How do Adverse Childhood Experiences Impact Health? Exploring the Mediating Role of Executive Functions

• Published in: Psychological trauma 2021-02, Vol.13 (2), p.206-213
• Main Authors: Trossman, Rebecca, Spence, Sherri-Lynn, Mielke, John G., McAuley, Tara
• Format: Article
• Language: English
• Subjects: Childhood Adversity; Cognitive Ability; College Students; Executive Function; Female; Health Risk Behavior; Human; Male; Mental Health; Psychopathology
• ISSN: 1942-9681; 1942-969X
• DOI: 10.1037/tra0000965

Objective: Adverse childhood experiences (ACEs) are stressful life events that occur during development. It is well-established that ACE exposure has negative downstream implications for a broad range of health-related behaviors, ultimately hastening mortality. Underlying mechanisms linking the experience of early life adversity with poor health remain less understood, however, and thus potential targets for intervention remain elusive. This work seeks to fill an important theoretical gap in the ACE literature by evaluating whether executive functions (EFs) constitute a biologically plausible mediating mechanism in this causal pathway. Methods: Two separate studies were conducted. In Study 1, undergraduate students completed measures of ACE exposure, EF, health-risk behaviors (e.g., drug and alcohol use, unsafe sexual practices), and psychopathology (e.g., anxiety, depression). Study 2 sought to replicate this work in a community sample. Results: Multivariate modeling determined that executive dysfunction in daily life mediated the relationship between childhood adversity exposure and mental health concerns but not the effect between ACEs and health-risk behaviors in an undergraduate sample. In a community sample, EF difficulties in daily life mediated the relationship between ACEs and both psychopathology symptoms and health-risk behavior, but not physical health status. Conclusions: These results partially support a neurodevelopmental model of ACE exposure vis-à-vis future health, focusing on the role of EF. Clinical Impact Statement Adverse childhood experiences (ACEs) have a deleterious influence on future health, yet little is known about underlying mechanisms linking ACE exposure to maladaptive health outcomes in later years. Here we present two studies demonstrating that the collection of self-regulatory skills commonly referred to as 'executive functions' (EF) mediate this association in undergraduate and community samples. Our work represents an initial step toward validating a neurobiological model of ACE exposure that will ultimately clarify the mechanisms behind the emergence of negative health factors following early life adversity and identify a potential target for intervention before consequences emerge.