Childhood adversity and mental health among Chinese young adults: The protective role of resilience

Aim The aims of this study were to examine the prevalence of adverse childhood experiences (ACEs) among health science students in China; associations between the number of ACE exposures and severity of depressive and anxiety symptoms; and the extent to which resilience moderates the effect of ACEs on mental health outcomes. Design This descriptive, cross-sectional study was conducted May-August 2020. Methods Five hundred and sixty-six health science students (18-38 years) from China completed online surveys measuring ACEs using the Simplified Chinese version of the ACE-International Questionnaire, depressive and anxiety symptoms and resilience. Descriptive statistical analysis, ANOVA with Tukey HSD post hoc tests and multiple regression analysis were performed using SPSS 27. Results 88.5% of participants reported at least one ACE; 42.6% reported four or more ACEs. Higher number of ACEs was associated with more symptoms of depression and anxiety. Four or more ACEs were associated with significantly worse mental health outcomes than those with no ACEs and those with one to three ACEs. Greater resilience significantly attenuated the effects of ACEs on mental health symptoms. Conclusions ACEs are highly prevalent among Chinese health science students but their impact on mental health can be buffered by higher levels of resilience. Impact Screening for ACEs and strength-based, trauma-informed interventions on fostering resilience is needed to promote mental health among Chinese young adults.