Adverse childhood experience patterns, major depressive disorder, and substance use disorder in older adults
Abstract
OBJECTIVES: This article investigates distinct patterns of adverse childhood experiences (ACEs) in a representative sample of US older adults, and how the ACEs patterns relate to major depression and substance use disorder (SUD). METHODS: = 11,386). The dependent variable was past-year SUD measuring any DSM-5 diagnosis for alcohol, tobacco, cannabis, and other illicit drugs. The independent variables were the classes of ACEs identified using 11 types of early adversities. The mediating variable was past-year major depressive disorder. We conducted a latent class analysis (LCA) to identify latent classes of ACEs, estimated the relationships between the ACEs classes, major depressive disorder, and SUD, and tested mediation by major depression. RESULTS: Results of the LCA identified four classes of ACEs: High Adversity (6%), Low Adversity (69%), Child Abuse (16%), and Parental Substance Use (8%). The three classes of High Adversity, Child Abuse, and Parental Substance Use showed significantly higher rates of SUD than the Low Adversity class. The High Adversity and Child Abuse classes were more likely to have major depression compared to the Low Adversity class. In addition, major depression mediated the association between ACEs and SUD for those two classes. CONCLUSION: The findings provide evidence for a long-term impact of ACEs on mental health and SUD later in life and emphasize trauma-informed care principles in interventions for older adults with SUD.
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- Authors
- Kim, Y., Kim, K., Chartier, K. G., Wike, T. L., & McDonald, S. E.
- Affiliations
- Virginia Commonwealth University (US)
- Corresponding author
- Kim, Kyeongmo
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2019-11-26
- Volume
- 25
- Issue
- 3
- Pages
- 484-491
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- OpenAlex
- W2989572823
- Cited by
- 120
- References
- 11
- Citations by year
- 2026: 20 · 2025: 13 · 2024: 29 · 2023: 22 · 2022: 22 · 2021: 7 · 2020: 7
- FWCI
- 10.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Aging & Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Safety Research › Child Welfare and Adoption
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- adverse childhood experiences, major depressive disorder, substance use disorders, older adults, childhood abuse, parental substance use, mediation by depression, trauma-informed care
- MeSH terms
- Adverse Childhood Experiences, Aged, Child, Child Abuse, Depressive Disorder, Major, Major Depressive Disorder, Humans, Mental Health, Substance-Related Disorders
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