Date of Award

11-2023

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Maryam Pyar Ali Lakhdir

Second Advisor

Syed Iqbal Azam

Third Advisor

Dr. Nargis Asad

Department

Community Health Sciences

Abstract

INTRODUCTION: Childhood is a pivotal developmental period in an individual’s life. Adverse childhood experiences (ACEs) occurring at a formative age are significantly associated with subsequent psychological distress later in life. Amid these challenges, resilience can emerge as a critical protective factor, capable of mitigating the adverse effects on students' mental well-being. Notably, health sciences students, who regularly encounter patients dealing with adversity while managing demanding clinical and academic coursework, face a heightened vulnerability to the impact of ACEs. OBJECTIVE The objective of this study was to assess the effect of resilience on the relationship between ACEs and psychological distress among Pakistani undergraduate health sciences students, between July to September 2023.
METHODS: We conducted an analytical cross-sectional study at the Aga Khan University, Karachi, Pakistan among undergraduate health sciences students. The study was conducted on 252 students aged 18 or above belonging to either the nursing or medical specialty. Moreover, psychological distress was evaluated using the Kessler-10 scale. Data was collected through an online web-based survey. Multiple linear regression was utilized to assess the relationship between ACEs, resilience and psychological distress accounting for demographic, academic and student-specific characteristics.
RESULTS: Among 252 health sciences student, the mean age was 21.25 ± 2.33. Among the students, more than three-quarters (200/252) were females (79.37%) having an average psychological distress score of 12.83 ± 7.93. Overall the mean psychological distress score was 12.7 ± 7.70. Half (50%) of the students had experienced two or more ACEs. Moreover, students with high resilience reported reduced mean psychological distress score than students with low resilience (10.02 ± 7.93 vs. 13.59 ± 7.68, p = 0.001). A significant Page | vii interaction between ACEs and resilience was observed, indicating that among low resilient students who had experienced four or more ACEs, the estimated mean psychological distress score was 5.07 (0.20, 9.93) higher compared to high resilient students who has experienced 0-1 ACEs. Other factors associated with increased psychological distress scores include the presence of recent threatening events in a student’s life.
CONCLUSION: The study findings implicate that students with low resilience, having experienced four or more ACEs exhibit elevated psychological distress scores. Additionally, the presence of recent threatening events are a notable contributing factor to higher psychological distress scores. These results highlight the importance of resilience building interventions aimed at assisting students in managing psychological distress with enhanced coping leading to overall improved well-being.

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1

Last Page

103

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