Abstract
Background:
The rising socioeconomic instabilities worldwide have exposed individuals to physical, social, and psychological difficulties. Children are not exempt from these effects; they often experience heightened emotional and behavioural challenges, which consequently result in psychological distress and diminished self-esteem. Despite these impacts, there are limited reports on the mental health implications of childhood trauma in Sub-Saharan regions of Africa.

Aim:
This study aimed to explore the relationship between childhood trauma, psychological distress, and self-esteem.

Methodology:
Using a multistage sampling technique, 297 secondary school students in Calabar, Cross River State, Nigeria, participated in the cross-sectional study. The General Health Questionnaire 12 (GHQ-12), the Childhood Trauma Questionnaire (CTQ), the Rosenberg Self-Esteem scale, and a Sociodemographic Questionnaire were used to gather data. Data were summarized using descriptive statistics, Pearson correlations, and logistic regression at a 5% level of significance.

Results:
The mean age of participants was 15.03 (±1.41) years, with 51.7% female and 54.7% attending private schools. Psychological distress showed a moderate positive correlation with overall childhood abuse (r = 0.43), while self-esteem was moderately negatively correlated with childhood abuse (r = -0.32).

Psychological distress was significantly predicted by emotional abuse (OR = 7.10, 95% CI: 2.95–17.07), physical abuse (OR = 3.57, 95% CI: 1.78–7.19), emotional neglect (OR = 2.21, 95% CI: 1.007–4.86), and physical neglect (OR = 2.23, 95% CI: 1.06–4.66).

Emotional abuse (OR = 0.78, 95% CI: 0.66–0.90), physical abuse (OR = 0.81, 95% CI: 0.66–0.91), emotional neglect (OR = 0.80, 95% CI: 0.69–0.87), and physical neglect (OR = 0.77, 95% CI: 0.61–0.89) were each significantly associated with a reduced likelihood of high self-esteem.

Sexual abuse did not significantly predict either psychological distress or self-esteem (p > 0.05).

Conclusion:
Childhood abuse significantly predicts psychological distress and low self-esteem. Early intervention can improve the mental well-being of affected children

Key words: Childhood, Self-Esteem, Psychological Distress, Trauma, Mental Well-being