Abstract: Adverse childhood experiences (ACEs) are plentiful within our society however the consequences that stem from these experiences are not often addressed particularly their impact on mental wellness. Given that ACEs have negative neurodevelopmental influences that persist over the lifespan this paper will present findings from a study that examined the relationship between ACEs and self-reported depression among low-income ethnic minority populations who live in an urban setting. Findings highlight the importance of research on the prevalence of and risks for multiple types of childhood maltreatment, particularly in the somewhat neglected area of self-reported depression. Statistical significance was found for most ACEs and clinical significance was noted for several ACEs. Efforts to mitigate and prevent depression will likely benefit from preventing ACEs and treating individuals exposed to them. Discernment that ACEs lead to risk behaviors that subsequently increase the likelihood of depression could provide insight that can improve prevention efforts.
Key Words: Adverse Childhood Experiences, Depression, Nurse Managed Health Care Center
The pervasiveness of childhood trauma (e.g., abuse, neglect, and household dysfunction), the single most important public health challenge in the United States (US), has strongly demonstrated that it is a reliable marker in foretelling the future impact of a multitude of social ills (Felitti et al., 1998). Although theorists (Beck, 1967; Bowlby, 1973, 1980) have long perceived that adverse childhood experiences (ACEs) may enhance vulnerability to the development of psychopathology, specifically depression across the lifespan (Kendler, Gardner, & Prescott, 2006; Maercker, Michael, Fehm, Becker, & Margraf, 2004; Spatz-Widom, DuMont, & Czaja, 2007), this link is infrequently acknowledged in the general nursing literature.
Data from the landmark Adverse Childhood Experiences (ACE) Study, a collaborative effort between Kaiser Permanente and tue Centers for Disease Control and Prevention provided useful data for many health clinicians, particularly nurses. This study tracked the effects of childhood trauma for about 17,000 predominately middle-class European American individuals to determine the relationship between childhood experiences and adult health. Evidence from this decade long study demonstrates that one of their underlying hypotheses, traumatic childhood experiences have negative neurodevelopmental influences that persist over the lifespan, was strongly supported, particularly as it relates to increased risk of depression (Felitti et al., 1998).
The purpose of this paper is to present findings from part of a larger study that replicated the original ACEs Study in an urban population of majority ethnic minority populations. This paper will (i) describe the demographic characteristics of the sample, (ii) identify the types of trauma individuals were exposure to, and (iii) examine the relationship between ACEs and self-reported depression among a low-income community sample of people who live in an urban setting.
Examining the prevalence of self-reported depression is important since research has found that perceived health status and number of chronic conditions are two prominent factors associated with self-reported depression (Bazargan, Bazargan-Hejazi,& Baker, 2005). Moreover, ethnic minority and underserved low-income groups have low rates of seeking care for depression and low rates of receiving high quality treatment when compared to European American populations, often delaying intervention until symptoms and/or functional impairment reach intolerable levels (Van Voorhees et al., 2006). In many communities where at-risk populations live, stigma persists and disparities in access to culturally sensitive care and intervention for depression and varied forms of trauma continue. Neither the biomedicai theories that champion the use of antidepressants nor the cognitive distortion model intrinsic in cognitive behavioral therapy make any link between trauma and the onset of depression (Hagen, Wong-Wylie, & Pijl-Zieber, 2010). …