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Social Psychiatry and Psychiatric Epidemiology

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23-11-2022 | Research

Association of childhood threat and deprivation with depressive symptoms and the moderating role of current economic status among middle-aged and older adults in China

Authors: Li Lin, Bing Cao, Weiqing Chen, Jinghua Li, Yuying Zhang, Vivian Yawei Guo

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 8/2023

Abstract

Purpose

To investigate the independent impact of threat-related and deprivation-related adverse childhood experiences (ACEs) on depressive symptoms among middle-aged and older adults, and to evaluate the moderating role of current economic status in these associations.

Methods

This cross-sectional study included 11,048 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study. We captured five threat-related ACEs and five deprivation-related ACEs by questionnaires. Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale. Current economic status was reflected by annual per capita household consumption expenditure. We performed logistic regression analyses to evaluate the independent association of childhood threat and deprivation with depressive symptoms, and conducted stratified analyses and tests for interaction to explore the moderation effect of current economic status in such associations.

Results

Compared with the nonexposed group, the experience of both childhood threat and deprivation were independently associated with greater risks of depressive symptoms later in life (odds ratio [OR] 1.75, 95% CI 1.49–2.05 for ≥ 2 threat-related ACEs; OR 2.02, 95% CI 1.67–2.43 for ≥ 2 deprivation-related ACEs). High current economic status significantly ameliorated the impact of childhood deprivation, but not threat, on depressive symptoms (P value for interaction 0.038).

Conclusions

Both threat-related and deprivation-related ACEs were associated with the risk of depressive symptoms among middle-aged and older adults, while current economic status was a significant moderator in such risks only for childhood deprivation. The findings implied that prioritising targeted interventions for individuals with ACEs, especially for childhood deprivation victims who were economically disadvantaged in adulthood, may help mitigate depressive symptoms in later life.

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Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. Am J Prev Med 14(4):245–258. https://doi.org/10.1016/s0749-3797(98)00017-8CrossRefPubMed

Cronholm PF, Forke CM, Wade R, Bair-Merritt MH, Davis M, Harkins-Schwarz M, Pachter LM, Fein JA (2015) Adverse childhood experiences: expanding the concept of adversity. Am J Prev Med 49(3):354–361. https://doi.org/10.1016/j.amepre.2015.02.001CrossRefPubMed

Lin L, Wang HH, Lu C, Chen W, Guo VY (2021) Adverse childhood experiences and subsequent chronic diseases among middle-aged or older adults in china and associations with demographic and socioeconomic characteristics. JAMA Netw Open 4(10):e2130143. https://doi.org/10.1001/jamanetworkopen.2021.30143CrossRefPubMedPubMedCentral

Bellis MA, Hughes K, Ford K, Ramos Rodriguez G, Sethi D, Passmore J (2019) Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Health 4(10):e517–e528. https://doi.org/10.1016/s2468-2667(19)30145-8CrossRefPubMedPubMedCentral

Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L, Dunne MP (2017) The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health 2(8):e356–e366. https://doi.org/10.1016/s2468-2667(17)30118-4CrossRefPubMed

Lin L, Chen W, Sun W, Chen M, Li J, Shen J, Guo VY (2022) Associations between adverse childhood experiences and obesity in a developing country: a cross-sectional study among middle-aged and older Chinese adults. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph19116796CrossRefPubMedPubMedCentral

Richardson RA, Keyes KM, Medina JT, Calvo E (2020) Sociodemographic inequalities in depression among older adults: cross-sectional evidence from 18 countries. Lancet Psychiatry 7(8):673–681. https://doi.org/10.1016/s2215-0366(20)30151-6CrossRefPubMedPubMedCentral

Iob E, Lacey R, Steptoe A (2020) Adverse childhood experiences and depressive symptoms in later life: longitudinal mediation effects of inflammation. Brain Behav Immun 90:97–107. https://doi.org/10.1016/j.bbi.2020.07.045CrossRefPubMed

Lacey RE, Minnis H (2020) Practitioner review: twenty years of research with adverse childhood experience scores—advantages, disadvantages and applications to practice. J Child Psychol Psychiatry 61(2):116–130. https://doi.org/10.1111/jcpp.13135CrossRefPubMed

10.

Sheridan MA, McLaughlin KA (2014) Dimensions of early experience and neural development: deprivation and threat. Trends Cogn Sci 18(11):580–585. https://doi.org/10.1016/j.tics.2014.09.001CrossRefPubMedPubMedCentral

11.

McLaughlin KA, Sheridan MA, Lambert HK (2014) Childhood adversity and neural development: deprivation and threat as distinct dimensions of early experience. Neurosci Biobehav Rev 47:578–591. https://doi.org/10.1016/j.neubiorev.2014.10.012CrossRefPubMedPubMedCentral

12.

Clark US, Herrington OD, Hegde RR (2022) Effects of early-life adversities on neuropsychiatric and executive functions in HIV-positive adults. J Int Neuropsychol Soc. https://doi.org/10.1017/s1355617721001466CrossRefPubMed

13.

Jodi Berger Cardoso (2022) Threat and deprivation as distinct predictors of posttraumatic stress and depression symptoms in first and second generation latinx youth [Conference presentation abstract]. Society for Social Work and Research 26th Annual Conference, Marriott Marquis Washington, DC. https://sswr.confex.com/sswr/2022/webprogram/Paper46624.html

14.

Sumner JA, Colich NL, Uddin M, Armstrong D, McLaughlin KA (2019) Early experiences of threat, but not deprivation, are associated with accelerated biological aging in children and adolescents. Biol Psychiatry 85(3):268–278. https://doi.org/10.1016/j.biopsych.2018.09.008CrossRefPubMed

15.

Weissman DG, Rosen ML, Colich NL, Sambrook KA, Lengua LJ, Sheridan MA, McLaughlin KA (2022) Exposure to violence as an environmental pathway linking low socioeconomic status with altered neural processing of threat and adolescent psychopathology. J Cogn Neurosci. https://doi.org/10.1162/jocn_a_01825CrossRefPubMedPubMedCentral

16.

Vaughn-Coaxum RA, Dhawan N, Sheridan MA, Hart MJ, Weisz JR (2020) Dimensions of adversity in association with adolescents’ depression symptoms: distinct moderating roles of cognitive and autonomic function. Dev Psychopathol 32(3):817–830. https://doi.org/10.1017/s0954579419001172CrossRefPubMedPubMedCentral

17.

Yazawa A, Shiba K, Inoue Y, Okuzono SS, Inoue K, Kondo N, Kondo K, Kawachi I (2022) Early childhood adversity and late-life depressive symptoms: unpacking mediation and interaction by adult socioeconomic status. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-022-02241-xCrossRefPubMed

18.

Wade R, Cronholm PF, Fein JA, Forke CM, Davis MB, Harkins-Schwarz M, Pachter LM, Bair-Merritt MH (2016) Household and community-level adverse childhood experiences and adult health outcomes in a diverse urban population. Child Abuse Negl 52:135–145. https://doi.org/10.1016/j.chiabu.2015.11.021CrossRefPubMed

19.

Oshio T, Umeda M, Kawakami N (2013) Impact of interpersonal adversity in childhood on adult mental health: how much is mediated by social support and socio-economic status in Japan? Public Health 127(8):754–760. https://doi.org/10.1016/j.puhe.2013.05.005CrossRefPubMed

20.

Houtepen LC, Heron J, Suderman MJ, Fraser A, Chittleborough CR, Howe LD (2020) Associations of adverse childhood experiences with educational attainment and adolescent health and the role of family and socioeconomic factors: a prospective cohort study in the UK. PLoS Med 17(3):e1003031. https://doi.org/10.1371/journal.pmed.1003031CrossRefPubMedPubMedCentral

21.

Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014) Cohort profile: the China health and retirement longitudinal study (CHARLS). Int J Epidemiol 43(1):61–68. https://doi.org/10.1093/ije/dys203CrossRefPubMed

22.

Chen X, Crimmins E, Hu PP, Kim JK, Meng Q, Strauss J, Wang Y, Zeng J, Zhang Y, Zhao Y (2019) Venous blood-based biomarkers in the china health and retirement longitudinal study: rationale, design, and results from the 2015 wave. Am J Epidemiol 188(11):1871–1877. https://doi.org/10.1093/aje/kwz170CrossRefPubMedPubMedCentral

23.

Andresen EM, Malmgren JA, Carter WB, Patrick DL (1994) Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med 10(2):77–84CrossRefPubMed

24.

Chen H, Mui AC (2014) Factorial validity of the center for epidemiologic studies depression scale short form in older population in China. Int Psychogeriatr 26(1):49–57. https://doi.org/10.1017/S1041610213001701CrossRefPubMed

25.

Lin L, Bai S, Qin K, Wong CKH, Wu T, Chen D, Lu C, Chen W, Guo VY (2022) Comorbid depression and obesity, and its transition on the risk of functional disability among middle-aged and older Chinese: a cohort study. BMC Geriatr 22(1):275. https://doi.org/10.1186/s12877-022-02972-1CrossRefPubMedPubMedCentral

26.

Boey KW (1999) Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatry 14(8):608–617. https://doi.org/10.1002/(sici)1099-1166(199908)14:8%3c608::aid-gps991%3e3.0.co;2-zCrossRefPubMed

27.

Lin L, Sun W, Lu C, Chen W, Guo VY (2022) Adverse childhood experiences and handgrip strength among middle-aged and older adults: a cross-sectional study in China. BMC Geriatr 22(1):118–118. https://doi.org/10.1186/s12877-022-02796-zCrossRefPubMedPubMedCentral

28.

Wolf S, Suntheimer NM (2019) A dimensional risk approach to assessing early adversity in a national sample. J Appl Dev Psychol 62:270–281. https://doi.org/10.1016/j.appdev.2019.03.004CrossRef

29.

Lin L, Cao B, Chen W, Li J, Zhang Y, Guo VY (2022) Association of adverse childhood experiences and social isolation with later-life cognitive function among adults in China. JAMA Network Open 5(11):e2241714. https://doi.org/10.1001/jamanetworkopen.2022.41714CrossRefPubMedPubMedCentral

30.

Angus D, Salman Z (2002) Guidelines for Constructing Consumption Aggregates for Welfare Analysis. LSMS Working Paper; No. 135. World Bank © World Bank. https://openknowledge.worldbank.org/handle/10986/14101 License: CC BY 3.0 IGO. Accessed 1 Apr 2022

31.

Wang Q, Cao H, Zhang S (2022) Trends of and factors associated with access to residential toilets among the middle-aged and elderly in rural China from 2011 to 2018. BMC Public Health 22(1):421. https://doi.org/10.1186/s12889-022-12739-3CrossRefPubMedPubMedCentral

32.

Zhao Y, Atun R, Oldenburg B, McPake B, Tang S, Mercer SW, Cowling TE, Sum G, Qin VM, Lee JT (2020) Physical multimorbidity, health service use, and catastrophic health expenditure by socioeconomic groups in China: an analysis of population-based panel data. Lancet Glob Health 8(6):e840–e849. https://doi.org/10.1016/s2214-109x(20)30127-3CrossRefPubMedPubMedCentral

33.

Zhou BF (2002) Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 15(1):83–96PubMed

34.

American Diabetes Association (2021) 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care 44(Suppl 1):S15–S33. https://doi.org/10.2337/dc21-S002CrossRef

35.

Lin L, Lu C, Chen W, Guo VY (2021) Daytime napping and nighttime sleep duration with incident diabetes mellitus: a cohort study in Chinese older adults. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph18095012CrossRefPubMedPubMedCentral

36.

Chen D, Liang Z, Sun H, Lu C, Chen W, Wang HHX, Guo VY (2021) Association between hypertriglyceridemic-waist phenotype and risk of type 2 diabetes mellitus in middle-aged and older Chinese population: a longitudinal cohort study. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph18189618CrossRefPubMedPubMedCentral

37.

Suglia SF, Koenen KC, Boynton-Jarrett R, Chan PS, Clark CJ, Danese A, Faith MS, Goldstein BI, Hayman LL, Isasi CR, Pratt CA, Slopen N et al (2018) Childhood and adolescent adversity and cardiometabolic outcomes: a scientific statement from the American heart association. Circulation 137(5):E15–E28. https://doi.org/10.1161/cir.0000000000000536CrossRefPubMed

38.

Huang Z-T, Luo Y, Han L, Wang K, Yao S-S, Su H-X, Chen S, Cao G-Y, De Fries CM, Chen Z-S, Xu H-W, Hu Y-H et al (2022) Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese. J Affect Disord 301:1–7. https://doi.org/10.1016/j.jad.2022.01.030CrossRefPubMed

39.

Sousa AC, Guerra RO, Thanh TuM, Phillips SP, Guralnik JM, Zunzunegui MV (2014) Lifecourse adversity and physical performance across countries among men and women aged 65–74. PLoS ONE 9(8):e102299. https://doi.org/10.1371/journal.pone.0102299CrossRefPubMedPubMedCentral

40.

Danese A, McEwen BS (2012) Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiol Behav 106(1):29–39. https://doi.org/10.1016/j.physbeh.2011.08.019CrossRefPubMed

41.

Ogłodek E, Szota A, Just M, Moś D, Araszkiewicz A (2014) The role of the neuroendocrine and immune systems in the pathogenesis of depression. Pharmacol Rep 66(5):776–781. https://doi.org/10.1016/j.pharep.2014.04.009CrossRefPubMed

42.

Danese A, Baldwin JR (2017) Hidden wounds? Inflammatory links between childhood trauma and psychopathology. Annu Rev Psychol 68(1):517–544. https://doi.org/10.1146/annurev-psych-010416-044208CrossRefPubMed

43.

McLaughlin KA, Sheridan MA (2016) Beyond cumulative risk: a dimensional approach to childhood adversity. Curr Dir Psychol Sci 25(4):239–245. https://doi.org/10.1177/0963721416655883CrossRefPubMedPubMedCentral

44.

Greene CA, McCoach DB, Briggs-Gowan MJ, Grasso DJ (2021) Associations among childhood threat and deprivation experiences, emotion dysregulation, and mental health in pregnant women. Psychol Trauma 13(4):446–456. https://doi.org/10.1037/tra0001013CrossRefPubMedPubMedCentral

45.

Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 18(1):156. https://doi.org/10.1186/s12888-018-1736-5CrossRefPubMedPubMedCentral

46.

Golm D, Maughan B, Barker ED, Hill J, Kennedy M, Knights N, Kreppner J, Kumsta R, Schlotz W, Rutter M, Sonuga-Barke EJS (2020) Why does early childhood deprivation increase the risk for depression and anxiety in adulthood? A developmental cascade model. J Child Psychol Psychiatry 61(9):1043–1053. https://doi.org/10.1111/jcpp.13205CrossRefPubMedPubMedCentral

47.

McLaughlin KA, Sheridan MA, Humphreys KL, Belsky J, Ellis BJ (2021) The value of dimensional models of early experience: thinking clearly about concepts and categories. Perspect Psychol Sci 16(6):1463–1472. https://doi.org/10.1177/1745691621992346CrossRefPubMedPubMedCentral

48.

Hurst JE, Kavanagh PS (2017) Life history strategies and psychopathology: the faster the life strategies, the more symptoms of psychopathology. Evol Hum Behav 38(1):1–8. https://doi.org/10.1016/j.evolhumbehav.2016.06.001CrossRef

49.

Kaltiala-Heino R, Kosunen E, Rimpelä M (2003) Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc 26(5):531–545. https://doi.org/10.1016/s0140-1971(03)00053-8CrossRefPubMed

50.

Conger RD, Donnellan MB (2007) An interactionist perspective on the socioeconomic context of human development. Annu Rev Psychol 58(1):175–199. https://doi.org/10.1146/annurev.psych.58.110405.085551CrossRefPubMed

51.

Luo Y, Waite LJ (2005) The impact of childhood and adult SES on physical, mental, and cognitive well-being in later life. J Gerontol B Psychol Sci Soc Sci 60(2):S93-s101. https://doi.org/10.1093/geronb/60.2.s93CrossRefPubMed

52.

Wang J, Geng L (2019) Effects of socioeconomic status on physical and psychological health: lifestyle as a mediator. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph16020281CrossRefPubMedPubMedCentral

53.

Han KM, Han C, Shin C, Jee HJ, An H, Yoon HK, Ko YH, Kim SH (2018) Social capital, socioeconomic status, and depression in community-living elderly. J Psychiatr Res 98:133–140. https://doi.org/10.1016/j.jpsychires.2018.01.002CrossRefPubMed

54.

Hardt J, Rutter M (2004) Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 45(2):260–273. https://doi.org/10.1111/j.1469-7610.2004.00218.xCrossRefPubMed

55.

Johnson D, Policelli J, Li M, Dharamsi A, Hu Q, Sheridan MA, McLaughlin KA, Wade M (2021) Associations of early-life threat and deprivation with executive functioning in childhood and adolescence: a systematic review and meta-analysis. JAMA Pediatr 175(11):e212511. https://doi.org/10.1001/jamapediatrics.2021.2511CrossRefPubMedPubMedCentral

Title: Association of childhood threat and deprivation with depressive symptoms and the moderating role of current economic status among middle-aged and older adults in China
Authors: Li Lin
Bing Cao
Weiqing Chen
Jinghua Li
Yuying Zhang
Vivian Yawei Guo
Publication date: 23-11-2022
Publisher: Springer Berlin Heidelberg
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 8/2023
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-022-02384-x

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Association of childhood threat and deprivation with depressive symptoms and the moderating role of current economic status among middle-aged and older adults in China

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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