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Associations of adverse childhood experiences and depressive symptoms among children and adolescents: the mediating effect of resilience and sleep quality

Wen-Ping Ji, Le-Wei Liu, Pei Tang, Lili Zhao, Zhaoyang Wen, Guang-Bo Qu, Yu Chen, Huan-Zhong Liu et al.

Scientific Reports, 2025

3,258 participants · 1 citation

Abstract

Adverse childhood experiences (ACEs) may precipitate depressive symptoms among children and adolescents, yet whether resilience and sleep quality jointly mediate this link remains unclear. Therefore, this study aimed to investigate these potential mediating pathways. From April to June 2023, a total of 3258 children and adolescents were included for this cross-sectional study from 11 primary and secondary schools in Chaohu City, Anhui Province, China. We used a series of scales to assess their depressive symptoms, ACEs, resilience, and sleep quality. To explore the potential mediating pathways between depressive symptoms, ACEs, resilience, and sleep quality, the chain mediation analysis was conducted using the PROCESS macro (Model 6). The prevalence of depressive symptoms was 30.1% among children and adolescents. The multivariate logistic regression analyses showed that females, ACEs total score, resilience, and poor sleep quality were independent correlates of depressive symptoms. When the dimensions of ACEs were involved in the regression model, emotional abuse, physical abuse, emotional neglect, physical neglect and mother suffered from domestic violence were also independent risk factors. Notably, resilience and sleep quality had a chain-mediated effect between ACEs and depressive symptoms. A high proportion of children and adolescents reported depressive symptoms. Moreover, resilience and sleep quality may have a chain-mediated effect between ACEs and depressive…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 3,258 participants or records.

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