Mental Health Promotion Model: Mixed-Method Study of Adverse Childhood Experience and Neurovegetative in Early Adulthood
Abstract
Introduction: In this study, we aim to analyze the relationship between mental health, adverse childhood experiences, and neurovegetative factors in early adulthood. The findings created a mental health promotion model that considers aspects of digital media use and direct psychological approaches.
Methods: The study used a mixed-method approach with an explanatory sequential design. Quantitative participant data were collected using non-probability sampling from 460 individuals (male = 85; female = 375; mean age: 18–20 years), while qualitative data were collected from 20 informants (4 = HIMPSI, 9 = Academician, 7 = General). The instruments used were the MHI-38, ACE Scale, NCQ, interview guide, and FGD. Quantitative data analysis was conducted using path analysis with SmartPLS 4.0 software. In contrast, qualitative data analysis involves reduction, data display, and drawing conclusions. This data influenced the design of the mental health promotion model.
Results: The results of this study found that adverse childhood experiences (ACE) and neurovegetative factors influence mental health in early adulthood (P = 0.001), with ACE (P = 0.009) and neurovegetative factors (P = 0.000), with ACE also specifically acting as a predictor for neurovegetative factors (P = 0.00). These results prompted the development of a mental health model within the context of the three variables, considering key challenges, effective strategies, reaching vulnerable groups, and model recommendations by experts. The final model consists of a digital scheme and a direct approach model, incorporating interventions such as infographics, videos, psychoeducation, community development, and VR-CBT.
Conclusion: This study describes the urgency of mental health stability by considering ACE and neurovegetative as predictors. The data contribute to the development of a mental health promotion model in early adulthood. Implementation of the model in various settings is recommended.
References
Chaudhari KS, Dhapkas MP, Kumar A, Ingle RG. Mental Disorders – A Serious Global Concern that Needs to Address. IJPQA. 2024 June 25;15(02):973–8. https://doi.org/10.25258/ijpqa.15.2.66
Kemenkes. Survei Kesehatan Indonesia (SKI). Jakarta, Indonesia: Kementerian Kesehatan Republik Indonesia; 2023.
Yun I, Kim JH, Moon JY. Restricted economic activity due to health conditions and risk of depression: results from the Korean Longitudinal Study of Aging. Front Public Health. 2025 Feb 18;13:1442925. https://doi.org/10.3389/fpubh.2025.1442925
Kaligis YA, Wardaningsih S. Increasing Care for Patients with Mental Disorders Thought Community Empowerment: A Literature Review. jika [Internet]. 2023 Apr 8 [cited 2025 Apr 5];8(2). Available from: https://aisyah.journalpress.id/index.php/jika/article/view/8249
Kondirolli F, Sunder N. Mental health effects of education. Health Economics. 2022;31:22–39. https://doi.org/10.1002/hec.4565
Zhan Q, Wang Q. The Development of the College Students’ Experience of Family Harmony Questionnaire (CSEFHQ). Front Psychol. 2021;12:658430. https://doi.org/10.3389/fpsyg.2021.658430
Fedina L, Mushonga DR, Bessaha ML, Jun HJ, Narita Z, DeVylder J. Moderating Effects of Perceived Neighborhood Factors on Intimate Partner Violence, Psychological Distress, and Suicide Risk. J Interpers Violence. 2021 Nov;36(21–22):10546–63. https://doi.org/10.1177/0886260519884687
Barton S, Porter H, Murphy S, Lysaght R. Potential outcomes of work integration social enterprises for people who are homeless, at risk of homelessness, or transitioning out of homelessness. Social Enterprise Journal. 2022;18(3):409–33. https://doi.org/10.1108/SEJ-07-2021-0054
Fujiwara T. Impact of adverse childhood experience on physical and mental health: A life?course epidemiology perspective. Psychiatry and clinical neurosciences. 2022;76(11):544–51. https://doi.org/10.1111/pcn.13464
Burnell R, Garry M. People draw on the consequences of others’ negative experiences to make unwarranted appraisals about those experiences. Journal of Applied Research in Memory and Cognition. 2021 Dec;10(4):656–66. https://doi.org/10.1037/h0101861
Sacks V, Murphey D, Moore K. Adverse Childhood Experiences: National and State-level prevalence. Bethesda, MA: Child Trends; 2014.
Misiak B, Sta?czykiewicz B, Pawlak A, Szewczuk-Bogus?awska M, Samochowiec J, Samochowiec A, et al. Adverse childhood experiences and low socioeconomic status with respect to allostatic load in adulthood: A systematic review. Psychoneuroendocrinology. 2022;136:105602. https://doi.org/10.1016/j.psyneuen.2021.105602
Sahle BW, Reavley NJ, Li W, Morgan AJ, Yap MBH, Reupert A, et al. The association between adverse childhood experiences and common mental disorders and suicidality: an umbrella review of systematic reviews and meta-analyses. Eur Child Adolesc Psychiatry. 2022 Oct;31(10):1489–99. https://doi.org/10.1007/s00787-021-01745-2
Fatehi M. Adverse Childhood Experiences And Caregiver Relationship Quality: Risk And Protective Factors Among Emerging Adults For Prescription Pain Reliever Misuse [Dissertation]. [Georgia]: The University of Georgia; 2024.
Mnyamana NT. Family-based adverse childhood experiences as a determinant of learner drug abuse in Soweto high schools: implications for early intervention [Doctoral dissertation]. [Johannesburg]: University of the Witwatersrand; 2023.
Misiak B. Understanding Lasting Consequences Of Early-Life Stress: Relevance Of The Allostatic Load Concept. Psychoneuroendocrinology. 2021;(131):105556. https://doi.org/10.1016/j.psyneuen.2021.105556
Grabowski ?. Neurocirculatory asthenia and mitral valve prolapse syndrome from a psychopathological perspective. Family Medicine and Primary Care Review. 2024;26(4):513–7. https://doi.org/10.5114/fmpcr.2024.144922
Bourvis N, Aouidad A, Cabelguen C, Cohen D, Xavier J. How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder? Front Psychol. 2017 Nov 30;8:2054. https://doi.org/10.3389/fpsyg.2017.02054
Nugsria A, Pratitis NT, Arifiana IY. Quarter life crisis pada dewasa awal: Bagaimana peranan kecerdasan emosi? INNER: journal of psychological research. 2023;3(1):1–10.
Rany N. Strategi Promosi Kesehatan. Penerbit Widina; 2024.
Carstens KJ, Mallon JM, Bataineh M, Al-Bataineh A. Effects of Technology on Student Learning. The Turkish Online Journal of Educational Technology. 2021;20(1).
Santrock JW. Life Span Development. Kesembilan Belas. New York: McGraw-Hill Education; 2023.
Hamai TA, Felitti VJ. Adverse childhood experiences: Past, present, and future. In: Handbook of interpersonal violence and abuse across the lifespan: a project of the national partnership to end interpersonal violence across the lifespan (NPEIV). Cham: Springer International Publishing; 2021.
Hoogenhout EM, Van Der Elst W, De Groot RHM, Van Boxtel MPJ, Jolles J. The neurovegetative complaints questionnaire in the maastricht aging study: Psychometric properties and normative data. Aging & Mental Health. 2010;14(5):613–23. https://doi.org/10.1080/13607861003587297
Parombean AC, Abidin FA, Qodariah L, Novita S. Adaptation of the Mental Health Inventory (MHI-38) for Adolescents - Indonesian Version. PRBM. 2023;16:2655–65. https://doi.org/10.2147/PRBM.S412460
Singh V, Kumar A, Gupta S. Mental Health Prevention and Promotion—A Narrative Review. Front Psychiatry. 2022 July 26;13:898009. https://doi.org/10.3389/fpsyt.2022.898009
Dewi KS. Kesehatan Mental. Semarang: Lembaga Pengembangan dan Penjaminan Mutu Pendidikan Universitas Diponegoro; 2012.
Bryngeirsdottir HS, Halldorsdottir S. The challenging journey from trauma to post?traumatic growth: Lived experiences of facilitating and hindering factors. Scandinavian Caring Sciences. 2022;36(3):752–68. https://doi.org/10.1111/scs.13037
Jahic I, Trulson CR, Caudill JW, Bonner T, Slemaker A, DeLisi M. Adverse Childhood Experiences and Forensic Typologies: Getting Specific about Trauma among Institutionalized Youth. IJERPH. 2021 28;18(21):11307. https://doi.org/10.3390/ijerph182111307
Chen J. Childhood Domestic Physical Violence Abuse and Emotional Violence Abuse Negative Effects on Adult Mental Health: In Sanya, China; 2022 [cited 2025 July 31]. Available from: https://www.atlantis-press.com/article/125969953
Gomis-Pomares A, Villanueva L, Prado-Gascó V. Does It Run in the Family? Intergenerational Transmission of Household Dysfunctions. Child Adolesc Soc Work J. 2023;40(3):419–32. 10.1007/s10560-021-00766-9
Williams SE, Ford JH, Kensinger EA. The power of negative and positive episodic memories. Cogn Affect Behav Neurosci. 2022;22(5):869–903. https://doi.org/10.3758/s13415-022-01013-z
Grabowski LB. Psychopathological analysis of several functional disorders and neurovegetative dysfunctions. Neuropsychiatria i Neuropsychologia. 2022;17(1):9–15. https://doi.org/10.5114/nan.2022.117951
Omopo OE. Exploring Post-Traumatic Stress Disorder: Causes, Diagnostic Criteria, and Treatment Options. International Journal of Academic Information Systems Research (IJAISR). 2024;8(7):35–44.
Tahan M, Taheri H, Saleem T. Review Of Psychological Trauma: Theory, Practice, Policy and Research. Riv Psichiatr. 2021;56(2):64–73. https://doi.org/10.1708/3594.35764
Gee B, Wilson J, Clarke T, Farthing S, Carroll B, Jackson C, et al. Review: Delivering mental health support within schools and colleges – a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents. Child Adoles Ment Health. 2021;26(1):34–46. https://doi.org/10.1111/camh.12381
Goodwin J, Savage E, O’Brien N, O’Donovan Á. “We’re Not Educated On That Enough, And We Really Should Be”: Adolescents’ Views Of Mental Health Service Education. International Journal of Qualitative Studies on Health and Well-being. 2023 Dec 31;18(1):2249287. https://doi.org/10.1080/17482631.2023.2249287
Pfaff K, Krohn H, Crawley J, Howard M, Zadeh PM, Varacalli F, et al. The Little Things Are Big: Evaluation Of A Compassionate Community Approach For Promoting The Health Of Vulnerable Persons. BMC Public Health. 2021;21(1):2253. https://doi.org/10.1186/s12889-021-12256-9
Kusmawaty Y. Pengembangan model promosi kesehatan mental untuk ibu hamil dalam upaya pencegahan depresi maternal [Doctoral dissertation]. [Yogyakarta]: Universitas Gadjah Mada; 2021.
She-hong LIANG, Wan-er ZHU, Yi-hong ZHU. Construction of Postgraduate Mental Health Promotion Model from the Perspective of Positive Psychology. Journal of University of Electronic Science and Technology of China (Social Science Edition). 2018;20(6):99–103.
Dong R bao, Dou K yun, Huang JB. The Reliability and Applicability of the Physical and Mental Health Promotion Model for Adolescent in Different Social Contexts. 2024. Available from: https://www.researchsquare.com/article/rs-4718618/v1
Arisyanto P, Cahyadi F, Azizah M. Media Grafis dalam Pendidikan Dasar Pendekatan Berbasis Kasus untuk Pembuatan Media Pembelajaran. Cahya Ghani Recovery; 2025.
Limbong E, Wadham B. Exploring Pre-Service English Teachers’ Digital Competence In Creating Interactive Instructional Materials. SiELE. 2024;11(2):748–67. https://doi.org/10.24815/siele.v11i2.35103
Emerson LM, Aktar E, De Bruin E, Potharst E, Bögels S. Mindful Parenting in Secondary Child Mental Health: Key Parenting Predictors of Treatment Effects. Mindfulness. 2021;12(2):532–42. https://doi.org/10.1007/s12671-019-01176-w
Mousavizadeh SN, Jandaghian Bidgoli MA. Recovery-Oriented Practices in Community-based Mental Health Services: A Systematic Review. IJPS. 2023;18(3):332–51. https://doi.org/10.18502/ijps.v18i3.13013
Zittleman L, Felzien M, Curcija K, Bennett C, Bennett K, Carrica J, et al. Changing Our Mental and Emotional Trajectory (COMET): The Feasibility and Acceptability of a Rural Community-Based Strategy to Prevent Mental and Emotional Health Problems. J Prim Care Community Health. 2025;16. https://doi.org/10.1177/21501319251317337
Healy LC, Benkwitz A, McVinnie Z, Sarkar M, Islin M, Brinded A, et al. Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness. IJERPH. 2023;20(3):2291. https://doi.org/10.3390/ijerph20032291
Reddy NP, Sureshkumar K, Kumar S. The Impact of Cognitive Behavioural Therapy on Depression among Individuals with Adverse Childhood Experiences: A Bibliometric Analysis. Salud, Ciencia y Tecnología - Serie de Conferencias. 2025;4:1370. https://doi.org/10.56294/sctconf20251370
Ko H, Lim HJ, Park J, Kim K, Suh H, Lee BD, et al. Subjective Experience on Virtual Reality-Assisted Mental Health Promotion Program. Psychiatry Investig. 2024 Apr 25;21(4):380–6. https://doi.org/10.30773/pi.2023.0286
Bonneterre S, Zerhouni O, Boffo M. Immersive Virtual Reality for Health Promotion and Primary Prevention in Psychology: Scoping Review. JMIR XR Spatial Comput. 2025;2:e49923–e49923. https://doi.org/10.2196/49923
Amdam R. New Perspectives in Health Promotion: Health in All Policies (HiAP). Taylor & Francis; 2024
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