Dataset Information

Association of Team Sports Participation With Long-term Mental Health Outcomes Among Individuals Exposed to Adverse Childhood Experiences.

ABSTRACT:

Importance

Adverse childhood experiences (ACEs) are associated with long-term poor mental health. Less is known about factors that improve long-term mental health among those with ACEs.

Objective

To evaluate, among those exposed to ACEs, whether team sports participation during adolescence is associated with better mental health in adulthood and whether the association between team sports participation and mental health varies by sex.

Design, setting, and participants

This study used data from 9668 individuals who participated in waves 1 (1994-1995) and 4 (2008) of the National Longitudinal Study of Adolescent to Adult Health. Individuals were included if they had complete data on exposure to ACEs (physical and sexual abuse, emotional neglect, parental alcohol misuse, parental incarceration, and living with a single parent) and a valid sample weight. Statistical analysis was performed from November 6, 2017, to January 4, 2019.

Main outcomes and measures

The association between team sports participation in grades 7 to 12 (wave 1) and diagnosis of depression and/or anxiety and current depressive symptoms (determined by Center for Epidemiologic Studies Depression scale-10 scores) at ages 24 to 32 years (wave 4) among individuals exposed to ACEs. Multivariable logistic regression models were weighted based on propensity scores for factors associated with team sports participation and controlled for individual, family, and school characteristics. Interaction terms tested whether associations between team sports participation and mental health varied by sex.

Results

Of 9668 individuals included in the study (4470 male [50.0%]; mean [SD] age, 15.2 [1.75] years), 4888 (49.3%) reported 1 or more ACE and 2084 (21.3%) reported 2 or more ACEs. Among those with ACEs, team sports participation during adolescence was significantly associated with lower odds of receiving a diagnosis of depression (unadjusted rate, 16.8% vs 22.0%; propensity score-weighted [PSW] adjusted odds ratio [aOR], 0.76; 95% CI, 0.59-0.97) or anxiety (11.8% vs 16.8%; PSW aOR, 0.70; 95% CI, 0.56-0.89) and having current depressive symptoms (21.9% vs 27.5%; PSW aOR, 0.85; 95% CI, 0.71-1.01). There were no significant differences in associations between team sports participation and mental health by sex. Stratified analyses showed significant associations for all outcomes among males (depression: PSW aOR, 0.67 [95% CI, 0.46-0.99]; anxiety: PSW aOR, 0.66 [95% CI, 0.45-0.96]; depressive symptoms: PSW aOR, 0.75 [95% CI 0.56-0.99]) but only 1 outcome among females (anxiety: PSW aOR, 0.73; 95% CI, 0.54-0.98).

Conclusions and relevance

Among individuals affected by ACEs, team sports participation in adolescence was associated with better adult mental health. Team sports may be an important and scalable resilience builder.

SUBMITTER: Easterlin MC

PROVIDER: S-EPMC6547068 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Importance:Associations between adverse childhood experiences (ACEs) and risks for adult depression, poor mental health, and insufficient social and emotional support have been documented. Less is known about how positive childhood experiences (PCEs) co-occur with and may modulate the effect of ACEs on adult mental and relational health. Objective:To evaluate associations between adult-reported PCEs and (1) adult depression and/or poor mental health (D/PMH) and (2) adult-reported social and emotional support (ARSES) across ACEs exposure levels. Design, Setting, and Participants:Data were from the cross-sectional 2015 Wisconsin Behavioral Risk Factor Survey, a random digit-dial telephone survey of noninstitutionalized Wisconsin adults 18 years and older (n = 6188). Data were weighted to be representative of the entire population of Wisconsin adults in 2015. Data were analyzed between September 2016 and January 2019. Main Outcomes and Measures:The definition of D/PMH includes adults with a depression diagnosis (ever) and/or 14 or more poor mental health days in the past month. The definition of PCEs includes 7 positive interpersonal experiences with family, friends, and in school/the community. Standard Behavioral Risk Factor Survey ACEs and ARSES variables were used. Results:In the 2015 Wisconsin Behavioral Risk Factor Survey sample of adults (50.7% women; 84.9% white), the adjusted odds of D/PMH were 72% lower (OR, 0.28; 95% CI, 0.21-0.39) for adults reporting 6 to 7 vs 0 to 2 PCEs (12.6% vs 48.2%). Odds were 50% lower (OR, 0.50; 95% CI, 0.36-0.69) for those reporting 3 to 5 vs 0 to 2 PCEs (25.1% vs 48.2%). Associations were similar in magnitude for adults reporting 1, 2 to 3, or 4 to 8 ACEs. The adjusted odds that adults reported "always" on the ARSES variable were 3.53 times (95% CI, 2.60-4.80) greater for adults with 6 to 7 vs 0 to 2 PCEs. Associations for 3 to 5 PCEs were not significant. The PCE associations with D/PMH remained stable across each ACEs exposure level when controlling for ARSES. Conclusions and Relevance:Positive childhood experiences show dose-response associations with D/PMH and ARSES after accounting for exposure to ACEs. The proactive promotion of PCEs for children may reduce risk for adult D/PMH and promote adult relational health. Joint assessment of PCEs and ACEs may better target needs and interventions and enable a focus on building strengths to promote well-being. Findings support prioritizing possibilities to foster safe, stable nurturing relationships for children that consider the health outcomes of positive experiences.

Project description:BackgroundAdverse childhood experiences (ACEs) are negatively associated with a range of child health outcomes. In this study, we explored associations between five individual ACEs and child mental health diagnoses or symptoms. ACEs included living with someone who had an alcohol-related problem, common mental health disorder or serious mental illness, or experienced victimisation or death of a household member.MethodsWe analysed data from a population-level electronic cohort of children in Wales, UK, (N = 191,035) between the years of 1998 and 2012. We used Cox regression with discrete time-varying exposure variables to model time to child mental health diagnosis during the first 15 years of life. Child mental health diagnoses include five categories: (i) externalising symptoms (anti-social behaviour), (ii) internalising symptoms (stress, anxiety, depression), (iii) developmental delay (e.g. learning disability), (iv) other (e.g. eating disorder, personality disorders), and (v) any mental health diagnosis, which was created by combining externalising symptoms, internalising symptoms and other. Our analyses were adjusted for social deprivation and perinatal risk factors.ResultsThere were strong univariable associations between the five individual ACEs, sociodemographic and perinatal factors (e.g. gestational weight at birth) and an increased risk of child mental health diagnoses. After adjusting for sociodemographic and perinatal aspects, there was a remaining conditional increased risk of any child mental health diagnosis, associated with victimisation (conditional hazard ratio (cHR) 1.90, CI 95% 1.34-2.69), and living with an adult with a common mental health diagnosis (cHR 1.63, CI 95% 1.52-1.75). Coefficients of product terms between ACEs and deprivation were not statistically significant.ConclusionThe increased risk of child mental health diagnosis associated with victimisation, or exposure to common mental health diagnoses, and alcohol problems in the household supports the need for policy measures and intervention strategies for children and their families.

Project description:Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure "classes" and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the 'Low Adversity' class. Conversely, most Black and Hispanic adolescents were classified in the 'High Socioeconomic Adversity and Paternal Incarceration' class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the 'High Global Adversity' class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.