Abstract
Background: Adverse childhood experiences (ACEs) are associated with increased incidence of poor mental health outcomes and depression diagnoses, yet little is known about the increased risk of depression among specific ACE domains. This study investigates the frequencies of those with a depression diagnosis across each ACE domain and which specific ACE domains are linked to a higher likelihood of receiving a depression diagnosis.
Methods: ACEs data were collected via the CDC’s BRFSS (Behavioral Risk Factor Surveillance System). Eight domains are included in the ACEs survey: sexual abuse, emotional abuse, physical abuse, interparental violence, incarcerated household member, household mental illness, household substance use, and parental separation/divorce. After excluding those with an ACE score of 0 and 8, a sample size of 52,971 adults was analyzed. The frequency of a depression diagnosis was analyzed within each ACE score as well as across each ACE domain. A series of logistic regressions within each ACE score determined the odds of a depression diagnosis from each ACE domain.
Results: Incidence of depression diagnoses was higher in individuals in each ACE group (e.g., those with exactly three ACEs) who had sexual abuse or family mental illness. For example, in those with one ACE, 23% of those with sexual abuse had depression diagnoses and 30% of those with familial mental illness had depression diagnoses, compared to 14-16% with depression diagnoses of all other ACE domains (e.g., physical abuse) within those with an ACE score of one. When comparing all individuals aggregately with ACEs between 1 and 7, sexual abuse (39%) and family mental illness (42%) constituted the highest percentage of depression diagnosis compared to all other domains (29-34%). Family history of mental illness had the highest odds ratio of depression diagnosis, as individuals with an ACE score of 1 were 3.5 times more likely than those with an ACE score of 1 without family history of mental illness (OR=3.508, 95% CI 2.866-4.295). Among those with 1 ACE, the second highest odds ratio are those who experienced sexual abuse who are two times more likely to receive a depression diagnosis when compared to those with no history of childhood sexual abuse (OR=1.770, 95% CI 1.427-2.194). When comparing individuals with ACE score ranging from 1-7, those with a familial history of mental illness were 2.8 times more likely than those without a familial history of mental illness to receive a depression diagnosis (OR=2.841, 95% CI 2.732-2.955) and individuals with a history of sexual abuse were 1.7 times more likely than those who did not experience sexual abuse to be diagnosed with depression (OR=1.692, 95% CI 1.621-1.766).
Conclusion: Though each ACE domain is scored equally, sexual abuse and family mental illness have higher statistical links to depression compared to the other six domains. Identifying individuals with ACE domains comprised of sexual abuse or family mental illness can be crucial in prevention and intervention programs focused on the antecedents of depressive disorders, hopefully leading to improved patient outcomes.
Methods: ACEs data were collected via the CDC’s BRFSS (Behavioral Risk Factor Surveillance System). Eight domains are included in the ACEs survey: sexual abuse, emotional abuse, physical abuse, interparental violence, incarcerated household member, household mental illness, household substance use, and parental separation/divorce. After excluding those with an ACE score of 0 and 8, a sample size of 52,971 adults was analyzed. The frequency of a depression diagnosis was analyzed within each ACE score as well as across each ACE domain. A series of logistic regressions within each ACE score determined the odds of a depression diagnosis from each ACE domain.
Results: Incidence of depression diagnoses was higher in individuals in each ACE group (e.g., those with exactly three ACEs) who had sexual abuse or family mental illness. For example, in those with one ACE, 23% of those with sexual abuse had depression diagnoses and 30% of those with familial mental illness had depression diagnoses, compared to 14-16% with depression diagnoses of all other ACE domains (e.g., physical abuse) within those with an ACE score of one. When comparing all individuals aggregately with ACEs between 1 and 7, sexual abuse (39%) and family mental illness (42%) constituted the highest percentage of depression diagnosis compared to all other domains (29-34%). Family history of mental illness had the highest odds ratio of depression diagnosis, as individuals with an ACE score of 1 were 3.5 times more likely than those with an ACE score of 1 without family history of mental illness (OR=3.508, 95% CI 2.866-4.295). Among those with 1 ACE, the second highest odds ratio are those who experienced sexual abuse who are two times more likely to receive a depression diagnosis when compared to those with no history of childhood sexual abuse (OR=1.770, 95% CI 1.427-2.194). When comparing individuals with ACE score ranging from 1-7, those with a familial history of mental illness were 2.8 times more likely than those without a familial history of mental illness to receive a depression diagnosis (OR=2.841, 95% CI 2.732-2.955) and individuals with a history of sexual abuse were 1.7 times more likely than those who did not experience sexual abuse to be diagnosed with depression (OR=1.692, 95% CI 1.621-1.766).
Conclusion: Though each ACE domain is scored equally, sexual abuse and family mental illness have higher statistical links to depression compared to the other six domains. Identifying individuals with ACE domains comprised of sexual abuse or family mental illness can be crucial in prevention and intervention programs focused on the antecedents of depressive disorders, hopefully leading to improved patient outcomes.
Original language | American English |
---|---|
Pages | 93 |
State | Published - 22 Feb 2021 |
Event | Oklahoma State University Center for Health Sciences Research Days 2021: Poster presentation - Oklahoma State University Center for Health Sciences Campus, Tulsa, United States Duration: 22 Feb 2021 → 26 Feb 2021 |
Conference
Conference | Oklahoma State University Center for Health Sciences Research Days 2021 |
---|---|
Country/Territory | United States |
City | Tulsa |
Period | 22/02/21 → 26/02/21 |
Keywords
- Adverse Childhood Experiences (ACE)
- Sexual Abuse
- Family Mental Illness