Breaking the Cycle: Investigating Family Resilience as a Pathway to Better Adolescent Mental, Emotional, Developmental, and Behavioral Health Outcomes

Over 20% of children aged 3-17 in the U.S. have at least one diagnosed mental, emotional, developmental, or behavioral health (MEDBH) condition. Adverse Childhood Experiences (ACEs) are linked to poor MEDBH outcomes. While family resilience has been examined as a protective factor for specific mental health outcomes, few studies have investigated its role as a distinct mediator in adolescent MEDBH. This study investigated the relationship between ACEs, family resilience, and MEDBH outcomes in adolescents aged 12-17 years. This analysis utilized cross-sectional data from the 2022 National Survey of Children's Health (NSCH). Logistic regression models assessed the association between ACEs, family resilience, and MEDBH outcomes. A generalized structural equation model tested the mediating role of family resilience in this relationship. Among adolescents aged 12-17 years, 34.22% were reported to have experienced MEDBH condition. Adolescents with one or more ACEs had significantly higher odds of experiencing MEDBH issues (aOR = 2.59, 95% CI: 2.56-2.96), while family resilience was protective (aOR = 0.78, 95% CI: 0.66-0.92), after adjusting for sociodemographic characteristics. Mediation analysis confirmed that family resilience partially mediated the association between ACEs and MEDBH outcomes (β = 0.0100, <i>p</i> < 0.001). Specifically, ACEs were negatively associated with family resilience. Our findings emphasize the significant negative association of ACEs on adolescent MEDBH, both directly and indirectly. While family resilience may serve as a protective factor, it is weakened by ACEs. Enhancing family resilience may mitigate the adverse consequences of ACEs.