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. 2018 Jul 5;18(1):835.
doi: 10.1186/s12889-018-5767-0.

Stress begets stress: the association of adverse childhood experiences with psychological distress in the presence of adult life stress

Mercy Manyema  1   2 , Shane A Norris  3 , Linda M Richter  4
Affiliations

Stress begets stress: the association of adverse childhood experiences with psychological distress in the presence of adult life stress

Mercy Manyema et al. BMC Public Health. .

Abstract

Background: Adverse childhood experiences (ACES) have been linked to poor health and well-being outcomes, including poor mental health such as psychological distress. Both ACEs and psychological distress pose a significant public health burden, particularly in low to middle income countries. Contemporaneous stress events in adulthood may also impact psychological distress. The aims of this study were to describe the prevalence of ACEs and psychological distress and to assess the separate and cumulative effect of ACEs on psychological distress, while accounting for the effect of adult stress.

Methods: In this cross-sectional study, we used retrospectively measured ACEs from a sample of 1223 young adults aged between 22 and 23 years (52% female) from the Birth to Twenty Plus Study. Psychological distress and adult life stress were measured with a six-month recall period. Hierarchical logistic regression was employed to assess the associations between the exposures and outcome.

Results: Nearly 90% of the sample reported at least one ACE and 28% reported psychological distress. The median number of ACEs reported was three (range 0-11). After accounting for demographic and socio-economic factors, all ACEs were individually associated with psychological distress except for parental divorce and unemployment. The individual ACEs increased the odds of PD by between 1.42 and 2.79 times. Compared to participants experiencing no ACEs, those experiencing one to five ACEs were three times more likely to report psychological distress (AOR 3.2 95% CI: 1.83-5.63), while participants who experienced six or more ACEs had nearly eight times greater odds of reporting psychological distress (AOR 7.98 95% CI: 4.28-14.91). Interaction analysis showed that in the absence of adult life stress, the effect of low ACEs compared to high ACEs on PD was not significantly different.

Discussion and conclusion: The prevalence of ACEs in this young adult population is high, similar to other studies in young adult populations. A significant direct association exists between ACEs and psychological distress. Adult life stress seems to be a mediator of this relationship. Interventions targeted at psychological distress should address both early life adversity and contemporary stress.

Keywords: Adverse childhood experiences; Birth to twenty plus; Mental health; Psychological distress; Stressful life events; Young adult.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical clearance for this study and the Bt20+ study were obtained from the Human Research Ethics Committee of the University of the Witwatersrand, clearance numbers M160921 and M111182 respectively. All participants were provided with information on the study and its procedures and signed consent forms at enrolment.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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

Figures

Fig. 1
Fig. 1
Conceptual framework for the hierarchical regression. ACEs – Adverse childhood events; PD-psychological distress; SES-socioeconomic status
See this image and copyright information in PMC

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