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Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among
Ahmad Khanijahani1, Kenan Sualp2
1Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA. khanijahania@duq.edu.
Insights
Adverse Childhood Experiences (ACEs) are common in US children. Higher neighborhood support can reduce the risk of internalizing and externalizing mental disorders, especially in adolescents.
Area of Science:
- Child Psychology
- Public Health
- Epidemiology
Background:
- Adverse Childhood Experiences (ACEs) affect nearly half of US children.
- Mental health disorders, including internalizing (anxiety/depression) and externalizing (ADHD/behavior problems), are prevalent in children.
- Understanding the interplay between ACEs, neighborhood support, and mental health is crucial for effective interventions.
Purpose of the Study:
- To investigate the association between lifelong Adverse Childhood Experiences (ACEs), neighborhood support, and mental disorders in US children aged 6-17.
- To determine if neighborhood support moderates the relationship between ACEs and mental health outcomes.
- To examine age-related differences in these associations.
Main Methods:
- Utilized pooled data from the National Survey of Children's Health (2016-2019), including 94,369 children aged 6-17.
- Employed logistic regression models to analyze the associations between ACEs, neighborhood support, and diagnoses of internalizing and externalizing mental disorders.
- Controlled for neighborhood support to assess its moderating effect on the ACEs-mental disorder relationship.
Main Results:
- Increased types of ACEs and lower neighborhood support were significantly associated with higher odds of internalizing and externalizing mental disorders.
- The association between ACEs and mental disorders remained significant even after accounting for neighborhood support.
- Neighborhood support showed a stronger association with externalizing disorders than internalizing disorders, and its protective effect was more pronounced in older children (12-17 years).
Conclusions:
- Higher neighborhood support can mitigate the negative impact of ACEs on children's mental health, particularly externalizing disorders in adolescents.
- Neighborhood support is a significant protective factor against mental disorders in children exposed to ACEs.
- Interventions aimed at strengthening neighborhood support may be beneficial in preventing and managing mental health issues in children with a history of ACEs.
Abstract:
We pooled data from four years (2016-2019) of the National Survey of Children's Health (NSCH) and included a nationally representative sample of 6 to 17 years old US children (N = 94,369; Mean age = 11.53 years, Standard Deviation [SD] = 3.53). Among 6-17-year-old US children, about 48% had a lifelong exposure to at least one of nine Adverse Childhood Experiences (ACEs), and 18.7% had a current diagnosis of at least one of four mental disorders. We examined the association between ACEs, neighborhood support, and mental disorders using several logistic regression models. More types of lifelong ACEs and lower neighborhood support were associated with a higher diagnosis of internalizing (anxiety/depression) and externalizing (ADHD/behavior problems) mental disorders (odds ratio [OR] > 1, and p < .001 for all relationships). After controlling for neighborhood support in the models, the odds ratios for ACEs attenuated but remained significant in all models regardless of mental disorder type or age group. However, the odds ratios for neighborhood support were larger for the association with ADHD/behavior problems than anxiety/depression. Moreover, odds ratios for neighborhood support levels were higher for older children (12-17 years old) compared to younger (6-11 years old) children. Higher neighborhood support appears to mitigate the adverse effects of ACEs on mental disorders, especially externalizing mental disorders (anxiety/depression) among adolescents (12-17 years old).
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