Individual and Interactive Effects of Adverse Childhood Experiences and Household Income on Adolescent Depression and Anxiety Symptoms.

This was an observational cohort, so it shows associations, not that Parent Challenges, Maltreatment, or income caused depression or anxiety. Maltreatment was parent-reported, did not include sexual abuse, and was coded only if items happened six or more times a year, which may understate exposure. Most participants had some or low-level maltreatment, limiting ability to detect effects of frequent or severe maltreatment. The analytic sample was not nationally representative, had higher ACE exposure than other samples, and differed from excluded participants, including more maltreatment and Parent Challenges. Household income was measured at birth, and about 25% of incomes were imputed. The Great Recession occurred when participants were about 9 years old, which may have influenced adolescent mental health.

The authors declared no relevant financial or non-financial interests.

Do not conclude that early childhood maltreatment has no effect on adolescent mental health. The study did not include sexual abuse, relied on parent-reported maltreatment, and most participants had low-level exposure, so the null result may reflect measurement limits.