Sources of resilience and their moderating relationships with harms from adverse childhood experiences

The Welsh Adverse Childhood Experience and Resilience Survey was undertaken to examine individual and community factors that may offer protection from the harmful impacts of adverse childhood experiences (ACEs) on health, well-being and prosperity across the life course. Resilience is described as the ability to overcome serious hardships such as those presented by ACEs.

The survey measured access to various sources of resilience in both childhood (personal, relational and community resources; social and leisure activities; relationships with adults) and adulthood (current personal, relationship and community resources; social and leisure activities; expectations of support from services; perceived financial security; and community culture and traditions).

The survey also measured participants’ exposure to eleven ACEs during childhood (parental separation, domestic violence, physical abuse, verbal abuse, sexual abuse, physical neglect, emotional neglect, mental illness, alcohol abuse, drug abuse, incarceration) and a range of health and behavioural outcomes.

Conclusions:

1. ACEs are common and represent a significantly increased risk of mental ill health across the life course.
2. Childhood resilience moderates the increased risks to mental health from ACEs.
3. Public sector support for social and emotional skills development, activities that create connectedness to schools, sign-posting children to available help, opportunities for creating friendship networks, and occasions to engage in cultural traditions should be considered investments in children’s lifelong mental health.
4. There are strong relationships between sports participation in childhood and lower lifetime mental illness. There are also associations between regular adult participation in sports and current mental illness.
5. Access to sources of resilience in adulthood continues to be associated with lower levels of current mental illness.
6. Poor mental health may reduce opportunities for community engagement, while lower engagement may further impact on mental ill health.
7. Those who require the most help may be the hardest to reach. Individuals with higher ACE counts reported lower resilience resources both in childhood and as adults. 
8. While resilience factors may provide some protection, they do not entirely counter the risks associated with exposure to multiple ACEs.