Understanding Adverse Childhood Experiences and Adolescent Mental Health in the Context of Social Support from Caregivers, Schools, and Neighborhoods

The prevalence of adolescent mental health issues, suicides, and psychiatric hospitalizations is on the rise (Blader, 2011; CDC, 2019). Those who have experienced Adverse Childhood Experiences (ACEs) are at increased risk (Duke & Borowsky, 2018; Moore & Ramirez, 2016). Using data from the nationally representative and longitudinal Fragile Families and Child Wellbeing (FFCWB) birth cohort study (Princeton University, 2019; Reichman, Teitler, Garfinkel, & McLanahan, 2001), this study examines how ACEs contribute to the growing mental health crisis while exploring protective factors aimed at informing interventions. Childhood adversity is examined by including a focus on specific timing, average occurrences over time, and chronic levels of high adversity. In addition, elements of youths’ social context (home, schools, neighborhoods) that might serve a protective function were examined. Multiple linear regression models were conducted to predict adolescent depression, anxiety, and positive functioning. Findings strengthen the overarching notion that ACEs across childhood relate to mental health in adolescence- joining work suggesting a dose-response relationship between cumulative ACEs and mental health outcomes (e.g., Blum et al., 2019). Work should consider ACEs at multiple points across time to best capture the potential accumulation of risk. Results also provide evidence that various contexts of social support have consistently positive, direct contributions to explaining adolescent mental health symptoms and well-being, but they did not serve as protective factors for ACEs. Implications include continuing efforts to reduce ACE exposure (prevention) and bolstering interventions that demonstrate the capacity to develop and enrich various social supports. For both aspects, there is a call for broad systemic intervention and community-based efforts (Kia-Keating et al., 2017; Liu et al., 2020), as initiatives enacting supports at multiple levels have the potential for the most wide-reaching impacts.