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Adverse life events that occur in childhood may decrease an individual’s ability to effectively cope with challenges throughout their lives. The proper management of stress is essential to avoid problems that can crop up in all areas of life. College students who employ stress management tactics are better able to achieve well-being and academic success. This study examined the potential moderating association between “from within” coping supports or internal risk factors and academic success, mental health, and resilience qualities. Using a sample of college students at a large public university in the southeastern United States, this study demonstrates that viewing stress in a negative way may increase a student’s chances of failing to cope well with difficulty. Similarly, results of the analysis demonstrate that high perceived stress increases college students’ mental health issues and may diminish their capacity to cope with the challenges of the college environment. University officials may use the results from this study to inform policy and practice to address students’ ability to cope with stress and succeed academically.

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Risky sexual behaviors (RSB) have the potential to negatively impact individuals by increasing the risk of mental health issues, sexually transmitted infections (STIs), and unwanted pregnancies. Adverse childhood experiences (ACEs) and mental health disorders, such as anxiety, PTSD, and depression, have been known to increase RSB. The purpose of this study was to see if these mental health disorders mediate the relationship between ACEs and RSB. Participants (n = 342, mean age = 32) were recruited through social media to complete an online questionnaire. While history of ACEs significantly predicted engagement in RSB as well as all three of the mental health measures, none of the three measures of mental health emerged as a significant mediator of the relationship between ACEs and engagement in RSB (depression: b = .0060, SE = .0568, 95% CI[-.1175, .1148]; anxiety: (b = -.0136, SE = .0565, 95% CI[-.1393, .0904]; PTSD: (b = .1131, SE = .0807, 95% CI[-.0313, .2867]. Ultimately, this research showed that the history of ACEs exerts a strong, direct effect on engaging in RSB, and that in this sample, mental health symptoms are not sufficient to explain this relationship. Therefore, other factors should be explored as possible mechanisms maintaining this relationship. Furthermore, future research efforts should extend this exploration to young participants that may be more likely to participate in RSB.

Parents’ adverse childhood experiences in relation to parent-child emotion socialization Objective: Parents have an integral role in a child’s development of important emotional and psychosocial processes through emotion socialization. The goal of this paper is to examine the presence of adverse childhood experiences during the parents’ childhood and adolescence alongside the parents’ responses to their child’s emotional expression. The impact of adverse childhood experiences on a parent’s ability to socialize their child’s emotions is a key factor in the continued objective of cultivating positive parent-child interaction and improving adolescent mental health. Methods: Participants were 165 adolescents and their parents. Adolescent participants had an age range of13 to 17 years, (M=14.56, SD= 1.34) and were 33% female. Participants completed several standard questionnaires as part of a larger online survey. Adolescents reported on how their parents typically respond to their negative emotions (Emotions as Child Questionnaire; O’Neal & Magai, 2005), and their parents reported on their exposure to adverse childhood events (ACE’s questionnaire). Results: Mediation analyses tested the study hypotheses regarding whether parent emotion dysregulation mediated the link between parent ACEs and parent emotion socialization responses (reward, punish). Covariates included parent and child gender, parent race, and parent education level. In the first model examining reward responses, there was an overall significant effect on parent reward and punishment responses. There was a significant indirect effect of parent ACEs on parent reward and parent punishment responses with parent emotion dysregulation as the mediator. Conclusion: Together, these findings suggest the value and necessity of healthy and stable emotion regulation, especially in parents. The present study shows a need for the recognition of the impact that a parent's ability to successfully regulate their own emotions has on their ability to effectively respond to their children’s emotions. Additionally, stable parent child emotion socialization outcomes improve the child’s ability to self- regulate emotions which ultimately makes an insurmountable impact on children’s mental health throughout the lifespan.

In 1998, a seminal study on adverse childhood experiences (ACEs) and subsequent health risks catapulted ACEs and the study questionnaire into the zeitgeist. However, its childhood sexual abuse (CSA) item is problematic as it requires the perpetrator have been 5-years or older than the victim. To assess whether some survivors’ CSA is not identified by the current item, whether their exclusion prevents access to services requiring a four-threshold ACE score, and how their health outcomes compared to other CSA groups and controls, an international sample of 974 women completed an online survey assessing their current health and CSA history using the original item and an experimental item without the 5-year modifier. Results indicated many CSA survivors are not identified by a 5-year modifier, exclusion has service implications for some, and on most variables, they had increased adverse health outcomes compared to controls. Means of assessing CSA must be thoughtfully revised.

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Grandfamilies, or families in which grandparents are raising their grandchildren, often form due to adverse childhood experiences (ACEs) experienced by the grandchildren. ACEs have been linked to multiple negative short- and long-term behavioral and emotional consequences for children. Yet, having an ACE history does not guarantee negative outcomes, as protective factors such as positive relationships with a safe and caring adult, healthy family functioning, and utilization of formal services can mitigate the negative effects of ACEs. Researchers have regularly called on families to seek timely intervention and services for ACEs; however, many grandparents raising grandchildren report negative interactions with service providers as well as service delivery. Limited research has explored the extent to which grandfamilies with ACEs may have experienced similar interactions while seeking and using formal services. Guided by Andersen's (1995) Behavioral Model of Health Service Use, this qualitative study sought to explore (1) the service needs of grandchildren with an ACE history who are being raised by their grandparents; (2) the service needs of grandparents raising grandchildren with an ACE history; (3) the process of seeking services when grandparents raising a grandchild with an ACE history look for services for their grandchild; and (4) best practices for delivering services to grandfamilies with an ACE history. The research questions were primarily addressed through via interviewing 10 grandparents from Central Appalachia who were raising a grandchild with an ACE history and by conducting two focus groups of 8 to 12 formal service providers with experience working with grandparents raising grandchildren with an ACE history. Interview data were analyzed using grounded theory and focus group data were analyzed through thematic analysis. Study findings indicated that grandchildren have emotional and developmental needs. Grandparents described needs related to the emotional impact of raising a grandchild with an ACE history, family and parent involvement, and parenting a grandchild with an ACE history. Study results also highlighted how grandparents can expect to encounter barriers throughout the service seeking and delivery process. Study results also highlighted the critical nature of having a strong relationship with a service provider and the importance of a service provider reducing barriers, being attentive to grandfamily needs, and involving the grandparent in the treatment process. Finally, results from the focus groups revealed best practices such as providing grandparents with education on ACEs, being aware of intergenerational ACE cycles, and engaging in assessment and intervention when working with this population. Implications for clinical practice as well as directions for future research are discussed. / Doctor of Philosophy / Historically, grandparents have long been called upon to assist with caring for their grandchildren. In the last forty years, grandparents have increasingly shifted to a new role—that of parent. Grandfamilies are commonly created due to adverse childhood experiences, or ACEs, which can include child abuse, child neglect, or household challenges such as parental substance abuse or parental incarceration. Experiencing ACEs does not guarantee negative outcomes in a child's life, but their presence and number can affect it, particularly when a child has experienced numerous ACEs. Professional services or treatment are one way to support these children. However, negative interactions with service providers or unfulfilled expectations with service delivery can dissuade grandparents from continuing services. This study sought to understand how grandparents raising a grandchild with an ACE history identify the grandchild's needs, come to the realization that their grandchild needs professional help, the process and experience of receiving that professional help, as well as what happened after the grandchild received professional services. After interviewing 10 grandparents raising a grandchild with an ACE history, study findings revealed how grandparents identify grandchild needs, and then manage those needs as well as grandchild behaviors. Study findings also illustrated a recursive relationship between grandparents managing grandchild needs and building a relationship of trust with the formal service provider once services have started. Building a relationship of trust with a formal service provider can then result in creating change or the grandparent deciding to end services. Finally, grandparent interview data revealed that throughout the entire process of service seeking, grandparents raising a grandchild with an ACE history commonly experience barriers hindering their access to services including personal, availability, and systemic barriers. Finally, the study sought to understand best practices for working with grandparents raising grandchildren with an ACE history, which include assessing for and creating interventions targeting ACEs, providing education on ACEs to grandparents, and being aware of intergenerational ACE cycles with these families. Strategies for clinical practice are also identified.

Sexual dysfunction can lead to a negative impact upon a person’s mental and relational health, including relational and overall distress, poor relationship and sexual satisfaction, and clinical mood disorders such as depression. Moving upstream to identify factors that may predict sexual dysfunction would therefore be beneficial for early intervention in at-risk populations. History of childhood trauma is one such factor that may influence sexual functioning later in life. While adverse childhood experiences (ACEs) have been less studied in association with sexual dysfunction, there is some evidence to indicate that they may be related. ACEs have been shown to increase the risk of physical and psychological conditions (such as physical inactivity, obesity, heart disease, substance use, depression, and anxiety) which can then impede sexual functioning; further, a study of sex therapy patients found that their ACE scores were significantly higher than those in community samples. Additionally, difficulties in emotion regulation (DERS) may also play an important role in this relationship, as they have been shown to mediate the relationship between ACEs and several subsequent health risks. The purpose of this study was to determine whether there was a significant relationship between ACEs and sexual problems, and further, if emotion regulation difficulties mediated this relationship. College students (N = 696) were recruited to complete an online survey of their health behaviors. The overall mediated model was significant, F(2, 692) = 5.78, p = .003, but explained only 1.6% of the variance in sexual functioning. Although ACEs significantly predicted both sexual functioning (b = 0.60, t(694) = 3.40, p < 0.001) and DERS (b = 2.08, t(694) = 4.83, p < 0.001), DERS did not significantly predict sexual functioning (b = -0.01, t(694) = -0.63, p = 0.52), and did not emerge as a significant mediator of the relationship between ACEs and sexual functioning (b = -.02, CI [-.08,.05]). Further, in contrast to hypotheses, participants with higher ACE scores actually reported higher sexual functioning relative to participants with lower ACE scores in this sample. Results highlight the complexities of the relationship between ACEs and current sexual functioning. While difficulties in emotion regulation are still likely to be clinically significant for individuals with trauma histories, they do not appear to be a major contributing factor to difficulties in sexual functioning.