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Adverse childhood experiences and psychological distress: A systematic review and meta-analysis
Xinyu Gao1, Gan Li2, Qing Yang3
1College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Background:
Adverse childhood experiences (ACEs) are a recognized risk factor for psychological distress, yet the strength of this association requires quantitative synthesis.
Methods:
We conducted a pre-registered systematic review and meta-analysis (PRISMA). Four databases were searched from inception to August 2025. Observational studies in adults were included, with quality assessed using JBI checklists. A random-effects meta-analysis synthesized correlation coefficients.
Results:
From 198 records, 17 studies (N = 19,747) were included in the review; 4 (N = 4023) were eligible for meta-analysis. We found a significant, moderate positive correlation between ACEs and psychological distress (pooled r = 0.26, 95% CI: 0.21-0.31), with low-to-moderate heterogeneity (I2 = 35.8%). Sensitivity analysis suggested the pooled estimate was relatively stable within the included studies.
Conclusion:
This synthesis consolidates current quantitative evidence linking ACEs to adult psychological distress, highlighting the need for integrating adverse childhood experiences screening into public health strategies. Future research should investigate the mechanisms underlying this association and develop targeted interventions.
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