ECPN Student Poster Contestant: Effects of Adverse Childhood Experience and Family Resilience on Child’s Anxiety: A Path Analysis

Introduction: Adverse Childhood Experiences (ACE; e.g. household poverty, parental divorce, domestic violence) are important determinants of childhood anxiety. Resilience is the capacity to adapt to adversity, which creates resistance to the effect of ACE in precipitating mental disorders. The role of family resilience in buffering the effect of adversity on children’s anxiety has not been thoroughly assessed in literature. The purpose of this study was to examine the relationships between family structure, ACE, family resilience, and childhood anxiety.

Methods: This study used the population-based survey data from the 2016 National Survey of Children’s Health, collected by the US Census Bureau from June 2016 to February 2017. This sample consisted of 46,438 adult caregivers who had a child between the ages of 3 and 17 years old. The independent variables included 1) parent’s nativity, 2) mother’s age when the child was born, 3) parental level of education, and 4) family structure, the mediators included 1) ACE and 2) family resilience, the dependent variable was childhood anxiety. Parent’s nativity ranged from 1=1st generation to 3=3rd generation immigrant. The measure for family structure was coded into a 4-level scale; 1=no parent reported, 2=single mother, 3=two parents who are not married, and 4=two parents, currently married. Parental level of education ranged from 1=less than high school to 4=college degree or higher. Nine ACE items were coded dichotomously (yes/no), and a sum score was calculated. Family resilience consisted of 4 items (e.g. How often does your family stay hopeful even in difficult times?) ranging from 1=none of the time to 5=all of the time. Severity of childhood anxiety ranged from 0=no symptoms to 2=moderate/severe symptoms. A saturated path model was tested using Mplus version 7.4.

Results: The results indicated that family structure had direct effects on ACE and family resilience (β = -.042, p < .01 and β = .011, p = .03, respectively) and an indirect effect on childhood anxiety through two mediators, ACE and family resilience. Parental level of education had a negative direct effect on ACE (β = -.021, p <. 01). ACE had a positive direct effect (β = .087, p < .01) on anxiety. Family resilience had a negative direct effect (β = -.040, p < .01) on anxiety.

Conclusions: The mediating effects of ACE and family resilience in the relationship between family structure and anxiety suggests that interventions delivered to at-risk families that are aimed at improving family resilience may have the beneficial effect of preventing or reducing childhood anxiety. Future research is needed to examine how family resilience mitigates the effects of ACE in high-risk families.