All ETDs from UAB

Advisory Committee Chair

Laura A Stoppelbein

Advisory Committee Members

Kristi C Guest

Edwin W Cook

Paula J Fite

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


The negative outcomes associated with adverse childhood experiences, especially child maltreatment ACEs (CM-ACEs), often emerge concomitantly with these experiences and have cascading negative effects across the lifespan. For example,childhood aggression, post-traumatic stress, and suicidal behaviors have all been identified as negative sequelae of CM-ACEs. They have been associated with each other, as well, and share several common underlying mechanisms. Thus, it might be that these outcomes collectively exacerbate the risk of experiencing negative effects of CM-ACEs, yet most existing research has examined these risk factors independently. Moreover, these outcomes often emerge early in development, yet most related research has been conducted in adult populations. In light of these gaps in current literature, the overarching goal of this line of research was to investigate a network of associations among CM-ACEs, two subtypes of aggression – proactive and reactive aggression, post-traumatic stress symptoms (PTSS), and suicidal behavior in a sample of high-risk male youth. To address this goal, three independent but related studies were completed. Findings from each study informed subsequent research questions and hypotheses, resulting in a series of studies that built upon each other to elucidate pathways from ACEs to various associated outcomes. Key findings revealed that PTSS, especially the intrusive symptoms cluster, mediated the relation between CM-ACEs and reactive aggression. The intrusive PTSS cluster mediated the relation between CM-ACEs and suicidal behaviors, as well. Findings also include emerging evidence for the role of the negative alterations in mood and cognitions PTSS cluster as a pathway from CM-ACEs to proactive aggression.Overall, these studies make significant contributions to existing literature and have numerous implications for clinical practice and future research. Broadly, findings highlight the importance of using trauma-sensitive and developmentally informed approaches to understanding, treating, and preventing outcomes associated with CM-ACEs in children and adolescents.