title: The association of adverse childhood experiences with mid-life depressive symptoms and quality of life among incarcerated males: exploring multiple mediation.
abstract: OBJECTIVE
  To explore the association of experiencing death, trauma, and abuse during childhood with depressive symptoms and quality of life at mid-life among incarcerated men and to understand how current social support and coping strategies mediate the impact of childhood trauma histories on mental health.
  
  
  METHODS
  Study participants were 192 male inmates in a maximum security prison. Participants completed measures of adverse childhood experiences related to death, trauma, and abuse, and depressive symptoms and quality of life. Data were analyzed using multiple mediation modeling.
  
  
  RESULTS
  Men who reported having experienced adverse childhood experiences reported more depressive symptoms and lower quality of life than their counterparts. The results showed that in models both unadjusted and adjusted for age, race, education, number of years served, and whether the inmate had a life sentence, the association between adverse childhood experiences and quality of life were partially explained by the total of the indirect effects (point estimate = -.5052; CI.95 = -1.0364, -.0429 and point estimate = -.7792; CI.95 = -1.6369, -.0381), primarily via social support. However, the associations between adverse childhood experiences and depressive symptoms were not explained by social support and coping.
  
  
  CONCLUSIONS
  Adverse childhood experiences are associated with deleterious mental health effects in later life. Social support and coping partially mediate the association between adverse childhood experiences and quality of life. The high prevalence of childhood trauma among aging prison inmates warrants attention to increasing social support mechanisms to improve mental health.
authors.affiliation: a Center on Aging and Health , School of Medicine, The Johns Hopkins University, Baltimore , MD , USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skarupski
authors.affiliation: b Department of Mental Health, Bloomberg School of Public Health , The Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Jeanine M
authors.initials: JM
authors.lastname: Parisi
authors.affiliation: c Department of Health, Behavior and Society, Bloomberg School of Public Health , The Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Roland
authors.initials: R
authors.lastname: Thorpe
authors.affiliation: d Department of Community-Public Health, School of Nursing , The Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Tanner
authors.affiliation: e Department of Acute and Chronic Care, School of Nursing , The Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Gross
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D055815:Young Adult
keywords: adverse childhood experiences; depressive symptoms; incarceration; quality of life