Abstract
Adverse childhood experiences (ACEs) have consistently been associated with elevated risk of multiple adverse health outcomes, yet their contribution to coping ability and psychiatric resilience in adulthood is unclear. Cross-sectional data were derived from the ongoing Stress-And-Gene-Analysis cohort, representing 30% of the Icelandic nationwide female population, 18-69 years. Participants in the current study were 26,198 women with data on 13 ACEs measured with the ACE-International Questionnaire. Self-reported coping ability was measured with the Connor-Davidson Resilience Scale and psychiatric resilience was operationalized as absence of psychiatric morbidity. Generalized linear regression assuming normal or Poisson distribution were used to assess the associations of ACEs with coping ability and psychiatric resilience controlling for multiple confounders. Number of ACEs was inversely associated with adult resilience in a dose-dependent manner; every 1SD unit increase in ACE scores was associated with both lower levels of coping ability (β = -0.14; 95% CI-0.15,-0.13) and lower psychiatric resilience (β = -0.28; 95% CI-0.29,-0.27) in adulthood. Compared to women with 0 ACEs, women with ≥5 ACEs had 36% lower prevalence of high coping ability (PR = 0.64, 95% CI 0.59,0.70) and 58% lower prevalence of high psychiatric resilience (PR = 0.42; 95% CI 0.39,0.45). Specific ACEs including emotional neglect, bullying, sexual abuse and mental illness of household member were consistently associated with reduced adult resilience. We observed only slightly attenuated associations after controlling for adult socioeconomic factors and social support in adulthood. Cumulative ACE exposure is associated with lower adult resilience among women, independent of adult socioeconomic factors and social support, indicating that adult resilience may be largely determined in childhood. This work was supported by the European Research Council (Consolidator grant; UAV, grant number 726413), and the Icelandic Center for Research (Grant of excellence; UAV, grant number 163362-051). HBD was supported by a doctoral grant from the University of Iceland Research Fund.
Highlights
Exposure to adverse childhood experiences (ACEs), including child abuse, neglect and growing up in dysfunctional households, is associated with elevated risk of a wide range of physical and mental health problems across the life course (Anda et al, 2006; Bellis et al, 2015; Hughes et al, 2017; Petruccelli et al, 2019)
Two common contemporary approaches to operationalize the concept among adults, define resilience as perceived coping ability reflecting individuals’ perceptions of their ability to cope effectively with stress and adversity (Campbell-Sills and Stein, 2007; Connor and Davidson, 2003), and as psychiatric resilience reflecting an empirically derived outcome, such as the absence of PTSD or other psychiatric disorders among individuals exposed to traumatic events (Nishimi et al, 2021; Sheerin et al, 2018)
Women who endorsed five or more Adverse childhood experiences (ACEs) had 36% lower prevalence of high perceived coping ability and 58% lower prevalence of high psychiatric resilience compared to women who endorsed 0 ACEs
Summary
Exposure to adverse childhood experiences (ACEs), including child abuse, neglect and growing up in dysfunctional households, is associated with elevated risk of a wide range of physical and mental health problems across the life course (Anda et al, 2006; Bellis et al, 2015; Hughes et al, 2017; Petruccelli et al, 2019). Two common contemporary approaches to operationalize the concept among adults, define resilience as perceived coping ability reflecting individuals’ perceptions of their ability to cope effectively with stress and adversity (Campbell-Sills and Stein, 2007; Connor and Davidson, 2003), and as psychiatric resilience reflecting an empirically derived outcome, such as the absence of PTSD or other psychiatric disorders among individuals exposed to traumatic events (Nishimi et al, 2021; Sheerin et al, 2018). Adverse childhood experiences (ACEs) have consistently been associated with elevated risk of multiple adverse health outcomes, yet their contribution to coping ability and psychiatric resilience in adulthood is unclear. Conclusions: Cumulative ACE exposure is associated with lower adult resilience among women, independent of adult socioeconomic factors and social support, indicating that adult resilience may be largely determined in childhood
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