Adverse childhood experiences and quality of life in a Mexican sample: a cross-sectional study

Mónica A. Martínez-Talamás, Instituto de Psicoterapia ABP, Monterrey, Nuevo León, Mexico
José A. Guerrero-Tamez, Department of Psychiatry, University Hospital and School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Andrés M. Treviño Alvarez, Department of Neurology, University Hospital and School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Dionicio A. Galarza-Molina, Instituto de Psicoterapia ABP; Department of Rheumatology, University Hospital and School of Medicine, Universidad Autónoma de Nuevo León. Monterrey, Mexico

Background: Adverse childhood experiences (ACEs), defined as specific instances of abuse, neglect, and household dysfunction occurring during critical developmental periods, are recognized as determinants of long-term physical and mental health. Evidence on their relationship with quality of life in Latin American populations, particularly in Mexico, remains limited. The aim of the study was to investigate the relationship between ACEs and self-reported quality of life among adults in Mexico. Methods: A cross-sectional study conducted in 2022 utilized an anonymous online survey distributed through Instagram, targeting Mexican adults aged 18 years and older. ACEs were measured using the 10-item ACE Questionnaire developed by Felitti and colleagues. Quality of life was assessed through the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), a 26-item instrument from the World Health Organization evaluating four domains: physical health, psychological health, social relationships, and environment, using a 5-point Likert scale. Pearson correlation coefficients were computed to assess the relationships between total ACE scores and WHOQOL-BREF domains. In addition, four binary logistic regression models analyzed the adjusted odds of poor quality of life and dissatisfaction with personal health, controlling for ACE type (or total ACE count), age, gender, and difficulties with weekly expenses. Results: A total of 4,505 participants, including 2,888 women and 1,617 men with a mean age of 26.6 years (± 6.8), were analyzed. Eighty percent reported experiencing at least one ACE, with emotional neglect (39%) and emotional abuse (37%) as the most common types. Women had higher rates of sexual abuse and cohabitation with a mentally ill family member, while men reported more physical abuse, physical neglect, parental separation or absence, household substance use, and household incarceration. Total ACE counts exhibited significant negative correlations with all four WHOQOL-BREF domains (p < 0.001). In adjusted models, emotional neglect, emotional abuse, and physical abuse were most strongly associated with poor quality of life. Each additional ACE was associated with 1.4-fold higher adjusted odds of poor quality of life and 1.2-fold higher adjusted odds of dissatisfaction with personal health, with financial strain being the covariate most strongly associated with these outcomes. Conclusions: In this extensive convenience sample of Mexican adults, ACEs were associated with lower self-reported quality of life and greater dissatisfaction with personal health. These findings should be interpreted cautiously due to the non-probabilistic sampling approach, underscoring the need for future population-based studies to confirm these associations and inform prevention strategies.

Keywords: Adverse childhood experiences. Quality of life. Child abuse. Psychological well-being. Cross-sectional studies.