The relationship between adverse childhood experiences and depression and anxiety in adolescents: the chain mediating effect of perceived stress and self-hate

Objective Adolescent emotional issues have gained increasing global attention. The connection between Adverse Childhood Experiences (ACEs) and emotional issues in adolescents is well-established. However, the specific psychological pathways that explain this link are not yet fully understood. Our study aims to clarify the link between ACEs and depressive/anxious symptoms in a large Chinese adolescent cohort. Methods We conducted a cross-sectional analysis with 7,158 students from Shandong Province, China, using a stratified cluster sampling method. Participants completed a series of self-report scales: the Adverse Childhood Experiences Scale (ACE-R), the Perceived Stress Scale (PSS-10), the Self-hate Scale (SHS), and the Patient Health Questionnaire-4 (PHQ-4). To test our chain mediation hypothesis, we used correlation analyses and a bootstrap approach. Results Female adolescents and those with poorer academic performance had higher scores on childhood adverse experiences, perceived stress, self-hate, and emotional symptoms ( p < 0.05). High school students scored higher than middle school students in terms of childhood adverse experiences and self-hate ( p < 0.05). Only children had higher scores on childhood adverse experiences compared to non-only children ( p < 0.05). Perceived stress and self-hate serve as chain mediators in the relationship between childhood adverse experiences and depressive-anxiety symptoms in adolescents. Discussion This study expands the research on the relationship between adverse childhood experiences and depressive and anxious emotions in adolescence, providing new insights for reducing the negative impacts of depressive and anxious emotions in adolescents and promoting their mental health.