The Impact of Adverse Experiences in Childhood Relationships on the Mental Health of University Students

Background and Objective: The aim of this study was to evaluate the rate of adverse experiences in childhood experiences (relational ACEs) in family and school settings, among university students, and investigate how they affect the students’ negative health outcomes including depression, anxiety, suicidal attitude, lifetime serious suicidal thought (LSST). Methods: In this study, 524 students aged 18-28 years were selected via multi-level sampling, from disciplines of humanities, engineering, and basic sciences at University of Tehran. Ethical considerations were approved by Ethical Committee of University of Tehran. HADS (≥8) for depression and anxiety, a researcher-made questionnaire for relational ACEs, and two single-questions for suicidal attitude and LSST, were employed. Analyzes were conducted using Exact Fisher’s test and binary logistic regression (univariate and multiple). Results: 487 participants (59.2% females) with mean age of 20.66±1.42 were analyzed. Depression with 43.6% and anxiety with 69.6% were reported. Suicidal attitude with 39.8% and LSST with 37.9% were reported, both of which were significantly higher among females. Affected outcomes mainly included anxiety and suicide variables. Major influential relational ACEs included emotional abuse (mostly on anxiety, odds=2.21,95%CI=1.40-3.35), lack of love (mostly on anxiety, odds=2.01, 95%CI=1.22-3.31), neglect (mostly on anxiety, odds=1.93,95%CI=1.19-314; and LSST, odds=1.93, 95%CI=1.24-2.94), divorce/separation (mostly on suicidal attitude, odds=2.23, 95%CI=1.04-4.79), peer victimization (mostly on anxiety, odds=1.60,95%CI=0.95-2.69, P<0.10), and physical (mostly on suicidal attitude, odds=1.78,95%CI=1.07-2.97) and non-physical (mostly on anxiety, odds=2.61, 95%CI=1.39-4.88) sexual abuse. Female gender contributed to the increased impact of relational ACEs on the outcomes. Conclusion: Findings emphasized a need for longitudinal and epidemiological studies in the country. Further investigation on social-environmental determinants contributing to development of ACEs and maintaining the consequences are recommnded.