Adverse childhood experiences (ACEs) and suicidality are highly prevalent and increasing social problems among the college and university student population, thereby underscoring a need to better understand the relationship between ACEs and suicidal risk, ideation, and attempts during college. There is also a need to examine current suicide prevention and intervention programs for the extent to which they are ACE- and/or trauma-informed. The purpose of this quantitative systematic review with narrative synthesis is to elucidate findings regarding the relationship between ACEs and suicidality in undergraduate and graduate students across the globe and provide recommendations for future ACE-informed suicide prevention and crisis intervention practices. A PRISMA flow diagram was utilized and illustrates the systematic review process, in which a total of 64 articles were included for final analysis. Results suggest that there is a strong-dose relationship between experiences of childhood adversity and suicidality during college, indicating that the more ACEs one experiences in childhood, the higher the likelihood of experiencing suicidal thoughts or attempting suicide as a young adult in college. Moreover, certain ACEs, such as childhood sexual, emotional, and physical abuse appear to be most strongly associated with later suicidality. Cross-cultural considerations, mechanisms through which suicidality may increase (e.g., perceived burdensomeness, thwarted belongingness, etc.) and decrease (e.g., strong social support, coping skills, sense of belonging, etc.) in the context of ACEs history, and limitations that may potentially impact the results are discussed. Results from international and U.S. research are also compared and contrasted. Recommendations for ACE- and/or trauma-informed care practices for suicide prevention and crisis intervention, such as screening for ACEs, training and education for clinicians in trauma-informed care, and other assessment and referral strategies are provided. Finally, recommendations for future research are discussed, including the need for research on culturally diverse populations and the effectiveness of ACE-informed interventions and practices.

Library of Congress Subject Headings

Suicide—Prevention; College students--Suicidal behavior--Prevention; College students--Mental health; Experience in children

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Stephanie Woo

Included in

Psychology Commons