Beyond Behavior: Internalizing Symptoms As a Mediating Pathway between Adverse Childhood Experiences and Impulsivity In African American Male Youth

Background and Purpose:
African American male youth are often referred for services because adults observe impulsivity, agitation, classroom disruption, or conflict. Less visible are the anxiety, sadness, vigilance, and emotional overload that may underlie those behaviors. This distinction matters in social work because behavior-centered interpretations can narrow assessment and shift intervention toward control rather than understanding. This study examined whether internalizing symptoms help explain the association between adverse childhood experiences (ACEs) and impulsivity among African American male youth entering outpatient mental health care.

Methods:
Data came from de-identified intake records at a community mental health center on Chicago’s South Side. Descriptive analyses used the full intake file of 774 African American youth ages 4 to 18, more than 98% of whom were male. Internalizing symptoms were represented by a latent factor derived from anxiety and depression indicators using exploratory factor analysis. The structural equation model used 672 cases and tested a mediation pathway from ACE exposure to impulsivity through internalizing symptoms, adjusting for age, educational level, and referral pathway.

Results:
ACE exposure significantly predicted higher internalizing symptoms (B = 0.109, SE = 0.025, p < .001). Internalizing symptoms significantly predicted greater impulsivity (B = 0.369, SE = 0.035, p < .001). The indirect effect from ACE exposure to impulsivity through internalizing symptoms was significant (B = 0.040, SE = 0.010, p < .001). The direct effect of ACEs on impulsivity was attenuated and no longer statistically significant after inclusion of the mediator (B = 0.031, SE = 0.019, p = .090). The total effect remained significant (B = 0.072, SE = 0.020, p < .001), supporting a pattern consistent with partial mediation.

Conclusions and Implications:
Findings support a trauma-informed interpretation of impulsive behavior among African American male youth. Impulsivity may reflect not only dysregulation visible to adults but also internal distress linked to adversity. Social work assessment with Black male youth should not stop at behavior alone. Screening and treatment planning should attend to anxiety, depression, and related internalizing processes that may sit beneath outward dysregulation. These results have implications for culturally responsive, trauma-informed practice in community mental health settings.