Associations between Adverse Childhood Experience Patterns and Anxiety and Depressive Symptoms among Chinese College Students

Abstract Purpose With depression and anxiety becoming one of the major public health problems in China, more evidence shows the long-lasting negative effects of adverse childhood experiences (ACEs) on mental health. This study aimed to explore the ACE exposure patterns in Chinese college students and their associations with mental health problems in adulthood. Methods In this cross-sectional study, data were collected from the Chinese college students aged 18 years old and above. Depressive symptoms and anxiety were measured using the Depression Anxiety and Stress Scale (DASS-21). ACEs were measured with the International Adverse Childhood Experiences Questionnaire (ACE-IQ), and the ACE patterns were identified using latent class analysis (LCA). Then, logit regression models were employed to analyze the association between ACE exposure patterns and anxiety and depressive symptoms. Results A total of 536 Chinese college students were recruited in this study. Nearly 68.7% had at least one ACE and 17.2% were exposed to at least four types of ACEs. Three specific ACE patterns were identified, including “low ACEs” (63.1%), “family dysfunction but low childhood abuse” (20.1%), and “high domestic violence and childhood abuse” (16.8%). Compared with the “low ACEs” class, both the “high domestic violence and childhood abuse” class and the “family dysfunction but low childhood abuse” class showed significantly higher risks of depression and anxiety (P < 0.05). Conclusions The co-occurrence of ACEs was positively associated with higher risks of anxiety and depressive symptoms among Chinese college students and different patterns of ACE exposure may lead to diverse mental health outcomes.