Childhood Adversity and Depression in Young Adults: Associations by Sex and Race/Ethnicity Open Access

Abstract

Background: Nearly six in ten adults in the United States have reported exposure to at least one adverse childhood experience. Childhood adversity exposure varies by sex, race/ethnicity, and educational attainment and is associated with increased risk of health outcomes such as substance abuse, cardiovascular disease, and depression. Some children may be less resilient to childhood adversity and more vulnerable to these negative consequences than others. Studies examining the relationship between childhood adversity and adult depression by racial and ethnic groups have found disparate results.

Objective: To estimate the effect of childhood adversity on depressive symptomology in young adulthood and determine if this association differs by sex and race/ethnicity.

Methods: Participants enrolled in the National Longitudinal Study of Adolescent to Adult Health (N=7,071) reported exposure to childhood adversity during three time points in adolescence and young adulthood and also completed a modified Center for Epidemiologic Studies Depression Scale during young adulthood. A cumulative childhood adversity score was assessed from a summation of reported adverse maltreatment, neglect, and family dysfunction experiences. High depression symptomology was characterized as CES-D scores of 11 or greater.

Results: After adjusting for covariates, experience of four or more childhood adversities was associated with a nearly 2-fold increase in prevalence of depressive symptomology in young adulthood (PR=1.94, 95% CI: 1.51, 2.50). Results indicate a threshold effect and dose response relationship. Neither sex by childhood adversity nor race/ethnicity by childhood adversity interactions reached statistical significance. However, results indicate non-Hispanic white and non-Hispanic Asian participants exposed to four or more childhood adversities have elevated prevalence of high depressive symptomology (PR=2.01, 95% CI: 1.36, 2.97; PR=4.85, 95% CI: 1.67, 14.07).

Conclusion: Non-Hispanic whites and non-Hispanic Asians may face an increased burden of childhood adversity compared to non-Hispanic blacks and Hispanics due to racial and ethnic disparities in resiliency. Future research should further examine the effect of childhood adversity on adult mental health in Asian Americans.

Table of Contents

Chapter 1: Introduction and Background ………. 1

Chapter 2: Manuscript ………. 13

Introduction ………. 13

Methods ………. 17

Measurement ………. 17

Analytic Sample ………. 22

Analytic Methods ………. 22

Results ………. 23

Descriptive Results ………. 23

Modeling Childhood Adversity and Depression………. 24

Modeling Childhood Adversity and Depression by Sex and Race/Ethnicity ………. 25

Discussion ………. 26

Strengths and Limitations ………. 29

Conclusion and Further Research ………. 30

References ………. 33

Table 1. ………. 38

Table 2. ………. 39

Table 3. ………. 40

Table 4. ………. 41

Figure 1. ………. 42

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Mental Health Health Sciences, Epidemiology
Keyword	Childhood adversity Depression
Committee Chair / Thesis Advisor	Suglia, Shakira, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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