Childhood Adversity and Stress Among African American Social Work Students: Self-Care As a Mediator

Background and Purpose: Adverse childhood experiences (ACEs; e.g., child abuse, neglect, and family dysfunction) are associated with health risks, ranging from 50% to 67% for depression, suicide attempts, and substance use. ACEs are highly prevalent among social work students and professionals. High stress levels and unhealthful coping strategies predicted high levels of work stress among child welfare social service professionals. The presentation will share results of a study that examined self-care as a mediator in the relationships between ACEs and perceived stress in a sample of African American female social work students.

Method: Data were collected using a cross-sectional, online survey during fall 2019. Of 359 BSW and MSW students, 190 completed the survey (52.9% response rate). Final data included 135 cases: African American female BSW and MSW students whose ages ranged from 18 to 39. Approximately 54% were single or never married. Adverse experiences prior to age 18 were measured by 10 types (Feliti et al., 1998). The ACEs questionnaire addressed child abuse (physical, psychological, and sexual), child neglect (physical and emotional), and types of household dysfunction (domestic violence, substance abuse, parental divorce, mental illness, and incarceration). Each type of ACE was coded as a binary variable (occurred = 1, did not occur = 0). The prevalence of ACEs in the study ranged from 0 to 10. The mean score of ACEs was 3.33 (SD = 2.64). Self-care behavior was measured by the 19-item Self-Care Behavior Inventory (SCBI; Santana & Fouad, 2017), a Likert-type scale ranging from 1 = never to 5 = always. Current stress was measured by the 14-item Perceived Stress Scale (PSS; Cohen et al., 1983), a Likert-type scale ranging from 0 = not at all to 4 = nearly every day. Mediation analysis using Haynes’s PROCESS macro was conducted to determine whether self-care is a mediator between ACEs and perceived self-care. Using SPSS (v. 27), correlations were calculated to examine the association among the major variables and covariates.

Results: The mediation analysis revealed a significant indirect effect of self-care behaviors on perceived stress (b = 0.16, CI [.19, .35]). The direct effect of ACEs on perceived stress in the presence of the mediator was not significant (b = 0.36, p < .001). Hence, it was concluded that self-care fully mediated the relationship between ACEs and perceived stress.

Conclusions and Implications: The results suggest self-care as a possible mediator between ACEs and perceived stress among female African American social work students. Support efforts for students could be based on self-care strategies to manage stress and well-being.