Timing of adverse childhood experiences and depressive, anxiety, comorbid symptoms among Chinese female nurses: A life course perspective

Abstract

Background

Nurses demonstrate a greater vulnerability to developing depressive and anxiety symptoms compared to the general population. Adverse Childhood Experiences (ACEs) are known risk factors for mental health issues, but impact of timing of these experiences remains unclear.

Objective

To investigate associations between timing of ACEs and depressive, anxiety, comorbid symptoms.

Participants and setting

Using convenience sampling, a cross-sectional study was conducted. The sample was 1966 female nurses from seven hospitals in Zhejiang Province, China.

Methods

Nurses completed a questionnaire assessing sociodemographic characteristics, ACEs, depressive and anxiety symptoms. Timing of ACEs was categorized as childhood, adolescence, and both periods. Comorbid symptoms referred to simultaneous presence of both depressive and anxiety symptoms. Multivariable logistic regression was used to examine associations between ACEs timing and mental health outcomes, presented as Odds Ratios (ORs) with 95 % Confidence Intervals (CIs).

Results

A total of 429 (21.82 %) participants experienced ACEs in both periods. ACEs occurring only in childhood, only in adolescence, and in both periods were all associated with increased depressive, anxiety, and comorbid symptoms. An increasing trend in number of ACEs from childhood to adolescence was linked to higher symptoms in adulthood. Familial ACEs in both periods were strongly linked to higher depressive (OR = 1.85, 95 % CI [1.14, 3.01]), anxiety (OR = 2.55, 95 % CI [1.41, 4.60]), and comorbid symptoms (OR = 2.92, 95 % CI [1.50, 5.70]).

Conclusions

The timing of ACEs influenced the development of mental health issues. It is imperative to provide targeted psychological support based on timing of ACEs to improve mental health in this population.