title: The mediating role of depressive symptoms in the relationship between adverse childhood experiences and smoking.
abstract: OBJECTIVE
  Adverse childhood experiences (ACEs), including various types of abuse and other forms of household dysfunction (i.e. witnessing domestic violence, parental substance abuse, etc.), have been consistently linked to increased rates of health risk behaviors and negative health outcomes in adulthood. Using data from the 2010 Centers for Disease Control and Prevention's (CDC) annual, nationwide Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, this study tested whether self-reported symptoms of depression mediate the significant relationship between the number of ACEs an individual reports (expressed as an "ACE score") and whether they are a current or past smoker.
  
  
  METHODS
  A path model was produced using multiple regression, and indirect effects were tested using bootstrapping of 2000 samples.
  
  
  RESULTS
  Results of analyses indicated that, among White, Asian, and Hispanic participants, self-reported depressive symptoms are indeed a significant, but only partial, mediator between participants' ACE score and their smoking status.
  
  
  CONCLUSIONS
  These results suggest that for smokers of White, Hispanic, and Asian ethnicity, screening for a history of ACEs and treatment for depressive symptoms may be indicated. However, while depressive symptoms may explain some of the associations between ACEs and smoking, these results suggest that other, unexamined factors also contribute to this pathway.
authors.affiliation: The University of Texas at Austin, Department of Educational Psychology, 1 University Station D5800, Austin, TX 78712-0383, United States. Electronic address: elizabeth.walsh@utexas.edu.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Walsh
authors.affiliation: The University of Texas at Austin, Department of Educational Psychology, 1 University Station D5800, Austin, TX 78712-0383, United States.
authors.forename: Stephanie W
authors.initials: SW
authors.lastname: Cawthon
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D017579:Domestic Violence / Q000523:psychology / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D012044:Regression Analysis; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D019966:Substance-Related Disorders; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: Adverse childhood experiences; Child maltreatment; Cigarette smoking; Depression; Mediation