Adverse Childhood Experiences and Chronic Medical Conditions: Emotion Dysregulation as a Mediator of Adjustment

  • Hannah C. EspeletaEmail author
  • Christina M. Sharkey
  • Dana M. Bakula
  • Kaitlyn L. Gamwell
  • Camille Archer
  • Megan N. Perez
  • Caroline M. Roberts
  • John M. Chaney
  • Larry L. Mullins


Adverse childhood experiences (ACEs) are known to contribute to long-term harmful effects on mental health in young adults. Research has demonstrated that having a chronic medical condition (CMC) can also be conceptualized as being a potentially traumatic experience, and that young adults with a CMC are also at risk for negative adjustment. Emotion dysregulation, or difficulty identifying and regulating one’s emotions, is common among individuals with ACEs, and is a predictor of young adult adjustment. Given the mediational link between ACEs, emotion dysregulation, and young adult adjustment, it is likely that emotion dysregulation may demonstrate a similar linkage to adjustment in individuals with a CMC. The current study compared the effects of ACEs and having a CMC on depressive and anxious symptoms, while also examining emotion dysregulation as a possible mediator for both ACEs and CMC on adjustment outcomes, specifically depressive and anxious symptoms. College students (N = 1911) completed online questionnaires that assessed history of ACEs, emotion regulation difficulties, adjustment, and chronic illness status. Path analyses demonstrated a significant correlation between ACEs and depressive and anxious symptoms, as well as having a CMC and depressive and anxious symptoms. Furthermore, emotion dysregulation demonstrated a significant mediation between ACEs and negative adjustment, as well as between having a CMC and negative adjustment. This study highlights the importance of emotion dysregulation in understanding outcomes for individuals with a CMC and/or ACEs.


Adverse childhood experiences Chronic medical condition Adjustment Emotion dysregulation 



This project represents an unfunded study.

Compliance with Ethical Standards

Conflict of interest

Hannah C. Espeleta, Christina M. Sharkey, Dana M. Bakula, Kaitlyn L. Gamwell, Camille Archer, Megan N. Perez, Caroline M. Roberts, John M. Chaney, and Larry L. Mullins declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This project was approved by the institutions IRB, reference code AS1385.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Research Involving Animal Rights

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Hannah C. Espeleta
    • 1
    Email author
  • Christina M. Sharkey
    • 1
  • Dana M. Bakula
    • 1
  • Kaitlyn L. Gamwell
    • 1
  • Camille Archer
    • 2
  • Megan N. Perez
    • 1
  • Caroline M. Roberts
    • 1
  • John M. Chaney
    • 1
  • Larry L. Mullins
    • 1
  1. 1.Department of PsychologyOklahoma State UniversityStillwaterUSA
  2. 2.Department of PsychologyVanderbilt UniversityNashvilleUSA

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