Adverse childhood experiences and psychological distress among higher education students in Southeast Nigeria: an institutional-based cross-sectional study

Olaoluwa Samson Agbaje; Chinwe Patience Nnaji; Evelyn Nwanebe Nwagu; Cylia Nkechi Iweama; Prince Christian Ifeanachor Umoke; Lawretta Eyuche Ozoemena; Charles Chike Abba

doi:10.1186/s13690-021-00587-3

Adverse childhood experiences and psychological distress among higher education students in Southeast Nigeria: an institutional-based cross-sectional study

Arch Public Health. 2021 Apr 29;79(1):62. doi: 10.1186/s13690-021-00587-3.

Authors

Olaoluwa Samson Agbaje¹, Chinwe Patience Nnaji¹, Evelyn Nwanebe Nwagu¹, Cylia Nkechi Iweama², Prince Christian Ifeanachor Umoke¹, Lawretta Eyuche Ozoemena¹, Charles Chike Abba¹

Affiliations

¹ Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
² Department of Human Kinetics and Health Education, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria. cylia.iweama@unn.edu.ng.

Abstract

Background: Exposure to adverse childhood experiences (ACEs) constitutes public health problems linked to adverse mental outcomes such as psychological distress during adulthood. This study examines the prevalence of ACEs and psychological distress and explores the association between ACEs and psychological distress and demographic factors among young adults.

Methods: We conducted a cross-sectional study of 330 students from May 2018 to July 2018. The participants completed the Adverse Childhood Experiences International Questionnaire (ACE-IQ), Kessler Psychological Distress Scale (K10), and the sociodemographic profile scale. We used descriptive statistics to describe the prevalence of ACEs and psychological distress in our sample. After adjusting for the demographic covariates, ACEs' association with psychological distress was determined using binary and multivariate logistic regressions.

Results: A total of 203 students with a mean age of 20.76 ± 2.73 years completed the study. The total mean ACE score was 4.58 ± 1.59, and the total mean psychological distress score was 20.76 ± 6.31. Most of the participants (86.7%) experienced ACEs, 14.8% reported experiencing one ACE, 30.5% reported experiencing 2-3 ACEs, and 41.3% reported experiencing 4+ ACEs. Further, about 85% of the youth have experienced at least one form of sexual abuse during childhood, and females reported a higher number of ACEs than males. Sexual abuse (OR = 2.36; 95% CI: 2.36, 7.65), physical neglect (OR = 2.87; 95% CI: 1.57, 5.31), overall ACE exposure (OR = 6.66; 95% CI: 2.41, 18.42), having 1 ACE (OR = 4.40; 95% CI: 1.32, 14.70), having 2-3 ACEs (OR = 4.13; 95% CI: 1.39, 12.29), and having 4+ (OR = 11.67; 95% CI: 3.95, 34.45) were significantly associated with psychological distress.

Conclusions: ACEs are prevalent among young adults and are associated with psychological distress in adulthood. Furthermore, parental factors are associated with ACEs and psychological distress. Thus, implementation of school, community-and facility-based routine mental health screening programs is essential for prompt identification, prevention, and treatment of youth with childhood adversities and poor mental health outcomes.

Keywords: Adverse childhood experiences; Higher education; Mental health; Nigeria; Psychological distress; Young adults.