Psychological Distress in University Students: The Impact of Adverse Childhood Experiences, Attachment Insecurity, and Quality of Life

Abstract

To examine the prevalence and predictors of depressive, anxiety, and stress symptoms among university students, focusing on attachment styles, adverse childhood experiences (ACEs), substance use, and quality of life (QoL). University students are particularly vulnerable to mental health problems due to academic demands, developmental challenges, and adverse life experiences. A cross-sectional survey was conducted among university students (N = 508). Participants completed measures of depressive, anxiety and stress symptoms, attachment styles, ACEs, substance use, and QoL. Logistic regression analyses were used to identify predictors of psychological distress. Anxiety (53.9%), stress (43.7%), and depressive (39.0%) symptoms were highly prevalent. Students with psychological symptoms were more likely to be female and report greater ACE exposure, insecure attachment styles, alcohol use disorder, tobacco use, and lower QoL. Regression analyses identified higher ACE exposure, insecure attachment, lower QoL, and female gender as significant predictors of depressive, anxiety, and stress symptoms. Students with histories of early adversity and insecure attachment appear particularly vulnerable to psychological distress, highlighting the need for targeted prevention and support programs. Symptoms of anxiety, stress, and depression were highly prevalent among university students. Greater exposure to adverse childhood experiences was consistently associated with higher levels of psychological distress. Fearful and preoccupied attachment styles were significant correlates of depressive, anxiety and stress symptoms. Psychological distress was associated with lower quality of life across multiple domains. Screening for adverse childhood experiences, attachment-related difficulties, and quality of life may help identify university students at increased risk of psychological distress and guide preventive interventions.