Adverse childhood experiences (ACEs) are traumatic events, such as abuse, neglect, or household dysfunction, that occur during childhood and can have negative, lasting effects on health and well-being.

Illustration of a stressed student, head in hands and books and papers flying around in the background to show they are overwhelmed.

Key Points:

Rationale

Previous studies have consistently shown that university students report high levels of ACEs (Aizpurua et al., 2021; Ho et al., 2019; Khrapatina & Berman, 2017), which can lead to severe mental health problems (Merians et al., 2019; Tran et al., 2015; Windle et al., 2018).

However, research on the impact of ACEs on mental well-being in this population is limited, especially in the cultural context of south-western Europe (Gomis-Pomares & Villanueva, 2020; Kaminer et al., 2022).

Moreover, few studies have explored the co-occurrence of different types of ACEs and their relationship with mental health outcomes (Hughes et al., 2017).

Method

The study employed across-sectional designand used self-report questionnaires to assess ACEs, mental well-being, and mental illness among university students in Spain.

The sample comprised 1,023 Spanish university students (71.6% female) aged between 18 and 64 years (M = 20.10, SD = 3.93).

Participants completed a structured self-report questionnaire that gathered demographic information and assessed their ACEs, mental well-being, and psychiatric diagnoses.

Measures

Statistical measures

Latent class analysis (LCA) was used to identify patterns of ACEs. Multiple linear hierarchical regression was conducted to examine the relationship between ACE classes, mental well-being, and other covariates.

Results

Insight

The study used latent class analysis (LCA) to investigate patterns of adverse childhood experiences (ACEs) among university students in Spain. Four distinct classes were identified, each with varying prevalence and types of ACEs. Significant differences in mental health outcomes were also found across the classes.

Students in the High ACEs class were more likely to have a mental illness diagnosis and reported lower well-being compared to those in other classes. Interestingly, the Household and Peer Abuse class and the High ACEs class had similar predicted levels of well-being, despite the Household and Peer Abuse class experiencing fewer adversities than the Dysfunctional Household class.

This suggests that when examining moderate levels of ACEs, it is crucial to consider the specific types of co-occurring ACEs rather than just the total number experienced, as the combination of ACEs may have a more substantial impact on self-reported well-being than the overall number. Understanding the specific types and combinations of ACEs is valuable for comprehending changes in mental health.

Having a mental illness was the strongest predictor of lower well-being among all analyzed variables. This may be due to the symptomatic challenges that not only affect the well-being of individuals with mental illnesses but also hinder various aspects of their lives, such as employment opportunities and social connections. Additionally, the stigma surrounding mental illnesses is a critical factor that often contributes to discrimination.

However, ACEs still played a role in mental well-being, indicating that mental illness alone does not determine this relationship. Experiencing childhood adversity was nearly as relevant as mental illness in understanding lower well-being.

Therefore, when working with university students, professionals should adopt a comprehensive approach that addresses both mental health issues and the impact of childhood adversity.

These findings highlight the association between childhood adversity, mental illness, and lower well-being outcomes, providing a foundation for future research in this area.

Strengths

Limitations

Implications

The results underscore the importance of screening for ACEs and mental health problems among university students and developing targeted interventions to promote mental well-being.

The findings also highlight the need for a comprehensive approach that addresses both mental health issues and the impact of childhood adversity when working with this population.

References

Primary reference

Bartolomé-Valenzuela, M., Pereda, N., & Guilera, G. (2024). Patterns of adverse childhood experiences and associations with lower mental well-being among university students.Child Abuse & Neglect, 152, 106770.https://doi.org/10.1016/j.chiabu.2024.106770

Other references

Aizpurua, E., Caravaca-Sanchez, F., & Stephenson, A. (2021). Victimization status of female and male college students in Spain: Prevalence and relation to mental distress.Journal of Interpersonal Violence, 36(11-12), 4988–5010.https://doi.org/10.1177/0886260518802842

Gomis-Pomares, A., & Villanueva, L. (2020). The effect of adverse childhood experiences on deviant and altruistic behavior during emerging adulthood.Psicothema, 32(1), 33–39.https://doi.org/10.7334/psicothema2019.142

Ho, G. W., Chan, A. C., Chien, W. T., Bressington, D. T., & Karatzias, T. (2019). Examining patterns of adversity in Chinese young adults using the Adverse Childhood Experiences—International Questionnaire (ACE-IQ).Child Abuse & Neglect, 88, 179–188.https://doi.org/10.1016/j.chiabu.2018.11.009

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

Kaminer, D., Bravo, A. J., Mezquita, L., & Pilatti, A. (2022). Adverse childhood experiences and adulthood mental health: A cross-cultural examination among university students in seven countries.Current Psychology.https://doi.org/10.1007/s12144-022-02978-3

Khrapatina, I., & Berman, P. (2017). The impact of adverse childhood experiences on health in college students.Journal of Child & Adolescent Trauma, 10, 275–287.https://doi.org/10.1007/s40653-016-0093-0

Merians, A. N., Baker, M. R., Frazier, P., & Lust, K. (2019). Outcomes related to adverse childhood experiences in college students: Comparing latent class analysis and cumulative risk.Child Abuse & Neglect, 87, 51–64.https://doi.org/10.1016/j.chiabu.2018.07.020

Tran, Q. A., Dunne, M. P., Vo, T. V., & Luu, N. H. (2015). Adverse childhood experiences and the health of university students in eight provinces of Vietnam.Asia Pacific Journal of Public Health, 27(8), 26S–32S.https://doi.org/10.1177/1010539515589812

Windle, M., Haardorfer, R., Getachew, B., Shah, J., Payne, J., Pillai, D., & Berg, C. J. (2018). A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students.Journal of American College Health, 66(4), 246–251.https://doi.org/10.1080/07448481.2018.1431892

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Olivia Guy-Evans, MSc

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

Saul McLeod, PhD

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.