Longitudinal Effects of Cumulative Adverse Childhood Experiences on Internalizing and Externalizing Problems in Adolescents in Out-of-Home Care: Emotion Dysregulation as a Mediator

Maltreated adolescents placed in the out-of-home care (OHC) system often experience multiple adversities, which are associated with many deleterious outcomes. The present study investigated the longitudinal effects of cumulative adverse childhood experiences (ACEs) on internalizing and externalizing problems among adolescents in OHC, as well as the extent to which emotion dysregulation can explain the links between exposure to multiple adversities and problematic behavioral outcomes over time. One hundred and sixty-two adolescents (Mage = 13.11 years, 90 females) who were placed in OHC in Singapore self-reported on their adversities experienced and symptoms of emotion dysregulation at baseline, as well as internalizing and externalizing problems in two consecutive waves. Path analyses indicated that cumulative ACEs were positively associated with both internalizing and externalizing problems at Wave 1, which in turn were positively related to internalizing and externalizing problems at Wave 2. Emotion dysregulation at Wave 1 partially explained the paths. These findings highlight the importance of addressing emotion dysregulation and the associated internalizing and externalizing problems in early interventions for adolescents in OHC to mitigate the risks of deteriorating mental health and promote positive outcomes.