Fig. 2.

Associations between recent COVID stress/disruption and parental mental health as a function of caregivers' history of adverse childhood experiences (ACEs) for distress (A), anxiety (B), substance use (C), and posttraumatic stress (D). Dotted lines are the 95% confidence bands around each association. Light-colored lines show associations between COVID stress/disruption and mental health for those with low levels of ACEs, while dark-colored lines show associations between COVID stress/disruption and mental health for those with high levels of ACEs. High versus low ACEs were categorized based on a median split for these plots (low = 0 or 1; high = 2+). In the main text, the interactions were conducted on the continuous ACEs and COVID stress/disruption variables. As detailed in Table 2, this figure shows a largely additive contribution of ACEs and COVID stress/disruption for female caregivers, and a multiplicative relation for male caregivers (shown by the interaction).