The relationship between adverse childhood experiences and depression: A cross-sectional survey with university students in Botswana

BACKGROUND: Adverse childhood experiences (ACEs) are associated with severe life-long negative outcomes, including depression. Particularly in low- and middle-income countries, few studies have been conducted to assess the impact of ACEs. AIM: To assess the influence of ACEs on depression among young adults. SETTING: Participants were students at a large university in Gaborone, Botswana. METHODS: Using a cross-sectional design, we investigated the associations between ACEs and depression in young adults in Botswana (n = 392, mean age = 22.2, ± 2.5, 53.4% female). Bivariate correlation analyses, t-tests and analyses of variance (ANOVA) were performed to assess associations and compare ACEs at different levels of depression. RESULTS: A total of 73% (n = 287) reported one or more ACEs, whilst 15% (59) reported five or more ACEs. About 64% (38) of those who reported five or more ACEs were female respondents. Prevalence of specific ACEs ranged from 9.5% (child neglect) to 36.3% (separation and divorce). One in three respondents reported parental separation or divorce, psychological abuse and family dysfunction, whilst 19% (11% moderate and 8% severe) reported significant depressive symptoms. Adverse childhood experiences significantly predicted depression (β = 0.27, 95% confidence interval [CI]: 0.18, 0.37). Respondents at different levels of depression significantly differed on reporting ACEs (F((3, 389)) = 11.43, p < 0.001). CONCLUSION: Adverse childhood experiences are highly prevalent and key determinants of depression in young adulthood. A multifaceted and cross-system intervention (e.g. schools, social work, psychological services, health services and law enforcement) is required to protect, prevent and treat survivors of childhood adversity.