The Influence Of Adverse Childhood Experiences On Depressive Symptoms Among Adolescent In Hunan Province

Objective: This study investigated the status and influencing factors of adolescent depressive symptoms in Hunan Province,and explored the influence path of personality traits and executive function as mediating factors between adverse childhood experience and depressive symptoms.Method: This was a cross-sectional study.Using the method of multi-stage stratified random sampling research method to investigate380 teenagers from 12 classes of 2 senior high schools and 2 junior high schools in Changsha county of Changsha City and Cili County of Zhangjiajie City,Hunan Province from July to November 2020.Under the guidance of the stress process framework,this study self-designed scales,including demographics,the Adverse Childhood ExperiencesInternational scale,Eysecnk Personality scale,Behavior Rating Inventory of Executive Function—Self Report Version scale,the Center for Epidemiologic Studies Depression Questionnaire.SPSS26.0 was used for descriptive statistics,single factor analysis,correlation analysis and binary Logistic regression analysis.The structural equation model was established by using AMOS21.0.Results:(1)Of Hunan adolescents,the prevalence of the adverse childhood experiences,Childhood abusement,Family dysfunction and Violence outside the family were87.6%(333/380),88.4%(336/380),62.6%(223/380),56.3%(214/380).Adverse childhood experiences is associated with the type of Caregivers(H=2.419,P=0.048),the caregivers’ educational levels(H=5.180,P=0.002),the caregivers’ health levels(H=13.397,P=0.000).(2)The prevalence of depressive symptoms were 40.3%(153/380).Depressive symptoms are associated with gender(Z=-3.491,P=0.000),the caregivers’ educational levels(H=8.240,P=0.041),the caregivers’ health levels(H=12.132,P<0.01).The overall scores of Extroversion,Psychoticism,Neuroticism,executive function were10.63±4.61,6.51±3.50,12.17±5.85 and 124.32±25.42,respectively.(3)Depressive symptoms were positively correlated with the adverse childhood experiences scores(r=0.435,P<0.01),Psychoticism(r=0.339,P<0.01),Neuroticism(r=0.486,P<0.01),and executive function scores(r=0.517,P<0.01).It was negatively correlated with Extroversion(r=-0.227,P<0.01).(4)Binary Logistic regression analysis results showed that: ACEs(OR=12.665,P<0.001),Psychoticism(OR=0.973,P<0.05),Neuroticism(OR=0.942,P<0.001),executive function(OR=0.970,P<0.001)were protective factors for depressive symptoms in adolescents,while Extroversion(OR=1.064,P<0.001)was a risk factor for depressive symptoms in adolescents.(5)The results of structural equation model showed that adverse childhood experiences(β=0.62,P<0.01),Neuroticism(β=0.06,P<0.01),Psychoticism(β=0.04,P<0.01)and executive function(β=0.17,P<0.01)could directly affect the depressive symptoms of adolescents.In addition,adverse childhood experiences can indirectly affect adolescent depressive symptoms through Psychoticism,Neuroticism and executive function,with an indirect effect of 0.220(0.158,0.285).Neuroticism can indirectly affect depressive symptoms through executive function,with a total effect of 0.359(0.254,0.460),an indirect effect of 0.188(0.136,0.258),and a direct effect of0.171(0.059,0.283).Conclusion:(1)The prevalence of adverse childhood experiences and depressive symptoms among adolescents in Hunan province are high.Medical institutions,schools and families should strengthen the screening of adverse childhood experiences and pay close attention to the mental health status of adolescents.(2)The adolescents with higher the adverse childhood experience scores,Psychoticism scores,Neuroticism scores,Extroversion scores,and executive function scores were at high risk of developing depressive symptoms.(3)The model of the influence of adverse childhood experiences on depressive symptoms based on stress process theory fits well.Based on the above impact model,follow-up studies can try to strengthen the screening of adverse childhood experiences among adolescents;Identify individuals at high risk of depressive symptoms with high Psychoticism,high Neuroticism,and low Extroversion.Future interventions related to improving executive function may be developed to reduce the adverse effects of adverse childhood experiences on adolescent depressive symptoms and improve adolescents’ ability to effectively cope with stress.