Adverse Childhood Experiences Promote Increased and Selective Caregiving in Adulthood

TL;DR

People who experienced childhood adversity are more likely to become caregivers in adulthood, often prioritizing others' needs over their own.

Contribution

This study identifies a strong link between various types of adverse childhood experiences and increased caregiving behavior in adulthood.

Findings

All types of adverse childhood experiences are significantly associated with increased caregiving in adulthood.

Adults with more ACEs are more likely to care for spouses, children, or friends rather than parents or grandparents.

Living with a mentally ill or suicidal caregiver is the strongest predictor of adult caregiving behavior.

Abstract

Public health relevance—How does this work relate to a public health issue?
Adverse Childhood Experiences (ACEs) can prompt parentification, which often extends to a propensity toward providing caregiving as adults.All types of ACEs can significantly increase providing caregiving as adults.

Adverse Childhood Experiences (ACEs) can prompt parentification, which often extends to a propensity toward providing caregiving as adults.

All types of ACEs can significantly increase providing caregiving as adults.

Public health significance—Why is this work of significance to public health?
While ACE-induced parentification may foster some positive characteristics, like empathy, responsibility, life skills, coping skills, and autonomy, it may result in adults becoming compulsive caretakers in relationships, putting others’ needs first, and feeling their self-worth depends on “being needed.”Adult caregivers are more likely to provide regular care for a spouse, child, sibling, friend or non-relative versus a parent as ACEs increase.

While ACE-induced parentification may foster some positive characteristics, like empathy, responsibility, life skills, coping skills, and autonomy, it may result in adults becoming compulsive caretakers in relationships, putting others’ needs first, and feeling their self-worth depends on “being needed.”

Adult caregivers are more likely to provide regular care for a spouse, child, sibling, friend or non-relative versus a parent as ACEs increase.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
There are both positive and negative aspects of ACE-induced caregiving, which should be recognized and balanced.ACE-driven caregivers should receive counseling to help them better understand motives and ways they can protect their own health and wellbeing, and that of others.

There are both positive and negative aspects of ACE-induced caregiving, which should be recognized and balanced.

ACE-driven caregivers should receive counseling to help them better understand motives and ways they can protect their own health and wellbeing, and that of others.

Adverse childhood experiences (ACEs) prompt parentification, which is related to providing regular caregiving as adults. This study examines the association between the number and types of ACEs and caregiving as adults, and to whom caregiving is extended. Analyses were based on 90,666 adults from 13 states in the U.S. in 2020–2024 and involved binomial and multinomial logistic regression, adjusted for selected covariates. Approximately 21% of participants provided regular care and 66% had ≥1 ACEs. Each of 11 ACEs considered was positively associated with providing regular care. As the number of types of ACEs increased, the odds of providing regular care increased. The strongest ACE predictor of providing regular care was living with a parent or adult who was depressed, mentally ill, or suicidal, and the weakest was when the parents were divorced, separated, or an unmarried couple. Among those receiving regular care, if the caregiver had more ACEs versus less, they were significantly less likely to care for a parent or grandparent but more likely to care for a spouse, child, sibling, or friend or non-relative.

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