Exploring the Relationships among Adverse Childhood Experiences and Childhood Trauma Knowledge, Stigma, and Support and Help-Seeking Attitudes

Abstract Despite the prevalence of adverse childhood experiences and childhood trauma (ACEs/CT), the factors shaping whether community members provide or seek help for related health impacts in adulthood remain underexplored. To address this gap, we analyzed cross-sectional survey data from Sacramento County, CA residents with ACEs/CT (N = 1,085). Hierarchical logistic and linear regression models examined how ACEs/CT knowledge and awareness of stigma toward individuals with ACEs/CT were associated with attitudes toward providing help to others and seeking help for oneself. In Step 1, models included ACEs/CT knowledge and participant characteristics; in Step 2, awareness of stigma was added to assess incremental explanatory value. ACEs/CT knowledge significantly predicted feeling comfortable providing support to others and increased likelihood of seeking help from mental health professionals and friends. Awareness of stigma further improved model fit and was also significantly associated with these outcomes. While ACEs/CT knowledge did not significantly predict the likelihood of help-seeking from medical professionals, community organizations, or family, awareness of stigma was a positive predictor across these outcomes. Conversely, ACEs/CT knowledge was negatively associated with the likelihood of help-seeking from police and religious leaders, although awareness of stigma was positively associated with the likelihood of help-seeking from religious leaders. These findings highlight the importance of multiple forms of understanding in shaping attitudes towards providing and seeking ACEs/CT-related help, and may inform efforts to promote healing, recovery, and well-being among community members with ACEs/CT.