Abstract
The purpose of this study is to examine the relationships among adverse childhood experiences (ACEs), intimate partner violence (IPV) victimization, and three adulthood health outcomes—perceived physical and mental health and depression—among college students. We analyzed the direct effects of a subset of ACEs including community violence, peer victimization, child abuse and neglect, exposure to domestic violence, and other physical and sexual victimization and a subset of IPV victimization including threats, physical, sexual, technological, and psychological violence on health, and the indirect effect of IPV victimization on the relationships between ACEs and health. We analyzed 3,535 college students from seven universities who reported information about major variables of interest. Results: Findings from structural equation modeling indicate that ACEs are positively associated with poorer perceived physical health (β = .37, p < .001), poorer mental health (β = .64, p < .001), and higher levels of depression (β = .40, p < .001). IPV victimization is positively associated with poorer perceived physical health (β = .36, p < .001), poorer mental health (β = .23, p < .001), and higher levels of depression (β = .16, p < .001). In addition, IPV victimization partially mediates the impacts of ACEs on perceived physical health (β = .06, p < .001), mental health (β = .28, p < .001), and depression (β = .10, p < .001). ACEs influenced adulthood health outcomes both physically and mentally via IPV victimization. This study suggests a life-course perspective and trauma-informed approach that incorporates the long-term effect of ACEs and IPV victimization on adulthood well-being.
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References
Acock, A. C. (2005). Working with missing values. Journal of Marriage and Family, 67(4), 1012–1028. https://doi.org/10.1111/j.1741-3737.2005.00191.x
Alvarez, C., Perrin, N., Lameiras-Fernandez, M., Rodriguez, R., & Glass, N. (2019). Adverse childhood experiences among Latina women and its association with mastery of stress and health. Child Abuse & Neglect, 93, 139–148. https://doi.org/10.1016/j.chiabu.2019.05.004
Amar, A. F., & Gennaro, S. (2005). Dating violence in college women: Associated physical injury, healthcare usage, and mental health symptoms. Nursing Research, 54(4), 235–242.
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C. H., Perry, B. D., ... & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256 (3), 174-186. https://doi.org/10.1007/s00406-005-0624-4
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411–423.
Ansara, D. L., & Hindin, M. J. (2010). Formal and informal help-seeking associated with women’s and men’s experiences of intimate partner violence in Canada. Social Science & Medicine, 70(7), 1011–1018. https://doi.org/10.1016/j.socscimed.2009.12.009
Bacchus, L. J., Ranganathan, M., Watts, C., & Devries, K. (2018). Recent intimate partner violence against women and health: A systematic review and meta-analysis of cohort studies. British Medical Journal Open, 8(7), e019995. https://doi.org/10.1136/bmjopen-2017-019995
Barrios, Y. V., Gelaye, B., Zhong, Q., Nicolaidis, C., Rondon, M. B., Garcia, P. J., . . . Williams, M. A. (2015). Association of childhood physical and sexual abuse with intimate partner violence, poor general health and depressive symptoms among pregnant women. PLoS ONE, 10(1), e0116609. https://doi.org/10.1371/journal.pone.0116609
Becker, K. D., Stuewig, J., & McCloskey, L. A. (2010). Traumatic stress symptoms of women exposed to different forms of childhood victimization and intimate partner violence. Journal of Interpersonal Violence, 25(9), 1699–1715. https://doi.org/10.1177/0886260509354578
Bellis, M. A., Hughes, K., Leckenby, N., Perkins, C., & Lowey, H. (2014). National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England. BMC Medicine, 12(72). https://doi.org/10.1186/1741-7015-12-72
Bensley, L., Van Eenwyk, J., & Wynkoop Simmons, K. (2003). Childhood family violence history and women’s risk for intimate partner violence and poor health. American Journal of Preventive Medicine, 25(1), 38–44. https://doi.org/10.1016/S0749-3797(03)00094-1
Bethell, C. D., Davis, M. B., Gombojav, N., Stumbo, S., & Powers, K. (2017). Issue Brief: Adverse childhood experiences among US children. Child and Adolescent Health Measurement Initiative, Johns Hopkins Bloomberg School of Public Health. Retrieved from https://www.publicschoolsfirstnc.org/wpcontent/uploads/2018/08/ACEs-Fact-Sheet.pdf.
Bosch, J., Weaver, T. L., Arnold, L. D., & Clark, E. M. (2017). The impact of intimate partner violence on women’s physical health: Findings from the Missouri Behavioral Risk Factor Surveillance System. Journal of Interpersonal Violence, 32(22), 3402–3419. https://doi.org/10.1177/0886260515599162
Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Sage.
Brown, M. J., Perera, R. A., Masho, S. W., Mezuk, B., & Cohen, S. A. (2015). Adverse childhood experiences and intimate partner aggression in the US: Sex differences and similarities in psychosocial mediation. Social Science & Medicine, 131(48), 57. https://doi.org/10.1016/j.socscimed.2015.02.044
Byrd, D. R., & McKinney, K. J. (2012). Individual, interpersonal, and institutional level factors associated with the mental health of college students. Journal of American College Health, 60(3), 185–193. https://doi.org/10.1080/07448481.2011.584334
Campbell, J. A., Farmer, G. C., Nguyen-Rodriguez, S., Walker, R., & Egede, L. (2018). Relationship between individual categories of adverse childhood experience and diabetes in adulthood in a sample of US adults: Does it differ by gender? Journal of Diabetes and Its Complications, 32(2), 139–143. https://doi.org/10.1016/j.jdiacomp.2017.11.005
Campbell, J., Jones, A. S., Dienemann, J., Kub, J., Schollenberger, J., O’Campo, P., Gielen, C., & Wynne, C. (2002). Intimate partner violence and physical health consequences. American Medical Association, 162(10), 1157–1163. https://doi.org/10.1001/archinte.162.10.1157
Campbell, J., Walker, R., & Egede, L. (2016). Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50(3), 344–352. https://doi.org/10.1016/j.amepre.2015.07.022
Centers for Disease Control and Prevention (2019). Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/pdf/preventingACES-508.pdf.
Choi, H. J., & Temple, J. R. (2015). Do gender and exposure to interparental violence moderate the stability of teen dating violence?: Latent transition analysis. Prevention Science, 17(3), 367–376. https://doi.org/10.1007/s11121-015-0621-4
Cloitre, M., Khan, C., Mackintosh, M.-A., Garvert, D. W., Henn-Haase, C. M., Falvey, E. C., & Saito, J. (2019). Emotion regulation mediates the relationship between ACES and physical and mental health. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 82–89. https://doi.org/10.1037/tra0000374
Cohen, J. R., Menon, S. V., Shorey, R. C., Le, V. D., & Temple, J. R. (2017). The distal consequences of physical and emotional neglect in emerging adults: A person-centered, multi-wave, longitudinal study. Child Abuse & Neglect, 63, 151–161. https://doi.org/10.1016/j.chiabu.2016.11.030
Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23(4), 260–268. https://doi.org/10.1016/S0749-3797(02)00514-7
Eshelman, L. R., & Levendosky, A. (2012). Dating violence: Mental health consequences based on type of abuse. Violence and Victims, 27(2), 215–228. https://doi.org/10.1891/0886-6708.27.2.215
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/j.amepre.2019.04.001
Finkelhor, D., Hamby, S. L., Ormrod, R., & Turner, H. (2005). The Juvenile Victimization Questionnaire: Reliability, validity, and national norms. Child Abuse & Neglect, 29(4), 383–412. https://doi.org/10.1016/j.chiabu.2004.11.001
Finkelhor, D., Shattuck, A., Turner, H., & Hamby, S. (2015). A revised inventory of adverse childhood experiences. Child Abuse & Neglect, 48, 13–21. https://doi.org/10.1016/j.chiabu.2015.07.011
Fogarty, C. T., Fredman, L., Heeren, T. C., & Liebschutz, J. (2008). Synergistic effects of child abuse and intimate partner violence on depressive symptoms in women. Preventive Medicine, 46(5), 463–469. https://doi.org/10.1016/j.ypmed.2007.12.009
Ford, J. K., MacCallum, R. C., & Tait, M. (1986). The application of exploratory factor analysis in applied psychology: A critical review and analysis. Personnel Psychology, 39(2), 291–314. https://doi.org/10.1111/j.1744-6570.1986.tb00583.x
Gobin, R. L., Iverson, K. M., Mitchell, K., Vaughn, R., & Resick, P. A. (2013). The impact of childhood maltreatment on PTSD symptoms among female survivors of intimate partner violence. Violence and Victims, 28(6), 984–999. https://doi.org/10.1891/0886-6708.VV-D-12-00090
Hamby, S. (2013). The Partner Victimization Scale. Life Paths Research Program.
Hinojosa, R., Nguyen, J., Sellers, K., & Elassar, H. (2019). Barriers to college success among students that experienced adverse childhood events. Journal of American College Health, 67(6), 531–540. https://doi.org/10.1080/07448481.2018.1498851
Hooven, C., Nurius, P. S., Logan-Greene, P., & Thompson, E. A. (2012). Childhood violence exposure: Cumulative and specific effects on adult mental health. Journal of Family Violence, 27(6), 511–522. https://doi.org/10.1007/s10896-012-9438-0
Hughes, K., Bellis, M., Hardcastle, K., Sethi, D., Butchart, A., Mikton, C., . . . Dunne, M. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health,2(8), E356-E366. doi:https://doi.org/10.1016/S2468-2667(17)30118-4
Jochman, J. C., Cheadle, J. E., Goosby, B. J., Tomaso, C., Kozikowski, C., & Nelson, T. (2019). Mental health outcomes of discrimination among college students on a predominately White campus: A prospective study. Socius: Sociological Research for a Dynamic World, 5, 237802311984272. https://doi.org/10.1177/2378023119842728
Julian, L. J., Gregorich, S. E., Tonner, C., Yazdany, J., Trupin, L., Criswell, L. A., . . . Katz, P. P. (2011). Using the center for epidemiologic studies depression scale to screen for depression in systemic lupus erythematosus. Arthritis Care & Research, 63(6), 884-890. https://doi.org/10.1002/acr.20447
Karatekin, C. (2018). Adverse childhood experiences (ACEs), stress and mental health in college students. Stress and Health, 34(1), 36–45. https://doi.org/10.1002/smi.2761
Kelley, K., & Preacher, K. J. (2012). On effect size. Psychological Methods, 17(2), 137–152. https://doi.org/10.1037/a0028086
Kline, R. B. (2005). Principles and practice of structural equation modeling. The Guilford Press.
Lilly, M. M., London, M. J., & Bridgett, D. J. (2014). Using SEM to examine emotion regulation and revictimization in predicting PTSD symptoms among childhood abuse survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 6(6), 644–651. https://doi.org/10.1037/a0036460
Lown, E. A., & Vega, W. A. (2001). Intimate partner violence and health: Self-assessed health, chronic health, and somatic symptoms among Mexican American women. Psychosomatic Medicine, 63(3), 352–360. https://doi.org/10.1097/00006842-200105000-00004
Mair, C., Cunradi, C. B., & Todd, M. (2012). Adverse childhood experiences and intimate partner violence: Testing psychosocial mediational pathways among couples. Annals of Epidemiology, 22(12), 832–839. https://doi.org/10.1016/j.annepidem.2012.09.008
McDowell, I. (2006). Measuring health: A guide to rating scales and questionnaires (3rd ed.). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195165678.001.0001
McKinney, C. M., Caetano, R., Ramisetty-Mikler, S., & Nelson, S. (2009). Childhood family violence and perpetration and victimization of intimate partner violence: Findings from a national population-based study of couples. Annals of Epidemiology, 19(1), 25–32. https://doi.org/10.1016/j.annepidem.2008.08.008
Merrick, M., Ports, K., Ford, D., Afifi, T., Gershoff, E., & Grogan-Kaylor, A. (2017). Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse & Neglect, 69, 10–19. https://doi.org/10.1016/j.chiabu.2017.03.016
Muthén, L. K., & Muthén, B. O. (2012). Mplus user’s guide. Muthén & Muthén.
Nathanson, A., Shorey, R. C., Tirone, V., & Rhatigan, D. L. (2012). The prevalence of mental health disorders in a community sample female victims of intimate partner violence. Partner Abuse, 3(1), 59–75. https://doi.org/10.1891/1946-6560.3.1.59
Nikulina, V., Gelin, M., & Zwilling, A. (2017). Is there a cumulative association between adverse childhood experiences and intimate partner violence in emerging adulthood? Journal of Interpersonal Violence. https://doi.org/10.1177/0886260517741626
Ouellet-Morin, I., Fisher, H. L., York-Smith, M., Fincham-Campbell, S., Moffitt, T. E., & Arseneault, L. (2015). Intimate partner violence and new-onset depression: A longitudinal study of women’s childhood and adult histories of abuse. Depression and Anxiety, 32(5), 316–324. https://doi.org/10.1002/da.22347
Ports, K. A., Ford, D. C., & Merrick, M. T. (2016). Adverse childhood experiences and sexual victimization in adulthood. Child Abuse & Neglect, 51, 313–322. https://doi.org/10.1016/j.chiabu.2015.08.017
Próspero, M. (2007). Mental Health Symptoms Among Male Victims of Partner Violence. American Journal of Men’s Health, 1(4), 269–277. https://doi.org/10.1177/1557988306297794
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Reiser, S. J., Mcmillan, K. A., Wright, K. D., & Asmundson, G. J. (2014). Adverse childhood experiences and health anxiety in adulthood. Child Abuse & Neglect, 38, 407–413. https://doi.org/10.1016/j.chiabu.2013.08.007
Riggs, S. A. (2010). Childhood emotional abuse and the attachment system across the life cycle: What theory and research tell us. Journal of Aggression, Maltreatment & Trauma, 19(1), 5–51. https://doi.org/10.1080/10926770903475968
Sabina, C., & Straus, M. (2008). Polyvictimization by dating partners and mental health among US college students. Violence and Victims, 23(6), 667–682. https://doi.org/10.1891/0886-6708.23.6.667
Sacks, V., & Murphey, D. (2018). The prevalence of adverse childhood experiences, nationally, by state, and by race or ethnicity. Child Trends. Retrieved from https://www.childtrends.org/publications/prevalence-adversechildhood-experiencesnationally-state-race-ethnicity.
Salinas-Miranda, A., Salemi, J., King, L., Baldwin, J., Berry, E., Austin, D., . . . Salihu, H. (2015). Adverse childhood experiences and health-related quality of life in adulthood: Revelations from a community needs assessment. Health and Quality of Life Outcomes, 13(1), 123, 1–12. https://doi.org/10.1186/s12955-015-0323-4
Sargent, K. S., Krauss, A., Jouriles, E. N., & McDonald, R. (2016). Cyber victimization, psychological intimate partner violence, and problematic mental health outcomes among first-year college students. Cyberpsychology, Behavior, and Social Networking, 19(9), 545–550. https://doi.org/10.1089/cyber.2016.0115
Southworth, C., Finn, J., Dawson, S., Fraser, C., & Tucker, S. (2007). Intimate Partner Violence, Technology, and Stalking. Violence against Women, 13(8), 842–856. https://doi.org/10.1177/1077801207302045
Substance Abuse and Mental Health Services Administration. [SAMHSA] (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. Rockville, MD: Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/system/files/sma14-4884.pdf.
Temple, J. R., Choi, H. J., Elmquist, J., Hecht, M., Miller-Day, M., Stuart, G. L., … Wolford-Clevenger, C. (2016). Psychological abuse, mental health, and acceptance of dating violence among adolescents. Journal of Adolescent Health, 59(2), 197–202. https://doi.org/10.1016/j.jadohealth.2016.03.034
Wadsworth, P., Kothari, C., Lubwama, G., Brown, C. L., & Benton, J. F. (2018). Health and health care from the perspective of intimate partner violence adult female victims in shelters: Impact of IPV, unmet needs, barriers, experiences, and preferences. Family and Community Health, 41(2), 123–133. https://doi.org/10.1097/FCH.0000000000000186
Wathen, C. N., MacGregor, J. C. D., & MacQuarrie, B. J. (2018). Relationships among intimate partner violence, work, and health. Journal of Interpersonal Violence, 33(14), 2268–2290. https://doi.org/10.1177/0886260515624236
Watt, T., Ceballos, N., Kim, S., Pan, X., & Sharma, S. (2020). The unique nature of depression and anxiety among college students with adverse childhood experiences. Journal of Child & Adolescent Trauma, 13(2), 163–172. https://doi.org/10.1007/s40653-019-00270-4
Willie, T. C., Kershaw, T., & Sullivan, T. P. (2018). The impact of adverse childhood events on the sexual and mental health of women experiencing intimate partner violence. Journal of Interpersonal Violence,088626051880285. https://doi.org/10.1177/0886260518802852
Windle, M., Haardörfer, R., Getachew, B., Shah, J., Payne, J., Pillai, D., & Berg, C. J. (2018). A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students. Journal of American College Health, 66(4), 246–251. https://doi.org/10.1080/07448481.2018.1431892
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Seon, J., Cho, H., Choi, GY. et al. Adverse Childhood Experiences, Intimate Partner Violence Victimization, and Self-Perceived Health and Depression among College Students. J Fam Viol 37, 691–706 (2022). https://doi.org/10.1007/s10896-021-00286-1
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DOI: https://doi.org/10.1007/s10896-021-00286-1