The Moderating and Mediating Role of Resilience in the Relationship Between Adverse Childhood Experiences and Depression, PTSD, and Suicidality in Kenyan Youth

Adverse Childhood Experiences (ACEs) are widely associated with mental health disorders such as depression, Post-Traumatic Stress Disorder (PTSD), and suicidality, with resilience playing a role in mediation and moderation. In Kenya, there is limited research on the role of resilience in the relationship between ACEs and mental health outcomes. This study aims to fill that gap among the youth in Nairobi metropolitan. This was a cross-sectional study on 1,972 participants aged 14-25, using the following tools: the Trauma and Distress Scale (ACEs), PHQ-9 (depression), Columbia-Suicide Severity Rating Scale (suicidality), Harvard Trauma Questionnaire (PTSD), and Adult Resilience Measure-Revised (resilience). Moderation and mediation analyses were conducted using Hayes Process Macro to evaluate resilience effects on the ACEs-mental health relationships. The participants had a mean age of 20.49 years (SD=2.631), and 55% were female. Moderation analysis showed that resilience reduced the association of ACEs with PTSD and depression. It had minimal effect on suicidality but moderated specific associations, including emotional/physical neglect on ideation, physical abuse on lifetime behavior (p = 0.0479), and total ACEs on recent behavior (p = 0.0514). Mediation analysis showed that resilience 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 has the potential to minimize the negative effects of ACEs on depression, PTSD, and suicidality in some domains of ACEs in Kenyan youth.