Life Course Adversity and Psychological Outcomes: A Longitudinal Investigation Among Chinese Emerging Adults

Background and Purpose: Adverse Childhood Experiences (ACEs) have garnered substantial research attention due to their profound impact on individuals' health and well-being. However, the existing literature predominantly focuses on Western populations. Additionally, little attention has been given to the link between ACEs and adverse adult experiences. Addressing these critical gaps, this investigation aims to elucidate paths of life course adversity that impact mental health outcomes among a cohort of Chinese rural youth. We hypothesize that ACEs increase the likelihood of exposure to adverse adult experiences, which, in turn, increase the risk of experiencing psychological challenges.

Methods: The present study analyzes data from a longitudinal cohort investigation of adversity and wellbeing among rural Chinese emerging adults. A convenience sample of over 300 participants completed two survey waves. Wave 1 data was collected from 2016 to 2018 when the youth graduated from high school (ages 18-20), and wave 2 data collection was completed in 2023 when participants were between 23-26 years of age.

ACEs were measured at wave 1 using the Childhood Experiences Survey (Choi et al., 2020; Mersky et al., 2017), and adverse adult experiences were measured at wave 2 using the Adult Experiences Survey (Mersky et al., 2021). Both assessments were translated into Mandarin by the lead author and a committee of experts. Brief, validated measures were used to assess four mental health outcomes at wave 2: anxiety, depression, perceived stress, and loneliness.

Statistical analyses were performed using SPSS version 29. Multivariate linear regression models were run to determine relationships between ACEs, adulthood adversities, and psychological outcomes, while controlling for a series of covariates. Specifically, a multivariate regression model was fit to test the relationship between ACEs and adult adversities. Subsequently, four distinct multivariate regression models were performed to assess the effects of both childhood and adult adversities on each psychological outcome. Finally, mediation analyses using PROCESS Model 4 were conducted to examine whether adulthood adversities mediate the associations between ACEs and psychological outcomes.

Results: A cumulative ACE score demonstrated a significant, positive relationship with a cumulative count measure of adverse adult experiences (B = 0.29; 95% CI = 0.18 – 0.40). Surprisingly, ACEs were not significantly associated with all mental health outcomes. But adverse adult experiences were directly associated with anxiety (B = 0.73; 95% CI = 0.36 – 1.11), depression (B = 1.08; 95% CI = 0.65 – 1.51), perceived stress (B = 0.37; 95% CI = 0.12 – 0.61), and loneliness (B = 0.33; 95% CI = 0.15 – 0.51). Results from the PROCESS model showed that adulthood adversities mediated the relationship between ACEs and all psychological outcomes.

Conclusions and Implications: The study findings revealed that ACEs increase the likelihood of poor psychological outcomes in emerging adulthood, albeit indirectly by increasing the risk of adverse adult experiences. Our work points to the need for further longitudinal research on how life course paths of adversity influence health and well-being in later life. Implications for interventions aimed at interrupting generational and intergenerational trauma will be discussed.