A Snapshot of Adverse Childhood Experiences among International Medical Students and Their Impact on Holistic Health during the Covid-19 Pandemic

ABSTRACT

Aims Adverse Childhood Experiences (ACE's) are those potentially traumatic events occurring in an individual between birth and 17 years of age.1 The term was first used in the pioneering study published in 1998, which showed causational relationships between ten adverse childhood experiences and negative health outcomes. Since then, a multitude of further research has been conducted in the field. Scientific curiosity led me to research the link between early trauma and physical, mental, and social health. Having conducted and presented the results of a pilot study (pre-pandemic), my passion grew, leading to an in-depth literature review on the relating factors, mechanism and relationship between ACE's and physical and mental health, followed by an extensive undergraduate study, to ascertain the impact of ACE's on medical students, in particular focusing on emotional health, during this pandemic (2021). Methods A sample of 140 students attending the university of medicine and pharmacy 'Grigore T. Popa' were surveyed, collecting demographic, physical, mental, social, and emotional health data by means of an Google Forms questionnaire (including the Pittsburgh sleep quality Index,2 and WHO ACE-IQ3). Correlations were made between different variables, such as gender, nationality, self-rated physical health and 'binary ACE score'. Results 61.4% were female, with participants from across the globe. The average age was 23.13 years. A snapshot of the prevalence of ACE's was obtained, 29.3% had an ACE score of 4 or more. Of the categories of ACE's a quarter having experienced sexual abuse, witnessing physical violence (without objects) in just under a third (31%), and threats or actual abandonment or exclusion from the house in just under 1 in 5 (19%). While data confirmed the findings of previous studies on the impact of ACE's on physical health, the most notable findings were in relation to emotional health. In the past year, 39.3% reported having felt deep sadness more than three times. 47.1% reported feelings of worthlessness more than three times in the past year. 27.1% reported excessive worry, 15% reported thoughts of self-harm. Positive correlations were observed between ACE score, and feelings of deep sadness, feelings of worthlessness, excessive worry, thoughts of self-harm, and suicidal thoughts (see figure 1). Conclusion These findings underline an important issue, equally affecting the future medical professionals. Findings reflect the generation and the world as a whole, with the compounded impact of the SARS-COV-2 pandemic on mental and emotional health. Results suggest, dealing with the effects of 'post-pandemic' stress and ACE will be an issue requiring particular attention. (Figure Presented).