Skip to main content

Advertisement

SpringerLink
Log in

Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender

  • Full length manuscript
  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

The original Adverse Childhood Experiences (ACE) study demonstrated strong, graded relationships between child maltreatment and household dysfunction and adult health status. The present study re-examined these relationships in a sample of young adult, college students to better characterize the developmental timing of health problems related to ACE exposure and differences by biological sex.

Method

A cross-sectional general health questionnaire that included items on ACE was administered to young adults (ages 18–29) at universities in California (n = 3880), Minnesota (n = 7708), and Texas (n = 451) between 2017 and 2018. Seven ACE were assessed: psychological, physical, or sexual abuse; violence between parents; or living with household members who were substance misusers, mentally ill, or ever imprisoned. Binary health indicators were regressed on number of ACE as 0 (referent), 1, 2, 3, and 4 or more using logistic regression controlling for age, biological sex, race/ethnicity, and site.

Results

Approximately 51.7% of the sample reported at least one ACE with a significantly higher rate among Texas participants (p < 0.001). We observed graded relationships between levels of ACE exposure and physical, mental, and behavioral health indicators including cigarette use, e-cigarette use, drinking and driving, obesity, lifetime depression, suicide ideation and attempt, non-suicidal self-injury, and lack of restful sleep. ACE-exposed females reported worse mental health status than ACE-exposed males while males reported more substance use than females. Most outcomes did not vary significantly by sex.

Conclusion

The strong, graded relationships observed between ACE exposure and health status among young adults reinforce the need for trauma-informed intervention programs on college campuses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, et al. Adverse childhood experiences and smoking during adolescence and adulthood. JAMA. 1999;282:1652–8.

    Article  CAS  PubMed  Google Scholar 

  2. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psy Clin Neurosci. 2006;256:174–86.

    Article  Google Scholar 

  3. Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult health, well-being, social function, and healthcare. In: Lanius R, Vermetten E, Pain C, editors. The impact of early life trauma on health and disease. New York: Cambridge University Press; 2010. p. 77–87.

    Chapter  Google Scholar 

  4. Turner HA, Finkelhor D, Ormrod R. Poly-victimization in a national sample of children and youth. Am J Prev Med. 2010;38:323–30.

    Article  PubMed  Google Scholar 

  5. Thompson RA, Haskins R. Early stress gets under the skin: promising initiatives to help children facing chronic adversity. Princeton: The Future of Children. https://futureofchildren.princeton.edu/sites/futureofchildren/files/media/helping_parents_helping_children_24_01_policy_brief.pdf. Published 2014. Accessed Aug 1, 2019

  6. Forster M, Gower AL, Borowsky IW, McMorris BJ. Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents. Addict Behav. 2017;68:30–4.

    Article  PubMed  Google Scholar 

  7. Felitti VJ. The relation between adverse childhood experiences and adult health: turning gold into lead. Perm J. 2002;6:44–7.

    PubMed  PubMed Central  Google Scholar 

  8. Read JP, Ouimette P, White J, Colder C, Farrow S. Rates of DSM–IV–TR trauma exposure and posttraumatic stress disorder among newly matriculated college students. Psychol Trauma-US. 2011;3:148–56.

    Article  Google Scholar 

  9. Smyth JM, Hockemeyer JR, Heron KE, Wonderlich SA, Pennebaker JW. Prevalence, type, disclosure, and severity of adverse life events in college students. J Am Coll Heal. 2008;57:69–76.

    Article  Google Scholar 

  10. Strand EB, Brandt J, Rogers K, Fonken L, Chun R, Conlon P, et al. Adverse childhood experiences among veterinary medical students: a multi-site study. J Vet Med Educ. 2017;44:260–7.

    Article  PubMed  Google Scholar 

  11. Masuda A, Hayes SC, Fletcher LB, Seignourel PJ, Bunting K, Herbst SA, et al. Impact of acceptance and commitment therapy versus education on stigma toward people with psychological disorders. Behav Res Ther. 2007;45:2764–72.

    Article  PubMed  Google Scholar 

  12. Singh S, Manjula M, Philip M. Suicidal risk and childhood adversity: a study of Indian college students. Asia J Psychiat. 2012;5:154–9.

    Article  Google Scholar 

  13. Tran QA, Dunne MP, Vo TV, Luu NH. Adverse childhood experiences and the health of university students in eight provinces of Vietnam. Asia Pac J Public Health. 2015;27:26S–32S.

    Article  PubMed  Google Scholar 

  14. Kim YH. Associations of adverse childhood experiences with depression and alcohol abuse among Korean college students. Child Abuse Negl. 2017;67:338–48.

    Article  CAS  PubMed  Google Scholar 

  15. Karatekin C, Ahluwalia R, Desir M. Tailoring health-related messages for young adults with adverse childhood experiences (ACEs). Child Abuse Negl. 2018;80:194–202.

    Article  PubMed  Google Scholar 

  16. Windle M, Haardörfer R, Getachew B, Shah J, Payne J, Pillai D, et al. A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students. J Am Coll Heal. 2018;66:246–51.

    Article  Google Scholar 

  17. Danese A, McEwen BS. Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav. 2012;106:29–39.

    Article  CAS  PubMed  Google Scholar 

  18. Perry B, Pollard R. Homeostasis, stress, trauma, and adaptation. A neurodevelopmental view of childhood trauma. Child Adolesc Psychiatr Clin N Am. 1998;7:33–51.

    Article  CAS  PubMed  Google Scholar 

  19. Teicher M, Andersen S, Polcari A, Anderson C, Navalta C. Developmental neurobiology of childhood stress and trauma. Psychiatr Clin North Am. 2002;25:397–426.

    Article  PubMed  Google Scholar 

  20. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to mangy of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–58.

    Article  CAS  PubMed  Google Scholar 

  21. Schilling E, Aseltine R, Gore S. Adverse childhood experiences and mental health in young adults: a longitudinal survey. BMC Public Health. 2007;7:30.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Mersky J, Topitzes J, Reynolds A. Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: a cohort study of an urban, minority sample in the U.S. Child Abuse Negl. 2013;37:917–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Dong M, Anda R, Felitti VJ, et al. Childhood residential mobility and multiple health risks during adolescence and adulthood. Arch Pediatr Adolesc Med. 2005;159:1104–10.

    Article  PubMed  Google Scholar 

  24. Slutske WS. Alcohol use disorders among US college students and their non–college-attending peers. Arch Gen Psychiat. 2015;62:321–7.

    Article  Google Scholar 

  25. Blanco C, Okuda M, Wright C, Hasin DS, Grant BF, Liu SM, et al. Mental health of college students and their non–college-attending peers: results from the national epidemiologic study on alcohol and related conditions. Arch Gen Psychiat. 2008;65:1429–37.

    Article  PubMed  Google Scholar 

  26. Cavanaugh CE, Petras H, Martins SS. Gender-specific profiles of adverse childhood experiences, past year mental and substance use disorders, and their associations among a national sample of adults in the United States. Soc Psych Psych Epid. 2015;50:1257–66.

    Article  Google Scholar 

  27. Dube SR, Anda RF, Whitfield CL, et al. Long-term consequences of childhood sexual abuse by gender of victim. Am J Prev Med. 2005;28:430–8.

    Article  PubMed  Google Scholar 

  28. Fang L, Chuang DM, Lee Y. Adverse childhood experiences, gender, and HIV risk behaviors: results from a population-based sample. Prev Med Reports. 2016;4:113–20.

    Article  Google Scholar 

  29. Almuneef M, ElChoueiry N, Saleheen HN, Al-Eissa M. Gender-based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia. Int J Equity Health. 2017;16:e90.

    Article  Google Scholar 

  30. Degenhardt L, Stockings E, Patton G, Hall WD, Lynskey M. The increasing global health priority of substance use in young people. Lancet Psychiat. 2016;3:251–64.

    Article  Google Scholar 

  31. Auerbach RP, Mortier P, Bruffaerts R, et al. World Health Organization world mental health surveys international college student project (WMH-ICS): prevalence and distribution of mental disorders. J Abnorm Psychol. 2018;127:623.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016;138:1878.

    Article  Google Scholar 

  33. Goldman-Mellor S, Caspi A, Harrington H, et al. Suicide attempt in young people: a signal for long-term health care and social needs. JAMA Psychiat. 2014;71:119–27.

    Article  Google Scholar 

  34. Harford T, Yi H, Grant B. Associations between childhood abuse and interpersonal aggression and suicide attempt among U.S. adults in a national study. Child Abuse Negl. 2014;38:1389–98.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Laska MN, Pasch KE, Lust K, Story M, Ehlinger E. Latent class analysis of lifestyle characteristics and health risk behaviors among college youth. Prev Sci. 2009;10:376–86.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Forster M, Rogers CJ, Benjamin SM, et al. Adverse childhood experiences, ethnicity, and substance use among college students: findings from a two-state sample. Subst Use Misuse. 2019:1–12.

  37. Sanchez-Villegas A, Schlatter J, Ortuno F, Lahortiga F, Pla J, Benito S, et al. Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I). BMC Psychiatry. 2008;8:43.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Macias C, Gold PB, Öngür D, Cohen BM, Panch T. Are single-item global ratings useful for assessing health status? J Clin Psyc Med Sett. 2015;22:251–64.

    Article  Google Scholar 

  39. Lanier P, Maguire-Jack K, Walsh T, Drake B, Hubel G. Race and ethnic differences in early childhood maltreatment in the United States. J Dev Behav Pediatr. 2014;35:419–26.

    Article  PubMed  Google Scholar 

  40. Maguire-Jack K, Lanier P, Johnson-Motoyama M, Welch H, Dineen M. Geographic variation in racial disparities in child maltreatment: the influence of county poverty and population density. Child Abuse Negl. 2015;47:1–3.

    Article  PubMed  Google Scholar 

  41. Vásquez E, Quiñones A, Ramirez S, Udo T. Association between adverse childhood events and multimorbidity in a racial and ethnic diverse sample of middle-aged and older adults. Innov Aging. 2019;3:igz016.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Forster M, Grigsby TJ, Rogers CJ, Benjamin SM. The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. Addict Behav. 2018;76:298–304.

    Article  PubMed  Google Scholar 

  43. Grigsby TJ, Forster M, Davis L, Unger JB. Substance use outcomes for Hispanic emerging adults exposed to incarceration of a household member during childhood. J Ethn Subst Abus. 2018:1–13.

  44. Primack BA, Soneji S, Stoolmiller M, Fine MJ, Sargent JD. Progression to traditional cigarette smoking after electronic cigarette use among US adolescents and young adults. JAMA Pediatr. 2015;169:1018–23.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Unger JB, Soto DW, Leventhal A. E-cigarette use and subsequent cigarette and marijuana use among Hispanic young adults. Drug Alcohol Depen. 2016;163:261–4.

    Article  Google Scholar 

  46. Lee HW, Park SH, Weng MW, Wang HT, Huang WC, Lepor H, et al. E-cigarette smoke damages DNA and reduces repair activity in mouse lung, heart, and bladder as well as in human lung and bladder cells. P Natl A Sci. 2018;115:E1560–9.

    CAS  Google Scholar 

  47. Rowell TR, Tarran R. Will chronic e-cigarette use cause lung disease? Am J Physiol-Lung C. 2015;309:L1398–409.

    Article  CAS  Google Scholar 

  48. Blount BC, Karwowski MP, Shields PG, Morel-Espinosa M, Valentin-Blasini L, Gardner M, et al. Vitamin E acetate in bronchoalveolar-lavage fluid associated with EVALI. New Engl J Med. 2020;382:697–705.

    Article  CAS  PubMed  Google Scholar 

  49. Forster M, Davis L, Grigsby TJ, Rogers CJ, Vetrone SF, Unger JB. The role of familial incarceration and ethnic identity in suicidal ideation and suicide attempt: findings from a longitudinal study of Latinx young adults in California. Am J Community Psychol. 2019b;64:191–202.

    Article  PubMed  Google Scholar 

  50. El Mhamdi S, Lemieux A, Bouanene I, et al. Gender differences in adverse childhood experiences, collective violence, and the risk for addictive behaviors among university students in Tunisia. Prev Med. 2017;99:99–104.

    Article  PubMed  Google Scholar 

  51. Matud MP. Gender differences in stress and coping styles. Pers Indiv Differ. 2004;37:1401–15.

    Article  Google Scholar 

  52. Meléndez JC, Mayordomo T, Sancho P, Tomás JM. Coping strategies: gender differences and development throughout life span. Span J Psychol. 2012;15:1089–98.

    Article  PubMed  Google Scholar 

  53. Logan-Greene P, Tennyson RL, Nurius PS, Borja S. Adverse childhood experiences, coping resources, and mental health problems among court-involved youth. Child Youth Care For. 2017;46:923–46.

    Article  Google Scholar 

  54. VanderEnde K, Chiang L, Mercy J, Shawa M, Hamela J, Maksud N, et al. Adverse childhood experiences and HIV sexual risk-taking behaviors among young adults in Malawi. J Interpers Violence. 2018;33:1710–30.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kaufman J, Montalvo-Ortiz JL, Holbrook H, O;Loughlin K, Orr C, Kearney C, et al. Adverse childhood experiences, epigenetic measures, and obesity in youth. J Pediatr. 2018;202:150–6.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Kalmakis KA, Chiodo LM, Kent N, Meyer JS. Adverse childhood experiences, post-traumatic stress disorder symptoms, and self-reported stress among traditional and nontraditional college students. J Am Coll Heal. 2019:1–8.

  57. Merians AN, Baker MR, Frazier P, Lust K. Outcomes related to adverse childhood experiences in college students: comparing latent class analysis and cumulative risk. Child Abuse Negl. 2019;87:51–64.

    Article  PubMed  Google Scholar 

  58. Hayward MD, Gorman BK. The long arm of childhood: the influence of early-life social conditions on men’s mortality. Demography. 2004;41:87–107.

    Article  PubMed  Google Scholar 

  59. Morris AS, Treat A, Hays-Grudo J, et al. Integrating research and theory on early relationships to guide intervention and prevention. Building Early Social and Emotional Relationships with Infants and Toddlers 2018:1–25.

  60. Arnett JJ. Emerging adulthood(s). Bridging cultural and developmental approaches to psychology: new syntheses in theory, research, and policy. Oxford: Oxford University Press; 2010.

    Google Scholar 

  61. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. P Natl A Sci. 2015;112:15078–83.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA

    Timothy J. Grigsby

  2. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Christopher J. Rogers

  3. Department of Health Sciences, California State University, Northridge, Northridge, CA, USA

    Larisa D. Albers, Stephanie M. Benjamin & Myriam Forster

  4. Department of Pediatrics and School of Public Health, University of Minnesota, Twin Cities, MN, USA

    Katherine Lust & Marla E. Eisenberg

Authors
  1. Timothy J. Grigsby
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher J. Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Larisa D. Albers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephanie M. Benjamin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katherine Lust
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marla E. Eisenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Myriam Forster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timothy J. Grigsby.

Ethics declarations

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement Regarding Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grigsby, T.J., Rogers, C.J., Albers, L.D. et al. Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender. Int.J. Behav. Med. 27, 660–667 (2020). https://doi.org/10.1007/s12529-020-09913-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-020-09913-5

Keywords

Search

Navigation