Cumulative interpersonal childhood adversity and post-traumatic stress symptoms across heterosexual, cisgender and gender and sexually diverse adolescents: The mediating role of emotion regulation

Background: Emotion regulation has been identified as an explanatory factor in the association between interpersonal childhood adversity and post-traumatic stress symptoms (PTSS). However, most studies focused on adults or older adolescents, neglecting youth from the community, especially gender and sexually diverse (GSD) adolescents, who have a higher risk for exposure to adverse events and psychological difficulties, compared to their heterosexual, cisgender (HC) peers.

Objective: The present cross-sectional study aimed to examine the mediating role of emotion regulation difficulties in the association between cumulative interpersonal childhood adversity and PTSS across HC and GSD adolescents.

Methods: A sample of 2904 ninth grade students (M_age = 14.53, SD = 0.61) completed a self-report survey. Multigroup path analyses were conducted to examine the proposed mediation model in all groups, and comparisons were made using chi-square difference tests.

Results: Greater difficulties in emotion regulation mediated the association between greater cumulative interpersonal childhood adversity (β = 0.36, p < .001) and greater PTSS (β = 0.35, p < .001) - regardless of HC or GSD status - although the direct association between cumulative interpersonal childhood adversity and PTSS was significantly stronger among GSD boys (β = 0.36, p < .001) and GSD girls (β = 0.35, p < .001) than among HC boys (β = 0.21, p < .001) and HC girls (β = 0.25, p < .001).

Conclusions: Findings offer a modifiable target for prevention and/or intervention among middle adolescents, as emotion regulation difficulties may partially explain the presence of PTSS following cumulative interpersonal childhood adversity.