Does social participation buffer the association? Adverse childhood experiences and 10-year depression symptom trajectories in middle-aged and older Chinese.

BACKGROUND

The relationships between adverse childhood experiences (ACEs), social participation, and long-term depression trajectories in middle-aged and older Chinese adults remain unclear, particularly regarding social participation's potential buffering role.

METHODS

We conducted a longitudinal analysis of 8141 participants (aged ≥45) from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020). Group-Based Trajectory Modeling (GBTM) was applied to identify trajectories of depression symptoms and social participation over 10 years. Multinomial logistic regression was used to examine associations between ACEs, baseline social participation, social participation trajectories, and depressive symptom trajectories.

RESULTS

Compared with participants reporting no ACEs, those with ≥3 types of ACEs had a higher likelihood of belonging to the chronic severe symptom trajectory group (RRR = 6.21, 95 % CI: 4.23-9.12, p < 0.001). Compared with the limited-declining participation group, individuals with the moderate-stable or active-increasing participation trajectories had lower probabilities of belonging to the unfavorable depression trajectories. Social participation significantly moderated the relationship between ACEs and depression symptom trajectories, with the strongest buffer association observed in the chronic severe symptom group (RRR = 0.73, 95 % CI: 0.65-0.82, p < 0.001).

CONCLUSIONS

A dose-response association was observed between ACEs and adverse depression symptom trajectories among middle-aged and older Chinese. Social participation was not only associated with more favorable depression symptom trajectories, but it also appeared to play a moderating role, weakening the association between ACEs and severe depression symptoms. These findings underscore social participation as a potentially critical factor in supporting mental well-being.