Exploring Relationship Quality as a Dyadic Mediator of Adverse Childhood Experiences and Health for Economically Disadvantaged Couples

The purpose of this research study was to investigate the directional relationships between Adverse Childhood Experiences (ACE; Felitti et al., 1998), relationship quality (as measured by the Relationship Assessment Scale [Hendrick, 1988] and the Behavioral Self-Regulation for Effective Relationships Scale [Wilson, Charker, Lizzio, Halford, & Kimlin, 2005]), and health (as measured by the OQ 45.2 [Lambert et al., 2004] and a Brief Medical History Questionnaire [Daire, Wheeler, & Liekweg, 2014]) among economically disadvantaged couples. The theorized model included a dyadic structure and mediation of ACE and health by relationship quality using the Actor-Partner Interdependence Mediation Model (APIMeM). The researcher employed structural equation modeling analyses and the APIMeM to investigate the model fit with archival and enrollment data from 503 heterosexual couples in a relationship education program. The majority of participants (76.9%) also identified a racial or ethnic minority background. Final results indicated a good fit for the model to the sample data and explained a significant portion of variance in health (i.e., 82.3% for men [a large effect], 56.5% for women [a large effect]). Significant findings included: (a) ACE exerted an effect on health indirectly through relationship quality (i.e., 98.05% of the male total actor effect, 57.4% of the female total actor effect); (b) ACE exerted a direct effect on health for women; (c) overall ACE, relationship quality, and health were significantly related at the actor-level; and (d) a dyadic influence between male and female reports of ACE, relationship quality, and health contributed to the overall model fit. Discussion of results, implications for practice, recommendations for future research, and study limitations are provided