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, 7 (9), e013228

Adverse Childhood Experiences (ACEs) and Later-Life Depression: Perceived Social Support as a Potential Protective Factor

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Adverse Childhood Experiences (ACEs) and Later-Life Depression: Perceived Social Support as a Potential Protective Factor

E Von Cheong et al. BMJ Open.

Abstract

Objective: To investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these.

Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-2011 cohort of 2047 men and women aged 50-69 years. Self-reported measures included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale) and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by ACE scores and ACE subtypes abuse, neglect and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors. We tested whether the estimated associations varied across levels of PSS (poor, moderate and strong).

Results: 23.7% of participants reported at least one ACE (95% CI 21.9% to 25.6%). ACE exposures (overall, subtype or ACE scores) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. Exposure to any ACE (vs none) was associated with almost three times the odds of depressive symptoms (adjusted OR 2.85; 95% CI 1.64 to 4.95) among individuals reporting poor PSS, while among those reporting moderate and strong PSS, the adjusted ORs were 2.21 (95% CI 1.52 to 3.22) and 1.39 (95% CI 0.85 to 2.29), respectively. This pattern of results was similar when exposures were based on ACE subtype and ACE scores, though the interaction was clearly strongest among those reporting abuse.

Conclusions: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms, particularly among those with poor PSS. Interventions that enhance social support, or possibly perceptions of social support, may help reduce the burden of depression in older populations with ACE exposure, particularly in those reporting abuse.

Keywords: adverse childhood experience; depression and mood disorders; mental health.

Conflict of interest statement

Competing interests: Health Research Board, Ireland (SSS'2014'781 to EVC). DD was further supported by a HRB Interdisciplinary Capacity Award (ICE/2012/12). CS was supported by the HRB National SpR Academic Fellowship Award (NSAFP/2011/3).

Figures

Figure 1
Figure 1
ORs and 95% CIs from a logistic regression model of later-life depressive symptoms and any adverse childhood experience (ACE) or ACE subtypes, illustrating the interaction with perceived social support (PSS) (n=2047).
Figure 2
Figure 2
ORs and 95% CIs from a logistic regression model of later-life depressive symptoms and adverse childhood experience (ACE) score, illustrating the interaction with perceived social support (PSS) (n=2047).

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