Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis

Child Abuse Negl. 2015 Jul:45:143-53. doi: 10.1016/j.chiabu.2015.03.008. Epub 2015 Apr 4.


Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N=13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed.

Keywords: Adverse childhood experiences; Mental health; Stress; Trauma; Victimization.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological*
  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Aged
  • Behavioral Risk Factor Surveillance System
  • Crime Victims / psychology*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Health
  • Middle Aged
  • Multivariate Analysis
  • Personal Satisfaction
  • Regression Analysis
  • Socioeconomic Factors
  • Stress, Psychological / psychology*
  • Washington