Abstract
BACKGROUND: Adverse childhood experiences (ACEs) are well-established risk factors for various mental health issues, including emotional eating behaviors. However, the mediating roles of perceived stress and depression in the relationship between ACEs and emotional eating behaviors, especially among college students, remain underexplored. This study aimed to investigate these associations, with a specific focus on the mediating effects of perceived stress and depression. METHODS: Using a stratified cluster random sampling method, this study recruited 984 students from a university in Guangzhou, China, between May and November 2024. Data were collected on participants' sociodemographic characteristics, perceived stress, depressive symptoms, ACEs, and emotional eating behaviors through self-reported measures. Mediation analysis was conducted using the PROCESS macro (SPSS 4.0) developed by Hayes, controlling for gender, age, place of residence, per capita monthly family income, and family type. RESULTS: The overall mean score for emotional eating behaviors among college students was 26.45 (SD = 12.046), with significant differences observed by sex, educational level, and self-reported health status. ACEs, perceived stress, depression, and emotional eating behaviors were significantly positively correlated (r = 0.105-0.473, P < 0.01). Although ACEs did not directly predict emotional eating behaviors (95% CI: -0.221-0.740, P > 0.05), they influenced emotional eating through two indirect pathways: (1) the independent mediating effect of depression, which accounted for 57.74% of the total indirect effect (β = 0.511, 95% CI: 0.323-0.723, P < 0.05), and (2) the serial mediation effect of perceived stress and depression, which accounted for 12.65% of the total indirect effect (β = 0.112, 95% CI: 0.054-0.181, P < 0.05). CONCLUSIONS: The findings indicate that depression and perceived stress fully mediate the relationship between ACEs and emotional eating behaviors. Interventions focusing on stress management and emotional regulation may help alleviate the negative impact of ACEs, ultimately promoting healthier eating behaviors among college students.