ABSTRACT
BACKGROUND: Adverse childhood experiences (ACEs) are common among children. Little is known on how resilience factors and positive childhood experiences (PCEs) may moderate the relationship between ACEs and childhood depression. OBJECTIVE: Our study fills this gap by providing recent, nationally representative estimates of ACE and PCE exposure for ages 8-17 and examines the associations between ACE exposure and PCEs on the outcome of depression. PARTICIPANTS AND SETTING: Data were drawn from the nationally representative 2016-2017 National Survey of Children's Health (NSCH) and included a total sample of 40,302 children and adolescents. METHODS: Chi square analysis and multivariate logistic regressions were performed to assess associations of depression with 9 ACE and 6 PCE exposures. Additive and multiplicative interactions were examined between ACE exposure and PCEs (resiliency measures) on depression. Survey sampling weights and SAS survey procedures were used. RESULTS: Our study found that 4% of children had current depression and those with an ACE count greater than four had increased odds (aOR: 2.29; CI: 1.74-3.02). Multivariate regressions demonstrated associations between depression and low resiliency as well as significant interactions between ACE exposure and three PCEs. Children who were exposed to greater than four ACEs and did not exhibit resilience had 8.75 higher odds of depression (CI: 5.23-14.65) compared to those with less than four ACEs and some resilience. CONCLUSIONS: These findings illustrate the need for the promotion of PCEs and the building of resiliency for combatting depression and reducing the impact of trauma in children and adolescents.
