Exploring the relationship between childhood adversity and adult depression: A risk versus strengths-oriented approach

Background: Previous research suggests a dose-response relationship between adverse childhood experiences (ACEs) and adult depression. Both constructs are also known correlates of child maltreatment risk. Objectives: This study examines the relationship between a cumulative count of ACEs and adult depressive symptoms in a sample of families at risk for child maltreatment. The study also aims to determine if a new childhood caregiving environment (CCE) scale predicts adult depressive symptoms as well as or better than the traditional ACE score in this high-risk population, and whether it holds potential as a service needs assessment tool for the child maltreatment prevention field. Participants and setting: Baseline survey data from a randomized control trial testing a child maltreatment prevention program in Milwaukee, Wisconsin were used. The sample (n = 618) included caregivers reported to and investigated by child protective services (CPS) for allegations of abuse or neglect. Methods: Ordinary least squares regression was used to look at the relationship between the number of ACEs, scores on the CCE scale, and adult depressive symptoms. Exploratory factor analysis was used to examine the CCE scale items in comparison to ACEs. Results: A high ACE score was associated with more depressive symptomatology (B = 0.82, p < 0.001). Conversely, adults with higher scores on the CCE scale had fewer depressive symptoms (B = -0.30, p < 0.001). There was also preliminary evidence that the CCE scale may tap into similar underlying constructs as ACEs. Conclusions: Given that the CCE measure favors strengths-oriented question items, it may be a promising alternative to the risk-oriented ACE score in assessing parental childhood adversities known to be associated with the maltreatment of one's own children, and as an approach for identifying service needs related to childhood trauma in a maltreatment prevention context.