Fathers' Adverse Childhood Experiences, Behavioral Health, and Fathering Stress and Satisfaction

Using a nationally representative sample, this study examined associations between fathers' adverse childhood experiences (ACEs) and fathering and whether fathers' behavioral health mediated this association.

Data from 4814 fathers who were followed from adolescence through early adulthood in the National Longitudinal Study of Adolescent to Adult Health. On average, fathers were 33 years old and self-identified as non-Hispanic White (64%), followed by non-Hispanic Black (17%) or Hispanic (12%). Fathers self-reported on 13 ACEs during waves 1 to 4 and 2 measures of behavioral health (depressive symptoms and alcohol consumption) and fathering (stress and satisfaction), assessed at wave 4 or 5. A multiple mediation model was estimated using a structural equation model to examine direct and indirect pathways between fathers' ACEs and fathering, through behavioral health.

There was a significant direct effect of ACEs on fathering satisfaction (B = -0.04, standard error (SE) = 0.02, P < .01), as well as a significant indirect effect through fathers' depressive symptoms (B = -0.04, SE = 0.01, P < .001), resulting in a total effect of -0.08 (SE = 0.02, P < .001). Fathers' ACEs were also linked to heavy drinking (B = 0.01, SE = 0.00, P < .05). ACEs were not associated with fathering stress.

Findings indicate the importance of reaching and engaging ACE-exposed fathers in behavioral health and parenting interventions. Given that health promotion in fathers has benefits for their children, leveraging pediatric encounters to identify at-risk fathers has the potential to improve both fathers' and children's health.