1 in online supplementary material).

Externalizing behaviors

The Child Behavior Checklist for ages 6 to 18 years (CBCL; Achenbach, 1978; Achenbach et al., 1987) was completed by the parents. Parents responded not true (0), somewhat or sometimes true (1), or very true or often true (2) to a series of 35 questions assessing children’s externalizing behaviors. This broadband externalizing behavior subscale was calculated by summing two subscales: the rule-breaking behavior scale (computed as the mean across 17 items; sample items include “runs away from home”; “truancy, skips school”; and “drinks alcohol without parent’s approval”) and aggressive behavior (computed as the mean across 18 items; sample items include “argues a lot”; “cruelty, bullying, or meanness to others”; and “physically attacks people”). Raw scores were used, consistent with recommendations by the Achenbach System of Empirically Based Assessment (ASEBA, 2024). Higher scores indicate greater externalizing behaviors.

Data analysis

We conducted hierarchical linear model (HLM) analyses (Snijders & Bosker, 2011) to examine associations of child-specific and family-wide ACEs and birth order with externalizing behavior. These models are used to analyze variance in the outcome variables with predictor variables that vary at nested or hierarchical levels (Woltman et al., 2012), with individuals (Level 1) nested within families (Level 2). Beginning with a random intercept model in which child externalizing behavior scores were predicted from ACEs, controlling for age and sex, we tested four different modeling approaches (Feng, 2021) to determine which distribution best modeled the externalizing behavior variable, which was a zero-inflated count variable: (1) Poisson, (2) negative binomial, (3) zero-inflated Poisson, and (4) zero-inflated negative binomial. The results of the tests of model fit are reported in the Supplementary Material (Table S.2). Model fit statistics indicated that negative binomial provided the best fit to the data; thus, the models described below all were modeled with a negative binomial distribution.

Next, a series of six HLM analyses were conducted using negative binomial distribution. First, an unconditional random-intercept model (Model 0) was fit to serve as a baseline model for comparison with Models 1 to 5. Model 0 included the random intercept but did not include any predictors at either the individual or family level. Next, we modeled child-specific ACEs as a fixed predictor of externalizing behaviors at the individual level (Model 1), followed by a model with family-wide ACEs as a fixed predictor at the family level (Model 2). Both child-specific ACEs and familial ACEs were included in Model 3. Finally, interaction terms were entered into Models 4 and 5. Specifically, Model 4 included an interaction between birth order and child-specific ACEs to explore whether birth order modified the association between child-specific ACEs and externalizing behaviors, controlling for familial ACEs. Model 5 was a parallel model to Model 4 but included an interaction between birth order and familial ACEs, controlling for child-specific ACEs.

Significant interaction effects were plotted. For ease of interpretation, parameter estimates are presented as incidence rate ratios (IRR), which quantify how the rate of externalizing behavior changes with a one-unit change in the predictor variable. Akaike information criterion (AIC), Bayesian information criterion (BIC), and log-likelihood values were calculated for all models to indicate model fit. When comparing models, lower AIC and BIC values indicate a better model fit, whereas higher log-likelihood values indicate a better fit.

Results

Descriptive statistics are reported in Table 2. Family-wide and child-specific ACEs were moderately positively associated, and both family-wide and child-specific ACE categories were positively associated with externalizing behavior scores.

Table 2.

Descriptive statistics

Variable 1 2 3 4 M (SD) or %
Family-wide ACEs 4.2 (3.2)
Child-specific ACEs .466*** 0.6 (1.0)
Externalizing behavior .428*** .503*** 5.4 (6.2)
Age .083 .281** −.011 12.3 (1.1)
Sex −.020 .028 .026 .082 52.1% female
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Note. ACEs, adverse childhood experiences.

**

p < .01.

***

p < .001.

Table 3 presents the parameter estimates and fit statistics from the HLM analyses. In Model 1, greater child-specific ACEs were associated with greater externalizing behavior. In Model 2, greater family-wide ACEs were associated with greater externalizing behavior. Both child-specific and family-wide ACEs were positively associated with externalizing behavior in Model 3. Results from Model 4 indicated that the main effects of both child-specific and family-wide ACEs were significantly and positively associated with externalizing behavior. The interaction term between child-specific ACEs and birth order was not significant, indicating that birth order did not modify the association between child-specific ACEs and externalizing behavior. Finally, in Model 5, the main effects of child-specific and family-wide ACEs were positively associated with externalizing behavior, and these main effects were qualified by a significant interaction between family-wide ACEs and birth order, indicating that birth order moderated the association between family-wide ACEs and externalizing behavior.

Table 3.

Parameter estimates and fit statistics from hierarchical linear models predicting externalizing behavior

Parameter Model 0 Model 1 Model 2 Model 3 Model 4 Model 5
Unconditional random intercept Child-specific ACEs Family wide ACEs Family-wide and child-specific ACEs Birth Order × Child-Specific ACEs Birth Order × Family-Wide ACEs
Intercept 1.39** (0.15) 3.72*** (0.97) 1.55 (0.92) 3.10** (0.98) 2.74 (1.59) 2.88 (1.61)
Child-specific ACEs 0.49*** (0.09) 0.37*** (0.10) 0.54** (0.18) 0.43*** (0.10)
Family-wide ACEs 0.16*** (0.03) 0.10** (0.04) 0.10* (0.04) 0.15*** (0.04)
Birth ordera 0.06 (0.32) 0.45 (0.38)
Ageb −0.22** (0.08) −0.08 (0.07) −0.21* (0.08) −0.18 (0.14) −0.20 (0.14)
Sex 0.10 (0.18) 0.14 (0.17) 0.12 (0.17) 0.09 (0.17) 0.09 (0.17)
Birth Order × Child-Specific ACEsa −0.19 (0.17)
Birth Order × Family-Wide ACEsa −0.09* (0.04)
Model fit statistic Model 0 Model 1 Model 2 Model 3 Model 4 Model 5
AIC 655.37 634.30 640.99 628.83 631.60 628.34
BIC 663.8 651.1 657.8 648.4 656.8 653.5
Log Lk −324.7 −311.15 −314.49 −307.42 −306.80 −305.17
Deviance 649.4 622.3 629.0 614.8 613.6 610.3
Variance intercept 0.63 0.42 0.51 0.41 0.40 0.44
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Note. Number of observations = 121; number of groups = 61. ACEs, adverse childhood experiences; AIC, Akaike information criterion; BIC, Bayesian information criterion; Log Lk, log-likelihood.

a

Younger sibling is the referent.

b

Age at enrollment, corresponding to the externalizing assessment.

*

p < .05.

**

p < .01.

***

p < .001.

Fit statistics are displayed at the bottom of Table 3. Considering AIC and BIC, Models 1, 3, and 5 fit better than Models 0, 2, and 4. AIC, the deviance statistic, and the −2 log-likelihood test indicated that Model 5 was the best-fitting model.

Fig. 1 shows the predicted observed values of externalizing behavior as a function of family-wide ACEs for younger versus older siblings. Externalizing behavior values are higher for younger siblings as compared with older siblings; visual inspection of the plot suggests that the difference between younger and older siblings is most pronounced at the highest levels of ACEs.

Fig. 1.

Fig. 1.

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Interaction effect of adverse childhood experiences (ACEs) on externalizing behaviors by birth order.

Discussion

ACEs, which can be categorized as family-wide or child-specific, can have lasting impacts on child health and opportunity. The goal of this study was to evaluate the role of birth order in the presentation of externalizing behavior in response to ACEs among siblings. It was hypothesized that both family-wide and child-specific ACEs would be positively associated with later externalizing behavior and that the associations between family-wide ACEs and externalizing behavior would be moderated by birth order, such that younger children within sibling dyads would exhibit greater externalizing behavior in response to ACEs relative to their older siblings.

Confirming the first hypothesis, greater ACEs—both child-specific and family-wide—were associated with greater externalizing symptoms. This pattern is consistent with the notion that ACEs work in a gradient/dose-dependent manner, such that those who are exposed to high numbers of ACEs tend to develop the most problematic health and behavior outcomes (Muniz et al., 2019). A significant body of work (e.g., Hicks et al., 2020; Lowthian et al., 2021; Wright & Schwartz, 2021) has demonstrated links between ACE exposure and later externalizing behavior. The current findings expand these observations in demonstrating that both groupings of ACEs—those that are characterized as family-wide (i.e., ACEs that affect the family unit, e.g., parental incarceration) and child-specific (i.e., directly affecting one child within a family, e.g., child failing a grade)—are associated with later externalizing behaviors. That is, both the direct, individual experience of ACEs and the experience of ACEs that affect the family more broadly are linked with externalizing behaviors in early adolescence. Various mechanisms for the association between ACEs and externalizing behavior have been proposed, including the likelihood that chronic disease manifestation following ACEs emerges from biological embedding that is rooted in HPA (hypothalamic–pituitary–adrenal) axis hypoactivity resulting from altered cortisol secretion, chronic inflammation, and cardiovascular and autonomic function (Dempster et al., 2021). More specific to externalizing behavior, another proposed pathway from ACEs to externalizing behavior is through child modeling of parental aggressive behavior (Gershoff & Bitensky, 2007).

It is perhaps more intuitive to conceptualize the link between child-specific ACEs and later externalizing behavior, such that an individual experiences (an) adverse event(s) and this experience contributes to the development of externalizing behavior (potentially via the mechanisms outlined above). The connection between family-wide ACEs and externalizing behavior is more nuanced to unravel because the link between the adverse experience and externalizing behavior is filtered through disruption to the family. Contemporary views on family processes propose that families are complex, interconnected social systems (Bowen, 1978), and child development in turn influences and is influenced by multiple relationships within the family (e.g., child–child, parent–child, parent–parent) that also influence each other (Fiese & Winter, 2008). Take, for example, parental death, a family-wide ACE that is well-documented as one of the most traumatic experiences for children (Bowlby, 1982) that carries a life course-persistent health burden (e.g., Pham et al., 2018). The death of a parent is not directed at one child within a family; rather, the absence of the parent can uproot the emotional, social, and fiscal functioning of a family, which can then cascade into the emergence of unhealthy outcomes for children. The current findings indicate that both groups of ACEs—those that directly affect a child and those that influence the family—are risk factors for the later externalizing behavior.

Confirming the second hypothesis, findings indicated that younger siblings exhibited more externalizing behaviors than older siblings in response to family-wide, but not child-specific, ACEs. It is reasonable to question whether there is an age-based explanation for this finding, that is, whether this pattern emerged because younger children are, by nature, younger at the time of the ACE and potentially more vulnerable to effects of the ACE. Exposure to ACEs earlier in life increases the risk of later negative outcomes related to externalizing behavior such as delinquency (Jones & Pierce, 2021) and drug use (Jackson et al., 2023) as well as internalizing behaviors such as severe depression (Cheong et al., 2017) and healthcare needs (e.g., requiring medical/mental health/educational services of physical, occupational, or speech therapy; Webster, 2022). Earlier onset of ACEs has also been related to difficulties with inhibitory control and memory (Cowell et al., 2015). Furthermore, there may be greater salience of recent versus more distal events, such that the immediate distress surrounding parental separation fades with time to a greater extent for older siblings. It is less likely that these findings for family-wide events can be explained by recency of event or timing of risk behavior assessment, however, given that findings were robust to the control for child age at enrollment. What follows is to unpack the systematic differences (e.g., in impulse control; Pratt et al., 2014) between younger and older siblings and to identify plausible explanatory factors; the current study was unable to test these mechanistic theories, but we hope to stimulate future work to better understand these processes.

One explanation for the different magnitude of associations observed across siblings is that the buffering effect for older children comes from their more developed and larger social network (Lois, 2022). The attenuation of negative outcomes of abuse as a function of strong friendship and social networks has been shown for behavior problems. For example, peer acceptance has been shown to buffer the negative effects of parental conflict on child behavior problems (Tetzner et al., 2022), and high levels of friendship quality and peer group affiliation attenuated the association between unilateral parental decision making and adolescent externalizing behavior (Lansford et al., 2003). In returning to the example about parental death and applying this proposed social network framework, younger siblings’ social networks are more likely to consist of family members, and when the family unit is disrupted by an adverse event there may be fewer opportunities for or lower levels of social support available. Older siblings, on the other hand, may be better poised to turn outside the family for that support. Thus, there is a clear value in strong friendships, but attaining the friendship breadth and quality necessary to stymie the negative effects of early family-wide ACEs is less attainable for younger siblings. In addition, a given event may have been less likely to be perceived by an older sibling as a negative life event (e.g., a divorce/separation could be welcome in the case of an abusive parent).

Strengths, limitations, and future directions

The current study has several strengths, including a comprehensive sampling of adverse life events, highly reliable coding of child-specific versus family-specific events, and rigorous analyses that carefully considered the outcome distribution and compared competing models. Moreover, ACEs were assessed at the same time as externalizing behavior, precluding the possibility that children’s externalizing behavior characteristics increased their subsequent risk of exposure to negative life events (Button et al., 2008). Limitations to this study should also be noted. The first pertains to the handling of ACEs. There are different approaches to measuring and categorizing ACEs (e.g., counts, grouping ACEs into abuse vs. neglect categories), and these different approaches can result in different patterns of associations between ACEs and outcomes (Rogers et al., 2022). We opted to categorize ACEs as counts of family-wide or child-specific events due to the nature of our research question, but we did not further group subtypes of ACEs (e.g., abuse vs. neglect) due to relatively low endorsement of these events. Evaluating cumulative ACE risk can mask differential associations that distinguish threat and deprivation events (Henry et al., 2021), and we recommend that others seeking to replicate these findings consider applying models that differentiate types of ACEs. Second, parent reports might not adequately identify all adverse events that are salient to the child, and events were reported retrospectively. Although obtaining parent reports of child ACEs is common in developmental research, we acknowledge that self-reported ACEs may be more valid when it is developmentally appropriate to assess these experiences in that manner. The characteristics of the study sample also warrant discussion. This was a relatively homogeneous sample with respect to race/ethnicity, and ACE exposure levels were relatively low. Findings might not generalize to those with more severe and/or different ACE exposure patterns and to a more diverse sample that is more likely to experience compounding risks associated with social determinants of health. Moreover, the sample included only sibling pairs who were relatively close in age and at a very distinct developmental stage (middle school). Different patterns may be seen when expanding the age difference, including additional siblings, and including children in grade school and adolescents in high school. Finally, the relatively small sample size precluded evaluation of same/opposite sibling sex as a risk or protective factor; we recommend that this be explored in the future.

Conclusion

This study contributes to existing literature on the relationship between ACEs and externalizing behavior by demonstrating that both child-specific and family-wide ACE categories contribute to the expression of later externalizing behaviors and that birth order moderates the effect of family-wide ACEs on externalizing behavior. The fact that younger siblings display heightened externalizing behavior responses relative to older siblings after experiencing family-wide ACEs suggests a specific mechanism of the development of externalizing behaviors related not only to birth order but also to the adversities experienced by the whole family. Although existing literature acknowledges the family’s role in child development, limited attention has been given to the influence of sibling birth order, so this research should prompt future exploration of mechanistic theories of the impact of family-wide and child-specific ACEs on adolescent behaviors and the role of birth order.

Supplementary Material

Supplemental Material

Acknowledgments

This work was supported by a doctoral grant (21190913) by the Chilean National Research and Development Agency (ANID) and by the National Institutes of Health (R01 AA16838 and K01 DA048135).

Appendix A. Supplementary material

Supplementary data to this article can be found online at https://doi.org/10.1016/j.jecp.2024.106077.

Footnotes

CRediT authorship contribution statement

Marcela Soto: Writing – review & editing, Writing – original draft, Visualization, Methodology, Formal analysis. Lauren Micalizzi: Writing – review & editing, Writing – original draft, Supervision, Formal analysis, Conceptualization. Dayna Price: Writing – original draft, Conceptualization. Michelle L. Rogers: Data curation. Kristina M. Jackson: Writing – review & editing, Writing – original draft, Supervision, Methodology, Investigation, Funding acquisition, Formal analysis, Conceptualization.

Data availability

Data will be made available on request.

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