Abstract
Adverse childhood events are made up of stressful and potentially traumatic events linked with advanced risk of long-term behavioral problems and long-lasting illness, which add up to depression of the adolescents in their adult life. In this case study, an estimation of an adolescent between the ages of 16 and 21 who score above a four on the Adverse Childhood Events Scale (ACES) measure and participate in Structured Psychotherapy for Adolescents Responding to Chronic Stress therapy are more likely to report adult depression compared to adolescents between the ages of 16 and 21 who score above a four on the ACES measure but do not participate in SPARCS therapy was made. A cross-sectional school-based research method was used. Four hundred and eight secondary students were chosen through a multistage sampling technique from 4 selected secondary schools. Adverse Childhood Events Scale was utilized to measure the degree adverse childhood events Among the 480 adolescents who took part in the study,60% answered yes to all the ten questions in the questionnaire, while the remaining 40% of the participants answered no (Martinez, 2019). Measuring above 4 in Adverse Childhood Events Scale and participating SPARCS or measuring above four on the scale has a direct relationship with adult depression.
Background
Adverse childhood event (ACE) describes a variety of stressful and traumatic experiences. This includes abuse, neglect, or domestic dysfunction, for instance, growing up with family members with substance abuse syndromes, intimate partner violence, and mental health problems. In addition, school violence, bullying, and economic adversity are other common ACEs encountered. A significant number of the recent literature shows that stress is linked to aversive states in most cases. The stress brings about the release of neuropeptides and hormones, including dynorphin; this hormone triggers kappa opioid receptors (KORs) found in the central and outlying nervous system (Martinez, 2019). When KOR is prolonged, it signals a response to uncontrollable or chronic stress; this can, in effect, lead to persistent expressions of behavioral signs characteristic of human depressive disorders.
Excess stress disrupts the developing of immune and nervous systems. Adolescents who experience neglect or abuse have a higher chance of experiencing depression in adult life. Research studies show that chronic cases of stress play a significant role in the development of medial prefrontal cerebral cortex deficits and hippocampal, which make up the significant neural anomalies in most of the depressive syndromes (Belleau, 2019).Social support may have a cushioning effect against the repercussions of traumatic experiences by enhancing emotional and cognitive processing in connection to the events—advanced knowledge on the association of distinct types of Adverse childhood experiences and adolescent depression. The interrelationship between the two variables offers credible insight into related psychological problems among 16 to 21 adolescents. he tailoring of mental healthcare services to the group is enhanced. Adverse childhood events’ study has been conducted across the world
Methods and Materials
The school-based cross-sectional research study was used. Adolescent students aged 16-21 selected from the four selected schools willing and having the consent of their parents were recruited for the study. Any adolescent who had a severe illness at the time of the study and had difficulties communicating their minds was excluded from the data collection exercise. The sample used for the study was determined by taking the pervasiveness of high school adolescent students aged 18 to 21. An assumption is made that any outcome must be within 5% margin error, whereas on the other hand, there is a 95% assurance range of inevitability (alpha =0.05) (Belleau, 2019). Based on the assumptions, the study’s sample size was determined using a single percentage formula, giving the ultimate sample size as 480 (Belleau, 2019). A multistage sampler method was used with the initial stage of the technique involving stratifying the schools into two. Government and private schools were numbered separately but each in equal proportion. The second stage consisted of stratifying students from the selected schools into different grade levels. The sample size allocation was done as based on the number of students in each grade level through the proportional allocation method.
A day prior to the data assortment, the selected juvenile students in the chosen schools were given an information sheet that showed the nature, benefits, purpose, and adverse impacts of the study, as well as a consent form paper that the student had to take to their folks for signing. The consent would act as reference proof that the students are participating in the study with their parents’ knowledge. Students allowed to participate in the study were provided with written informed consent to officiate their participation.
Adverse childhood experiences exposure to ACE were determined using questionnaires on an adverse childhood experience. This questionnaire addressed a total of ten items in connection to ACEs. The questionnaire was divided into three subcategories: abuse, neglect, and household dysfunction. The ACE questionnaire and the scale measure are outstanding valid and reliable measures of childhood adversity used exhaustively as far as large-scale ACE studies are concerned. The questions contained in the questionnaire were about the respondent’s past 21 years of their living which binary answers of a yes or no. The variables obtained from this were created to replicate any respondents’ acquaintance to each other ACE subtype.
Adding to sociodemographic variables, each respondent had to respond to a set of self-rated vigor questions present on the Likert scale, which has five points. (“excellent,” “very,” “good,” “good,” “fair” and “poor”). Eight third-year MSC psychotherapy students were mandated to disseminate and supervise the questionnaires. The supervisors checked the questionnaires daily to ensure their consistency and completeness. The instruments used for the study were considered reliable and held a high degree of validity.
Prior to data analysis being conducted, some assumptions were made, the assumptions included the linear relationship between independent variables, outliers, multicollinearity and normal distribution. Chi-square tests were conducted to determine any variances in ACE prevalence, both individual and cumulative ACEs in terms of depression symptoms and gender (Gaboardi, 2018). Manifold linear regression analysis was conducted using the forward methods to determine the association between depressive symptoms and independent variables.
Results
Among the cumulative number of 480 circulated questionnaires, 460 of them were filled in completion and with a great degree of consistency, making the response rate stood at 95.83%. The other 20 questionnaires could not be included in the study analysis as they have not been responded to from all the collected samples from the selected schools. The number of adolescent females sampled was higher than that of male adolescents. The majority of the partakers were from urban centers, ranging from 16 to 21 years of age.
Among the 480 adolescents who took part in the study, 288 (60%) of the respondents answered yes to the ten inquiries of ACEs. From the three groupings of adverse childhood experience (ACE) data from 332 female adolescent respondents, 60 (18.1%) were abused sexually or materially. Fifty-eight of them had been neglected, while 100 had experienced domestic dysfunction. Of the 148 male adolescents, 75 had been physically or sexually harassed, 30 of them being neglected, and 43 had experienced household dysfunction. From the measurement of the Oslo 3-Item Social Scale, it was discovered that 173 of the respondents had undergone poor social sustenance, 211 of them had experienced reasonable social support, while 96 were lucky enough to have strong social support in their life lived so far (Belleau, 2019). Amongst the respondents, there are also notable substance abuse cases, with some of them abusing alcohol, khat chewing, smoking cigarette, and illicit drugs.
Discussion
Notably, this study is one of a kind that examines adolescents between the ages of 16 and 21 who score above a four on the Adverse Childhood Events Scale (ACES) measure and participate in Structured Psychotherapy for Adolescents Responding to Chronic Stress therapy are more likely to report adult depression compared to adolescents between the ages of 16 and 21 who score above a four on the ACES measure but do not participate in SPARCS therapy.
There is a consistent significant difference with regard to ACE prevalence by grade level or gender. Adolescents between the ages of 16 and 21 who get Structured Psychotherapy for Adolescents and score over a four on the Adverse Childhood Events Scale (ACES) are studied. Compared to teenagers between the ages of 16 and 21, who score above a four on the ACES measure but do not participate in SPARCS therapy, those who respond to Chronic Stress therapy are more likely to suffer adult depression.
From the findings, it is also evident that childhood adverse experiences are closely associated with the severity and prevalence of depressive symptoms. This further shows that while holding all other factors constant, including residence, social support, gender, self-rated health, and grade level, the severity of the ACEs increases. The effect is seen more clearly on adolescents aged 16 and 21 who score four and above on the ACES measure and participate in Structured Psychotherapy for Adolescents Responding to Chronic Stress therapy than those who don’t go through the same.
Conclusion
A tremendous potential implication for future research can be deduced from our research study. Our analysis expounds on the already prevailing body of evidence that supports the ideology that there is a persistent significant variation by grade level or gender when it comes to ACE prevalence. And from the study, adolescents aged 16 to 21 get Structured Psychotherapy for Adolescents and score a four or higher on the Adverse Childhood Events Scale (ACES). Those who react to Chronic Stress therapy are more likely to suffer from adult depression than teenagers between the ages of 16 and 21, who score above a four on the ACES measure but do not participate in SPARCS therapy. The prospect of having outstanding social support can effectively reduce the degree of severity and risk associated with adult depression symptoms. The critical relationship existing between ACEs and adolescent related mental disorders necessitates early intervention strategies. Some examples of measures that can be used including having initiatives at the community and family level.
References
Belleau, E. L., Treadway, M. T., & Pizzagalli, D. A. (2019). The impact of stress and major depressive disorder on hippocampal and medial prefrontal cortex morphology. Biological Psychiatry 85(6), 443-453.
Gaboardi, M., & Rogers, R. (2018, July). Local private hypothesis testing: Chi-square tests. In International Conference on Machine Learning (pp. 1626-1635). PMLR.
Kupferschmidt, D. A., & Gordon, J. A. (2018). The dynamics of disordered dialogue: prefrontal, hippocampal and thalamic miscommunication underlying working memory deficits in schizophrenia. Brain and neuroscience advances, 2, 2398212818771821.
Martinez, D., Slifstein, M., Matuskey, D., Nabulsi, N., Zheng, M. Q., Lin, S. F.,… & Huang, Y. (2019). Kappa-opioid receptors, dynorphin, and cocaine addiction: a positron emission tomography study. Neuropsychopharmacology, 44(10), 1720-1727.