Adverse childhood experiences and distal health outcomes: the mediating effect of depression, anxiety, and stress
1
Institute of Public Health, United Arab Emirates University, Al-Ain, United Arab Emirates
2
School of Psychology, University of Birmingham, Edgbaston,, United Kingdom
3
Thrive Center for Children, Families, and Communities, Georgetown University, Washington, DC, United States
4
Concordia University, Montreal,, Canada
5
Early Childhood Authority, Abu Dhabu, United Arab Emirates
Popul. Med. 2026;8(Supplement Supplement 1):A2554
ABSTRACT
INTRODUCTION:
Adverse childhood experiences (ACEs) are associated with long-term psychological distress and increased risk of chronic disease. However, evidence from multicultural populations, including those in the United Arab Emirates (UAE), remains limited. This study examined the direct and indirect associations between ACEs and adult mental and physical health outcomes in a diverse community-based sample in Abu Dhabi.
METHODS:
A cross-sectional community-based study was conducted among 922 adults residing in Abu Dhabi. Participants completed the adverse childhood experiences international questionnaire and the depression, anxiety, and stress scale. Self-reported data on physical and mental health conditions and health-related behaviors were also collected. Structural equation modelling was used to assess direct and indirect pathways linking ACEs with psychological distress and physical health outcomes, including chronic conditions.
RESULTS:
Higher ACE scores were significantly associated with increased levels of depression, anxiety, and stress. Elevated ace exposure was also associated with a higher prevalence of chronic conditions, particularly hypertension. The association between ACEs and physical health outcomes was statistically consistent with partial mediation through psychological distress and engagement in risk-related behaviors. In contrast, regular physical activity was associated with lower levels of psychological distress and appeared to attenuate some adverse pathways.
CONCLUSIONS:
ACEs are strongly associated with poorer mental health and increased chronic disease burden among adults in Abu Dhabi. Psychological distress plays a key mediating role in linking early-life adversity to adult physical health outcomes. These findings highlight the need for integrated, trauma-informed mental health services and preventive public health strategies. In the context of the UAE culturally diverse population, tailored interventions aimed at reducing childhood adversity and mitigating its long-term health consequences are warranted.
Adverse childhood experiences (ACEs) are associated with long-term psychological distress and increased risk of chronic disease. However, evidence from multicultural populations, including those in the United Arab Emirates (UAE), remains limited. This study examined the direct and indirect associations between ACEs and adult mental and physical health outcomes in a diverse community-based sample in Abu Dhabi.
METHODS:
A cross-sectional community-based study was conducted among 922 adults residing in Abu Dhabi. Participants completed the adverse childhood experiences international questionnaire and the depression, anxiety, and stress scale. Self-reported data on physical and mental health conditions and health-related behaviors were also collected. Structural equation modelling was used to assess direct and indirect pathways linking ACEs with psychological distress and physical health outcomes, including chronic conditions.
RESULTS:
Higher ACE scores were significantly associated with increased levels of depression, anxiety, and stress. Elevated ace exposure was also associated with a higher prevalence of chronic conditions, particularly hypertension. The association between ACEs and physical health outcomes was statistically consistent with partial mediation through psychological distress and engagement in risk-related behaviors. In contrast, regular physical activity was associated with lower levels of psychological distress and appeared to attenuate some adverse pathways.
CONCLUSIONS:
ACEs are strongly associated with poorer mental health and increased chronic disease burden among adults in Abu Dhabi. Psychological distress plays a key mediating role in linking early-life adversity to adult physical health outcomes. These findings highlight the need for integrated, trauma-informed mental health services and preventive public health strategies. In the context of the UAE culturally diverse population, tailored interventions aimed at reducing childhood adversity and mitigating its long-term health consequences are warranted.
| eISSN: | 2654-1459 |
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