1. Introduction
Substantial empirical evidence from multiple countries has demonstrated that adverse childhood experiences (ACEs) are highly correlated with depression in adulthood [
1,
2,
3]. For example, scholars have long believed that ACEs may enhance vulnerability to psychological development throughout the course of a person’s life, specifically depression [
4,
5,
6,
7,
8]. In addition, some meta-analyses confirm that a history of ACEs significantly increases the risk of depression and anxiety in adulthood [
9,
10,
11,
12,
13]. These results underscore the importance of evaluating the negative effects of ACEs.
The existing literature has also examined the effects of different types of ACEs on depression. Of the various ACEs in the literature, childhood physical and sexual abuse and a history of family violence showed the strongest relationships with anxiety disorders later in life [
10,
12,
14]. Researchers found that childhood verbal and emotional abuse increased the risk of depression [
15,
16,
17]. Sachs-Ericsson et al. [
18] also found people who were verbally abused had 1.6 times as many symptoms of depression and anxiety as those who had not been verbally abused and were twice as likely to have experienced a mood or anxiety disorder in their lifetime. Adolescents who experienced peer isolation and emotional neglect were found to be most at risk of symptoms of depression and anxiety [
19]. Symptom severity and major depressive episodes were greater for those who experienced community violence and family distress [
20]. In addition, Cavanaugh and Nelson [
21] found that Black American adults who reported any of the five types of child abuse/neglect or any of the five types of family dysfunction had a greater risk of major depression in the past year.
Some scholars have discussed the influencing mechanisms and factors alleviating the effect of ACEs, as many individuals experience ACEs without developing depression and other psychological problems. Many studies have identified multiple factors that reduce the effect of ACEs on depression. For example, some scholars have found that positive childhood experiences at home and school protect at-risk adolescents against mental health problems [
22]. Mindfulness is a cognitive resource that protects people against symptoms of psychological distress [
23]. Self-esteem mediates the negative correlation between child maltreatment and depressive symptoms and protects against the adverse effects of early adversity exposure on mental health [
24]. Researchers have also found that resilience moderates the association between ACEs and depression, and that the association between ACEs and depression is stronger in low-resilience individuals than in high-resilience individuals [
25]. Some scholars have found that religious service attendance and ethnic identity are protective factors for the effects of ACEs on depression [
21].
Moreover, some studies revealed that the effect of ACEs on depression may be reduced by managing current stressors and building psychological resilience [
26]. Interventions that focus on improving emotion-regulation skills might provide an efficient “transdiagnostic” treatment strategy for psychological and physical health problems [
27]. A longitudinal study on acculturation stress and the relationship between ACEs and depression in a sample of young adult Hispanic immigrants indicated that ACEs predicted depressive symptoms and revealed significant mediating and moderating effects of cumulative and distinct facets of acculturation stress [
28].
In China, children’s experiences are gradually being diversified due to social transformation. In 2021, the number of rural migrant workers in cities reached 290 million [
29]. Children left behind in rural areas are often looked after by their grandparents, while some children move to cities with their parents and face a life of displacement [
30,
31]. Furthermore, the family structure in China is changing, and the divorce rate is increasing annually; the crude divorce rate rose from 1.1% in 1987 to 3.1% in 2020 [
32,
33]. Moreover, as the divorce rate rises, the phenomenon of remarriage also increases; data show that the remarriage rate after divorce reached 60%, and the divorce rate after remarriage was as high as 80% in 2020 [
33]. Evidently, the proportion of children who suffered from family changes increased, and it was found that children in single-parent households or restructured families were more likely to have negative family experiences [
34]. Thus, as Chinese families diversify, the effect of ACEs on adulthood becomes particularly important.
In summation, the existing literature analyzes various aspects of the relationship between ACEs and mental health outcomes in adulthood, revealing that adverse experiences in early life are likely to cause depression in adulthood. However, the mechanisms and mitigating factors of the effect of ACEs on depression in adults remain unclear. Some studies examined the effects of intergenerational transmission of ACEs and found that higher parental childhood adversity scores were associated with higher children’s depression [
35], while parents’ positive childhood experiences counteract intergenerational ACEs [
36]. However, the bridging effect of intergenerational communication on mental health disadvantages caused by ACEs has not yet been established. Identifying this effect could facilitate a better understanding of the role of ACEs on adult mental health outcomes. Therefore, this study focuses on the effects of ACEs in adult depression, particularly emphasizing the inhibitory effect of contact with children on adult depression. The following research hypotheses were established:
Research hypothesis 1: ACEs have a significant effect on depression, and adults who experienced ACEs are at a higher risk of depression than those who did not experience ACEs.
Research hypothesis 2: Contact with children mitigates the effects of ACEs on depression in adulthood, and communication with their children reduces the risk of developing depression in some individuals who experienced ACEs.
4. Discussion
This study examined the effect of ACEs on depression and the moderating role of contact with children based on CHARLS data. First, this study further confirmed the fact that most ACEs contribute to depression in adulthood. The present study examined 13 types of ACEs. Eight of these were significant, accounting for 62%. More specifically, adults who experienced physical abuse, emotional neglect, sibling death, parental illness/disability, parental depression, starvation, violence, and being bullied by schoolmates in childhood were more likely to experience depression in adulthood than those who did not. This finding was consistent with extant studies [
40,
41,
42].
Second, the current study demonstrated that not all ACEs cause depression in adulthood and further illustrated that different ACEs have different outcomes. Although the ever-increasing literature indicates that ACEs may trigger mental health problems, such as depression [
2,
4], not all individuals who experience ACEs develop depression. Five ACEs (parental divorce, parental death, parental drug abuse, parental alcoholism, and parental crime) did not cause depression in adulthood. However, this does not mean that these ACEs did not cause other harm. For instance, parental divorce has been shown to lead to lower self-rated health [
43]. The reasons and mechanisms behind only certain ACEs leading to depression and not others require further research.
Third, this study determined the role of contact with children in mitigating the effects of ACEs on depression risks in adulthood. The results revealed that an increase in contact with their children resulted in lower depression scores in adulthood among individuals who experienced parental drug abuse and starvation in childhood, indicating that contact with children mitigated these adverse effects. Childhood adversity should be healed in adulthood, and the family is an important arena for such healing. Contact with children helps ACE victims experience the family warmth that they did not experience as children, thereby reducing the risk of depression. Starvation is a physical experience, and it develops into a psychological experience as an individual grows, evolving into a fear of starvation and a sense of insecurity. Contact with children enables individuals suffering from hunger to gain a sense of security through interaction with family members. Some scholars have noted that resilience [
25] and stress management [
26] as moderating variables are particularly important when it comes to reducing the effect of ACEs on depression. However, resilience and stress management are both intrinsic qualities of the individual and do not reveal how family intergenerational relationships affect people’s mental health. This study revealed that contact with children moderates the relationship between ACEs and depression, further underscoring the role of family intergenerational relationships in reducing the vulnerability effect of ACEs.
The effects of ACEs on adult depression further indicated the importance of family support. With the moderation of contact with children, parental divorce and death had significant marginal effects. Parental divorce and death are family issues. As mentioned above, Chinese families are becoming increasingly diverse, with rising divorce rates and an increase in single-parent families. The results of this study demonstrated that better communication with their children could reduce the impact of parental divorce and death on depression in an individual’s adult life. In other words, pain caused by the family should be treated by the family. Furthermore, this sheds light on the importance of family policy in reducing the negative impact of childhood adversity [
44,
45,
46]. These findings suggest that China, which has experienced diverse family forms, should strive to implement policies that facilitate family communication. For instance, public services, such as education and medical care, that are consistent with the local registered population should be provided in the permanent residence of migrant workers, which would allow left-behind children to live in cities with their parents. Moreover, the government introduced policies to prevent family breakdowns, such as a cooling-off period for divorce; however, this policy lacks sufficient flexibility and influence, and the effect is not satisfactory. The development of modern communication technology has brought people more convenient communication conditions and facilitated communication between family members. Social policy should be family oriented and systematically integrated.
The results of the present study have certain limitations. First, although the survey data used in this study are nationally representative, the sample age was mainly over 40 years old, and cannot reflect the situation of ACEs and depression among adults under 40 years old. Moreover, people born in the 1970s or 1960s experienced historical events, such as the Cultural Revolution and the transition from a planned economy to a market economy in their early childhood, which are unique and lack universal significance. Second, this study used a self-rated depression scale, which was not confirmed by a clinical evaluation by a licensed mental health provider and may have certain errors. Third, regarding the mechanism of ACEs and depression in adulthood, this study only examined the role of contact with children and did not include social support variables, such as contact with friends. Future studies can investigate additional moderator variables to identify more variables that can mitigate the effects of ACEs on depression in adults.
5. Conclusions
The present study explored the role of contact with children as a moderator in the effect of ACEs on depression in adulthood and found that enhancing contact with children could reduce the effects of at least two ACEs (parental drug abuse and starvation) on depression in adulthood.
These findings highlight the need to focus on the role of the family in individual mental health. First, we should develop a good family culture. As an important element of a social organism, the family carries out basic functions, such as providing guidance on social norms, moral education, cultural inheritance, and emotional comfort. Family culture has a direct, lasting, and subtle influence on the healthy growth of individual family members. Second, we must consolidate and cultivate family education in the youth. It is necessary to provide guidance around the implementation of the fundamental task of moral education and guide parents to use correct actions, thoughts, and methods to cultivate good thoughts, conduct, and habits in children. Family education is the foundation of all education, and it shoulders the important responsibility of cultivating values in young people. Finally, we should improve family services and promote social harmony. Harmony should be created between the society at large and small families, thus facilitating happiness and a sense of well-being in every family. Social harmony is ultimately reflected in the happiness of thousands of families and in the continuous improvement of the lives of hundreds of millions of people.