Adverse childhood experiences, commonly abbreviated as ACEs, encompass abuse, neglect, and household dysfunction such as parental substance abuse, mental illness, domestic violence, separation, or incarceration. Previous research has established a robust dose-response relationship between these experiences and adult depression and anxiety: the more adversity a child endures, the greater the psychological burden later in life. In Germany, earlier surveys had found that around 43.7 percent of adults report at least one such experience, with affected individuals facing a seven- to eightfold higher risk of depression and anxiety disorders. Yet while constructs such as self-efficacy and mastery have been extensively studied as potential mediators of this relationship, locus of control—a concept first introduced by psychologist Julian Rotter in 1966—has received comparatively little attention.

Locus of control describes whether individuals attribute the outcomes of their lives to internal factors, such as their own decisions and efforts, or to external forces like chance, fate, or powerful others. An internal orientation is generally associated with proactive coping and greater persistence, whereas an external orientation tends to accompany passivity and heightened emotional distress. The research team, led by investigators at the University Medical Center of the Johannes Gutenberg-University Mainz together with colleagues from Rostock and Ulm, set out to determine whether locus of control merely correlates with distress or actively transmits the impact of childhood adversity into adulthood.

The study analyzed data from 2,463 participants aged 16 to 96 years, roughly half of them women, recruited in 2022 through a multistage random-route sampling procedure based on electoral districts. Within each randomly selected household, the target respondent was identified using the Kish selection grid, and nonresponding households were recontacted at least twice before exclusion. The result was a demographically representative sample with respect to sex, age, and educational attainment. Participants completed the Adverse Childhood Experiences Questionnaire, a ten-item measure covering abuse, neglect, and household dysfunction; the Patient Health Questionnaire-4, a brief screener for depression and anxiety; and the Internal-External Locus of Control Short Scale-4, a four-item instrument rated on a five-point Likert scale.

Rather than relying on raw questionnaire scores, the researchers employed structural equation modeling with robust diagonally weighted least squares estimation, an approach suited to the ordinal nature of the survey items. This allowed all three key constructs—ACE exposure, locus of control, and psychological distress—to be modeled as latent variables, reducing measurement error. Model fit was evaluated using conventional indices, with comparative fit index and Tucker-Lewis index values above .95 and root mean square error values well below the accepted thresholds, indicating that the statistical models represented the data well.

The results confirmed the expected chain of associations. Higher ACE exposure strongly predicted greater psychological distress, with a standardized effect size of β = .514. Exposure also predicted a more external locus of control, β = -.457, meaning that people with more adverse childhood experiences were significantly more likely to believe that their outcomes are governed by forces beyond their personal influence. In turn, a more external locus of control was strongly associated with higher distress, β = -.669. When participants reporting at least one ACE were compared with those reporting none, the difference in latent distress scores corresponded to a large effect size of nearly one standard deviation.

The mediation analysis delivered the study’s central finding. When locus of control was entered as a pathway between childhood adversity and adult distress, it accounted for approximately half of the total effect. The indirect effect through control beliefs was statistically significant and of moderate size, and the result held when adversity was treated as a binary exposure and when the models were adjusted for age, gender, and income group. This pattern aligns with learned helplessness theory, which holds that repeated uncontrollable stressors foster a generalized sense of helplessness, and with compensatory control theory, which proposes that people facing uncontrollable environments may outsource their sense of control to external entities—a strategy that can be adaptive in childhood but becomes maladaptive in adulthood.

Not every hypothesis survived the analysis. The researchers had also predicted that locus of control would moderate the relationship between adversity and distress, buffering the impact for internally oriented individuals and amplifying it for those with an external orientation. Although the interaction term reached statistical significance, its effect size was negligible, and the moderation models showed unacceptable fit to the data, making the parameter estimates questionable. The authors contrasted this with an earlier study of US undergraduates that had found moderation using a broader sense-of-control measure, and they speculated that a general sense of control may be more malleable through intervention, whereas the specific locus of control shaped by early adversity may be more stable and state-like.

The study has limitations that temper interpretation. Its cross-sectional design precludes causal inference, and longitudinal studies will be needed to establish the temporal sequence between adversity, control beliefs, and distress. The brief screening instruments limit precision, the traditional ACE framework omits stressors such as parental loss and peer victimization, and generalizability beyond the German context remains uncertain. Notably, the observed ACE prevalence in this sample was lower than in earlier German surveys using identical methodology, which the authors suggest may reflect changes in the population or in response behavior rather than methodological differences.

For clinicians and policymakers, the practical implications are nonetheless concrete. Interventions that strengthen internal control beliefs—through cognitive-behavioral or resilience-based approaches—may help mitigate distress in people with histories of childhood adversity. At the same time, the absence of a moderation effect indicates that shifting locus of control alone is unlikely to be sufficient. The authors argue for comprehensive, multi-component interventions that also address social support, emotional regulation, and coping strategies, positioning control beliefs as one important thread within a broader fabric of psychological and social determinants of mental health.

Subject of Research: The mediating role of locus of control in the relationship between adverse childhood experiences and adult psychological distress

Article Title: Adverse childhood experiences, psychological distress, and the role of locus of control

Article References: Behrens, I., Schmalbach, B., Brähler, E., Clemens, V., Petrowski, K., & Fegert, J. M. (2026). Adverse childhood experiences, psychological distress, and the role of locus of control. Frontiers in Epidemiology, 6, Article 1915843. https://doi.org/10.3389/fepid.2026.1915843

Image Credits: AI Generated

DOI: 10.3389/fepid.2026.1915843

Keywords: adverse childhood experiences, locus of control, psychological distress, depression, anxiety, childhood adversity, structural equation modeling, learned helplessness, compensatory control theory, mental health, German population survey, mediation analysis