How do Differences in Adolescent and Caregiver Reports of Adolescent Adverse Childhood Experiences Relate to Adolescent Depression?

Objective: To compare adolescent and caregiver reports of adolescent adverse childhood experiences (ACEs) and their relationship with current adolescent depression and to analyze the relationship between ACEs and depression.

Methods: We recruited 46 adolescent-caregiver dyads from a large, inner-city medical center's adolescent medicine clinic. Adolescents and caregivers completed the Center for Youth Wellness ACE questionnaire, encompassing traditional ACEs (eg, abuse, neglect, household dysfunction) and nontraditional ACEs (eg, foster care, parental death, exposure to community violence). Adolescents also completed the Patient Health Questionnaire-9A (PHQ-9A) depression screening tool.

Results: Among adolescents, 14 (30%) reported no traditional ACEs, 11 (24%) reported 1, and 21 (46%) reported more than 1. Regarding nontraditional ACEs, 16 (35%) reported none, 11 (24%) reported 1, and 19 (41%) reported more than 1. Caregiver reports consistently indicated lower ACEs compared with adolescent self-reports ( < .005). For the PHQ-9A scores, 26 (57%) of adolescents showed no or minimal depression, 14 (30%) mild, and 6 (13%) moderate depression. A moderate positive correlation emerged between PHQ-9A scores and self-reported traditional ACEs (r = 0.5,  < .001) and nontraditional ACEs (r = 0.49,  < .001). In addition, a positive correlation was observed between the absolute differences in adolescent and caregiver reports of traditional ACEs and PHQ-9A scores (n = 46, ρ = 0.51,  < .001).

Conclusions: As the differences in ACE reports between adolescents and caregivers increased, there was a corresponding increase in adolescent depression scores. It is essential to incorporate comprehensive ACE screening and encourage open communication between adolescents and caregivers, which may improve mental health outcomes.