Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach

Background: Adverse childhood experiences (ACEs) refer to various types of abuse, neglect, and household dysfunction that individuals may experience in childhood. These experiences can lead to significant long-term effects on mental health and behavior. Individuals with higher ACE scores are more li...

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Main Authors: Ajith K. Remesan, Varalakshmi Chandra Sekaran, Satyanarayana Poojari, Teddy Andrews Jaihind Jothikaran, Vani Lakshmi R, Lena Ashok
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical Epidemiology and Global Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213398425002039
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author Ajith K. Remesan
Varalakshmi Chandra Sekaran
Satyanarayana Poojari
Teddy Andrews Jaihind Jothikaran
Vani Lakshmi R
Lena Ashok
author_facet Ajith K. Remesan
Varalakshmi Chandra Sekaran
Satyanarayana Poojari
Teddy Andrews Jaihind Jothikaran
Vani Lakshmi R
Lena Ashok
author_sort Ajith K. Remesan
collection DOAJ
description Background: Adverse childhood experiences (ACEs) refer to various types of abuse, neglect, and household dysfunction that individuals may experience in childhood. These experiences can lead to significant long-term effects on mental health and behavior. Individuals with higher ACE scores are more likely to experience psychological distress and the uptake of substances. This study aimed to explore the relationship between ACEs, psychological distress, and substance use among emerging adults. Methods: The cross-sectional study was conducted in the Udupi district of Karnataka, India. The undergraduate colleges associated with Mangalore University were the sampling units. A multi-stage cluster random sampling method was employed to select 12 colleges from the undergraduate institutions in the district affiliated with Mangalore University based on their various courses. Data was collected in a classroom setting among 957 emerging adults between June 2023 and October 2023. Results: Among the participants, 18.91 % reported ACEs. Additionally, the prevalence of psychological distress and substance use were noted to be 27.03 % and 17.97 %, respectively. Tobacco and alcohol were having a higher prevalence in comparison with other substances. Furthermore, emerging adults who have experienced ACEs are significantly more prone to experiencing psychological distress. Conclusion: The study highlights the connection between ACEs, psychological distress, and substance use in emerging adults. It calls for integrating ACEs into interventions and policies, emphasizing the need for global research, particularly in India, to foster social cohesion and well-being through prevention and early detection strategies.
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spelling doaj-art-14358c611a6746ed8a02052afc3e710b2025-08-20T03:14:01ZengElsevierClinical Epidemiology and Global Health2213-39842025-07-013410211410.1016/j.cegh.2025.102114Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approachAjith K. Remesan0Varalakshmi Chandra Sekaran1Satyanarayana Poojari2Teddy Andrews Jaihind Jothikaran3Vani Lakshmi R4Lena Ashok5Department of Global Public Health Policy and Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, IndiaDepartment of Global Public Health Policy and Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, India; Corresponding author.Department of Applied Statistics and Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, IndiaDepartment of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, IndiaDepartment of Health Technology and Informatics, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, IndiaDepartment of Social and Health Innovation, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, IndiaBackground: Adverse childhood experiences (ACEs) refer to various types of abuse, neglect, and household dysfunction that individuals may experience in childhood. These experiences can lead to significant long-term effects on mental health and behavior. Individuals with higher ACE scores are more likely to experience psychological distress and the uptake of substances. This study aimed to explore the relationship between ACEs, psychological distress, and substance use among emerging adults. Methods: The cross-sectional study was conducted in the Udupi district of Karnataka, India. The undergraduate colleges associated with Mangalore University were the sampling units. A multi-stage cluster random sampling method was employed to select 12 colleges from the undergraduate institutions in the district affiliated with Mangalore University based on their various courses. Data was collected in a classroom setting among 957 emerging adults between June 2023 and October 2023. Results: Among the participants, 18.91 % reported ACEs. Additionally, the prevalence of psychological distress and substance use were noted to be 27.03 % and 17.97 %, respectively. Tobacco and alcohol were having a higher prevalence in comparison with other substances. Furthermore, emerging adults who have experienced ACEs are significantly more prone to experiencing psychological distress. Conclusion: The study highlights the connection between ACEs, psychological distress, and substance use in emerging adults. It calls for integrating ACEs into interventions and policies, emphasizing the need for global research, particularly in India, to foster social cohesion and well-being through prevention and early detection strategies.http://www.sciencedirect.com/science/article/pii/S2213398425002039Adverse childhood experiencesEmerging adultsPsychological distressStructural equation modelingSubstance useSustainable development goals
spellingShingle Ajith K. Remesan
Varalakshmi Chandra Sekaran
Satyanarayana Poojari
Teddy Andrews Jaihind Jothikaran
Vani Lakshmi R
Lena Ashok
Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
Clinical Epidemiology and Global Health
Adverse childhood experiences
Emerging adults
Psychological distress
Structural equation modeling
Substance use
Sustainable development goals
title Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
title_full Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
title_fullStr Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
title_full_unstemmed Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
title_short Pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults: A structural equation modeling approach
title_sort pathway of effects of adverse childhood experiences on psychological distress and substance use among emerging adults a structural equation modeling approach
topic Adverse childhood experiences
Emerging adults
Psychological distress
Structural equation modeling
Substance use
Sustainable development goals
url http://www.sciencedirect.com/science/article/pii/S2213398425002039
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