Depressive Symptoms in Relation to Adverse Childhood Experiences, Discrimination, Hope, and Social Support in a Diverse Sample of College Students

Abstract

Background

Young adulthood is a critical transitory period, with various factors impacting mental health and longer-term health outcomes, particularly among racial/ethnic minorities. Drawing from minority stress theory, this study examined correlates of depressive symptoms, specifically adverse childhood experiences (ACEs), racial/ethnic discrimination, hope, social support, and their interactive effects, among a diverse sample of college students.

Methods

We analyzed data from 666 racial/ethnic minority college students (57% Black, 22% Latinx, 21% Asian) attending seven colleges and universities in the state of Georgia. Depressive symptoms were assessed using the Patient Health Questionnaire-9 Item (PHQ-9). Multivariable linear regressions included ACEs, racial/ethnic discrimination, hope, and social support, adjusting for sex, race/ethnicity, parent education, nativity, and age. We tested two-way interaction terms in four separate models to examine the potential buffering effect of social support and hope on the association between ACEs and discrimination.

Results

Participants were on average 20.56 years old (SD = 1.93) and 30% were male. The mean PHQ-9 score was 3.89 (SD = 4.91); 56% reported at least one ACE; 70% experienced racial/ethnic discrimination. ACEs and racial/ethnic discrimination correlated with higher levels of depressive symptoms; higher social support and hope correlated with decreased depressive symptoms. While hope and social support did not moderate the relationships between ACEs or discrimination and depressive symptoms among the full sample, racial/ethnic subgroup analyses indicated that, among Asian students, the positive association between discrimination and depressive symptoms was significantly weaker for those perceiving greater hope.

Conclusions

Eliminating racial/ethnic disparities in mental health requires concerted efforts to prevent and/or reduce ACEs and discrimination and identifying protective factors that can mitigate their relationship to depressive symptoms.

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Acknowledgements

We thank our Campus Advisory Board members across the state of Georgia in developing and assisting in administering this survey. We also thank ICF International for its scientific input and technical support in conducting this research.

Funding

This research was supported by the National Cancer Institute (1R01CA179422-01; PI: Berg). Dr. Berg is also supported by other NCI funding (R01CA215155-01A1; PI: Berg; R01CA239178-01A1; MPIs: Berg, Levine), the Fogarty International Center/NIH (1R01TW010664-01; MPIs: Berg, Kegler), and the NIEHS/Fogarty (D43ES030927-01; MPIs: Berg, Marsit, Sturua). Ms. Vu is supported by the National Cancer Institute (F31CA243220) and the 2020-2021 PEO Scholar Award. The funders had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.

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Correspondence to Emily D. Lemon.

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Lemon, E.D., Vu, M., Roche, K.M. et al. Depressive Symptoms in Relation to Adverse Childhood Experiences, Discrimination, Hope, and Social Support in a Diverse Sample of College Students. J. Racial and Ethnic Health Disparities (2021). https://doi.org/10.1007/s40615-021-01038-z

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Keywords

  • ACEs
  • Discrimination
  • Mental health
  • Social support
  • Hope