The Moderating Effects of Adult Attachment and Emotional Intimacy on the Relationship Between ACEs and Mental Health in Social Work Students

Social work students report significantly more adverse childhood experiences (ACEs) than other majors or the general population. ACEs increase the risk of depression, anxiety, and stress (DAS) and can impact students’ ability to effectively serve future clients. Attachment theory and current research suggest a substantial potential therapeutic impact of secure adult attachments, particularly those with high emotional intimacy (EI), for those with ACEs. This study explored the moderating effect of primary adult attachment (PAA) on the relationship between ACEs and mental health. The Adverse Childhood Experiences (ACE-10) Scale, the State Adult Attachment Measure (SAAM), the Functional Analytic Psychotherapy Intimacy Scale (FAPIS), and the Depression, Anxiety and Stress Scale (DASS-21) were administered to a diverse group of 347 undergraduate and graduate social work students. Statistical analyses did not find support for a three-way interaction of secure PAA and EI on the relationship between ACEs and DAS. However, direct and conditional direct effects were noted. Anxious attachment and emotional intimacy (EI) each contributed substantially to the variance in DAS in various models, with anxious attachment having a positive association, and EI relating inversely, to DAS. An interaction between anxious attachment and ACEs was found in which the effect of ACES on DAS was strengthened as anxious attachment increased. Both anxious attachment and EI moderated the impact of ACEs on DAS at low and moderate levels of ACEs. Secure attachment and EI were associated with reduced DAS. Social work educators are encouraged to promote awareness of ACEs and their long-term effects through curriculum, experiential learning, self-reflection, and supporting students in identifying and strengthening PAAs and increasing EI, to enhance student well-being and equip them to serve future clients and the profession.