The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study

Abstract

Background Exposure to adverse childhood experiences (ACEs) and being female are distinct risk factors for having a major depressive episode (MDE) or an anxiety disorder (AD) in adulthood, but it is unclear whether these two risk factors are synergistic. The purpose of this study was to determine whether exposure to ACEs and being female are more than additive (synergistic) in their association with MDE and AD in US adults. Methods We pooled cross-sectional survey data in the Midlife in the United States study from two nationally-representative cohorts of English-speaking US adults. Data from the first cohort were collected in 2004–2006 and from the second in 2011–2014. Data from both cohorts included the 12-month prevalence of MDE and AD (generalized anxiety disorder or panic disorder) assessed with the Composite International Diagnostic Interview Short Form, gender (here termed female and male), and the count of five categories of exposure to ACEs: physical, sexual, or emotional abuse; household alcohol or substance abuse; and parental separation or divorce. Results Of the 5834 survey respondents, 4344 (74.5%) with complete data on ACEs were included in the analysis. Mean (SD) age was 54.1 (13.8) years and 53.9% were female. The prevalences of MDE, AD, and exposure to 3–5 categories of ACEs were 13.7, 10.0, and 12.5%, respectively. After adjusting for covariates (age, race, and current and childhood socioeconomic disadvantage), for those with both risk factors (female and 3–5 ACEs) the prevalence of MDE was 26.9%. This was 10.2% (95% CI: 1.8, 18.5%) higher than the expected prevalence based on the additive associations of the two risk factors. The adjusted prevalence of AD among females with 3–5 ACEs was 21.9%, which was 11.4% (95% CI: 4.0, 18.9%) higher than the expected prevalence. Conclusions For both MDE and AD, there was synergy between the two risk factors of exposure to ACEs and being female. Identification and treatment of MDE and AD may benefit from understanding the mechanisms involved in the synergistic interaction of gender with ACEs.

Characteristics and Mediating Effect of Gut Microbiota With Experience of Childhood Maltreatment in Major Depressive Disorder

“…The role of environmental factors in the pathogenesis of MDD has attracted greater attention from physicians and researchers ( Foster et al, 2017 ; O’Mahony et al, 2017 ). Several studies have shown that people who have experience of physical abuse (PA) or emotional abuse (EA) are more likely to suffer from depression ( Biedermann et al, 2021 ; Husain et al, 2021 ), and the severity of symptom is strongly associated with childhood maltreatment ( Whitaker et al, 2021 ; Yang et al, 2021 ; Rep et al, 2022 ). According to a study, the effects of childhood maltreatment could last for decades and are strongly associated with the onset of mental disorders at an older age ( Macpherson et al, 2021 ).…”

Attachment mediates the impact of previous trauma on posttraumatic symptoms during the COVID-19 pandemic.

“…It should also be considered that sample characteristics may have influenced the current findings. The majority of the sample were women, and prior research has widely documented that women are more likely to report exposure to traumatic events (Whitaker et al, 2021) and higher PTSS severity than men (Breslau et al, 1997). Future studies should be conducted to analyze these hypotheses in samples in samples with a higher proportion of men.…”

No Sex Differences in Self-Reported Childhood Maltreatment in Major Depressive and Bipolar Disorders: A Retrospective Study

“…Similarly, a subsequent meta-analysis has failed to find any sex differences in the association between CM and MDD morbidity or in the severity of depressive symptoms in adulthood [ 31 ]. In contrast, a recent study revealed a synergistic effect of female sex and unfavorable childhood experiences on the 12-month prevalence of major depressive episodes in US adults [ 32 ]. Similarly, a Brazilian population-based study identified CM as a significant risk factor for MDD in women rather than in men [ 33 ].…”