From Childhood Adversity to Psychological Distress: The Mediating Role of Difficulties in Emotion Regulation and the Moderating Role of Acute Stress and Mentalising Skills

Despite substantial evidence indicating an association between adverse childhood experiences (ACEs) and psychological distress, the psychological mechanisms underlying this association remain unclear. This naturally occurring, cross-sectional study examines the mediating role of difficulties in emotion regulation and the moderating effects of exposure to acute stress due to regional armed conflict and mentalising skills on this mediation. A total of 195 young adults participated in two subgroups. One subgroup was recruited before the onset of the armed conflict, while the other subgroup was recruited shortly after the conflict began. The participants completed self-report questionnaires and a written task to assess mentalising skills. This preregistered study employed a moderated-mediation model. The findings indicated that difficulties in emotion regulation partially mediated the relationship between ACEs and psychological distress. However, this mediation was contingent upon exposure to acute stress and mentalising skills. The indirect effect was significant only for individuals who had experienced acute stress and demonstrated higher mentalising skills. Furthermore, acute stress and mentalisation skills moderated the association between ACEs and difficulties in emotion regulation. These findings underscore the importance of incorporating contextual factors and individual differences in mentalising when intervening with distressed youngsters who have experienced ACEs and acute stress.