Caregiver Adverse Childhood Experiences, Resilience, and Mental Health in a Predominantly Hispanic Pediatric Clinic Setting

Adverse childhood experiences (ACEs) increase risk for negative health outcomes, including depression and posttraumatic stress disorder (PTSD), and have intergenerational effects. Hispanic families are at heightened risk for ACEs yet remain understudied. Pediatric primary care clinics are an ideal location to identify at-risk families. The current study examined caregiver ACEs, resilience, depression, and PTSD and whether resilience moderated associations between ACEs and psychiatric symptoms. Caregivers (N = 178; 93.3% female; 87.0% Hispanic) were recruited at infant well-child visits in a pediatric primary care clinic serving predominantly Hispanic families. Informed consent and measures were obtained prior to the medical visit in a private space within the clinic. ACEs, resilience, and depression and PTSD symptoms were measured using self-report. ACE levels (44.9% ≥4) were high. Caregivers that spent majority of their childhood in the U.S. reported significantly higher expanded ACEs (p = .001) and depression (p < .05) compared to caregivers that spent childhood elsewhere. Correlational analyses showed a significant negative association between expanded ACEs and resilience (p < .001), and positive associations with PTSD and depression symptoms (ps < 0.001). Resilience moderated the association between ACEs and depression symptoms (B=-0.29, p < .05); at high levels of resilience, the relation between ACEs and depression was not significant. ACEs and related psychiatric symptoms are high among Hispanic caregivers of infants; notably risk is increased among those living in the U.S. during childhood. Resilience may buffer effects of ACEs on parental depression, highlighting the value considering preventive interventions for Hispanic families.