Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health

Soc Work Health Care. 2014;53(8):776-97. doi: 10.1080/00981389.2014.944251.


Although evidence is rapidly amassing as to the damaging potential of early life adversities on physical and mental health, as yet few investigations provide comparative snapshots of these patterns across adulthood. This population-based study addresses this gap, examining the relationship of adverse childhood experiences (ACEs) to physical and mental health within a representative sample (n = 19,333) of adults, comparing the prevalence and explanatory strength of ACEs among four birth cohorts spanning ages 18-79. This assessment accounts for demographic and socioeconomic factors, as well as both direct and moderating effects of resilience resources (social/emotional support, life satisfaction, and sleep quality). Findings demonstrate (1) increasing trends of reported ACEs across younger cohorts, including time period shifts such as more prevalent family incarceration, substance abuse, and divorce, (2) significant bivariate as well as independent associations of ACEs with poor health within every cohort, controlling for multiple covariates (increasing trends in older age for physical health), and (3) robust patterns wherein resilience resources moderated ACEs, indicating buffering pathways that sustained into old age. Theoretical and practice implications for health professionals are discussed.

Keywords: adult health; adverse childhood experiences; cohort analysis; mental health; physical health.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Behavioral Risk Factor Surveillance System
  • Child Abuse / psychology*
  • Cohort Studies
  • Female
  • Health Status*
  • Humans
  • Life Change Events
  • Male
  • Mental Health* / statistics & numerical data
  • Middle Aged
  • Regression Analysis
  • Resilience, Psychological
  • Self Concept
  • Stress, Psychological / psychology*
  • Washington
  • Young Adult