Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of Adverse Childhood Experiences (ACEs)

Clin Psychol Psychother. 2022 Mar 10. doi: 10.1002/cpp.2732. Online ahead of print.ABSTRACTAdverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on wellbeing. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalisation of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilised formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and CTQ) and common mental health outcomes (depressive, anxiety, PTSD symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression, and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Authors: Source Type: research