Purpose <p>People who experience childhood adversity often experience more than one type, yet traditional modeling approaches may not adequately account for complex adversity patterns. We used a person-centered approach to identify subgroups of individuals with distinct childhood adversity profiles and compared this method with traditional approaches to examine their associations with young adult mental health.</p> Methods <p>Data came from 1,022 young adults aged 18–25 years in the 2022 Rhode Island Young Adult Survey, a cross-sectional, community-based web survey. Participants self-reported anxiety (GAD-7) and depressive (CES-D-10) symptoms and 14 types of childhood adversities. Latent class analysis (LCA) identified childhood adversity subgroups. We used modified Poisson regression models to examine associations of childhood adversity with mental health outcomes. We compared models using individual adversities (specificity approach), sum-scores (cumulative approach), and LCA-derived subgroups (person-centered approach).</p> Results <p>Childhood adversities were individually weakly associated with mental health outcomes (prevalence ratios [PRs] &lt; 2.0), and people who experienced more forms of childhood adversity were more likely to report high anxiety and depressive symptoms. We identified four childhood adversity latent classes. Groups characterized by multiple forms of maltreatment, household dysfunction, and family mental illness were the most likely to report poor mental health outcomes, and estimates were greater in magnitude compared to the cumulative approach (PRs &gt; 4.0 and 5.5 for high anxiety and depressive symptoms, respectively, for the highest risk subgroup “High cumulative household threat and deprivation”).</p> Conclusion <p>LCA may better estimate the impact of complex patterns of childhood adversity on mental health than traditional approaches.</p>