Effects of Adverse Childhood Experiences and Intimate Partner Violence Victimization on Health Outcomes Among College Students

Background: Recent estimates report that six in ten people in the U.S. have been exposed to adverse childhood experiences (ACEs), such as child abuse and neglect. Such ACEs are associated with negative health and behavioral consequences on survivors, which could last throughout adulthood. Further, ACEs have been shown to be a risk factor for intimate partner violence (IPV) victimization in adulthood. Literature suggests that both ACEs and IPV victimization are associated with negative health outcomes, including physical and mental health, and depression. Understanding such relationships will better prepare service providers for the survivors of ACEs and IPV victimization, who are likely to have complicated needs across lifespan. However, previous studies are limited in this area, often using small samples, and focusing on a single type of victimization of ACEs or IPV. This study fills this gap by examining how ACEs and IPV victimization affect health outcomes using a recent data collected from college students.

Methods: This study collected data from college students at seven universities in the U.S. and Canada through a cross-sectional survey in 2016 (N=4,607). Major variables are ACEs, IPV, and health outcomes. ACEs were measured by 21 items, including community victimization, child abuse and neglect, and exposure to domestic violence; IPV by 12 items, including threats and physical, psychological, sexual, and technological violence; and three health outcomes, including perceived physical and mental health, and depression. Covariates include gender and race/ethnicity. Confirmatory factor analyses (CFA) were conducted for two measurement models for ACEs and IPV, and structural equation modeling (SEM) for structural models, using Mplus 7.0.

Results: CFA for ACEs revealed a good model fit to the data (X²=12.18, CFI=.99, TLI=.99, RMSEA=.03), with factor loadings from .45 to .83 (p<.001). CFA for IPV showed a good model fit (X²=771.930, CFI =.91, TLI=.90, RMSEA =.02), with factor loadings from .56 to .80 (p<.001). The proposed structural models produced a good model fit (X²=803.837, CFI=.94, TLI=.91, RMSEA=.05). The model estimation showed positive relationships of ACEs with poor physical health (β=.35, p<.001), poor mental health (β=.55, p<.001), and higher levels of depression (β=.38, p<.001). IPV was positively associated with poor physical health (β=.04, p<.01), poor mental health (β=.22, p<.001), and higher levels of depression (β=.14, p<.001). IPV mediated the effects of ACEs on physical health (β=.06, p<.01), mental health (β=.11, p<.001), and depression (β=.07, p<.001).

Conclusions: Study findings indicate that college students with ACEs and IPV are more likely to experience higher levels of health problems, both physically and mentally. The earlier children experiencing ACEs and young adults victimized by IPV are identified, the sooner survivors can be connected to the services they need to prevent or reduce the health problems. Given that ACEs result in negative health outcomes through a pathway of IPV victimization, service providers should provide necessary information and referrals for those who reveal ACEs and IPV to help survivors adequately address unsolved issues of past violence experiences for their better health.