Childhood adversity and depressive symptoms among middle-aged and older Chinese: results from China health and retirement longitudinal study

Figures & data

Table 2. Associations between childhood adversity and CES-D-10 score among men.

	Model 1 (β, 95% CI)	Model 2 (β, 95% CI)	Model 3 (β, 95% CI)	Model 4 (β, 95% CI)
Total observations	16,972	16,972	16,972	16,972
Childhood abuse and neglect
Parental physical abuse (no)
Yes	0.81 (0.59, 1.04)			0.51 (0.28, 0.74)
Maternal emotional neglect (no)
Yes	0.28 (0.05, 0.50)			0.30 (0.07, 0.51)
Caregiver’s characteristics
Parent’s relationship (tertiles: good)
Medium		0.24 (−0.04, 0.51)		0.20 (−0.07, 0.48)
Poor		0.71 (0.45, 0.97)		0.56 (0.29, 0.82)
Parental mental health (tertiles: good)
Medium		0.88 (0.57, 1.19)		0.84 (0.53, 1.15)
Poor		1.88 (1.61, 2.15)		1.78 (1.51, 2.05)
Parental death before age 17 (no)
Yes		−0.12 (−0.43, 0.19)		−0.13 (−0.44, 0.18)
Childhood SES
Father’s education (literate)
Illiterate			0.27 (0.05, 0.50)	0.35 (0.13, 0.57)
Father’s occupation (non-agricultural)
Agricultural			−0.14 (−0.43, 0.16)	−0.10 (−0.39, 0.19)
Adequacy of food (yes)
No			0.78 (0.54, 1.01)	0.53 (0.29, 0.76)
-Log likelihood	51101.58	51007.23	51108.15	50972.10

Model 1: childhood abuse and neglect + covariates; Model 2: caregiver’s characteristics + covariates.

Model 3: childhood SES + covariates; Model 4: all childhood adversity variables + covariates.

β, coefficient estimated in the mixed linear regression models; CI, confidence interval; Reference groups were in parentheses.

Covariates included age, educational attainment at baseline, residential area, marital status, ADL limitations, current smoking, current drinking, chronic diseases, childhood self-rated health; SES, socioeconomic status.

Results for categories of missing and covariates were not shown in the table due to the space.

Table 3. Associations between childhood adversity and CES-D-10 score among women.

	Model 1 (β, 95% CI)	Model 2 (β, 95% CI)	Model 3 (β, 95% CI)	Model 4 (β, 95% CI)
Total observations	18,078	18,078	18,078	18,078
Childhood abuse and neglect
Parental physical abuse (no)
Yes	0.97 (0.70, 1.25)			0.59 (0.31, 0.88)
Maternal emotional neglect (no)
Yes	0.33 (0.08, 0.57)			0.33 (0.08, 0.58)
Caregiver’s characteristics
Parent’s relationship (tertiles: good)
Medium		0.33 (0.02, 0.65)		0.29 (−0.02, 0.60)
Poor		1.08 (0.79, 1.38)		0.86 (0.56, 1.16)
Parental mental health (tertiles: good)
Medium		0.80 (0.45, 1.15)		0.70 (0.35, 1.05)
Poor		1.94 (1.64, 2.25)		1.77 (1.46, 2.07)
Parental death before age 17 (no)
Yes		−0.02 (−0.38, 0.35)		−0.04 (−0.40, 0.42)
Childhood SES
Father’s education (literate)
Illiterate			0.14 (−0.11, 0.40)	0.16 (−0.09, 0.42)
Father’s occupation (non-agricultural)
Agricultural			−0.60 (−0.93, −0.26)	−0.56 (−0.88, −0.23)
Adequacy of food (yes)
No			1.15 (0.90, 1.41)	0.90 (0.64,1.15)
-Log likelihood	56780.32	56681.72	56761.20	56634.17

Model 1: childhood abuse and neglect + covariates; Model 2: caregiver’s characteristics + covariates.

Model 3: childhood SES + covariates; Model 4: all childhood adversity variables + covariates.

Covariates included age, educational attainment at baseline, residential area, marital status, ADL limitations, current smoking, current drinking, chronic diseases, childhood self-rated health; SES: socioeconomic status.

β; coefficient estimated in the mixed linear regression models; CI; confidence interval; Reference groups were in parentheses.

Results for categories of missing and covariates were not shown in the table due to the space.

Table 4. Associations between childhood adversity and CES-D-10 score by gender and birth cohorts.

	Male		Female
	born in 1952–1966 (β, 95% CI)	born before 1952 (β, 95% CI)	born in 1952–1966 (β, 95% CI)	born before 1952 (β, 95% CI)
Total observations	9,289	7,683	10,821	7,257
Childhood abuse and neglect
Parental physical abuse (no)
Yes	0.52 (0.24, 0.81)	0.52 (0.16, 0.89)	0.39 (0.04, 0.75)	0.89 (0.41, 1.37)
Maternal emotional neglect (no)
Yes	0.51 (0.23, 0.80)	−0.01 (−0.36, 0.33)	0.36 (0.05, 0.67)	0.30 (−0.10, 0.69)
Caregiver’s characteristics
Parent’s relationship (tertiles: good)
Medium	0.04 (−0.30, 0.39)	0.49 (0.05, 0.93)	0.35 (−0.03, 0.74)	0.25 (−0.28, 0.78)
Poor	0.59 (0.25, 0.92)	0.53 (0.12, 0.95)	1.00 (0.63, 1.37)	0.64 (0.15, 1.13)
Parental mental health (tertiles: good)
Medium	0.69 (0.30, 1.09)	1.05 (0.56, 1.53)	0.53 (0.14, 0.99)	0.97 (0.39, 1.55)
Poor	1.88 (1.54, 2.23)	1.61 (1.18, 2.04)	1.62 (1.24, 2.01)	1.99 (1.49, 2.50)
Parental death before age 17 (no)
Yes	−0.39 (−0.84, 0.05)	0.01 (−0.43, 0.45)	−0.33 (−0.82, 0.16)	0.39 (−0.18, 0.96)
Childhood SES
Father’s education (literate)
Illiterate	0.36 (0.07, 0.64)	0.31 (−0.04, 0.66)	0.15 (−0.17, 0.46)	0.14 (−0.29, 0.57)
Father’s occupation (non-agricultural)
Agricultural	−0.14 (−0.51, 0.24)	−0.07 (−0.52, 0.39)	−0.68 (−1.07, −0.28)	−0.46 (−1.04, 0.11)
Adequacy of food (yes)
No	0.72 (0.41, 1.03)	0.21 (−0.16, 0.59)	0.91 (0.59, 1.23)	0.63 (0.19,1.07)
-Log likelihood	27671.40	23241.29	33659.04	22928.79

Models were adjusted for all childhood adversity and covariates.

β: coefficient estimated in the mixed linear regression models; CI: confidence interval; Reference groups were in parentheses.

Covariates included age, educational attainment at baseline, residential area, marital status, ADL limitations, current smoking, current drinking, chronic diseases, childhood self-rated health; SES: socioeconomic status; Results for categories of missing and covariates were not shown in the table due to the space.

Table 1. Distribution of childhood adversity, CES-D-10 score, and covariates at baseline.

	Men		Women		p value (men vs. women on CES-D-10)
	%	Mean CES-D-10 score (sd)	%	Mean CES-D-10 score (sd)
Total	6,578	7.3 (5.8)	7,132	9.4 (6.6)	<0.000
Child abuse and neglect
Parental physical abuse
Yes	33.1	8.0 (6.0)	22.2	10.3 (6.8)	<0.000
No	57.1	6.9 (5.6)	68.3	9.1 (6.5)	<0.000
Missing	9.8	7.8 (5.9)	9.5	10.3 (6.7)
Maternal emotional neglect
Yes	30.6	7.4 (5.8)	32.9	9.6 (6.7)	<0.000
No	62.9	7.2 (5.7)	61.0	9.2 (6.5)	<0.000
Missing	6.5	8.6 (6.4)	6.1	10.8 (7.1)
Caregiver’s characteristics
Parental mental health (tertiles)
Good	40.6	6.1 (5.2)	40.1	8.2 (6.2)	<0.000
Medium	14.2	7.5 (5.7)	14.7	9.4 (6.6)	<0.000
Poor	22.7	8.7 (6.2)	22.7	10.8 (6.8)	<0.000
Missing	23.5	8.1 (6.0)	22.5	10.2 (6.7)
Parent’s relationship (tertiles)
Good	37.1	6.9 (5.6)	42.2	8.8 (6.5)	<0.000
Medium	21.1	7.1 (5.7)	19.2	8.9 (6.5)	<0.000
Poor	27.1	7.8 (5.9)	25.4	10.2 (6.7)	<0.000
Missing	14.7	8.0 (6.1)	13.2	10.4 (6.6)
Parental death before age 17
Yes	16.4	7.7 (5.9)	13.9	9.7 (6.5)	<0.000
No	50.6	7.1 (5.7)	47.4	8.9 (6.5)	<0.000
Missing	33.0	7.6 (5.8)	38.7	10.1 (6.8)
Childhood SES
Father’s education
Illiterate	56.1	7.8 (5.9)	54.4	9.8 (6.6)	<0.000
Literate	37.5	6.6 (5.5)	35.6	8.7 (6.5)	<0.000
Missing	6.4	8.1 (6.1)	10.0	9.6 (5.6)
Father’s occupation
Non-agricultural	16.3	6.3 (5.3)	17.3	7.6 (6.1)	<0.000
Agricultural	77.3	7.6 (5.9)	75.9	9.8 (6.6)	<0.000
Missing	6.4	7.6 (5.9)	6.8	9.8 (6.6)
Adequacy of food
Yes	25.3	6.5 (5.5)	30.7	8.1 (6.3)	<0.000
No	73.8	7.6 (5.8)	68.3	10.0 (6.7)	<0.000
Missing	0.9	8.1 (6.6)	1.0	9.8 (6.8)
Respondent’s characteristics
Educational attainment
Illiterate	12.4	8.7 (6.1)	41.9	10.4 (6.9)	<0.000
Can read and write	19.1	8.7 (6.2)	18.5	10.0 (6.6)	<0.000
Primary	26.7	7.6 (5.7)	16.8	9.0 (6.2)	<0.000
Junior, high and university	41.8	6.1 (5.3)	22.8	7.4 (5.8)	<0.000
Residential area
Rural	64.3	7.9 (5.9)	62.8	10.2 (6.7)	<0.000
Urban	35.7	6.4 (5.4)	37.2	8.1 (6.1)	<0.000
Marital status
Married	91.4	7.1 (5.6)	84.9	9.1 (6.5)	<0.000
Unmarried	8.6	10.0 (6.7)	15.1	10.9 (6.8)	0.01
ADL limitation
Yes	13.3	11.7 (6.6)	18.1	13.8 (6.8)	<0.000
No	85.4	6.7 (5.3)	80.2	8.4 (6.1)	<0.000
Missing	1.3	5.4 (3.9)	1.7	7.1 (5.8)
Current smoking status
Yes	74.0	7.5 (5.8)	8.0	10.4 (7.0)	<0.000
No	25.6	6.9 (5.7)	91.4	9.3 (6.6)	<0.000
Missing	0.4	6.8 (5.6)	0.6	7.5 (6.0)
Current drinking status
Yes	56.6	7.0 (5.6)	11.8	9.9 (6.7)	<0.000
No	43.0	7.8 (6.0)	87.6	9.3 (6.6)	<0.000
Missing	0.4	6.8 (5.6)	0.6	7.5 (6.0)
Childhood self-rated health
Healthy	35.3	6.6 (5.5)	34.1	8.5 (6.2)	<0.000
Average	51.8	7.6 (5.8)	51.4	9.5 (6.6)	<0.000
Less healthy	12.3	8.7 (6.2)	13.6	11.2 (7.0)	<0.000
Missing	0.6	8.7 (6.2)	0.9	11.0 (7.0)
Hypertension
Yes	24.6	8.0 (6.1)	27.7	10.0 (6.7)	<0.000
No	74.5	7.1 (5.7)	71.2	9.2 (6.6)	<0.000
Missing	0.9	7.7 (5.7)	1.1	11.9 (7.0)
Diabetes or high blood sugar
Yes	5.8	7.9 (6.1)	6.9	10.1 (6.7)	<0.000
No	93.0	7.3 (5.8)	91.6	9.4 (6.6)	<0.000
Missing	1.2	7.5 (5.2)	1.5	10.2 (5.6)
Cancer
Yes	0.7	9.6 (6.6)	1.1	8.9 (6.6)	<0.000
No	98.4	7.3 (5.8)	97.9	9.5 (6.6)	0.45
Missing	0.9	8.9 (6.8)	1.0	9.9 (6.2)
Heart problems
Yes	10.3	8.4 (6.1)	14.2	11.6 (7.0)	<0.000
No	88.8	7.2 (5.7)	84.7	9.1 (6.5)	<0.000
Missing	0.9	9.4 (6.8)	1.1	10.9 (6.1)
Stroke
Yes	2.7	10.4 (6.6)	2.4	12.5 (7.0)	<0.000
No	96.7	7.3 (5.7)	96.9	9.4 (6.6)	0.03
Missing	0.6	7.8 (5.3)	0.7	9.8 (8.3)
Dyslipidaemia
Yes	8.9	7.6 (6.1)	10.2	10.2 (6.7)	<0.000
No	88.9	7.3 (5.8)	87.1	9.3 (6.6)	<0.000
Missing	2.2	7.0 (5.7)	2.7	10.7 (6.6)