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Adverse Childhood Events and Current Depressive Symptoms Among Women in Hawaii: 2010 BRFSS, Hawaii

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Abstract

Research on the association between adverse childhood events (ACEs) and depression among women in Hawaii is scarce. ACEs have been linked to unfavorable health behaviors such as smoking and binge drinking which are more prevalent in the state compared to the US overall. The concomitant presence of ACEs with smoking or binge drinking may explain the excess depression prevalence in Hawaii compared to the national average. Using data of women residing in the state (2010 Hawaii Behavioral Risk Factor Surveillance System Survey), we examined the association between ACEs count or type (household dysfunction and physical, verbal and sexual abuse) and current depressive symptoms (CDS), in addition to modification by current smoking status (smoked >100 cigarettes in a lifetime and currently smoke) and binge drinking (consumed ≥4 alcoholic beverage within the past month and in ≥1 occasion(s)). Evaluation of ACEs before age 18 consisted of 11 indicators. Eight indicators of the Patient Health Questionnaire (PHQ-8) were used to assess CDS. All analyses utilized logistic regression taking into account sampling design. The odds ratio of having CDS between those with versus without ACEs increased per increasing number of ACEs (1 ACE: OR = 2.11, CI = 1.16–3.81; 2 ACEs: OR = 2.90, CI = 1.51–5.58; 3 or 4 ACEs: OR = 3.94, CI = 2.13–7.32; 5+ ACEs: OR = 4.04, CI = 2.26–7.22). Household dysfunction (OR = 2.10, CI = 1.37–3.23), physical abuse (OR = 1.67, CI = 1.08–2.59), verbal abuse (OR = 3.21, CI = 2.03–5.09) and sexual abuse (OR = 1.68, CI = 1.04–2.71) were all positively associated with CDS. Verbal abuse had the strongest magnitude of association. Neither current smoking status nor binge drinking modified the relationship between ACEs count (or type) and CDS. In conclusion, the presence of ACEs among women in Hawaii was indicative of CDS in adulthood, notably verbal abuse. Further, a dose response existed between the number of ACEs and the odds for CDS. The concomitant exposure to ACEs and current smoking status or binge drinking did not elevate odds for CDS.

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Acknowledgments

This research was in collaboration with the Hawaii DOH, Family Health Services Division, and funded through the Health Resources and Services Administration, Maternal and Child Health (MCH) Bureau’s Graduate Student Internship Program. The authors appreciate the assistance from Cheryl Prince, Dave Goodman, and Charlan Kroelinger from the MCH Epidemiology Program, Applied Sciences Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, CDC, for scientific guidance on this analysis and manuscript.

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None of the authors have any conflicts of interest.

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  1. Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0725, La Jolla, CA, 92093-0725, USA

    Rosemay A. Remigio-Baker

  2. Family Health Services Division, Hawai’i Department of Health, 3652 Kilauea Ave, Honolulu, HI, 96816, USA

    Rosemay A. Remigio-Baker & Donald K. Hayes

  3. Behavioral Risk Factor Surveillance System Program, Hawai’i Department of Health, 1250 Punchbowl Street Room 262, Honolulu, HI, 96813, USA

    Florentina Reyes-Salvail

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Correspondence to Rosemay A. Remigio-Baker.

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Remigio-Baker, R.A., Hayes, D.K. & Reyes-Salvail, F. Adverse Childhood Events and Current Depressive Symptoms Among Women in Hawaii: 2010 BRFSS, Hawaii. Matern Child Health J 18, 2300–2308 (2014). https://doi.org/10.1007/s10995-013-1374-y

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