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The Association of Adverse Childhood Experiences with Anxiety: The Moderating Role of Stress

Thu, April 8, 10:15 to 11:15am EDT (10:15 to 11:15am EDT), Virtual

Abstract

Research has established that exposure to adverse childhood experiences (ACEs) is a risk factor for later anxiety symptoms in adulthood (Anda et al., 2010; Lähdepuro et al., 2019). Research has also identified that stress confers risk for developing symptoms of anxiety (Daviu et al., 2019). It remains unclear as to how ACEs and perceived stress may interact and jointly predict symptoms of anxiety. Recognizing potential moderators in the association of ACEs with anxiety symptoms is important to ameliorate the effects of early trauma on later mental health outcomes. The purpose of this study was to examine whether stress interacted with early childhood adversity and shaped the association of ACEs with anxiety symptoms.
A sample of 624 participants (460 females, Mage = 27.0, SDage = 14.6) were recruited to provide self-report responses to an online survey. The 10-item Adverse Childhood Experience scale (Dong et al., 2004; Felitti et al., 1998) was used to examine one’s recall of ACEs which occurred prior to the eighteenth birthday. These adverse early events pertain to an individual’s personal history of emotional abuse, physical abuse, sexual abuse, emotional neglect, physical maltreatment and/or neglect, parental separation/divorce, family substance use, mental illness with the household, and/or parental incarceration. The Anxiety subscale (7 items) and Stress subscale (7 items) of the Depression Anxiety and Stress Scale (Lovibond & Lovibond, 1995; 21 items) were used to assess self-reported anxiety symptoms and perceived level of stress.
The results indicated that scores of ACEs (M = 1.8, SD = 1.9) were significantly associated with those of anxiety (M = 4.1, SD = 4.5) and stress (M = 6.8, SD = 4.5), r = .33, p < 0.001, and r = .27, p < .001, respectively. Also, stress was significantly correlated with anxiety, r = .72, p < .001. With gender controlled (considering the greater number of female participants than that of male participants and the gender differences in the study variables), moderation analysis revealed a significant interaction effect between ACEs and stress on anxiety (b = 0.06, p = .021), F = 124,87, p < .001, R2 = .54. Specifically, higher ACEs were associated with higher levels of anxiety when stress was not low (medium level of stress: b = 0.11, p = .001; high level of stress: b = 0.17, p < .001).
The findings underscored the role of stress in the lasting impact of early adverse experiences on adult anxiety symptoms. In particular, when the level of perceived stress could be managed to reach a low level, ACEs no longer showed association with anxiety symptoms. As levels of perceived stress increased, the strength of the association between ACEs and anxiety symptoms increased. Thus, stress appeared to exacerbate the impact of ACEs on adult anxiety symptoms. Screening for early adverse experiences in adult populations may help identify individuals with increased anxiety symptoms. Results from this study highlight the potential utility of preventive and therapeutic interventions targeting stress among those with anxiety symptoms associated with adverse childhood experiences.

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