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Wu S, Ta L, Vieira J, Schwartz K, Perez J, Zeien J, Li D, Hartmark-Hill J. Adverse Childhood Experiences and Depression among Homeless Young Adults: A Social Determinants of Health Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:81. [PMID: 38248544 PMCID: PMC10815729 DOI: 10.3390/ijerph21010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Homelessness is a pervasive issue in the United States that presents significant challenges to public health. Homeless young adults (HYAs) are at particular risk for increased incidence and severity of depression. Using primary survey data (n = 205) collected in the Phoenix Metropolitan Area, Arizona, from June to August 2022, this study aims to examine the relationship between adverse childhood experiences (ACEs) and depression among HYAs. We adopted the ACEs 10-item scale to measure childhood traumatic experiences, whereas depression was measured by using a PHQ-4 depression scale and diagnosed depression. Regression models were conducted to test the relationships between ACEs and depression outcomes while controlling for the covariates at the individual, interpersonal, and socioeconomic/living environment levels. The average PHQ-4 score was 5.01 (SD = 3.59), and 59.69% of HYAs reported being diagnosed previously with depression. The mean ACEs score was 5.22 out of 10. Other things being equal, for every one unit increase in ACEs scores, the odds of being diagnosed with depression increased by 11.5%, yet it was not statistically significant, while the PHQ-4 score increased by 0.445 (p < 0.001). Overall, HYAs were disproportionately affected by depression. This study elucidates the complex relationship between ACEs and depression among HYAs.
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Affiliation(s)
- Shiyou Wu
- School of Social Work, Arizona State University, Phoenix, AZ 85004, USA
| | - Lac Ta
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Jaime Vieira
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Kendall Schwartz
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Joshua Perez
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
| | - Justin Zeien
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA;
| | - Danyi Li
- Keck School of Medicine Preventive Medicine, University of Southern California, Los Angeles, CA 90032, USA;
| | - Jennifer Hartmark-Hill
- College of Medicine–Phoenix, University of Arizona, Phoenix, AZ 85004, USA; (L.T.); (J.V.); (K.S.); (J.P.); (J.H.-H.)
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Zhang Y, Li S, Xu H, Jin Z, Li R, Zhang Y, Wan Y. Gender-based differences in interaction effects between childhood maltreatment and problematic mobile phone use on college students' depression and anxiety symptoms. BMC Psychiatry 2023; 23:286. [PMID: 37098541 PMCID: PMC10127168 DOI: 10.1186/s12888-023-04777-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/12/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Childhood maltreatment and problematic mobile phone use are risk factors for depression and anxiety symptoms among college students. However, how the interaction between the two factors affects depression and anxiety has yet to be validated. This study aimed to investigate the independent and interaction effects of childhood maltreatment and problematic mobile phone use on depression and anxiety among college students and explored gender-based differences in these associations. METHOD A cross-sectional study was conducted from October to December 2019. We collected data from 7623 students at two colleges in Hefei and Anqing cities in Anhui Province, China. Multinomial logistic regression models were performed to explore the associations of childhood maltreatment and problematic mobile phone use with depression and anxiety symptoms and their interaction effects on depression and anxiety symptoms. RESULTS Childhood maltreatment and problematic mobile phone use were significantly associated with increased risk of depression and anxiety symptoms (P < 0.001). Moreover, following adjustments for covariates, there was a multiplicative interaction between childhood maltreatment and problematic mobile phone use on depression and anxiety symptoms (P < 0.001). Gender-based differences were also observed in the associations. For instance, depression was more common in males and male students with childhood maltreatment were at higher risk of depression-only symptoms. CONCLUSION Focusing on childhood maltreatment and problematic mobile phone use could facilitate a reduction in the occurrence of depression and anxiety symptoms in college students. Furthermore, it is necessary to develop gender-targeted intervention strategies.
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Affiliation(s)
- Yulin Zhang
- The Second Clinical Medical College, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- MOE Key Laboratory of Population Health Across the Life Cycle, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- MOE Key Laboratory of Population Health Across the Life Cycle, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- MOE Key Laboratory of Population Health Across the Life Cycle, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China
- MOE Key Laboratory of Population Health Across the Life Cycle, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yi Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China.
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No. 81 Meishan Road, Hefei, Anhui, 230032, China.
- MOE Key Laboratory of Population Health Across the Life Cycle, No. 81 Meishan Road, Hefei, Anhui, 230032, China.
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O’Campo P, Nisenbaum R, Crocker AG, Nicholls T, Eiboff F, Adair CE. Women experiencing homelessness and mental illness in a Housing First multi-site trial: Looking beyond housing to social outcomes and well-being. PLoS One 2023; 18:e0277074. [PMID: 36763583 PMCID: PMC9916643 DOI: 10.1371/journal.pone.0277074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 10/19/2022] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes over a 24 month-period. METHODS The At Home/Chez Soi multi-site randomized controlled Housing First trial recruited over 600 women between October 2009 and July 2011. This is a post-hoc subgroup exploratory analysis of self-identified women with at least one follow-up interview who were randomized to Housing First (HF) (n = 374) or treatment-as-usual (TAU) (n = 279) and had at least one follow-up interview. Linear mixed models and generalized estimating equations were used after multiple imputation was applied to address missing data. RESULTS At the end of follow-up, the mean percentage of days spent stably housed was higher for women in the intervention 74.8% (95%CI = 71.7%-77.8%) compared with women in the treatment-as-usual group, 37.9% (95%CI = 34.4%-41.3%), p<0.001. With few exceptions, social and mental health outcomes were similar for both groups at 6-, 12-, 18- and 24-months post-enrollment. Suicidality was a consistent predictor of increased mental health symptoms (beta = 2.85, 95% CI 1.59-4.11, p<0.001), decreased quality of life (beta = -3.99, 95% CI -6.49 to -1.49, p<0.001), decreased community functioning (beta = -1.16, 95% CI -2.10 to -0.22, p = 0.015) and more emergency department visits (rate ratio = 1.44, 95% CI 1.10-1.87, p<0.001) over the study period. Lower education was a predictor of lower community functioning (beta = -1.32, 95% CI -2.27 to -0.37, p = 0.006) and higher substance use problems (rate ratio = 1.27, 95% CI 1.06-1.52, p = 0.009) during the study. CONCLUSIONS Housing First interventions ensured that women experiencing homelessness are quickly and consistently stably housed. However, they did not differentially impact health and social measures compared to treatment as usual. Ensuring positive health and social outcomes may require greater supports at enrolment for subgroups such as those with low educational attainment, and additional attention to severity of baseline mental health challenges, such as suicidality. TRIAL REGISTRATION International Standard Randomized Control Trial Number Register Identifier: ISRCTN42520374.
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Affiliation(s)
- Patricia O’Campo
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- * E-mail:
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, St Michael’s Hospital, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Anne G. Crocker
- Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, Canada
- Department of Psychiatry & Addictions, Université de Montréal, Montreal, Canada
- School of Criminology, Université de Montréal, Montreal, Canada
| | - Tonia Nicholls
- British Columbia Mental Health & Substance Use Services, Provincial Health Services Authority, Vancouver, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Faith Eiboff
- Interdisciplinary Studies, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Carol E. Adair
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Chen Y, Hua K, Huang C, Zhou G, Wang J. Adverse Childhood Experiences and Psychological Well-Being in Chinese College Students: Moderated Mediation by Gender and Resilience. Front Psychiatry 2021; 12:710635. [PMID: 34434130 PMCID: PMC8381021 DOI: 10.3389/fpsyt.2021.710635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/14/2021] [Indexed: 11/29/2022] Open
Abstract
Adverse childhood experiences (ACEs), including child abuse/neglect and household challenges, are a prevalent social issue that impacts individuals' well-being worldwide. Relatively few ACEs studies orient to the presence of psychological wellness, especially in ethnically Chinese populations. Furthermore, less is known about resilience as a mechanism between ACEs and psychological well-being, in addition to the moderating effect of gender. This study examined the relationship between ACEs and psychological well-being among Chinese college students and the potential mediating and moderating effects of resilience and gender, respectively. A total of 1,871 college students studying social science from 12 Chinese colleges completed an anonymous online survey between late September and early October 2020. Multiple-group path analyses were conducted to examine whether the relationships among ACEs, resilience, and psychological well-being differed as a function of gender. Results suggested that gender moderated the relationships studied. For female students, resilience mediated the association between abuse/neglect and psychological well-being, where abuse/neglect was negatively associated with resilience, which in turn had a negative relationship with psychological well-being. For male students, household challenges were negatively related to psychological well-being through reduced resilience. Based on the findings, various ACE-informed initiatives may be essential to prevent and protect individuals from ACEs. We also call for resilience-based interventions to enhance individuals' resilience and thus strengthen their psychological well-being.
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Affiliation(s)
- Yafan Chen
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Kai Hua
- Soccer Academy, Wuhan Sports University, Wuhan, China
| | - Chienchung Huang
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Gaosheng Zhou
- Institute of Social Development, Wenzhou University, Wenzhou, China
| | - Jianfeng Wang
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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