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      Association of Adverse Childhood Experience and Attention Deficit Hyperactivity Disorder with depressive symptoms among men who have sex with men in China: moderated mediation effect of resilience

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          Abstract

          Background

          Adverse childhood experience (ACE), attention deficit hyperactivity disorder (ADHD), and resilience can all contribute to depressive symptoms. However, little is known regarding the complex relationships between these factors and their joint effects on depressive symptoms. This study aimed to explore the underlying mechanism of ACE, ADHD, and resilience on depressive symptoms among men have sex with men (MSM) in China.

          Methods

          A total of 714 MSM were recruited from gay/bisexual men-serving venues in Wuhan, Changsha, and Nanchang of China. The data was collected using computer-assisted self-interview. The mediated and moderated mediation models were employed to explore the underlying mechanisms between ACE, ADHD, resilience, and depressive symptoms.

          Results

          Among 714 MSM, 51.4% reported at least one ACE and 13.0% reported three or more. ACE had a direct (β = 1.01, 95% CI: 0.45–1.57) effect on depressive symptoms. ADHD partially mediated the correlation between ACE and depressive symptoms (indirect effect: 0.55; 95% CI: 0.34–0.79). Additionally, the effect of ACE on depressive symptoms was moderated and buffered by resilience (β = −0.09, 95% CI: -0.15 - −0.03).

          Conclusion

          The findings suggested that, programs and policies that promote resilience and address ADHD might protect Chinese MSM exposed to ACE from depressive symptoms.

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          Most cited references41

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          Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

          Kathryn M Connor, Jonathan Davidson (2003)
          Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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            Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder.

            M. Rutter (1985)
            Article 0 comments Cited 452 times – based on 0 reviews     Review now
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              Childhood adversity and neural development: deprivation and threat as distinct dimensions of early experience.

              Katie A. McLaughlin, Margaret Sheridan, Hilary Lambert (2014)
              A growing body of research has examined the impact of childhood adversity on neural structure and function. Advances in our understanding of the neurodevelopmental consequences of adverse early environments require the identification of dimensions of environmental experience that influence neural development differently and mechanisms other than the frequently-invoked stress pathways. We propose a novel conceptual framework that differentiates between deprivation (absence of expected environmental inputs and complexity) and threat (presence of experiences that represent a threat to one's physical integrity) and make predictions grounded in basic neuroscience principles about their distinct effects on neural development. We review animal research on fear learning and sensory deprivation as well as human research on childhood adversity and neural development to support these predictions. We argue that these previously undifferentiated dimensions of experience exert strong and distinct influences on neural development that cannot be fully explained by prevailing models focusing only on stress pathways. Our aim is not to exhaustively review existing evidence on childhood adversity and neural development, but to provide a novel framework to guide future research.
              Article 0 comments Cited 329 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Hong Yan: yanhmjxr@aliyun.com
                Shiyue Li: lsywhd@sina.com
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 19 December 2019
                Publication date PMC-release: 19 December 2019
                Publication date Collection: 2019
                Volume: 19
                Electronic Location Identifier: 1706
                Affiliations
                [1 ]ISNI 0000 0001 2331 6153, GRID grid.49470.3e, School of Health Sciences, , Wuhan University, ; Wuhan, China
                [2 ]ISNI 0000 0001 0941 6502, GRID grid.189967.8, Rollins School of Public Health, , Emory University, ; Atlanta, USA
                [3 ]ISNI 0000 0000 9927 0537, GRID grid.417303.2, School of Public Health, , Xuzhou Medical University, ; Xuzhou, China
                Article
                Publisher ID: 8016
                DOI: 10.1186/s12889-019-8016-2
                PMC ID: 6923911
                PubMed ID: 31856776
                SO-VID: cff139e2-2ece-4de7-a1e2-0c67369e6dc7
                Copyright © © The Author(s). 2019
                License:

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 16 August 2019
                Date accepted : 28 November 2019
                Funding
                Funded by: the Humanities and Social Science Foundation of Ministry of Education
                Award ID: 15YJAZH094
                Award Recipient :
                Funded by: the National Natural Science Foundation of China
                Award ID: 81673196
                Award Recipient :
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Public health
                Keywords: ace,adhd,resilience,depressive symptoms,msm
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: ace, adhd, resilience, depressive symptoms, msm

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