ACE domains and depression: Investigating which specific domains are associated with depression in adulthood

Zachary Giano, Campbell W. Ernst, Kelsey Snider, Abby Davis, Andrew M. O'Neil, Randolph D. Hubach

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: The study of adverse childhood experiences (ACEs) has shown deleterious effects throughout adulthood. Little attention, however, is given to specific ACE domains as they relate to mental health outcomes, as most studies use cumulative ACE score models. 

Objective: The current study disaggregates ACEs domains to investigate their independent effect (while controlling for each other and other demographic covariates) on receiving a depression diagnosis as an adult. Participants and Setting: Data were obtained from the Behavioral Risk Factor Surveillance Survey (BRFSS; N = 52,971). 

Methods: To control and account for the numerical number of ACEs, separate models were run among each ACE score (e.g., those with an ACE score of exactly two, three, etc.). An aggregate model with all participants is also included. 

Results: Across all ACE scores, those with a history of family mental illness had the highest likelihood of receiving a depression diagnosis. The second strongest association were those with sexual abuse. No other trends were found among the six other domains. Further, those with a combination of family mental illness and sexual abuse had the highest odds of depression. 

Conclusions: Mental health providers should consider the numerical number of ACEs as well as the specific ACE domains (specifically, family mental illness and sexual abuse). Additionally, this provides evidence for a possible weighting schema for the ACEs scale.

Original languageEnglish
Article number105335
JournalChild Abuse and Neglect
StatePublished - Dec 2021


  • ACEs
  • Adversity
  • Childhood
  • Depression


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