Unpacking the Specific Associations Between Adverse Childhood Experiences and Depressive Symptoms among the Middle-Aged and Elderly Chinese Populations: A Dimensional Approach and Latent Class Analysis in a Cohort Study

Table 3

Associations between ACEs and the new occurrence of DSs in the Cox proportional hazards model.

	Crude model		Adjusted model 1		Adjusted model 2
	HR (95% CI)	value	HR (95% CI)	value	HR (95% CI)	value
Total ACE score
0	Ref		Ref^a		Ref^a1
1	1.159 (0.949, 1.415)	0.149	1.090 (0.891, 1.333)	0.404	1.040 (0.850, 1.273)	0.701
2	1.161 (0.951, 1.416)	0.143	1.099 (0.899, 1.344)	0.357	1.042 (0.851, 1.274)	0.692
≥3	1.712 (1.424, 2.058)	<0.001	1.664 (1.382, 2.005)	<0.001	1.562 (1.296, 1.882)	<0.001
for trend	<0.001		<0.001		<0.001
Deprivation-related ACE score
0	Ref		Ref^b		Ref^b1
1	1.140 (0.977, 1.330)	0.095	1.089 (0.925, 1.283)	0.306	1.050 (0.897, 1.228)	0.545
2	1.188 (1.017, 1.389)	0.030	1.117 (0.947, 1.319)	0.190	1.060 (0.904, 1.242)	0.474
≥3	1.809 (1.535, 2.131)	<0.001	1.519 (1.273, 1.814)	<0.001	1.446 (1.221, 1.712)	<0.001
for trend	<0.001		<0.001		<0.001
Threat-related ACE score
0	Ref		Ref^c		Ref^c1
1	1.272 (1.127, 1.436)	<0.001	1.239 (1.089, 1.410)	0.001	1.260 (1.115, 1.425)	<0.001
2	1.342 (1.160, 1.553)	<0.001	1.442 (1.236, 1.681)	<0.001	1.407 (1.212, 1.634)	<0.001
≥3	1.688 (1.461, 1.950)	<0.001	1.572 (1.343, 1.841)	<0.001	1.585 (1.366, 1.840)	<0.001
for trend	<0.001		<0.001		<0.001
LCA-driven ACE
Low risk	Ref		Ref^a		Ref^a1
Poor parent relationship	1.788 (1.498, 2.134)	<0.001	1.797 (1.504, 2.148)	<0.001	1.758 (1.471, 2.100)	<0.001
Physical abuse	1.298 (1.142, 1.475)	<0.001	1.395 (1.224, 1.590)	<0.001	1.361 (1.194, 1.553)	<0.001
Biological parent absent	1.207 (0.854, 1.707)	0.287	1.067 (0.754, 1.510)	0.715	1.108 (0.782, 1.571)	0.563
Mental neglect	1.146 (0.951, 1.381)	0.153	1.098 (0.908, 1.327)	0.334	1.100 (0.910, 1.330)	0.325

^aAdjusted for age, sex, marital status, education level, hukou, chronic disease, smoking status, drinking status, life satisfaction, and household income. ^a1Additionally adjusted for CES-D-10 score at baseline based on model 1. ^bAdjusted for threat-related ACE score, age, sex, marital status, education level, hukou, chronic disease, smoking status, drinking status, life satisfaction, and household income. ^b1Additionally adjusted for CES-D-10 scores at baseline based on model 1. ^cAdjusted for deprivation-related ACE score, age, sex, marital status, education level, hukou, chronic disease, smoking status, drinking status, life satisfaction, and household income. ^c1Additionally adjusted for CES-D-10 scores at baseline based on model 1. ACEs: adverse childhood experiences; HR: hazard ratios; CI: confidence interval.