THE EFFECTS OF ADVERSE CHILDHOOD EXPERIENCES ON PSYCHOSOCIAL WELLBEING AND MEDIATING ROLE OF SELFESTEEM AMONG MEDICAL STUDENTS

Abstract

Background: Adverse childhood experience (ACE) has cumulative consequences on physical, mental and social wellbeing. The impact of ACEs is amplified by stressors, such as academic, physical, social and emotional stressors, which medical students are constantly exposed to. Aim and Objective: This study is aimed at determining the association between adverse childhood experiences and adult psychosocial wellbeing and mediating role of selfesteem among preclinical medical students.Participants and setting:A total of 138 undergraduate medical students at C.U. Shah medical college and hospital, Surendranagar participated in the study. Methods: Participants completed online google forms having socio-demographic, an Adverse Childhood Experience, the World Health Organization's Quality of Life (WHOQOL-BREF) and the Rosenberg's self-esteem questionnaires. Data obtained were analysed using SPSS.Descriptive and inferential statistical analyses were performed. Results:At least one out of ten categories of ACEs were reported by 39.8% of respondents;physical abuse (19.1%),emotional abuse (18.2%),parental divorce (9.4%) and sexual abuse (9.0%). There was a significant association between adverse childhood experiences and adult psychosocial wellbeing (p<0.05), as well as low self-esteem (p<0.05). Respondents with previous exposure to ACEs were six times more likely to suffer from low esteem compared to non-exposed students (Adj OR:6.3, 95%CI:1.3-31.4, p=0.003).Mother's (p=0.001) and father's (p=0.028) level of education,parental separation (p<0.0001),were associated with exposure to ACEs. Conclusion: this study revealed an association between exposure to adverse childhood experiences and adult psychosocial well-being with those exposed reporting poorer wellbeing and functioning;and a strong likelihood of having low self-esteem among medical undergraduates