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Impact of ACEs on Executive function and Emotion regulation: Protective Family and Community Factors

Fri, March 22, 7:45 to 9:15am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Adverse childhood experiences (ACEs) significantly increase the likelihood that an individual will develop risky behaviors, health problems, and mental health difficulties over the long term (Felitti et al., 1998; Brockie, Dana-Sacco, Wallen, Wilcox & Campbell, 2015). Deficits in executive functioning (EF) and emotion regulation (ER) have been proposed as likely mediators of the association between ACEs and long-term negative outcomes (Danese & McEwen, 2012; Hart & Rubia, 2012). Early intervention may mitigate the effects of ACEs on EF and ER, subsequently preventing some of the long-term negative health outcomes associated with ACEs. The current study used a social-ecological framework to examine potential family and community level protective factors which mitigate the effects of ACEs on EF and ER indicators (Bronfenbrenner & Morris, 2006; Viner et al., 2012). This study utilized data from the 2011-2012 National Survey of Children’s Health. Parents of children ages 6-17 (N=59,989) reported on their child’s lifetime experiences of ACEs, and answered questions about their child’s well-being tapping into domains of EF and ER. Logistic regression analyses were used to assess the impact of ACEs on EF and ER indicators. All analyses controlled for race, age, sex and poverty level. Children who had experienced 1,2, or 3+ ACEs were more likely to fail EF (AORs=1.38, 1.72, 2.10, ps<.01) and ER (AORs=1.32, 1.62, 2.10, ps<.01) indicators. To examine the role of potentially protective factors, the sample was restricted only to children with ACE exposure (N=22,343). Two additional steps were added to each regression model testing the respective effects of family and community factors. Family factors included family structure (2 parent, parent and step-parent, single parent, other) and regularity of family meals. Eating family meals at least half of the week was associated with reduced odds of failing the EF and ER indicators (AORs=0.77, 0.80 ps<.01). Family structure was not associated with either indicator. Community factors included community cohesion, neighborhood amenities and neighborhood detractions. Each community factor was significantly associated with reduced odds of failure of the EF indicator (AOR= 0.76, p<.01: AORs 0.83, 0.91, p<.05). Community cohesion and neighborhood amenities were associated with reduced odds of failing the ER indicator (AORs=0.74, 0.85, ps<.01). This study contributes to evidence that ACEs impact development of EF and ER in childhood, highlighting the need for early intervention. Several family and community level factors were associated with improved EF and ER, despite the presence of ACEs. Future research is warranted to examine whether interventions manipulating these protective factors lead to improved outcomes for children with high ACE exposure.

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