Adverse Childhood experiences, conflict resolution strategies and relationship satisfaction among young adults in India

Introduction

Research on adverse childhood experiences examines a wide range of early life traumatic experiences and their impact. The World Health Organization (2016) defines adverse childhood experiences (ACEs) as “some of the most intensive and frequently occurring sources of stress that children may suffer early in life”.¹ ACEs encompass childhood maltreatment, serious household dysfunctions such as violence between parents, alcohol and substance abuse, mentall illness, suicidal ideations, or imprisoned family members, and peer, community and collective violence.

Deleterious effects of ACEs has been understood since a long time. ACEs often lead to physical, cognitive, emotional, and social problems that can last a lifetime, especially without support or targeted intervention. According to the ACE pyramid model, individuals who have experienced four or more ACEs are at a higher risk of developing chronic diseases like cardiovascular disease, diabetes, and cancer.² They may also engage in risky health behaviors and potentially face premature death.² There is growing evidence of the ways in which childhood adversity can lead to toxic stress.^3,4 Maltreated children may live in a state of hyperarousal, expecting threats from all directions.⁵ Experiencing ACEs can leave the HPA system more susceptible to stress, resulting in hyperactivity when faced with stressors, particularly in situations similar to past experiences. This can lead to the development of chronic stress and impede the development of positive emotions. ACEs have a significant impact on mental health.^6–10 Studies suggest that the higher the number of maltreatment conditions faced by an individual, the greater is the severity of psychological distress.² Many people with mental illnesses have faced childhood maltreatment with women reporting a greater incidence of trauma in their childhood. One Indian study showed that teenage young males who experienced adverse childhood experiences (ACEs) reported significantly higher substance misuse.¹¹ An increase in cumulative ACEs was significantly associated with a higher number of unresolved past traumas, greater difficulty in disclosing past traumas, and a higher incidence of adult traumatic events.¹² Thus, ACEs seem to have a significant impact on adult functioning.

It has been established internationally that adverse childhood experiences (ACEs) increase the burden of disease and social issues, making ACEs a public health concern. Over the past 20 years, adverse childhood experiences (ACEs) have been extensively studied in North America and Europe. However, research on ACEs in India has been limited. Even though there is evidence for specific type of ACEs in India, it is necessary to consider their combined influence. The majority of ACEs research in India have been centered around psychiatric patients and have revealed higher ACE prevalence rates in this population.^6–8,10

Research has shown that ACEs have an impact on adult interpersonal issues, particularly in the context of adult romantic relationships. ACEs are associated with relational relationship outcomes such as partner selection, decreased relationship support, increased relationship strain, lower overall relationship quality, and a higher risk of intimate partner violence.^13–18 Evidence suggests that the presence of ACEs is also linked with negative physical health outcomes in couples such as decline in long term health and accelerated aging of romantic partners.¹⁹ It has also been observed that individuals with childhood trauma are found to be more insecurely attached to their romantic partners due to their disturbed attachment systems.^12,20 For example, the exposure to certain ACEs such as childhood physical abuse is linked with attachment avoidance.²¹ Childhood exposure to family violence predicts relationship violence and it is mediated through attachment anxiety.¹⁷ ACE also impacts intimate partner violence partially through psychological characteristics such as depression, impulsivity, and anxiety.¹⁸

Identifying and understanding the mechanisms or processes that clarify the connection between ACEs and adult romantic relationship difficulties will enhance scientific knowledge and theory surrounding this subject. To gain a deeper understanding of this link, mediating processes can be used. The mediating effect of factors that influence interaction between the two partners can be evaluated. These interactional factors can be addressed through psychological interventions and will be essential in the development of effective prevention and treatment methods for relationship issues.

One important interactional factor between romantic partners is conflict and its resolution. According to Peterson, conflict is “an interpersonal approach that occurs whenever the actions of one person interferes with the actions of another”.^22,23 Conflict is normal in romantic relationships²³ and should be studied as part of relationships. The presence of conflicts is not always indicative of a troubled or distressed relationship. They can also lead to the expression, understanding, and fulfillment of people’s own and their partner’s needs.²⁴ The manner in which a couple cope with problems in their interactions predicts the quality of relationships.²⁵ In the Indian context, the male partner reports significantly higher usage of collaboration and avoidance conflict resolution strategies as compared to females, whereas females show significant usage of accommodation strategies.²⁶ Thus, if conflicts are not managed or resolved successfully, they can have detrimental effects on the couple’s relationship.

Children who have undergone emotional, physical or sexual abuse often experience disrespect, emotional insults, and physical violence, which can have a direct impact on how they interact with others throughout their lives.²⁷ This can be explained by the theoretical framework given by Briere. His self-trauma model demonstrates how trauma disrupts the development of a child, especially his/her attachment system. The attachment system is one of the main action systems which regulates threat responses and prevents them from interfering with daily action systems. When the attachment system is impaired, the main focus of individuals turns to issues such as security and safety.¹ Adults, who have undergone childhood trauma may display dysfunctional thoughts, feelings and develop unhealthy attachment styles with their romantic partners due to this disruption to their attachment system.¹

Individuals with anxious attachment seek intimacy but fear rejection, while avoidant individuals show emotional detachment and self-sufficiency. In romantic partners, these styles can lead to negative conflict resolution strategies, as they may engage in dysfunctional thoughts and behaviors. Secure attachment is linked to positive conflict resolution styles.¹ Anxiously attached individuals seem to fluctuate between withdrawal and active engagement through intrusive behaviors and criticisms; the former strategy being driven by their fear of rejection and the latter by trying to satisfy the needs for proximity, support, and love.¹ Couples with secure-secure and secure-insecure attachment styles had fewer negative styles of conflict resolution and more positive conflict resolution styles (such as problem-solving and collaboration) than couples with insecure-insecure attachment styles.²⁸ Partners with secure attachments recovered from conflict more effectively than the targets with insecure attachments. Furthermore, being with a romantic partner who knows how to handle disagreements is linked to higher levels of satisfaction in the relationship and positive relationship emotions.²⁹

Anxious attachment predisposes individuals to view partners with hostility/withdrawal, with higher possibilities of conflicts.³⁰ An avoidant attachment style is seen to coexist with avoidance and vague communication.³¹ Thus, while the latter might use delaying conflict resolution tactics, their partners might tend to criticize/use confrontation.³² Couples with secure-secure attachment combination reported most mutual usage of constructive communication during conflict across different partner combinations whereas the couples with insecure-insecure attachment combination reported most usage of demand-withdrawal and mutual avoidance and withholding communication pattern during conflict.³³

The couples’ experiences of relationship satisfaction can be a reliable indicator of their relational dynamics. Relationship satisfaction can be defined as “an interpersonal evaluation of positivity of feelings for one’s partner and attraction to the relationship”.³⁴ It is considered the final common pathway that leads to a relationship’s breakdown³⁵ and has been dominantly researched in the literature of relationships. Satisfied couples reported more agreement, empathy, support, met expectations and validation than unsatisfied couples. Conflict had a detrimental impact on marital satisfaction, whereas couples’ experiences and expressions of intimacy predicted higher levels of marital happiness.³⁶ When compared to satisfied couples, couples who are dissatisfied exhibit a variety of dysfunctional communication behaviors. These include higher levels of negative behaviors such as criticisms, complaints, and hostility, as well as defensive and disengaging behaviors.³⁷ Evidence suggests that the more severe the childhood maltreatment is, the lower will be the satisfaction in the romantic relationship and sex-life.³⁸ For example, the presence of emotional maltreatment in women or in their male partners was found to be significantly associated with lower relationship satisfaction in women and this relationship was found to be moderated by hostility levels when dealing with conflicts in the relationship.³⁹ The likelihood that a person may voice grievances to their romantic partner is influenced by both exposure to familial verbal aggression in childhood and cognitive aspects of personalization of conflicts. Individuals with exposure to familial verbal aggression report lowered complaint avoidance.⁴⁰

The partners may differ in their individual relationship satisfaction levels. While intrapersonal approach looks at subjective evaluation of the relationship like satisfaction/happiness, the interpersonal approach considers communication, conflict, adjustment and companionship as important. According to interdependence theory, there is interpersonal interdependence between partners, with one partner’s thoughts, feelings, behaviors, and relational outcomes influencing the other partner’s outcomes.⁴¹ For both genders, satisfaction in relationship is linked with intimacy in relationship and problem-solving behaviors whereas lower satisfaction in relationships is slightly linked with hostile behaviors.⁴² A dyad-based study showed that individuals whose partners participated had greater relationship satisfaction and personal well-being compared to those who invited their partner, but their partner did not participate, and those who were invited by their partner but did not participate themselves. Lower relationship satisfaction and personal well-being were reported by participants whose partners were invited but didn’t choose to participate. Strongest group differences were found in relationship factors such as relationship satisfaction and stability.⁴³

While adverse childhood experiences have been extensively studied in literature, prior research has primarily focused on the clinical population. The current study aims to investigate the long-term effects of “adverse childhood experiences (ACEs)” on the general population, whether they have a psychiatric diagnosis or not. Furthermore, it addresses the lack of dyadic studies on the relational outcomes of trauma, using dyadic data analysis to examine the relationship between ACEs, conflict resolution strategies, and relationship satisfaction among young couples.

Methods

The study design was cross-sectional and sampling technique used was convenience sampling. 203 individuals participated in the study. The inclusion criteria mentioned that they had to be currently in an exclusive relationship for the past 6 months, to participate. Those who were married/divorced were excluded. Those who had any physical or psychiatric conditions that would make them unamenable for participation were also excluded.

Results

The average age of the participants was 23 years (SD = 2.5). The number of males and females in the study were the same as the sample consisted of 91 couples (182 individuals). Majority of the participants had completed under-graduation (63.74%) and post-graduation (31.32%) and are currently student (51.10%) or employed in an organization (39.01%). Very few of the individuals were involved in live-in relationships (9.89%), had psychiatric illness (4.95%) and psychiatric illness in family (6.04%). The individuals in the resulting sample had been dating for a mean of 35.12 months (SD = 28.72 months, range 6-144 months). The average duration of the relationship was found to be 35 months (SD = 28.73).

The prevalence of ACE was found to be 71.43% (n = 40) in the sample. Individuals were exposed to single or multiple categories of ACE (cumulative ACE exposure range = 0-8). 49.45% (n = 90) had experienced at least 2 types of ACE. Majority of individuals had undergone sexual abuse (41.21%), emotional neglect (28.57%), household member treated violently (23.08%) or emotional abuse (20.33%) as the nature of ACE.

In the sample of young adults, out of all conflict resolution strategies, compromise was found to be the highest (average score: 3.15, SD = 0.61). The average score of relationship satisfaction by young adults was 66.36 units (SD = 12.38). 11.54% of young adults with no adverse childhood experiences were dissatisfied, whereas 10% of young adults who experienced exactly one type of adverse childhood experience were dissatisfied and 16.67% of young adults who experienced at least two types of adverse childhood experiences were dissatisfied in their current relationship. Categories of adverse childhood experiences, conflict resolution strategies and relationship satisfaction (W = 0.899, p < 0.001) were not found to be normally distributed.

With regard to conflict resolution strategies used across different ACE groups, through Kruskal Wallis’ rank sum test and Dunn’s post hoc analysis, it was found that those with 2 or more ACEs had significantly lower scores on avoidance as a conflict resolution strategy that those who didn’t experience any ACE ( Table 1). More so, this strategy was used less, especially when the nature of ACE was any of the following: emotional abuse (z = -3.47, p < 0.01), contact sexual abuse (z = -2.45, p = 0.01), emotional neglect (z = -2.02, p = 0.04), alcohol and/or drug abuse in the household (z = -2.41, p = 0.02), a family member with depression, mental illness, institutionalization, or suicidal tendencies (z = -2.75, p = 0.01), household violence (z = -2.56, p = 0.01), or community violence (z = -2.05, p = 0.04), as observed through Mann-Whitney U-test. It was also found that young adults who experienced contact sexual abuse (z = -2.36, p = 0.02) and emotional neglect (z = -3.09, p < 0.01) also reported statistically significant lower usage of submission as conflict resolution strategy, whereas those who had a family history of illnesses (chronically depressed, mentally ill, institutionalized, or suicidal) reported significantly higher usage of separation as conflict resolution strategy in their romantic relationship as compared to those who didn’t experience this (ACE, z = -2.18, p = 0.03).

It was also noted that young adults whose partner experienced parental loss, separation or divorce in their childhood, reported significantly higher usage of compromise in their romantic relationship as compared to people whose partner didn’t experience that ACE (z = -2.59, p = 0.01). Kruskal-Wallis test showed that there was no difference in relationship satisfaction in individuals based on the number of ACEs² (H = 1.57, p = 0.046). However, as observed through the results of Mann-Whitney U test, those who experienced contact sexual abuse and emotional neglect in childhood had significantly lower relationship satisfaction as compared to those who didn’t experience these ACEs (z = -1.95, p = 0.05 and z = -2.49, p = 0.01). When Mann-Whitney U Test was conducted on actor’s relationship satisfaction for the presence of different categories of ACE in partners, it was found that young adults (actors) whose partner experienced parental loss, separation or divorce in their childhood, reported significantly higher relationship satisfaction in their romantic relationship as compared to people whose partner didn’t experience that ACE (z = -2.29, p = 0.02).

We treated the dyads as indistinguishable based on the distinguishability tests reported in Supplementary Information. An APIM mediational model was run using multi-level modelling to assess the mediating effects of conflict resolution strategies on the relationship of childhood adversity and relationship satisfaction. Specific combinations of conflict resolution strategies and ACE types were investigated based on the previous significant findings. First mediational analysis was also conducted to assess the mediating role of submission on the relationship between presence of emotional neglect and relationship satisfaction. Second mediational analysis was also conducted to assess the mediating role of submission on the relationship between presence of contact sexual abuse and relationship satisfaction. And finally, third mediational analysis was also conducted to assess the mediating role of compromise on the relationship between presence of ‘parental loss, separation or divorce’ in partner and actor’s relationship satisfaction.

The total effects (both actor and partner) of emotional neglect on actor’s relationship satisfaction as the dyads are treated as indistinguishable ( Table 2). The regression of actor’s relationship satisfaction on actor’s and partner’s emotional neglect, ignoring the mediator (submission) showed that the total actor effect of emotional neglect was statistically significant (β = -4.45, t (179) = -2.18, p = 0.03), whereas the total partner effect was not statistically significant (β = -2.48, t (179) = -1.22, p = 0.23). With the inclusion of actor and partner’s usage of submission (mediating variables), the actor effect of emotional neglect on relationship satisfaction became insignificant (β = -3.42, t (177) = -1.64, p = 0.10). Thus, this disappearance of significance on controlling for the mediator shows complete mediation between emotional neglect and relationship satisfaction. This indirect effect was tested for significance using the Monte-Carlo method. The actor-actor indirect effect of emotional neglect on relationship satisfaction mediated by submission was found significant, β = -1.19, p = 0.02, 95% CI [-2.63, -0.13]. The actor-actor path signifies the path from actor’s emotional neglect to actor’s submission to actor’s relationship satisfaction.

The total effects (both actor and partner) of contact sexual abuse on the actor’s relationship satisfaction as the dyads are treated as indistinguishable ( Table 3). The regression of actor’s relationship satisfaction on actor’s and partner’s contact sexual abuse, ignoring the mediator (submission) showed that the total actor effect of contact sexual abuse was statistically significant (β = -3.70, t (179) = -1.97, p = 0.05), whereas the total partner effect was not statistically significant (β = -1.26, t (179) = -0.67, p = 0.50). With the inclusion of actor and partner’s usage of submission (mediating variables), the actor effect of contact sexual abuse on relationship satisfaction was again found to be significant with a larger effect size (β = -4.56, t (177) = -2.45, p = 0.02). This showed that submission does not play a mediating role in the actor effect of contact sexual abuse on relationship satisfaction.

The total effects (both actor and partner) of experiencing parental loss, separation, or divorce in childhood on actor’s relationship satisfaction as the dyads were treated as indistinguishable. The regression of actor’s relationship satisfaction on actor’s and partner’s Parental loss, separation or divorce, ignoring the mediator (compromise) was conducted, the total actor effect of loss of Parental loss, separation or divorce was statistically insignificant, β = 2.97, t (179) = 1.12, p = 0.26, whereas the total partner effect was statistically significant, β = 5.21, t (179) = 1.97, p = 0.05. With the inclusion of actor and partner’s usage of compromise (mediating variables), the actor effect of experiencing Parental loss, separation or divorce on relationship satisfaction became insignificant, β = 2.32, t (177) = 0.98, p = 0.33. Thus, this disappearance of significance on controlling for the mediator showed complete mediation between experiencing Parental loss, separation or divorce and relationship satisfaction. This indirect effect was tested for significance using the Monte-Carlo method. The partner-actor indirect effect of experiencing parental loss, separation or divorce on relationship satisfaction mediated by compromise was found significant, β = -0.05, p = 0.01, 95% CI [0.86, 5.87]. The partner-actor path signified the path from actor’s parental loss, separation, or divorce to actor’s compromise to actor’s relationship satisfaction.

Discussion

The current study aimed to investigate the long term effects of ACEs on the relationship satisfaction and conflict resolution strategies used by young adults in the Indian context. A total of 91 couples (182 participants) participated in the study. The participants had a mean age of 23 years, of equal gender distribution, and were residents of Mangalore city in India. The majority had completed undergraduate postgraduate studies and were either students or employed. A few had a personal or family history of psychiatric illness, and a small percentage were in live-in relationships. It is worth noting that prevalence rates in the current study are higher than a few other Indian studies.^47,8 Out of all categories of ACEs, the highest prevalence was observed in sexual abuse, then emotional neglect, violence against household members, and emotional abuse in one such study.

Conflicts are valuable learning experiences between partners and are important for the maintenance of a healthy relationship.^22,37,48 Results of the current study suggested that individuals with two or more ACEs tend to use avoidance less frequently during conflicts in romantic relationships compared to those who experienced no ACEs. Moreover, those who experienced emotional abuse, contact sexual abuse, emotional neglect, alcohol/drug abuse in the household, chronic mental illness/suicide in the family, household violence, and community violence reported significantly lower usage of avoidance as a conflict resolution strategy compared to those who did not experience these ACEs. These findings have been observed in a prior study⁴⁹ and can be explained through the attachment framework.⁵⁰ Research has established a link between ACEs and the development of insecure attachment.^12,21,51 It is common for survivors of different ACEs to place a strong emphasis on safety in their adult relationships.⁵² It can be speculated that individuals who strive to feel safer in their romantic relationships use avoidance less frequently and instead actively attempt to resolve conflicts with their partners.

When individuals do not avoid conflicts, they communicate more openly with their partners and engage in problem-solving. Previous research has shown that individuals who avoid conflicts less, feel more intimate and secure in their relationships and therefore are more satisfied in their relationships.⁵⁰ According to Table 3, lower usage of avoidance during conflicts is significantly associated with higher usage of compromise and lower usage of submission. Therefore, individuals are more likely to address their needs, likes/dislikes, and opinions to their partners.⁴⁵ Table 3 shows that if one partner uses avoidance less during conflicts, the other partner is also likely to use avoidance less.

It was also found that those who had a childhood experience of having a family member with mental illness or suicidality reported significantly higher usage of separation during conflicts with their romantic partner. It can be speculated that these individuals tend to act more responsibly when it comes to dealing with stressful situations.⁴⁹ Thus, they may take time out to think more clearly about the problems and respond better.

The current study found that individuals with emotional neglect exhibit higher levels of submission compared to those without such history. This finding can also be explained by attachment theory, which suggests that emotional neglect is associated with insecure attachment,⁵³ specifically the anxious-ambivalent attachment style.⁵⁴ Individuals with anxious-ambivalent attachment style tend to have a negative self-image and prioritize the needs of others over their own to please them. Thus, they may engage in more submissive or obliging behavior during conflicts with partners,^55–57 which explains the higher usage of submission observed in individuals with a history of emotional neglect.

Literature suggests that an individual’s view of themselves and others (attachment patterns) can influence their use of conflict resolution strategies.⁵⁷ Based on this, it is speculated that survivors of CSA who report lower usage of avoidance and submission conflict resolution strategies may have a positive self-view. Additionally, a positive view towards others may lead to higher usage of constructive strategies, such as compromise, while a negative view towards others may lead to higher usage of destructive strategies, such as domination or interactional reactivity.

The results of this study showed no differences in relationship satisfaction between young adults with or without a history of ACEs. Contrary to the findings of the current study, previous studies suggested that ACEs are negatively linked with relationship satisfaction.^39,58,59 ACEs can indirectly lead to lower relationship satisfaction through mediating variables such as emotional regulation, partner selection, hostile behaviors, intimate partner violence, conflict resolution, partner’s acceptance of disclosure of ACE, and other psychosocial factors.^{13,17,18,38–40,58,60} Previous studies have mostly focused on specific categories of adverse childhood experiences (ACEs), whereas this finding resulted from the variety of ACEs present in the ACE groups. This difference in focus may be the reason for discrepancies in the results between the literature and this study. To investigate this further, this study looked into the differences of relationship satisfaction, depending on whether or not they experienced certain types of ACEs.

This study found that emotional neglect and sexual abuse are associated with lower relationship satisfaction. No significant effect of other categories of ACEs on relationship satisfaction was found. The participants of the current study reported lower prevalence rates in these other ACEs categories, which may have contributed to these insignificant results. Previous studies have also found detrimental effect of emotional neglect on relationship satisfaction.^61–65 Individuals who experience emotional neglect are likely to develop insecure attachment,⁵³ and a negative internal working model, which may result in formation of a negative view towards self.⁵⁴ Past studies have shown that emotional neglect has also been significantly associated with various psychosocial and interpersonal factors such as anxious arousal and anhedonic depression,^54,66 social isolation, loneliness and codependency on romantic partner, and conflict related patterns.^49,53,62,63 All these factors could contribute to lower relationship satisfaction in individuals with a childhood history of emotional neglect.

As mentioned before, current study found that emotional neglect has been found to be linked with both submission as a conflict resolution strategy and relationship satisfaction. Previous studies have reported that an increase in the use of submission during conflicts with romantic partners is linked with lower relationship satisfaction. This finding is consistent with the research.^37,67,68 To examine the role of conflict resolution strategies between childhood emotional neglect and relationship satisfaction, mediational analysis was conducted. The analysis revealed that the use of submission during conflicts between romantic partners completely mediated the relationship. In other words, it showed that individuals who have undergone emotional neglect have a higher possibility of using submission as their conflict resolution strategy and further, in a lower relationship satisfaction.

Individuals who experienced childhood sexual abuse were also found to have lower relationship satisfaction in their romantic relationship with their current partners. This finding has been consistent with previous research^69,70 and can be due to development of insecure attachment,⁵¹ difficulties in emotional regulation, relational difficulties,^71,72 experiences of hyposexuality or hypersexuality⁷³ and other long-term effects of CSA on the survivors such as a sense of betrayal, powerlessness, stigmatization, and responsibility for the abuse.^74,75 It harms a survivor’s ability to trust and feel at ease around others. Moreover, female survivors of CSA often experience hypervigilance around males in general, which might be contributing to difficulty in maintaining a healthy intimate partner relationship.⁷⁶

The mediating effect of submission on the relationship between child sexual abuse and relationship satisfaction was investigated. The findings suggest that submission does not mediate the relationship between sexual abuse and relationship satisfaction. It is possible that other psychological or psychosocial factors, such as attachment, personality traits, and sexual shame, partner’s response to disclosure of child sexual abuse, may be contributing significantly more towards poor relationship satisfaction.

While investigating mediational partner effects, it was found that a significant relationship between an individual’s experience of parental loss, separation, or divorce and their partner’s higher usage of compromise during conflicts. This, in turn, led to significantly higher relationship satisfaction in the partner. Therefore, the parental loss, separation, or divorce experienced by an individual indirectly impacts the relationship satisfaction in their partner and this relationship is mediated by higher use of compromise in their partners.

Although no significant effect was found for conflict resolution strategies related to this ACE in the actors themselves, it’s possible that people who have experienced this ACE might behave in ways that make their partners more willing to compromise. Previous studies suggest that these individuals may have a desire to be loved and may be more prone to feelings of hurt, low self-confidence, and a tendency to view others as cooperative and agreeable.⁴⁹ They may also feel a sense of responsibility to maintain the relationship. All of these factors could contribute to an individual’s increased use of compromise to keep the relationship stable and thriving.

The current study also found that when one partner uses compromise more frequently, the other partner is more likely to do so as well. Individuals who have experienced parental loss, separation, or divorce may also use more domination in their adult relationships to gain control, which they may have lacked in significant relationships during their childhood. Perhaps, these individuals use both compromise and domination equally during conflicts with their romantic partner, which can cancel out any constructive or destructive effects on the relationship. This may be why there was no significant actor effect of this ACE on the individual’s own relationship satisfaction. The partner’s higher usage of compromise during conflicts further led to significantly higher relationship satisfaction in the partner. It is well-established in literature that use of compromise or a constructive conflict resolution strategy is linked with higher relationship satisfaction.^37,45

Overall, this study investigates the long-term effects of adverse childhood experiences (ACEs) on the general population, using dyadic data analysis to examine the relationship between ACEs, conflict resolution strategies, and relationship satisfaction among young couples. Sexual abuse and emotional neglect in childhood were found to have a significant impact on relationship satisfaction. Individuals who experienced sexual abuse in childhood were found to use submission during conflicts with their partners less frequently. Individuals who experienced emotional neglect in childhood were found to use submission during conflicts with their partners more frequently, which further led to them experiencing dissatisfaction in their relationship. The study also found that parental loss, separation, or divorce experienced by an individual indirectly impacts the relationship satisfaction in their partner and this relationship is mediated by higher use of compromise in their partners.

The strength of the current study includes the dyadic perspective of ACE and its relational outcomes. It is one of the few studies in the field of childhood adversity to use a dyadic model assessing relational functioning in both members of the couple, and the use of APIM model and mediational analysis provides not just the outcomes of ACE, but the possible pathways through which it affects relationship satisfaction.

There are a few limitations to the current study. Firstly, it used retrospective self-reports measures. Second, when couples recruited themselves for the study, there was a potential for self-selection bias in studies as it is shown in literature that majorly higher functioning couples participating choose to participate in couple-based studies. Thirdly, the tool used in the current study to measure conflict strategies did not allow us to examine a dominating conflict resolution strategy. This made it difficult to assess whether the participant mainly uses constructive or destructive strategies. Lastly, the participant’s multiple ACEs may have had an impact on the results, which can be mitigated by controlling other types of trauma.

The current study has identified a clear relationship between Adverse Childhood Experiences (ACEs), conflict resolution techniques, and relationship satisfaction among young adults. These findings have significant implications for understanding the potential long-term effects of ACEs on relationship dynamics. The study also highlights the influence of specific types of ACEs on conflict resolution behaviors in individuals and their partners. Couple and family therapists may focus on eliminating destructive conflict resolution skills and fostering constructive ones, while also considering the individual’s history of childhood trauma, to enhance the quality of intimate relationships. Future studies should consider adopting a dyadic perspective in the study of childhood adversity and its impact on relational outcomes in light of current results. To improve the understanding of ACE and relationship dynamics, the study requires a wider variety of couples, which may include couples from different racial and ethnic backgrounds, different student or employment statuses, and different sexual orientations. Future studies can focus on whether having the same conflict resolution strategies among romantic partners helps improve their relationship more than just having integrative individual conflict resolution strategies.

Ethical considerations

The study was received the approval of the institutional review committee of Kasturba Medical College, Mangalore (lEC KMC MLR 04-2022/128), dated 21-4-’22. Written consent to participate in the study along with a right to withdraw at any point, was taken from all participants and confidentiality was ensured through the use of Informed Consent Form.

After the procedure, the researcher provided psychological debriefing to each participant as a way of addressing any potential distress associated with the participation in the study, as well as with appropriate referrals to mental health professionals in case of felt need.