2024 Reports

The Impact of Adverse Childhood Experiences on Academic Outcomes among Medical Students in Pakistan and the Role of Social Support

Safi, Sara; Hotiana, Usman; Nisar, Mariam; Khayyam, Nimra; Nasir, Shabban

Background: Adverse Childhood Experiences (ACEs), also referred to as Developmental Trauma, can profoundly affect long-term mental health and cognitive functioning. Although these effects often manifest as poor academic performance, the extent of such an impact within highly resilient groups, such as medical students, remains unclear. Social support is widely recognized as a protective factor against the detrimental effects of ACEs, yet its role in buffering academic performance among medical students has not been fully explored.

Objective: This study examined the relationships among ACEs, academic performance, and perceived social support in a population of medical and dentistry students in Lahore, Pakistan.

Methods: A cross-sectional survey was administered to second-year or higher students (N=217) at Rashid Latif Medical College. Participants completed the 10-item ACE questionnaire, the 12-item Interpersonal Support Evaluation List (ISEL-12) for social support, and provided self-reported academic outcomes (most recent annual marks, passed courses, and failed courses). Statistical models assessed correlations and regression estimates among the three primary variables.

Results: The average ACE score was 1.48 (SD=2.11), with 50.23% of participants reporting at least one ACE. ACEs had a negligible correlation with academic performance but showed a moderate negative association with social support (r=-0.39). Unexpectedly, social support also had a weak negative correlation with academic performance (r=-0.15). Subcategory analysis indicated that neglect and household challenges significantly diminished social support levels.

Conclusion: While childhood adversities did not predict academic outcomes in this sample, they were linked to reduced social support. These findings underscore the complex interplay of resilience factors in medical students, suggesting that protective mechanisms, possibly inherent in this population, may mitigate the influence of ACEs on academic performance. Future research should employ longitudinal designs and explore additional mediating or moderating variables, such as institutional support and coping strategies, to better understand how ACEs shape the academic and psychosocial trajectories of medical students.

Keywords: Adverse Childhood Experiences, Developmental Trauma, Social Support