Adverse Childhood Experiences, Mental Health, and Resilience in 2SLGBTQIA + Persons: a Scoping Review

Abstract

Abstract

Adverse childhood experiences (ACEs) represent traumatic contexts negatively impacting mental health. Additional adversity is experienced by 2SLGBTQIA + persons, in the forms of discrimination and rejection. While minority stress theory predicts greater mental health challenges for 2SLGBTQIA + persons, resilience theory proposes pathways of adaptation. Little attention has been given to the impact of ACEs among 2SLGBTQIA + adults and the role of resilience. Given the emergent literature base, a scoping review, adhering to Arksey and O’Malley’s (2005) framework, documents the extent and nature of extant research in this complex area. Peer-reviewed, English-language publications investigating relationships between ACEs, resilience, and mental health among 2SLGTBQIA + persons were searched from five databases (EMBASE, Medline, Web of Science, PsycInfo, and CINAHL). Abstracts and full texts were reviewed by two authors independently. Data were charted and synthesized qualitatively. Searches yielded 16,183 records; of these, 11,915 abstracts and 76 full texts were reviewed, and 19 studies (eight qualitative, 11 quantitative) were included. Most studies did not explore all ACEs on the original, 10-item ACE questionnaire. ACEs, especially child sexual abuse, were elevated in 2SLGBTQIA + persons and linked with poorer mental health, exacerbated by intersecting oppressions (i.e., racialization). Studies assessing the effects of resilience on the ACE-mental health relationship found mediation or moderation meriting further empirical clarification. Though 2SLGBTQIA + identity is associated with greater ACEs and poorer mental health in adulthood, higher resilience buffers or explains the ACE-mental health relationship. Resilience interventions may counter minority stress experienced by 2SLGBTQIA + persons.