Does historical loss impact the relation between ACEs and PTSD symptoms for American Indian and Alaska Native adults?

American Indian/Alaska Native (AI/AN) individuals experience disproportionate rates of adverse childhood experiences (ACEs; e.g., physical or emotional abuse and neglect) and posttraumatic stress disorder (PTSD). However, few studies have considered how historical loss may exacerbate the negative impact of ACEs in relation to PTSD symptoms, particularly among AI/AN adults. The current study examined how historical loss and historical loss-associated symptoms may strengthen the relation between ACEs and PTSD symptoms among AI/AN adults. Due to gender differences in ACEs exposure, we also examined possible gender differences in the frequency of ACEs, historical loss, historical loss associated symptoms, and PTSD symptoms in this sample (Total N = 266; 173 women, 83 men, 9 individuals who identified as Two-Spirit, non-binary, or transgender). Results from moderation analyses indicated that historical loss, historical loss associated symptoms, and ACEs were associated with greater PTSD symptoms. Individuals with high historical loss associated symptoms and ACEs had greater PTSD symptoms compared to those with high historical loss associated symptoms and low ACEs. Results from one-way ANOVAs suggested that Two-Spirit/transgender/non-binary AI/AN adults had the highest ACEs, historical loss associated symptoms, and PTSD symptoms. The current findings provide implications for PTSD interventions and public health initiatives to prevent ACEs and future sociopolitical harms to AI/AN Peoples.