Examining Patterns of Family Resilience and Neighborhood Cohesion as Moderators of the Effects of Adverse Childhood Experiences on the Mental Health of Black Adolescents

Adverse childhood experiences (ACEs) confer risk to the mental health of Black youth, but few studies have examined how youth gender, family, and neighborhood factors jointly influence the psychological impact of adversity. This study investigates if family resilience and neighborhood cohesion jointly moderate the link between latent ACE profiles and mental health among Black girls and boys. This study uses data from the National Survey of Children's Health, combined across the years 2016 through 2021, and includes a nationally representative sample of 5,493 Black youth (48% female) between the ages of 12 and 17. Two patterns of ACEs were identified using latent class analysis characterized by no-to-minimal ACE exposure and moderate-to-high ACE exposure. Membership in the high-ACEs class increased the risk for internalizing problems among Black boys (<em>b</em> = 0.56, <em>p</em> &lt; .001) and girls (<em>b</em> = 0.42, p &lt; .01). Only boys in the high-ACEs class who also reported low levels of family resilience and low neighborhood cohesion evidenced an increased risk for externalizing concerns (<em>b</em> = 0.70, <em>p</em> &lt; .001). Conversely, only girls in the high-ACEs class who reported high levels of family resilience and low levels of neighborhood cohesion evidenced an increased risk for externalizing problems (<em>b</em> = 0.69, <em>p</em> &lt; .01). Findings suggest that the impact of ACEs on mental health is not uniform across Black boys and girls, and that family and neighborhood-level factors may collectively shape the impact of ACEs on the mental health among Black youth in unique ways.