Adverse Childhood Experience, Depression, and Diabetes: Is there a link?
Abstract
Adverse childhood experiences (ACES) have negative ramifications for mental and physical health across the life course. While this area of research is extensive among the general population, little knowledge exists about American Indian (AI) health and ACES. This includes the association with depression and type 2 diabetes (T2D) outcomes. Objectives: To present the prevalence of ACES among a sample of AI adults with T2D from two Midwest tribal communities, and evaluate the relationship between ACES, depressive symptoms, and diabetes control. We hypothesize that depression plays a mediating role in the relationship between ACES and diabetes control. Methods: We will use data from the Mino Giizhigad (A Good Day) study, a community based participatory research project. A random sample from Indian Health Services clinic records resulted in a cohort of AI adults with T2D (n=218) who participated in interviewer‐administered pencil and paper surveys. Surveys included measures of ACES (modified ACES measure), depressive symptoms (PHQ‐9), diabetes control (Diabetes Care Profile Control Problems scale), and demographic variables. Using MPlus, we will test a proposed model whereby depressive symptoms mediate the relationship between ACES and diabetes control. Results: Data analysis is currently ongoing. The most frequently reported ACE was growing up living with someone who was a problem drinker. Over half of participants (50.7%) reported 3 or more ACES, while 21.9% reported no ACES. Preliminary findings suggest that on a bivariate level ACES is associated with depressive symptoms, and both ACES and depressive symptoms are associated with worse diabetes control. Implications: This study expands our knowledge about the prevalence of ACES and the relationship between ACES and diabetes control among AIs, and explores the interplay between ACES and depressive symptoms on diabetes‐related outcomes.