Community-level Adverse Experiences and Emotional Regulation in Children and Adolescents

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Purpose:The association of adverse childhood experiences (ACEs) with negative health outcomes is well established, and the concept of allostatic load has been proposed as a possible causal mechanism. Most studies measure conventional (household) ACE exposures without accounting for non-conventional (community) ACE exposures, which may underrepresent the adversity experienced by racial/ethnic minorities. We address this gap by calculating the prevalence of both types of ACE exposures for racial/ethnic subgroups. We also examine associations of ACE exposures and emotional regulation in school aged children and youth.Design and Methods:This study used data (n = 65,680) for a nationally representative sample of children ages 6 to 17 years in the National Survey of Children's Health (2011−2012). Confirmatory factor analysis, descriptive statistics and regression models were used to examine the relationships between ACEs and emotional regulation.Results:Community level ACE events disproportionately affect ethnic minorities. Some but not all ACEs were significantly and inversely associated with the ability to emotionally regulate in children. Experiencing racism had the strongest negative effect of all ACE variables. The strength of the child-caregiver relationship was associated with increased odds of emotional regulation, independent of exposure to ACEs.Conclusions:The study supports the need to refine and expand ACE health screenings to fully capture the adversity faced by all children. Emotional regulation is identified as a possible intervention point.Practice Implications:Expansion of programs that strengthen the child-caregiver relationship and reduce ACEs in early childhood may be a key approach to increasing coping abilities in youth.Highlights:The National Survey of Children's Health now includes community level questions.Community level ACEs disproportionately affect ethnic minorities.Emotional regulation may be in the causal pathway between ACEs and negative health outcomes.Experiencing racial prejudice had the greatest magnitude of any of the ACEs.The child-caregiver relationship was positively associated with emotional regulation, independent of ACE exposure.

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