Community-level Adverse Experiences and Emotional Regulation in Children and Adolescents

Holly Thurston, Janice F. Bell, Marta Induni

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Purpose: The association of adverse childhood experiences (ACEs) with negative health outcomes is well established, and the concept of allostatic load has been proposed as a possible causal mechanism. Most studies measure conventional (household) ACE exposures without accounting for non-conventional (community) ACE exposures, which may underrepresent the adversity experienced by racial/ethnic minorities. We address this gap by calculating the prevalence of both types of ACE exposures for racial/ethnic subgroups. We also examine associations of ACE exposures and emotional regulation in school aged children and youth. Design and Methods: This study used data (n = 65,680) for a nationally representative sample of children ages 6 to 17 years in the National Survey of Children's Health (2011−2012). Confirmatory factor analysis, descriptive statistics and regression models were used to examine the relationships between ACEs and emotional regulation. Results: Community level ACE events disproportionately affect ethnic minorities. Some but not all ACEs were significantly and inversely associated with the ability to emotionally regulate in children. Experiencing racism had the strongest negative effect of all ACE variables. The strength of the child-caregiver relationship was associated with increased odds of emotional regulation, independent of exposure to ACEs. Conclusions: The study supports the need to refine and expand ACE health screenings to fully capture the adversity faced by all children. Emotional regulation is identified as a possible intervention point. Practice Implications: Expansion of programs that strengthen the child-caregiver relationship and reduce ACEs in early childhood may be a key approach to increasing coping abilities in youth.

Original languageEnglish (US)
Pages (from-to)25-33
Number of pages9
JournalJournal of Pediatric Nursing
StatePublished - Sep 1 2018
Externally publishedYes


  • Adverse childhood experiences
  • Allostatic load
  • Children and adolescents
  • Emotional regulation
  • Household and community
  • National Survey of Child Health

ASJC Scopus subject areas

  • Pediatrics


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