Adverse Childhood Events Significantly Impact Depression and Mental Distress in Adults with a History of Cancer

Oluwole A Babatunde; Katherine Gonzalez; Nosayaba Osazuwa-Peters; Swann Arp Adams; Chanita Hughes Halbert; Frank Clark; Anusuiya Nagar; Jessica Obeysekare; Eric Adjei Boakye

doi:10.3390/cancers16193290

Adverse Childhood Events Significantly Impact Depression and Mental Distress in Adults with a History of Cancer

Cancers (Basel). 2024 Sep 27;16(19):3290. doi: 10.3390/cancers16193290.

Authors

Oluwole A Babatunde¹, Katherine Gonzalez^{2

3}, Nosayaba Osazuwa-Peters^{3

4

5}, Swann Arp Adams^{6

7}, Chanita Hughes Halbert^{8

9}, Frank Clark^{1

10}, Anusuiya Nagar^{1

10}, Jessica Obeysekare^{1

10}, Eric Adjei Boakye^{11

12

13

14}

Affiliations

¹ Department of Psychiatry, Prisma Health, Greer, SC 29650, USA.
² School of Medicine, California University of Science and Medicine, Colton, CA 92324, USA.
³ Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
⁴ Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
⁵ Duke Cancer Institute, Durham, NC 27701, USA.
⁶ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
⁷ Biobehavioral Health and Nursing Science Department, College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208, USA.
⁸ Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA.
⁹ Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA.
¹⁰ School of Medicine-Greenville, University of South Carolina, Greenville, SC 29605, USA.
¹¹ Department of Public Health Sciences, Henry Ford Health System, Detroit, MI 48202, USA.
¹² Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI 48202, USA.
¹³ Henry Ford Health + Michigan State University Health Sciences, Detroit, MI 48202, USA.
¹⁴ Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing, MI 48824, USA.

Abstract

Objectives: Adverse childhood experiences (ACEs) are linked to a heightened risk of depression. We explored the relationship between ACEs and both depression and mental distress among cancer survivors. Methods: This was a cross-sectional analysis using the 2022 Behavioral Risk Factor Surveillance System database of cancer survivors aged ≥18 (n = 14,132). The primary outcome was self-reported history of depression, and the secondary outcome was mental distress. The exposure variable was the number of ACEs, classified as 0, 1-2, and ≥3. Weighted multivariable logistic regression models assessed the association between the number of ACEs and depression and mental distress while adjusting for covariates. Results: Approximately 22% of respondents reported experiencing ≥3 ACEs. The prevalence of depression was 21.8%, and mental distress was 15.4%. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 3.94; 95% CI, 3.04-5.10) or 1-2 (aOR = 1.85; 95% CI, 1.47-2.32) ACEs had a higher likelihood of reporting depression. Compared with cancer survivors who had experienced 0 ACEs, those who had experienced ≥3 (aOR = 0.67; 95% CI, 0.48-0.93) had a lower likelihood of reporting mental distress. Conclusions: This study highlights the impact of ACEs on depression in adulthood among cancer survivors.

Keywords: BRFSS; adverse childhood experiences; cancer survivors; depression; mental abuse; mental distress; physical abuse; sexual abuse.

Grants and funding

Hughes Halbert was supported by NIMHD U54MD010706 and American Cancer Society, and NCI U54CA233465. Swann Arp Adams was supported by Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) award #U48 DP006401.