Adverse Childhood Experiences Patterns And Depressive Symptoms In Chinese Adolescents: The Role Of Psychological Resilience And Self-esteem

Objective To develop Adverse childhood experiences（ACEs）items based on Chinese social context,classify ACEs exposure patterns with latent class analysis（LCA）to analyse the effects of single adversity,cumulative adversity,and latent class adversity on depressive symptoms,and further explore the chain mediating roles of resilience and self-esteem between ACEs patterns and depressive symptoms.Methods Data were derived from a middle school in Huaibei city of Anhui Province in2019 and 2020.At the initial evaluation（T1,grade 7）,ACEs,psychological resilience,self-esteem,and depressive symptoms of students were assessed.At Time 2（T2,Grade 8）,depressive symptoms of students were assessed.A total of 1,687 valid questionnaires were collected to describe the relationship between demographic characteristics and outcome variables using the t-test and ANOVA in SPSS 23.0.LCA on ACEs was conducted with Mplus version 8.2 to further explore the chain mediating roles of resilience and self-esteem between ACEs patterns and depressive symptoms using BCH.Results Descriptive analysis showed that the mean scores of psychological resilience,self-esteem,T1 depressive symptoms,T2 depressive symptoms were 60.76±18.21,28.05±4.29,20.97±10.42,18.79±11.88.LCA identified three ACE patterns: low adversity（36.4%）moderate adversity（44.2%）and high adversity（19.4%）.The mean scores of T1 depressive symptoms in the low adversity,moderate adversity,and high adversity were16.22±8.84,21.27±9.3,29.20±10.25;The mean scores of T2 depressive symptoms in the low adversity,moderate adversity,and high adversity were 15.19±10.36,18.36±11.14,26.50±12.62.Compared with those who did not experience ACEs,adolescents exposed to emotional abuse,sexual abuse,parent absent for an extended period,losing a good friend,and those exposed to multiple adversity had higher scores for depressive symptoms;Compared with the low adversity class,the scores of depressive symptoms were higher in the moderate adversity and high adversity classes Mediation analysis showed that ACE patterns affect T1 depressive symptoms through the following three mediation paths: psychological resilience alone,self-esteem alone and a path combining psychological resilience and self-esteem.ACE patterns affect T2 depressive symptoms through the following two mediation paths only in the moderate adversity class but not in the high adversity class:self-esteem alone and a path combining psychological resilience and self-esteem.Psychological resilience separately did not mediate the association between ACE patterns and T2 depressive symptoms in this study.Conclusion Psychological resilience and self-esteem chainly mediates the relationship between ACE patterns and depressive symptoms.Therefore,adolescents’ depressive symptoms can be alleviated or reduced by enhancing their psychological resilience and self-esteem.