The relationship between adverse childhood experiences and depression: A cross-sectional survey with university students in Botswana.

Kennedy Amone-P'Olak,Nkalosang K Letswai

doi:10.4102/sajpsychiatry.v26i0.1444

Abstract

BackgroundAdverse childhood experiences (ACEs) are associated with severe life-long negative outcomes, including depression. Particularly in low- and middle-income countries, few studies have been conducted to assess the impact of ACEs.AimTo assess the influence of ACEs on depression among young adults.SettingParticipants were students at a large university in Gaborone, Botswana.MethodsUsing a cross-sectional design, we investigated the associations between ACEs and depression in young adults in Botswana (n = 392, mean age = 22.2, ± 2.5, 53.4% female). Bivariate correlation analyses, t-tests and analyses of variance (ANOVA) were performed to assess associations and compare ACEs at different levels of depression.ResultsA total of 73% (n = 287) reported one or more ACEs, whilst 15% (59) reported five or more ACEs. About 64% (38) of those who reported five or more ACEs were female respondents. Prevalence of specific ACEs ranged from 9.5% (child neglect) to 36.3% (separation and divorce). One in three respondents reported parental separation or divorce, psychological abuse and family dysfunction, whilst 19% (11% moderate and 8% severe) reported significant depressive symptoms. Adverse childhood experiences significantly predicted depression (β = 0.27, 95% confidence interval [CI]: 0.18, 0.37). Respondents at different levels of depression significantly differed on reporting ACEs (F(3, 389) = 11.43, p < 0.001).ConclusionAdverse childhood experiences are highly prevalent and key determinants of depression in young adulthood. A multifaceted and cross-system intervention (e.g. schools, social work, psychological services, health services and law enforcement) is required to protect, prevent and treat survivors of childhood adversity.

Highlights

Depression amongst young adults in low- and middle-income countries is a growing public health concern
Compared with Europe and other Western countries, little attention has been given to adverse childhood experiences (ACEs) as risk factors of depression in low- and middle-income countries
The results showed that respondents at different categories of ACEs significantly varied in reporting depressive symptoms (F (3, 388) = 12.62, p < 0.001, η2 = 0.09)

Summary

Introduction

Depression amongst young adults in low- and middle-income countries is a growing public health concern. Several factors have been implicated in the development of depressive disorders. Such factors include poverty,[1] sexual abuse,[2] conflict,[3] unemployment[4] and adverse childhood experiences (ACEs).[5,6,7,8]. Compared with Europe and other Western countries, little attention has been given to ACEs as risk factors of depression in low- and middle-income countries. Adverse childhood experiences (ACEs) are associated with severe life-long negative outcomes, including depression. In low- and middle-income countries, few studies have been conducted to assess the impact of ACEs

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Discussion

Conclusion