LAUSR

OBJECTIVE To determine the prevalence of anxiety and depression and examine their association with adverse childhood experiences (ACEs) among children and adolescents ages 8-17 years old. METHODS Using data from the 2016-2017 National Survey of Children's Health (NSCH), we conducted a cross-sectional study design with a total sample of 39,929. Our exposure and outcome variables included caregiver report of 9 ACE exposures and current anxiety or current depression. Survey sampling weights and SAS survey procedures were implemented to produce nationally representative results. RESULTS Our study found that 9% of children had current anxiety while 4% had current depression. Multivariate analysis concluded that all ACE measures were associated with significantly higher odds of both anxiety and depression. Children exposed to four or more ACEs had higher odds of anxiety (aOR:1.7; 95% CI 1.4-2.1) and depression (aOR: 2.2; 95% CI 1.7-2.9) than children with exposure to less than four ACEs. Assessment of the outcomes of anxiety and depression separately showed differential impacts of ACE exposures as associations were stronger with depression for almost all ACE categories. CONCLUSIONS Our study demonstrates a differential association between ACEs and anxiety and depression. Thus, highlighting the importance of assessing the impact of ACEs on internalizing behaviors separately. These findings are significant for pediatric providers as diagnosis and treatment for mental health disorders are a vital component of pediatric care and further supports the American Academy of Pediatrics recommendation to screen for ACEs.