Adverse Childhood Experiences and Undergraduate Student Outcomes in Ghanaian Higher Education: Prevalence, Developmental Attainment, Academic Achievement and Student Support at the University of Mines and Technology — A Mixed-Methods Study

This study examines adverse childhood experience (ACE) prevalence, psychosocial wellbeing, academic achievement, developmental attainment, protective factors, and help-seeking barriers among undergraduates at the University of Mines and Technology (UMaT), Tarkwa, Ghana — a specialist institution embedded in the Tarkwa-Nsuaem mining economy, which generates a distinctive adversity profile dominated by community violence, economic precarity, and occupational risk to parents. An explanatory sequential mixed-methods design was employed. Phase 1 administered a culturally adapted 25-item ACE instrument alongside validated outcome measures to 358 undergraduate students (response rate: 86.1%). Phase 2 conducted semi-structured interviews with 23 purposively selected participants carrying elevated ACE burdens, analysed using Reflexive Thematic Analysis. ACE prevalence was 83.8% (n = 300), with 56.7% endorsing four or more adversity types and 16.5% endorsing thirteen or more (Very High burden). Multiple linear regression revealed dose-response associations between ACE exposure and lower cumulative weighted average scores (β = −.38, p < .001), elevated psychological distress (β = .41, p < .001), and reduced academic engagement (β = −.29, p < .001). Qualitative analysis identified five themes: normalised adversity and ecological embedding; invisible labour and the performance gap; conditioned hypervigilance and its academic consequences; reactive defiance as a contextually grounded resilience mechanism; and a four-tier help-seeking barrier model encompassing physical visibility, institutional trust, identity-level resistance, and cultural-experiential distance. Integration indicated that the quantitative performance gap is most plausibly understood in light of participant accounts of dissociative-adjacent cognitive disruption under evaluative pressure and the hidden labour of managing concurrent adversity; given the cross-sectional design, these are advanced as interpretive mechanisms rather than causally established pathways. A 62.6 percentage-point gap between ACE prevalence and counselling service uptake (21.2%) reflects a specific barrier architecture. Findings inform trauma-informed counselling, student support policy, and institutional equity reform across Ghanaian higher education.

Adverse Childhood Experiences; University Students; Ghana; Mixed Methods; Trauma-Informed Higher Education

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