Adverse childhood experiences and residential care environment: The mediating role of trauma-related symptoms and psychological maladjustment in adolescents

Background: Research has consistently found poorer outcomes in adolescents who have been exposed to early interpersonal adversities, especially those in out-of-home placements. The presence of mental health problems also contributes to the perception of a more negative group climate and peer interactions through cascading effects. Objective: To analyze the sequential relationships between exposure to adverse childhood experiences (ACEs), trauma-related symptoms, psychological maladjustment, and the perception of group climate and peer interactions. In addition, the study analyzes the mediating role of traumarelated symptoms and psychological maladjustment. Participants and setting: The sample comprised 161 adolescents in out-of-home care (46.6 % males, 49.7 % females, 3.7 % non-binary), aged 12-18 (M = 15.22, SD = 1.59) from 24 residential facilities in Spain. Methods: This study is part of the VRINEP project. Group care workers reported about ACEs and trauma-related symptoms through online questionnaires, whereas adolescents self-reported about psychological maladjustment, group climate, and peer interactions. Results: Differential associations between ACEs with trauma-related symptoms and internalizing problems were found. The relationship between certain ACEs and externalizing problems was fully mediated by trauma-related symptoms. Likewise, psychological maladjustment was related to a more negative perception of the group climate and peer interactions. Although traumarelated symptoms were not directly associated with the perception of the residential environment, they were indirectly associated with peer relational aggression through externalizing problems. Conclusions: Mental health has a significant impact on the perception of the group climate and peer interactions among adolescents in residential care who have been exposed to ACEs.