Coping Strategies Moderate the Relationship between ACEs and Future Physical Health

• In Event: Poster Session 09
  In Poster Session: PS 09 Topic - Social, Emotional, Personality

Abstract

Adverse childhood experiences (ACEs) have been robustly linked to problematic future health outcomes (Hughes et al., 2017). One pathway through which ACEs could affect adult health is via maladaptive coping strategies. Certain coping strategies, such as problem-focused coping, may promote physical health, while others, such as avoidance, may undermine physical health (Penley et al., 2002). It is critical to understand the connections between ACEs, coping strategies, and physical health, as coping strategies represent a possible point of intervention. To our knowledge, only one study (Sheffler et al., 2018) has examined the relationship between these variables in a longitudinal investigation. ACEs were found to be associated with avoidant coping, which in turn, partially mediated the association between ACEs and later health problems. Unfortunately, the study’s sample was 90.7% Caucasian and had a high attrition rate of 54%. The goal of the present study was to examine the relationship between ACEs, coping strategies, and physical health outcomes in a more diverse sample.

Methods
N=151 participants (61 male, 90 female), drawn from a larger study of adolescent and adult development. These participants represented 82% of the original sample, for whom ACEs data were available. The sample was racially/ethnically diverse: 57% of participants identified as Caucasian, 30% as African American, 9% as mixed race/ethnicity, and 4% as other race/ethnicity.

Measures:
Age 27: Coping strategies were assessed using the COPE (Carver et al., 1989).
Age 28: ACEs were reported via the ACE Questionnaire (Felitti et al., 1998). Participants were asked to rate their general health (GH), and report the number of hospital visits they made over the past two years.

Analyses: Regression analyses were used to examine associations between ACEs and health outcomes. Interactions between ACEs and coping strategies were examined. Analyses controlled for gender and family income.

Results
ACEs were associated with worse GH (β = -0.20, p < 0.05) and more hospitalizations (β = 0.20, p < 0.05) in adulthood. Active coping was associated with better GH (β = 0.18, p < 0.05); behavioral disengagement was associated with worse GH (β = -0.27, p < 0.001).

Coping via emotional support-seeking (ESS) moderated the relationship between ACEs and hospital visits: participants with high ACEs who did not use ESS made more visits to the hospital, while those who used ESS had fewer hospital visits (β = -0.18, p < 0.05; Fig 1).

Coping via humor moderated the relationship between emotional abuse (EA) and GH: participants who experienced less EA and used humor to cope reported better GH, while those who experienced high EA and used humor to cope reported worse GH (β = -0.17, p < 0.05; Fig 2).

Discussion
Children who experience ACEs are at a higher risk for physical health concerns in adulthood, but use of healthy coping strategies may mitigate these health risks. In this study, emotional support-seeking appeared to decrease risk of adult-era hospitalizations in individuals with high ACEs. Conversely, using humor to cope appeared actively beneficial for those with low ACEs, but potentially harmful for those with histories of emotional abuse.

Authors

• Alida Davis, University of Virginia - Charlottesville
  Presenting Author

• Jessica Kansky, University of Virginia - Charlottesville
  Non-Presenting Author

• Kayla Kemp, James Madison University
  Non-Presenting Author

• David E. Szwedo, James Madison University
  Non-Presenting Author

• Joseph P Allen, University of Virginia - Charlottesville
  Non-Presenting Author