Perceived Social Support as a Statistical Indirect Pathway Linking Adverse Childhood Experiences to Risky Behaviors Among University Students: A Cross-Sectional Study

Abstract

Background/Objectives: Adverse childhood experiences (ACEs) are a major public health concern associated with long-term health consequences and a range of risky behaviors. This study examined whether perceived social support statistically accounted for part of the association between ACEs and seven risky behavior dimensions among university students. Methods: This cross-sectional online survey included 524 students enrolled at a state university. Data were collected using a descriptive information form, the Adverse Childhood Experiences Scale, the Risky Behaviors Scale, and the Multidimensional Scale of Perceived Social Support. Spearman rank correlations, covariate-adjusted multiple linear regression analyses with HC3 robust standard errors, and indirect-effect analyses using Hayes’ PROCESS macro (Model 4; 5000 bootstrap samples) were conducted. Results: Overall, 40.8% of participants reported at least one ACE, with psychological abuse being the most frequently reported experience (20.8%). ACE scores were positively associated with all seven risky behavior dimensions (p < 0.001 for six dimensions and p = 0.004 for substance use). Significant indirect associations through perceived social support were observed for antisocial behaviors, alcohol use, suicidal tendency, and substance use, but not for smoking, eating habits, or school dropout. Conclusions: Although the cross-sectional design precludes causal inference, the findings suggest that perceived social support may play a meaningful role in the associations between ACEs and selected risky behaviors among university students.