Background: Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity.

Objectives: Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations.

Method: A representative sample of the German population (N =2531; Mage =48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE educational involvement, and gender were found to moderate these associations in exploratory analyses.

Results: Four distinct latent classes of ACEs were identified; “no/low ACEs” (N =1968, 77.8 %);“household-dysfunction” (N =259, 10.2 %), “child abuse and neglect” (N =188, 7.4 %), and“polyadversity” (N =116, 4.6 %). Compared to participants in the no/low ACE class, those in theACE-exposed classes showed overall lower levels of perceived social participation and health- related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory
analyses.

Conclusions: This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL – an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.