Racial/ethnic differences in the association of childhood adversities with depression and the role of resilience

Abstract

Background Adverse childhood experiences (ACE) including childhood abuse and trauma increase depressive symptoms. The role of resilience and how it interacts with both ACEs and the potential development of depressive symptoms, including how race and ethnicity moderate these effects, are much less studied. The aims of this study were to examine: 1) whether there is a dose-response relationship between trauma and depressive symptoms; 2) whether early trauma affected European Americans (EA) and African Americans (AA) in a similar fashion; and 3) whether resilience mitigates the effect of trauma. Methods The present study comprised a cross-sectional study of subjects from a longitudinal cohort. All subjects were 19 years or older with traumatic experiences prior to age 18. Subjects were assessed for depressive symptoms as well as resilience. Results In 413 subjects enrolled, ACEs were significantly associated with depression severity in a dose-response fashion (p<0.001). Notably, AAs had lower depression scores at low to moderate levels of ACEs than EAs, but reported comparable levels of depression with severe exposure to ACEs (pInteraction=0.05). In both EAs and AAs, young adults with high and medium levels of resilience showed less depressive symptoms compared to those with low resilience (p<0.05). Limitations to consider are the cross-sectional design, possibility of other confounders, and potential for recall bias of this study. Conclusion While ACEs were significantly associated with severity of depression in a dose-response fashion, higher resilience mitigated the impact of childhood adversities on depressive symptoms in young adults. The results are encouraging, and guides research for therapeutics to boost resilience.

Childhood adversity and mechanistic links to hypertension risk in adulthood

“…Others have also shown that African Americans have a higher rate of ACEs compared to other ethnicities (Duru, Harawa, Kermah, & Norris, ; Turner & Lloyd, ). Childhood physical neglect, domestic violence, parental marital discord, and experiencing a household member who went to prison are types of ACEs that have been reported to be nearly two‐fold higher in African Americans compared with European Americans (Youssef et al, ). Symptoms of depression were significantly lower in African Americans, compared with European Americans, at mild to moderate levels of exposure to ACEs.…”

Starting strong: Dietary, behavioral, and environmental factors that promote “strength” from conception to age 2 years

“…Recent research methodologies have provided a fresh perspective on how external events alter how children develop. One of the most important findings has been the complex role of recurring stress (Felitti et al 1998;Gilbert et al 2015;Youssef et al 2017). Children, like all humans, face stresses every day.…”

Integrating Trauma‐Informed Care Into Maternity Care Practice: Conceptual and Practical Issues

“…The concept of stress is important because stress per se and posttraumatic stress are plausible biologic pathways that link an experience to subsequent disease . Based on research synthesized across numerous disciplines, maltreatment and the toxic stress that results from it are considered major public health challenges : They are strongly associated with very adverse outcomes, including early death; they affect a large proportion of the population; and ACEs and their sequelae contribute to health disparities seen in disadvantaged populations . In addition, both abuse and mental health vulnerability can be an intergenerational pattern …”