Peer-reviewed article

Longitudinal associations between patterns of childhood adverse experiences and positive experiences and depression and anxiety symptom trajectories among college students.

Wan Xiao, Huiqiong Xu, Shuangshuang Deng, Yue Gao, Xianbing Song et al. · 19 May 2026

Abstract

Background: Despite the increased attention paid to the separate effects of cumulative adversities and protection on mental health, the extent to which distinct clusters of risk and protective factors exist and have special effects on depression and anxiety symptom trajectories remains under-explored.Objective: To explore the effects of clusters of childhood adverse experiences and positive experiences on depression and anxiety symptom trajectories.Methods: A longitudinal study was conducted at two colleges in Anhui province, China, between October 2022 and November 2023. Questionnaires were administered to 4,764 first-year students anonymously, requesting information regarding their adverse childhood experiences (ACEs), positive childhood experiences (PCEs), depression and anxiety symptoms. Latent class analysis was utilized to identify classes based on ACEs and PCEs. Latent class growth analysis was used to recognize trajectories of depression and anxiety symptoms. Two models were conducted using regression analysis. The correlation between a single type of ACEs and PCEs and clusters and depression and anxiety symptom trajectories was explored.Results: Three classes of ACEs and PCEs clusters were identified, comprising between 17.8% and 61.% of the sample each. Three distinct classes were identified for trajectories of depression and anxiety symptoms. Those who were referred to trajectory 1 ('low depression symptoms reducing') were found to be at an increased risk of developing 'high depression symptoms increasing' and 'moderate depression symptoms stabilized', when compared with those in class 3 ('low risk and high protection'). This was also the case for anxiety symptom trajectories.Conclusion: It is not only the case that distinct categories of ACEs and PCEs exist; furthermore, these groups exhibit varying probabilities of future depression and anxiety symptom trajectories. It is evident that a child's preventative measures of ACEs are likely to be of greater consequence than positive protection.