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Exploring the Relationship Between Modifiable Protective Factors and Mental Health Issues Among Children Experiencing Adverse Childhood Experiences Using a Resilience Framework
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The purpose of this study was to examine whether the National Scientific Council on the Developing Child (NSCDC) resilience framework statistically predicted whether a child with 4 or more adverse childhood experiences (ACEs) ever had a mental health issue. The study also explored which NSCDC modifiable resilience factors had the strongest relationship with mental health issues among children with 4 or more ACEs. Utilizing the 2019 National Survey of Children's Health, secondary data analysis was conducted using a sample of 1,225 children between 6 and 17 years old that had experienced 4 or more ACEs. Logistic regression examined whether the NSCDC framework was associated with a lower likelihood of mental health issues in school-aged children. Analysis found that the NSCDC framework predicted whether children with 4 or more ACEs ever had a mental health issue. Self-regulation had the strongest relationship with whether a child with 4 or more ACEs ever had a mental health issue. A supportive parent/caregiver relationship was also associated with a lower likelihood of ever having a mental health issue. The results demonstrate the promise of the NSCDC framework and modifiable protective factors to mitigate the impact of ACEs on mental health outcomes. Interventions that teach children skill-based self-regulation and parent/caregiver co-regulation while providing safe and supportive environments can build self-regulation to overcome ACEs. Promoting resilience-building parent-child relationships also have the potential to build resilience to mitigate ACEs.
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“Child-level factors including executive functioning and emotion regulation skills have also been linked to resilient outcomes following adversity, and these factors may also reflect indicators or components of resilience (Abate et al., 2024;Gee & Cohodes, 2023;Keane & Evans, 2022;Masten, 2014).”
From Resilience following severe early life neglect: A review of longitudinal evidence from the Bucharest Early Intervention Project (2026) · cites this paper as Keane & Evans, 2022
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“Schools can even utilize universal approaches such as trauma-informed schools that create safe environments for students who have experienced trauma by increasing school-wide trauma awareness while preventing re-traumatization (Thomas et al., 2019).”
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Cited by
Sorted by citations
Hong, S.-J., Vu, M. H., Vanderbilt, D., Yin, L., Imagawa, K. K., & Deavenport-Saman, A. (2025) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000001395 · Cited by 1
Holt-Gosselin, B., Adri, F., Humphreys, K. L., & Nelson, C. A. (2026) · Development and Psychopathology · doi:10.1017/s0954579426101837
“Child-level factors including executive functioning and emotion regulation skills have also been linked to resilient outcomes following adversity, and these factors may also reflect indicators or components of resilience (Abate et al., 2024; Gee & Cohodes, 2023; Keane & Evans, 2022; Masten, 2014).”
Metadata
- Authors
- Keane, K., & Evans, R. R.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Keane, Kevin
- Venue
- Journal of Child & Adolescent Trauma
- Published
- 2022-07-14
- Volume
- 15
- Issue
- 4
- Pages
- 987-998
- ISSN
- 1936-1521 (ISSN-L)
- 1936-153X
- PMC
- PMC9684361
- OpenAlex
- W4285388937
- Cited by
- 15
- References
- 7
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 2 · 2023: 1
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child & Adolescent Trauma (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Keywords
- adverse childhood experiences, child mental health, resilience framework, self-regulation, parent-child relationship, co-regulation, school-aged children, trauma-informed interventions
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- Keane, K., & Evans, R. R. (2022). Exploring the Relationship Between Modifiable Protective Factors and Mental Health Issues Among Children Experiencing Adverse Childhood Experiences Using a Resilience Framework. Journal of Child & Adolescent Trauma. https://doi.org/10.1007/s40653-022-00471-4
