Association Between Patterns Of Adverse Childhood Experiences And Depression And Anxiety Symptoms In Medical College Students:A Longitudinal Study

ObjectiveWe aimed to explore adverse childhood experiences（ACEs）patterns combined type and timing and depression and anxiety symptom trajectories,and to analyse the relationship between ACEs patterns and anxiety trajectories in college students.MethodsA school-based health survey used data from a longitudinal study of two medical colleges in Anhui Province,China.Baseline survey（wave1）was conducted from November to December 2019,and twice follow-up visits（wave2 and wave3）were conducted once every six months.3662 participants completed questionnaire survey from wave 1 to wave 3.Latent class analysis（LCA）was used to identify patterns of ACEs combined type and timing,while depression and anxiety symptom trajectories were used latent class growth analysis（LCGA）to identify.Multiple logistic regressions were conducted to evaluate the relationships between ACEs types,timing and patterns and depression and anxiety symptom trajectories.ResultsWe identified five patterns of ACEs as follow: “High ACEs”（13.4%）,“High neglect and emotional abuse”（25.7%）,“High family dysfunction”（6.9%）,“High neglect”（27.1%）,“low ACEs”（26.3%）.We traced three depression trajectories:“High depression symptom”（4.0%）“Moderate depression symptom”（23.9%）,“Low depression symptom”（72.1%）.If the reference category was “low depression”,“high ACEs”,“high neglect and emotional abuse” and “high family dysfunction”demonstrated a high risk for high depression and moderate depression trajectories.“High neglect” showed a high risk for “moderate depression” but not for “high depression”.If the reference category was “moderate depression”,only “high ACEs”demonstrated a high risk for “high depression”.Four course anxiety trajectories were identified: “high anxiety decline ”（7.1%）,“high anxiety increase”（4.1%）,“moderate anxiety”（52.9%）,“low anxiety”（35.9%）.If the reference category was “low anxiety”,“high ACEs”,“high neglect and emotional abuse” and “high family dysfunction”demonstrated a high rate of risk for moderate and high anxiety trajectories than “low ACEs”（P < 0.05）.“High ACEs” significantly increased the risk of “high anxiety increase” and “high anxiety decline”.ConclusionsHigh ACEs exposure patterns are associated with increased rate of depression and anxiety symptom in college students.Reducing ACEs exposure and focusing on the development of depression and anxiety symptoms are beneficial to the prevention and control of depression and anxiety symptoms in college students.