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However, not all exposures to violence exert the same negative impact. This study aimed to develop a bifactor model of childhood adversity by integrating two established measures, the Child Exposure to Community Violence questionnaire and the Pediatric Emotional Distress Scale. The Adversity Exposure-Response Model was created using caregiver-proxy report data from children aged 3.5 and 4.5\u2009years (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    \u2009=\u2009801) in a South African birth cohort from two high-risk, low-income communities. A bifactor model best fit the data, with the newly formed composite serving as a statistically significant predictor of exposure to traumatic events (\u03b2\u2009=\u2009.34,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u2009.001). As predicted, this bifactor model provided a holistic approach to childhood adversity, challenging the assumption that all adverse events result in uniformly negative outcomes. It offers a comprehensive screening tool to identify at-risk children early, facilitating targeted interventions in high-risk settings.\n                  <\/jats:p>","DOI":"10.1177\/10731911251340221","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T01:36:41Z","timestamp":1748569001000},"page":"701-719","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Bifactor Model of Childhood Adversity in a Longitudinal South African Birth Cohort Study"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-7465","authenticated-orcid":false,"given":"Joannes S. 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