Adverse Childhood Experiences in Medical Students: Implications for Wellness

Abstract

Objective The primary purpose of the study was to assess the prevalence of adverse childhood experiences (ACEs) in a cohort of third-year medical students and characterize their childhood protective factors. Methods The authors developed a web-based anonymous survey distributed to all third-year medical students in one school ( N = 98). The survey included the 10-item ACE Study questionnaire, a list of childhood protective factors (CPF) and questions to assess students’ perception of the impact of ACEs on their physical and mental health. The medical school’s IRB approved the student survey as an exempt study. The authors computed descriptive and comparative statistical analyses. Results Eighty-six of 98 students responded (88% response rate). Forty-four students (51%) reported at least one ACE exposure and 10 (12%) reported ≥ 4 exposures. The latter were all female. The average difference in the ACE score between male and female medical students was − 1.1 (independent t test with unequal variances t (57.7) = − 2.82, P = .007). Students with an ACE score of ≥ 4 were significantly more likely to report a moderate or significant effect on their mental health, compared with students with scores ≤ 3 (chi-square test, P = < .0001). Most students reported high levels of CPF (median score = 13 of a maximum score = 14). ACEs and CPF were inversely associated (Pearson correlation = − 0.32, P = .003). Conclusions A sizeable minority of medical students reported exposure to multiple ACEs. If replicated, findings suggest a significant vulnerability of these medical students to health risk behaviors and physical and mental health problems during training and future medical practice.

Association of Adverse Childhood Experience and Attention Deficit Hyperactivity Disorder with depressive symptoms among men who have sex with men in China: moderated mediation effect of resilience

“…MSM in our study reported higher scores of ACE, with over half of participants reporting one or more ACE exposures, compared to general male population [13, 49]. Our results showed a strong positive association of ACE with depressive symptoms, which was in accordance with that of previous studies [13–15].…”

The Relationships among Self-Designated Disadvantage, Socioeconomic Disadvantage, and Academic Performance in Medical School: A Multi-Institutional Study

“…Students may use the AMCAS disadvantaged (SDA) prompt to disclose their experiences in a marginalized or underrepresented group, which may not otherwise be included in their application. Reporting SDA+ may reflect exposure to childhood adverse experiences, 33 including childhood maltreatment, bullying, and growing up with mental illness or substance use 34 in the family. 35,36 Students from negatively stereotyped or devalued social groups are more likely to experience bias and discrimination, 37,38 low self-efficacy and sense of belonging, 34,39,40 imposter syndrome (i.e., the feeling that they do not deserve to "be there" and that they have simply fooled anyone who thinks otherwise) 41 and microaggressions 42 -any one of which may adversely affect academic progression in medical school.…”

An Update on Trainee Wellness: Some Progress and a Long Way to Go

“…Two papers in this collection take very different approaches to exploring the etiology of burnout and depression during psychiatry training. Sciolla et al [5] attempt to place these issues in the context of developmental trauma and adverse childhood experiences (ACEs) of medical students. Although robust evidence shows that ACEs are a strong risk factor for later depression, suicidality, and substance abuse [6], there is a paucity of data on medical student populations.…”

“…Most of the cohort reported that they compared themselves to their peers to a moderate or great degree, and close to half reported that their self-worth was tied to their performance relative to their classmates. It is important to recognize, however, that both the Sciolla et al [5] and Hu et al [8] studies are limited by methodological challenges, including relatively small samples and a potential lack of generalizability of results.…”