Background: While the negative impacts of Adverse Childhood Experiences (ACEs) on mental health have already been established in previous research, the pathways through which these events affect psychological well-being are still unclear. This cross-sectional study analyzed the relationship between ACEs and psychological distress. It also examined the role of coping strategies, emotion regulation, and adult attachment in this association.
Method: The sample consisted of 207 women receiving psychotherapeutic support from Public Mental Health Services in Spain. Just under half (46.4%) being treated by clinical psychology services and just over half (53.1%) were also being treated by psychiatry services. Descriptive and association analysis were performed on the variables involved.
Results: 48.3% of participants reported four or more ACEs and the correlation with symptom severity was significant. Regression equations showed that four variables explained 56.2% of the variance: Fear of Rejection and Abandonment, Lack of Control, Rejection and Cognitive Restructuring.
Conclusions: ACEs are directly associated with the severity of psychological distress. The data suggest that appropriate, sensitive exploration of these experiences can be therapeutic. The relationships between type of adversity, attachment relationships, emotion regulation, and coping strategies reveal indirect pathways through which ACEs affect women's mental health.