Adverse childhood experiences, health risk factors, and significant problems with substances and behaviors among U.S. college students

Abstract Adverse childhood experiences (ACEs) are often associated with higher rates of mental health issues and problematic behaviors within the U.S. college population. Therefore, the primary purpose of this study was to investigate the current associations among ACEs, six psychosocial risk factors for poor health (i.e., anxiety, depression, loneliness, negative urgency, positive urgency, and stress), and significant behavioral and substance problems in a large sample of college students ( N = 1,993). Overall, 72.3% of participants reported one or more ACEs, with 21.7% reporting at least five of these experiences; the most prevalent ACE types were emotional abuse (51.7%) and parental mental illness (33.8%). Cumulative ACEs were positively associated with all health risk factors, r s = .07–.38, p s ≤ .001, and these ACE scores were most connected to student problems with alcohol, overeating, and sex, r s = .19–.22, p s < .001. Furthermore, using logistic regression, cumulative ACEs predicted which students were more likely to report behavioral problems, OR = 1.08, 95% CI 1.03, 1.14; substance problems, OR = 1.16, 95% CI 1.07, 1.26; and both types of problems, OR = 1.28, 95% CI 1.20, 1.36, relative to students without these problems. Aside from ACEs, higher anxiety was the only other risk factor all three problem types shared. Collectively, these findings highlight the differential impact of ACEs and other psychosocial risk factors on the susceptibility of college students to particular forms of maladaptive coping and suggest potential targets for intervention and prevention efforts in these areas.