Sciolla Andrés F, Sandholdt Cara M, Jandrey Karl E, Rea Margaret, Rice Elizabeth I, Wilson Machelle D, Wilkes Michael S
Acad Med. 2025 Sep 1;100(9):1051-1060. doi: 10.1097/ACM.0000000000006093. Epub 2025 May 22.
To determine the relationship between adverse childhood experiences (ACEs), social disadvantage, psychological distress, and resilience in graduate health professions students.
This study includes cross-sectional analyses from a longitudinal survey of medical, veterinary, and advanced practice provider students at matriculation to the University of California Davis in July 2019. The survey contained an expanded Adverse Childhood Experiences Questionnaire (ACEs-14), a measure of psychological distress (the Medical Student Well-Being Index [MSWBI]), and the Brief Resilience Scale. Responses were linked to demographics, including markers of social disadvantage (female gender, underrepresented in medicine [URM] status, and first-generation college graduate [first-gen] status). The relationships between ACEs, social disadvantage, psychological distress, and resilience were tested using linear or logistic regression.
Complete survey responses were provided from 240 of 357 students (67% completion rate). About two-thirds of students (67%, 161/240) reported ≥ 1 ACE, while a quarter (25%, 60/240) reported ≥ 4 ACEs. URM and first-gen students had higher odds of reporting ≥ 4 ACEs (odds ratio [OR] = 1.56; P = .049 and OR = 2.63; P < .001, respectively) than their nondisadvantaged peers based on binary logistic regression analysis. Higher ACEs-14 scores were associated with higher psychological distress scores ( P < .001). The majority of students reported normal or high resilience (normal: 76%, 183/240; high: 10%, 25/240) regardless of ACEs-14 scores. There was not a statistically significant relationship between ACEs-14 scores and resilience scores ( P = .936).
Health professions students from some socially disadvantaged backgrounds at this institution reported statistically significantly higher ACEs-14 scores than their nondisadvantaged peers. Childhood adversity was associated with increased psychological distress but not with low resilience. Implications for equity- and trauma-informed health professions education and interventions are discussed.
确定不良童年经历（ACEs）、社会劣势、心理困扰和加州大学戴维斯分校健康专业研究生的心理韧性之间的关系。
本研究包括对2019年7月入学的医学、兽医学和高级实践提供者专业学生进行的纵向调查的横断面分析。该调查包含一份扩展的不良童年经历问卷（ACEs - 14）、一份心理困扰测量量表（医学生幸福感指数[MSWBI]）和简易心理韧性量表。调查结果与人口统计学数据相关联，包括社会劣势指标（女性性别、医学领域代表性不足[URM]身份和第一代大学生[第一代]身份）。使用线性或逻辑回归测试ACEs、社会劣势、心理困扰和心理韧性之间的关系。
357名学生中有240名（完成率67%）提供了完整的调查回复。约三分之二的学生（67%，161/240）报告有≥1次ACE，而四分之一（25%，60/240）报告有≥4次ACE。根据二元逻辑回归分析，URM学生和第一代学生报告≥4次ACE的几率（优势比[OR]分别为1.56；P = 0.049和OR = 2.63；P < 0.001）高于非弱势同龄人。ACEs - 14得分越高，心理困扰得分越高（P < 0.001）。无论ACEs - 14得分如何，大多数学生报告心理韧性正常或较高（正常：76%，183/240；高：10%，25/240）。ACEs - 14得分与心理韧性得分之间没有统计学上的显著关系（P = 0.936）。
该机构中一些社会弱势背景学生的ACEs - 14得分在统计学上显著高于非弱势同龄人。童年逆境与心理困扰增加有关，但与心理韧性低无关。讨论了对公平和创伤知情的健康专业教育及干预措施的启示。
