Forgiveness Role Between Adverse Childhood Experience and Anxiety Among Persons Deprived of Liberty
-
Jay Conde Wong(1*)
De La Salle University - Dasmariñas
-
Jemerson Dominguez(2)
De La Salle University - Dasmariñas
https://orcid.org/0000-0003-3032-0876
(*) Corresponding Author
Keywords:
Adverse childhood experiences, Anxiety, Forgiveness, Incarceration, trauma-informed care
Abstract
Introduction Anxiety prevalence among PDL is 40%
to 100%, and unmanaged anxiety may lead to more severe
psychological and health concerns.
Aim This study examined the mediating role of forgiveness in
the relationship between adverse childhood experiences
(ACEs) and anxiety among PDL.
Methods A cross-sectional non-experimental design was
conducted among 376 PDL. Participants completed the ACE
Q, Heartland Forgiveness Scale, and GAD-7. Data were
analyzed using correlation, regression, and mediation
analyses.
Results ACEs were positively associated with anxiety (r = .43, p
< .001) and negatively associated with forgiveness (r = -.16, p
= .002), while forgiveness was negatively associated with
anxiety (r = -.37, p < .001). Forgiveness partially mediated the
relationship between ACEs and anxiety (β = 0.104, p = .004).
Conclusion Forgiveness partially mediates the relationship
between ACEs and anxiety; however, trauma-informed
interventions remain necessary to address underlying
childhood adversity and reduce anxiety among PDL.
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References
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Ramiro, L. S., Madrid, B. J., & Brown, D. W. (2010). Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting. Child Abuse & Neglect, 34(11), 842–855. https://doi.org/10.1016/j.chiabu.2010.02.012
Rosseel, Y. (2019). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1-36. https://www.jstatsoft.org/article/view/v048i02
Rungduin, D. C., Rungduin, T. T., & Acopio, J. R. B. (2021). The development of a Filipino seeking and granting forgiveness inventory (Fil-SAGFI). North American Journal of Psychology, 23(4), 653–668.
Santelices, M., Velasco-Hodgson, M., Ferreccio, C., Undurraga, C., & Carvajal-Araneda, K. (2025). The psychometric properties of the ACE-IQ questionnaire’s binary and frequency scoring methods in a Chilean community sample. Children, 12(3), 340. https://doi.org/10.3390/children12030340
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
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Tamayo, K.R., Rungduin, D., Rungduin, T. (2025). Letting Bygones be Bygones: The Stability of Forgivingness Tendency. https://doi.org/10.51200/sapj.v13i1.6037
The jamovi project (2022). jamovi. (Version 2.3) [Computer Software]. Retrieved from https://www.jamovi.org.
Thompson, L. Y., Snyder, C. R., Hoffman, L., Michael, S. T., Rasmussen, H. N., Billings, L. S., Heinze, L., Neufeld, J. E., Shorey, H. S., Roberts, J. C., & Roberts, D. E. (2005). Dispositional forgiveness of self, others, and situations. Journal of Personality, 73(2), 313–359. https://doi.org/10.1111/j.1467-6494.2005.00311.x
Toussaint, L. L., Worthington, E. L., & Williams, D. R. (2020). Forgiveness and health: Scientific evidence and theories relating forgiveness to better health. Springer.
World Health Organization. (2020). Adverse childhood experiences international questionnaire (ACE-IQ). https://www.who.int/publications/m/item/adverse-childhood-experiences-international-questionnaire-(ace-iq)
World Health Organization. (2023). Anxiety disorders. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
Worthington, E. (2013). Forgiveness and Reconciliation. https://doi.org/10.4324/9780203942734
Arafat, S. M. Y., Kar, S. K., Abhayanayake, C., Sharma, P., & Marthoenis, M. (2024). Prison mental health in South‐East Asia: A narrative review. Brain and Behavior, 14(8), e70004. https://doi.org/10.1002/brb3.70004
Carvalho, A., Lecat, B. & Sendas, S. (2016). Detention conditions’ impact on anxiety and depression levels of prisonersImpact des conditions de détentions sur les niveaux d’anxiété et de dépression des prisonniers. https://doi.org/10.1016/j.erap.2016.05.002
Cramer, V. & Kim, J. (2023). Religious Intellectual Humility, Empathy, and Forgiveness Among Christians: A Longitudinal Investigation. https://doi.org/10.1177/00916471261434167
Dominguez, J. (2025). Mediating role of social support between regrets and quality of life among Filipino Lasallian retirees. https://doi.org/10.24167/psidim.v24i1.13444
Dominguez, J. N. (2014). Letting go (pagpapalaya) among school helping professionals: A phenomenological study. Retrieved from https://www.researchgate.net/publication/305108697_Pagpapalaya_among_School_Helping_Professionals
Enright, R. D., & Fitzgibbons, R. P. (2015). Forgiveness therapy: An empirical guide for resolving anger and restoring hope (2nd ed.). American Psychological Association.
Ferrer, Y. J. C., & Moore, R. (2020). The prevalence of adverse childhood experiences in Payatas, an urban poor community in the Philippines. Philippine Social Science Journal, 3(3), 24–32. https://doi.org/10.52006/main.v3i3.130
Gao, F., Li, Y., & Bai, X. (2022). Forgiveness and subjective well-being: A meta-analysis review. Personality and Individual Differences, 186(Part B), Article 111350. https://doi.org/10.1016/j.paid.2021.111350
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4
Ibrahim, D., Ahmed, R. M., Mohammad, A. Z., Ibrahim, B., Mohammed, T., Mohamed, M. E., Abdelgadir, T., Shaaban, K. M. A. (2024). Prevalence and correlates of generalized anxiety disorder and perceived stress among Sudanese medical students. BMC Psychiatry, 24(1), 55. https://doi.org/10.1186/s12888-024-05510-y
Jin, Y., Xu, S., Shao, Z., Luo, X., Wilson, A., Li, J., & Wang, Y. (2024). The lasting effects of childhood trauma on developing psychiatric symptoms: A population-based, large-scale comparison study. Cambridge Prisms: Global Mental Health, 11, e100. https://doi.org/10.1017/gmh.2024.100
COVID-19 of social workers in Southern Leyte, Philippines. Asian Journal of Psychiatry, 62, 102733. https://doi.org/10.1016/j.ajp.2021.102733
Kanter, R.L. & Wortham, J.S. (2026). Forgiveness and Adverse Childhood Experiences: A Scoping Review. Trauma, Violence & Abuse. https://doi.org/10.1177/15248380251410088
Kemp, E., Strelan, P., Roberts, R. M., Burns, N. R., & Mulvey, K. L. (2021). The children’s forgiveness card set: Development of a brief pictorial card-sorting measure of children’s emotional forgiveness. Frontiers in Psychology, 12, 628152. https://doi.org/10.3389/fpsyg.2021.628152
Lajmi, N., Duan, S., Moll, J., & Zahn, R. (2025). “Longing is good”: Proof-of-concept for a novel psychological intervention to tackle self-blaming emotions. Frontiers in Psychology, 15, 1438896. https://doi.org/10.3389/fpsyg.2024.1438896
Martinez, A. B., Co, M., Lau, J., & Brown, J. S. L. (2020). Filipino help-seeking for mental health problems and associated barriers and facilitators: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 55(11), 1397–1413. https://doi.org/10.1007/s00127-020-01937-2
Merrick, M. T., Ports, K. A., Ford, D. C., Afifi, T. O., Gershoff, E. T., & Grogan-Kaylor, A. (2017). Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse & Neglect, 69, 10–19. https://doi.org/10.1016/j.chiabu.2017.03.016
National Institute of Mental Health. (2025). Anxiety disorders. U.S. Department of Health & Human Services. https://www.nimh.nih.gov/health/topics/anxiety-disorders
Philippine Health Research Registry. (2025). Prevalence of anxiety among post-graduate interns in Southern Philippines Medical Center during the COVID-19 pandemic using GAD-7. https://registry.healthresearch.ph
Ramiro, L. S., Madrid, B. J., & Brown, D. W. (2010). Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting. Child Abuse & Neglect, 34(11), 842–855. https://doi.org/10.1016/j.chiabu.2010.02.012
Rosseel, Y. (2019). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1-36. https://www.jstatsoft.org/article/view/v048i02
Rungduin, D. C., Rungduin, T. T., & Acopio, J. R. B. (2021). The development of a Filipino seeking and granting forgiveness inventory (Fil-SAGFI). North American Journal of Psychology, 23(4), 653–668.
Santelices, M., Velasco-Hodgson, M., Ferreccio, C., Undurraga, C., & Carvajal-Araneda, K. (2025). The psychometric properties of the ACE-IQ questionnaire’s binary and frequency scoring methods in a Chilean community sample. Children, 12(3), 340. https://doi.org/10.3390/children12030340
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). U.S. Department of Health & Human Services. https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf
Tamayo, K.R., Rungduin, D., Rungduin, T. (2025). Letting Bygones be Bygones: The Stability of Forgivingness Tendency. https://doi.org/10.51200/sapj.v13i1.6037
The jamovi project (2022). jamovi. (Version 2.3) [Computer Software]. Retrieved from https://www.jamovi.org.
Thompson, L. Y., Snyder, C. R., Hoffman, L., Michael, S. T., Rasmussen, H. N., Billings, L. S., Heinze, L., Neufeld, J. E., Shorey, H. S., Roberts, J. C., & Roberts, D. E. (2005). Dispositional forgiveness of self, others, and situations. Journal of Personality, 73(2), 313–359. https://doi.org/10.1111/j.1467-6494.2005.00311.x
Toussaint, L. L., Worthington, E. L., & Williams, D. R. (2020). Forgiveness and health: Scientific evidence and theories relating forgiveness to better health. Springer.
World Health Organization. (2020). Adverse childhood experiences international questionnaire (ACE-IQ). https://www.who.int/publications/m/item/adverse-childhood-experiences-international-questionnaire-(ace-iq)
World Health Organization. (2023). Anxiety disorders. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
Worthington, E. (2013). Forgiveness and Reconciliation. https://doi.org/10.4324/9780203942734
Published
2026-06-29
How to Cite
Wong, J., & Dominguez, J. (2026). Forgiveness Role Between Adverse Childhood Experience and Anxiety Among Persons Deprived of Liberty. Journal of Health and Behavioral Science, 8(2), 87-100. https://doi.org/10.35508/jhbs.v8i2.28210
Section
Articles
Copyright (c) 2026 Jay Conde Wong, Jemerson Dominguez
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