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Patterns of exposure to adverse childhood experiences and their associations with mental health: a survey of 1346 university students in East Asia

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Abstract

Introduction

Adverse childhood experiences (ACEs) constitute a significant global mental health burden. Prior studies typically investigated the impact of ACEs on mental health using a cumulative risk approach; most ACEs studies were also conducted in Western settings.

Purpose

This study aimed to examine ACEs using a pattern-based approach and assess their associations with mental health outcomes by early adulthood in East Asia.

Methods

The present study included measures of exposure to 13 categories of ACEs, depression, anxiety, maladjustment, and posttraumatic stress in a sample of 1346 university students from Hong Kong, China, Taiwan, and Japan.

Results

Latent class analysis indicated three distinct patterns of ACE exposure: Class 1: Low ACEs (76.0%); Class 2: Household Violence (20.6%); and Class 3: Household Dysfunction (3.4%). Those representing Class 3 had significantly more ACEs compared with those in Classes 1 or 2. Controlling for age and sex, those in Class 2 reported significantly higher depression and maladjustment symptoms compared with those in Class 1; both Classes 2 and 3 had significantly higher anxiety symptoms and odds for meeting diagnostic criteria for posttraumatic stress disorders compared with those in Class 1.

Conclusions

Study findings suggest that young adults’ mental health, at least under certain contexts, is more closely linked with the nature and pattern of ACE co-occurrence, rather than the number of ACEs.

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Acknowledgements

This study was supported by The Hong Kong Polytechnic University Internal Start-Up Fund.

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Authors and Affiliations

  1. School of Nursing, The Hong Kong Polytechnic University, PQ426, Hung Hom, Hong Kong

    Grace W. K. Ho, D. Bressington & A. C. Y. Chan

  2. School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK

    T. Karatzias

  3. NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK

    T. Karatzias

  4. The Nethersole School of Nursing, The Chinese University of Hong Kong, Sha Tin, Hong Kong

    W. T. Chien

  5. Department of Nursing Science, Okayama Prefectural University, Okayama, Japan

    S. Inoue

  6. Graduate Institute of Social Work, National Chengchi University, Taipei City, Taiwan

    P. J. Yang

  7. Department of Psychology, Maynooth University, Maynooth, Ireland

    P. Hyland

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  1. Grace W. K. Ho
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Correspondence to Grace W. K. Ho.

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Ho, G.W.K., Bressington, D., Karatzias, T. et al. Patterns of exposure to adverse childhood experiences and their associations with mental health: a survey of 1346 university students in East Asia. Soc Psychiatry Psychiatr Epidemiol 55, 339–349 (2020). https://doi.org/10.1007/s00127-019-01768-w

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