Adverse childhood experiences and test anxiety in Chinese nursing students: The mediating effect of psychological distress

Background: Test anxiety is a common issue among students, potentially leading to adverse academic consequences. Students with psychological distress are more susceptible to test anxiety. Adverse childhood experiences (ACEs) have been linked to psychological distress. However, there is a lack of studies on the associations between ACEs, psychological distress, and test anxiety in college students. Aim: We examined the mediating role of psychological distress on the relationship between ACEs and test anxiety among Chinese nursing students. Methods: A cross-sectional analysis using an electronic survey of nursing students (N = 621). Results: Psychological distress scores partially mediated the association between a greater number of ACEs and test anxiety, accounting for 49.5 % of the total effect of the association between the two variables. Conclusion: Early intervention strategies should prioritize nursing students experiencing test anxiety, particularly focusing on identifying and providing resources for ACEs and psychological distress.