Social Support Buffers the Impact of Adverse Childhood Experiences (ACEs) on the Cortisol Stress Response Among High Risk Fathers Engaged in a Stressful Parenting Task

Purpose: Social support buffers the impact of stress on multiple psychosocial domains (Schwarzer & Knoll, 2007). Specific to parenting, greater social support is associated with lower risk of child maltreatment and lower parenting stress (Lutz, et. al., 2013). For parents, the stress of Adverse Childhood Experiences (ACEs) on parenting may also be moderated by social support. However, little is understood about the potential biological pathways through which social support buffering occurs and little research examines the buffering role of social support for fathers specifically. The primary aim of this study was to examine the effects of ACEs and social support on the physiological stress response (cortisol levels) of expectant fathers during a stressful simulated parenting task.

Methods: Data were analyzed from a larger study of the influence of bio-psycho-social factors on early parenting processes in 102 expectant mothers and fathers. Exposure to ACEs was assessed via the Adverse Childhood Experiences Questionnaire (Felitti, et. al., 1998). Covariates included age, race, education, economic status and baseline cortisol level. Social support was assessed using the Multidimensional Scale of Perceived Social Support (Zimet & Farley, 1988). Salivary cortisol was collected before, during, and after a stressful simulated baby cry protocol (BCP). Multilevel random effects models tested associations between ACEs, social support and cortisol while controlling for sociodemographic covariates.

Results: The sample included 38 expectant fathers who provided 187 cortisol samples. The mean age was 27.55 years and the majority self-identified as African American (60.53%). Higher ACEs were associated with a higher initial cortisol level (B = 0.59, p<0.01), while higher social support was associated with lower initial cortisol levels (B = -0.01, p<0.05). An interaction between ACEs and social support (B = -0.04, p<0.05) suggests that the effect of ACEs on cortisol levels is moderated by social support. This was further explored with predictive margins, which showed that fathers in the high ACEs group who experienced low levels of social support had higher initial cortisol levels (p<0.01). This difference in cortisol decreased as social support increased until there was no difference between the high and low ACEs groups (p=0.76).

Implications: The apparent dosing effect of social support on the ACEs-cortisol relationship has important implications for parenting, as the buffering effect of social support may reduce the potential for transmission of transgenerational stress among fathers who experienced ACEs. ACEs are associated with heightened physiological stress responses (elevated cortisol) in fathers. This is especially concerning among fathers of infants and young children for whom the stress of parenting may also stimulate the physiological stress response, posing risks for emotion dysregulation and potential child maltreatment. These data increase our understanding of the risks associated with low social support at the biological level, for parents in high risk contexts (violence and poverty). Findings may inform the development of early parenting assessments and interventions to identify fathers at risk for high parenting stress due to high ACEs and low social support. Interventions might target enhancement of social support in order to regulate fathers’’ biological stress responses.