Association between adverse childhood experiences and depression and anxiety: a review
ZHU Siyu1, WU Jing1, YING Jiayao1, SONG Peige1,2
1. School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310058, China; 2. The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
Abstract：Adverse childhood experiences (ACEs) refer to traumatic events such as abuse and neglect experienced before the age of 18 years, which have negative impacts on an individual's physical and mental health. Studies have shown that ACEs not only increase the risk of health-harming behaviors such as smoking and alcohol abuse, but are also risk factors for depression and anxiety. The influence of ACEs on depression and anxiety exhibits type-specificity, cumulative effects, and temporal dynamics. The impact of ACE types on depression and anxiety varies across populations and genders, a dose-response relationship exists between the number of ACEs and depression/anxiety, and the phase, trajectory, and frequency of ACEs also significantly influence depression and anxiety. This article collected literature on ACEs and depression/anxiety from January 1995 to June 2024 by searching the CNKI and PubMed databases. It provides a comprehensive review of the associations between different ACEs types, quantities, categories, timing, trajectories, frequencies, and the risks of depression and anxiety, while also exploring the underlying mechanisms of these associations. The findings aim to offer references for the prevention and intervention of ACEs and the improvement of mental health.
[1] FELITTI V J,ANDA R F,NORDENBERG D,et al.REPRINT OF:Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults:the adverse childhood experiences(ACE)study[J].Am J Prev Med,2019,56(6):774-786. [2] BHUTTA Z A,BHAVNANI S,BETANCOURT T S,et al.Adverse childhood experiences and lifelong health[J].Nat Med,2023,29(7):1639-1648. [3] HUGHES K,BELLIS M A,HARDCASTLE K A,et al.The effect of multiple adverse childhood experiences on health:a systematic review and meta-analysis[J].Lancet Public Health,2017,2(8):356-366. [4] LIU J N,NING W,ZHANG N,et al.Estimation of the global disease burden of depression and anxiety between 1990 and 2044:an analysis of the global burden of disease study 2019[J].Healthcare,2024,12(17):1-19. [5] 李书琴,万宇辉.不同暴露形式童年期不良经历健康效应研究进展[J].中国学校卫生,2020,41(4):636-640. LI S Q,WAN Y H.Research progress on the health effects of adverse childhood experiences with different exposure patterns[J].Chin J Sch Health,2020,41(4):636-640.(in Chinese) [6] 屈光波. 童年期正性与负性经历对中小学生焦虑抑郁的影响及炎症负荷的中介效应研究[D].合肥:安徽医科大学,2023. QU G B.Study on the effect of positive and negative childhood experiences on anxiety and depression of primary and middle school students and the mediating effect of inflammatory burden[D].Hefei:Anhui Medical University,2023.(in Chinese) [7] 郑利锋,杨开仁,谭素仙,等.青少年抑郁症状现况调查[J].预防医学,2018,30(4):338-340,344. ZHENG L F,YANG K R,TAN S X,et al.Prevalence of depressive symptoms among adolescents[J].China Prev Med J,2018,30(4):338-340,344.(in Chinese) [8] AL SHAWI A F,SARHAN Y T,ALTAHA M A.Adverse childhood experiences and their relationship to gender and depression among young adults in Iraq:a cross-sectional study[J].BMC Public Health,2019,19(1):1-7. [9] 杜本峰,耿蕊,李炜洁.童年逆境类别及其累加与中老年期抑郁倾向[J].中国健康心理学杂志,2022,30(1):12-17. DU B F,GENG R,LI W J.Types and accumulation of childhood adversity and depression tendency in middleaged and elderly people[J].China J Health Psychol,2022,30(1):12-17.(in Chinese) [10] DEVRIES K,KNIGHT L,PETZOLD M,et al.Who perpetrates violence against children?A systematic analysis of age-specific and sex-specific data[J/OL].BMJ Paediatr Open,2018,2(1)[2025-08-13].https://doi.org/10.1136/bmjpo-2017-000180. [11] 李娟娟,章荣华,邹艳,等.浙江省青少年抑郁症状的影响因素分析[J].预防医学,2021,33(2):139-142. LI J J,ZHANG R H,ZOU Y,et al.Influencing factors of depressive symptoms in Zhejiang adolescents[J].China Prev Med J,2021,33(2):139-142.(in Chinese) [12] JIANG W W,JI M X,CHI X L,et al.Relationship between adverse childhood experiences and mental health in Chinese adolescents:differences among girls and boys[J].Children,2022,9(5):1-13. [13] KIM I,GALVÁN A,KIM N.Independent and cumulative impacts of adverse childhood experiences on adolescent subgroups of anxiety and depression[J/OL].Child Youth Serv Rev,2021,122[2025-08-13].https://doi.org/10.1016/j.childyouth.2020.105885. [14] SUBRAMANIAM M,ABDIN E,SEOW E,et al.Prevalence,socio-demographic correlates and associations of adverse childhood experiences with mental illnesses:results from the Singapore Mental Health Study[J/OL].Child Abuse Negl,2020,103[2025-08-13].https://doi.org/10.1016/j.chiabu.2020.104447. [15] WITT A,SACHSER C,PLENER P L,et al.The prevalence and consequences of adverse childhood experiences in the German population[J].Dtsch Arztebl Int,2019,116(38):635-642. [16] HEDRICK J,BENNETT V,CARPENTER J,et al.A descriptive study of adverse childhood experiences and depression,anxiety,and stress among undergraduate nursing students[J].J Prof Nurs,2021,37(2):291-297. [17] 陈珊珊. 童年期不良经历模式与青少年抑郁症状的关联研究:心理弹性和自尊的链式中介作用[D].合肥:安徽医科大学,2023. CHEN S S.Adverse childhood experiences patterns and depressive symptoms in Chinese adolescents:the role of psychological resilience and self-esteem[D].Hefei:Anhui Medical University,2023.(in Chinese) [18] IOB E,LACEY R,GIUNCHIGLIA V,et al.Adverse childhood experiences and severity levels of inflammation and depression from childhood to young adulthood:a longitudinal cohort study[J].Mol Psychiatry,2022,27(4):2255-2263. [19] ALVAREZ C,SABINA C,BROCKIE T,et al.Patterns of adverse childhood experiences,social problem-solving,and mental health among Latina immigrants[J].J Interpers Violence,2022,37(23/24):22401-22427. [20] 蒲文婷. 童年逆境对儿童抑郁情绪与认知能力的影响[D].成都:西南财经大学,2022. PU W T.Effects of childhood adversity on children's depression and cognitive ability[D].Chengdu:Southwestern University of Finance and Economics,2022.(in Chinese) [21] 李书琴. 童年期不良经历暴露模式与医学生抑郁焦虑症状发展轨迹关联的队列研究[D].合肥:安徽医科大学,2023. LI S Q.Association between patterns of adverse childhood experiences and depression and anxiety symptoms in medical college students:a longitudinal study[D].Hefei:Anhui Medical University,2023.(in Chinese) [22] 王伟,樊昌盛,徐慧琼,等.高职院校大学生不同时相童年期虐待经历与抑郁症状的关联[J].中国学校卫生,2022,43(10):1505-1508. WANG W,FAN C S,XU H Q,et al.The association between different timing of childhood abuse experiences and depressive symptoms in college students[J].Chin J Sch Health,2022,43(10):1505-1508.(in Chinese) [23] SCHALINSKI I,TEICHER M H,NISCHK D,et al.Type and timing of adverse childhood experiences differentially affect severity of PTSD,dissociative and depressive symptoms in adult inpatients[J].BMC Psychiatry,2016,16(1):1-15. [24] TRACY M,SALO M,SLOPEN N,et al.Trajectories of childhood adversity and the risk of depression in young adulthood:results from the Avon Longitudinal Study of Parents and Children[J].Depress Anxiety,2019,36(7):596-606. [25] JONES M S,HOFFMANN J P.Measuring adverse childhood experiences with latent class trajectories[J/OL].Child Abuse Negl,2023,140[2025-08-13].https://doi.org/10.1016/j.chiabu. 2023.106142. [26] HOVENS J G F M,GILTAY E J,WIERSMA J E,et al.Impact of childhood life events and trauma on the course of depressive and anxiety disorders[J].Acta Psychiatr Scand,2012,126(3):198-207. [27] 王露露,谭茗慧,谢文照,等.皮质醇在不良童年经历与抑郁症状关联中的中介作用及性别差异[J].现代预防医学,2022,49(15):2751-2756. WANG L L,TAN M H,XIE W Z,et al.Mediating role of cortisol in the association between adverse childhood experience and depressive symptoms and gender differences[J].Mod Prev Med,2022,49(15):2751-2756.(in Chinese) [28] NUSSLOCK R,MILLER G E.Early-life adversity and physical and emotional health across the lifespan:a neuroimmune network hypothesis[J].Biol Psychiatry,2016,80(1):23-32. [29] ARSLAN G.Psychological maltreatment,coping strategies,and mental health problems:a brief and effective measure of psychological maltreatment in adolescents[J].Child Abuse Negl,2017,68:96-106.
