Adverse Childhood Experiences and Associated Health-Risk Behaviors among University Students in Turkey: A Cross-Sectional Analysis

Adverse childhood experiences (ACEs) are potentially traumatic events occurring before the age of 18 that may have long-term consequences for health and well-being. This study aimed to examine the association between ACEs and health-risk behaviors (HRBs) among university students in Turkey. A cross-sectional web-based survey was conducted between April and June 2024 with 1,115 university students aged 18–27 years. Data were collected using a structured self-report questionnaire assessing exposure to ACEs, including child maltreatment and household dysfunction, as well as a range of HRBs in young adulthood. Overall, 97.7% of participants reported experiencing at least one ACE, while 47.8% reported exposure to four or more ACEs. The most frequently reported ACEs were community violence (81.1%), emotional neglect (74.0%), emotional abuse (49.9%), witnessing violence against household members (39.2%), bullying (33.2%), and physical abuse (27.9%). A higher number of ACEs was significantly associated with several HRBs, including tobacco use, alcohol consumption, sedentary behavior, overweight and obesity, suicidal ideation, suicide attempts, interpersonal violence, and early sexual initiation (before age 16). These findings demonstrate a strong association between cumulative exposure to childhood adversity and multiple health-risk behaviors in young adulthood. The results highlight the need for trauma-informed public health strategies aimed at preventing ACEs and promoting resilience to reduce the long-term health consequences of childhood adversity.