Adverse Childhood Experiences and Dissociation Among Adults in Rural Alabama: The Moderating Role of Perceived Racial Discrimination.

Purpose: Adverse childhood experiences (ACEs) have been linked to increased risk of dissociative experiences. Evidence suggests that Black Americans report higher levels of dissociative experiences than their White counterparts, yet the factors contributing to this disparity are not well understood. The purpose of this study was to examine the moderating effect of perceived racial discrimination on the relationship between ACEs and dissociative experiences among a sample of adults from predominantly Black communities in rural Alabama.

Materials and methods: Participants completed paper-and-pencil surveys across 5 rural sites in Alabama (N = 184). Adverse childhood experiences were measured by the 10-item ACE Study Questionnaire. Dissociative experiences were assessed by the 8-item Brief Dissociative Experiences Scale and perceived racial discrimination was measured by a 5-item subscale of the African American Historical Trauma Questionnaire. Multiple linear regression examined the moderating effect of perceived racial discrimination on the relationship between ACEs and dissociative experiences while controlling for depressive and anxious symptoms as well as sociodemographic factors.

Results: Ninety-two percent of participants were Black Americans. ACEs (b = .32, SE = .04, p < .001) and depressive and anxious symptoms (b = .26, SE = .04, p < .001) were significantly associated with dissociative experiences in the regression model. Perceived racial discrimination moderates the relationship between ACEs and dissociative experiences.

Discussion and conclusion: Findings underscore the need to screen for race-based traumatic stress as a component of equity-centered, trauma-informed mental health care.