*4.2. ACE-Distress Relationship, ACE-Wellbeing Relationship and Psychological Flexibility-Mediational Analyses*

Mediational analyses revealed Psychological Flexibility as a strong significant negative predictor of all three DASS-21 outcomes, while ACE score was a significant positive predictor of anxiety and depression, but not stress. ACE total score did not significantly predict Psychological Flexibility. While Psychological Flexibility did reduce the effect ACE exposure had on prolonged distress outcomes, it was not significant and did not mediate this relationship. Concerning wellbeing, Psychological Flexibility was a significant positive predictor, and also indirectly reduced the negative effect of ACE exposure on wellbeing with a small mediation effect observed.

In terms of future research, for people with or without ACE, fostering Psychological Flexibility skills through evidence-based interventions could be used to improve wellbeing, reduce psychological distress, and increase resilience against prolonged stressors [14,19,71]. Research could prospectively investigate psychological interventions such as these, which may mitigate this ACE- Distress/Wellbeing relationship.
