Mutiso Victoria, Ndetei David, Jeremiah Eric, Nyamai Pascalyne, Walusaka Samuel, Onyango Veronica, Musyimi Christine, Bhui Kamaldeep, Mamah Daniel
Africa Institute of Mental and Brain Health (formerly Africa Mental Health Research and Training Foundation), Nairobi, Kenya.
World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
Glob Ment Health (Camb). 2025 Jul 21;12:e88. doi: 10.1017/gmh.2025.10041. eCollection 2025.
Adverse childhood experiences (ACEs) are widely associated with mental health disorders, such as depression, post-traumatic stress disorder (PTSD), and suicidality. Resilience plays a role in mediation and moderation of these associations, yet there is limited data from Kenya on this. This cross-sectional study examined the role of resilience in the relationship between ACEs and mental health outcomes among 1,972 participants aged 14-25 years in the Nairobi Metropolitan area. Participants completed the Trauma and Distress Scale (ACEs), Patient Health Questionnaire-9 (depression), Columbia-Suicide Severity Rating Scale (suicidality), Harvard Trauma Questionnaire (PTSD), and Adult Resilience Measure-Revised (resilience). Analyses of moderation and mediation using Hayes Process Macro indicated that resilience moderated the association between ACEs with PTSD and depression, with minimal effect on suicidality. It also moderated specific associations, including emotional/physical neglect on ideation, physical abuse on lifetime behavior ( = 0.0479), and total ACEs on recent behavior ( = 0.0514). Resilience also partially mediated the effects of ACEs on PTSD and depression, and fully mediated suicidality for specific ACE domains (emotional neglect, physical neglect, and physical abuse on suicidal ideation and all ACEs on recent suicidal behaviors). Building resilience mitigates the effects of ACEs on depression, PTSD, and suicidality among Kenyan youth.
童年不良经历（ACEs）与心理健康障碍广泛相关，如抑郁症、创伤后应激障碍（PTSD）和自杀倾向。心理韧性在这些关联的中介和调节中发挥作用，但肯尼亚关于这方面的数据有限。这项横断面研究调查了心理韧性在内罗毕大都市区1972名14至25岁参与者的ACEs与心理健康结果之间关系中的作用。参与者完成了创伤与痛苦量表（ACEs）、患者健康问卷-9（抑郁症）、哥伦比亚自杀严重程度评定量表（自杀倾向）、哈佛创伤问卷（PTSD）和成人心理韧性测量修订版（心理韧性）。使用海斯过程宏进行的调节和中介分析表明，心理韧性调节了ACEs与PTSD和抑郁症之间的关联，对自杀倾向影响最小。它还调节了特定关联，包括情感/身体忽视与自杀意念、身体虐待与终身行为（=0.0479）以及总ACEs与近期行为（=0.0514）之间的关联。心理韧性还部分中介了ACEs对PTSD和抑郁症的影响，并完全中介了特定ACE领域（情感忽视、身体忽视以及身体虐待与自杀意念和所有ACEs与近期自杀行为）对自杀倾向的影响。培养心理韧性可减轻ACEs对肯尼亚青少年抑郁症、PTSD和自杀倾向的影响。
