Adverse childhood experiences and psychological well-being in a rural sample of Chinese young adults

Zhang, L., Mersky, J. P., & Topitzes, J. (2020). Adverse childhood experiences and psychological well-being in a rural sample of Chinese young adults. Child Abuse & Neglect. 


International interest in adverse childhood experiences (ACE) is on the rise. In China, recent research has explored the effects of ACEs on health-related outcomes, but little is known about how ACEs impact the psychological functioning of rural Chinese youth as they make transition to adulthood.


This study is aimed to assess the prevalence and psychological consequences of ACEs among a group of rural Chinese young adults.

Participants and settings

1019 rural high school graduates from three different provinces of China participated in this study.


A web-based survey was used to assess ten conventional ACEs and seven other novel ACEs using the Childhood Experiences Survey. Using validated brief measures, six indicators of psychological functioning were assessed: anxiety, depression, perceived stress, posttraumatic stress, loneliness, and suicidality. Descriptive and correlational analyses of all ACEs were performed, and multivariate regressions were conducted to test associations between ACEs and study outcomes.


Three-fourths of Chinese youth endorsed at least one of ten conventional ACEs. The most prevalent ACEs were physical abuse (52.3 %) and domestic violence (43.2 %). Among seven new adversities, prolonged parental absence (37.4 %) and parental gambling problems (19.7 %) were most prevalent. Higher conventional ACEs scores were significantly associated with poorer psychological functioning, and each type of new adversity was associated with one or more psychological problems.


ACEs were prevalent among rural Chinese young adults and had deleterious effects on their psychological well-being. Further work is needed to address ACEs by developing culturally appropriate assessment practices, interventions, and policy responses.

Link to publication

All Publications