The Role of School Engagement in the Link Between Adverse Childhood Experiences and Adolescent Mental Health.

Purpose: Adverse childhood experiences (ACEs) increase the risk for poor adolescent mental health, yet mediational pathways that connect ACEs with mental health problems remain unaddressed. Our study investigates whether school involvement and disengagement mediate the longitudinal associations between ACEs and adolescent mental health problems.

Methods: Using data from the longitudinal Adolescent Brain Cognitive Development Study, this study included 7,558 adolescents aged 9-10 years at baseline. ACEs were a cumulative risk score of 21 adverse experiences (e.g., emotional abuse, community violence) reported by parents and youths at baseline or 1-year follow-up. School involvement and disengagement were reported by youths at two-year follow-up. Internalizing and externalizing problems were reported by parents using the Child Behavior Checklist at 3-year follow-up.

Results: A higher ACE score was associated with decreased school involvement (β = -0.08, 95% CI = [-0.10, -0.05]) and increased school disengagement (β = 0.09, 95% CI = [0.06, 0.11]) one year later, and with increased internalizing (β = 0.10, 95% CI = [0.07, 0.12]) and externalizing problems (β = 0.08, 95% CI = [0.06, 0.10]) 2 years later, adjusted for demographics and baseline mental health and school engagement levels. Decreased school involvement and increased disengagement mediated the associations between ACEs with the change in internalizing and externalizing problems over time.

Discussion: The present study highlights the roles of school involvement and disengagement in linking ACEs to worsened mental health outcomes. The findings may inform tailored school-based interventions that address mental health challenges faced by adolescents exposed to ACEs.