# Depressive symptoms of school-aged adolescents: cumulative effect of adverse events and mediation of social support

## TL;DR

This study finds that accumulated childhood adversity increases adolescent depression, with social support reducing the risk.

## Contribution

The paper identifies the mediating role of social support in mitigating depressive symptoms from cumulative adverse childhood experiences.

## Key findings

- The prevalence of depressive symptoms among school-aged adolescents was 8.2%.
- Social support mediates 16.7% of the total effect of adverse experiences on depression.
- Each dimension of adversity (socioeconomic, family, community) increases depression risk, with varying mediation by social support.

## Abstract

To analyze the effect of cumulative adverse childhood experiences and depressive symptoms on adolescence and to identify direct and indirect relationships between the variables and the mediating role of social support.

This is a cross-sectional study with a sample of 1,117 school-aged adolescents aged 13 to 19 years. The Children's Depression Inventory and Adverse Childhood Experiences scales were used, organized into socioeconomic, family, community, and total dimensions. Descriptive analysis was carried out and the structural equation model was used, with probit estimation, applying social support as mediator.

The prevalence of depressive symptoms among school-aged adolescents was 8.2%. We observed that the accumulation of socioeconomic, family, and community factors increases the occurrence of depressive symptoms, adjusted for sex, skin color, and social support. Mediation by social support explains 16.7% of the total effect of exposure to the analyzed factors. In the socioeconomic dimension, the depression probit increases by 0.033 for each category, with 21.2% mediated by social support. In the family dimension, the increase is 0.020 (25% mediated); in the community, 0.018 (16.7% mediated); and in the total dimension, 0.012 (17% mediated).

The observation of the effect of the accumulation of Adverse Childhood Experiences on depressive symptoms in adolescence requires actions in vulnerable groups, with social support helping to mitigate the risk of depression.

Analisar o efeito do acúmulo de experiências adversas na infância (EAI) e sintomas depressivos na adolescência, bem como identificar relações diretas e indiretas entre as variáveis e o papel mediador do apoio social.

Estudo transversal com 1.117 adolescentes escolares de 13 a 19 anos, usando o Inventário de Depressão Infantil e escalas EAI organizadas nas dimensões socioeconômica, familiar, comunitária e total. Realizaram-se análise descritiva e modelo de equação estrutural com estimativa de probit, aplicando o apoio social como mediador.

A prevalência de sintomas depressivos entre adolescentes escolares foi de 8,2%. Observou-se que o acúmulo de fatores socioeconômicos, familiares e comunitários aumenta a ocorrência de sintomas depressivos, ajustado por sexo, cor da pele e apoio social. A mediação pelo apoio social explica 16,7% do efeito total da exposição aos fatores analisados. Na dimensão socioeconômica, o probit de depressão aumenta 0,033 a cada categoria, com 21,2% mediado pelo apoio social. Na dimensão familiar, o aumento é de 0,020 (25% mediado), na comunitária de 0,018 (16,7% mediado) e na dimensão total de 0,012 (17% mediado).

A constatação do efeito do acúmulo de EAI nos sintomas depressivos na adolescência requer ações em grupos vulnerabilizados, com o apoio social ajudando a mitigar o risco de depressão.