In Sync or Out of Tune? How Do Differences in Adolescent and Caregiver Reports of Adolescent Adverse Childhood Experiences Relate to Adolescent Depression? A Cross-Sectional Study

Abstract

ObjectiveThis study aims to compare adolescent and caregiver reports of adolescent ACEs and their relationship with current adolescent depression and to analyze the relationship between ACEs and depression. MethodsWe recruited 46 adolescent-caregiver dyads from a large inner city medical center's adolescent medicine clinic. Adolescents and caregivers completed the Center for Youth Wellness ACE questionnaire, encompassing traditional ACEs (e.g., abuse, neglect, household dysfunction) and non-traditional ACEs (e.g., foster care, parental death, exposure to community violence). Adolescents also completed the PHQ-9A depression screening tool. ResultsAmong adolescents, 14 (30%) reported no traditional ACEs, 11 (24%) reported one, and 21 (46%) reported more than one. Regarding non-traditional ACEs, 16 (35%) reported none, 11(24%) reported one, and 19 (41%) reported more than one. Caregiver reports consistently indicated lower ACEs compared to adolescent self-reports (p < .005). For the PHQ-9A scores, 26 (57%) of adolescents showed no or minimal depression, 14 (30%) mild, and six (13%) moderate depression. A moderate positive correlation emerged between PHQ-9A scores and self-reported traditional ACEs (rs=0.5, p<.001) and non-traditional ACEs (rs=0.49, p<.001). Additionally, a positive correlation was observed between the absolute differences in adolescent and caregiver reports of traditional ACEs and PHQ-9A scores (n=46, ρ=0.51, p<0.001). ConclusionAs the differences in ACE reports between adolescents and caregivers increased, there was a corresponding increase in adolescent depression scores. It is essential to incorporate comprehensive ACE screening and encourage open communication between adolescents and caregivers which may improve mental health outcomes.