Coping Strategies, ACEs, and Mental Health Among Adolescents with Child Welfare Involvement

Adolescents involved in the child welfare system face disproportionate mental health risks, yet our understanding of how coping strategies function within this population remains limited. This cross-sectional study examined how various coping strategies relate to mental health functioning among 245 adolescents with child welfare involvement and whether these relationships were moderated by adverse childhood experiences (ACEs). Using a modified version of the Children’s Coping Strategies Checklist and the Trauma Symptom Checklist for Children, hierarchical regression analyses revealed both direct associations and significant moderation effects. Direct effects showed that positive cognitive restructuring was associated with lower anxiety, depression, and posttraumatic stress symptoms, and problem-focused coping was related to fewer anger symptoms. Additionally, avoidance and distraction coping were associated with higher symptoms across multiple mental health concerns. However, simple slopes analyses revealed that ACEs altered these associations. Problem-focused coping showed negative associations with anger, dissociation, and sexual concerns at high ACE levels but not at mean or low ACE levels, and avoidance coping was positively associated with anxiety and depression at high and mean ACEs levels but not at low ACE level. Two strategies typically associated with fewer mental health problems showed a different pattern at high ACE levels (while showing no association at mean or low ACE levels): support-seeking was associated with increased anger symptoms and cognitive restructuring with increased sexual concerns. These findings highlight the context-dependent nature of coping and mental health associations and underscore the need for trauma-informed interventions that consider both adversity exposure and the development of coping skills tailored to adversity levels and available resources.