Adverse Childhood Experiences and Depression: Do Left-Behind Families Place Children at Higher Risk in Rural China

Objective: Currently, the risk of, trauma associated with, and intervention strategies for adverse childhood experiences (ACEs) among parent-absent children in developing countries have not been adequately discussed. This study aims to explore the associations between ACEs and depression for left-behind children (LBC) in rural China. Method: A total of 4708 children (M_age = 12.07, male = 48.49%) from eight Chinese provinces were investigated from June to December 2019. Descriptive statistics, nonparametric test and regression analysis were mainly used to analyze the data. Results: First, in the past year, the prevalence of ACEs among rural children in mainland China reached 82.63%, 34.66% of respondents had experienced four or more adverse events, and LBC were at higher risk than parent-present children. Second, ACEs increased the likelihood of children’s depression, and the depression of LBC was not more serious than that of children whose parents were at home. Third, the parent-child relationship was negatively correlated with children’s depression, while the association between social support and children’s depression was not statistically significant. There was no fundamental disparity between LBC and parent-present children in the factors associated with depression. Conclusion: LBC not only suffered from a higher risk of ACEs but also showed better resilience to them. The inadequate coverage, deficient program design and underqualified professional of China children welfare services limited the amelioration of ACEs-related depression. This study suggests that mainland China should prioritize the risk of ACEs in parent-absent families, break the intrinsic link between ACEs and depression, and enhance the professionalism of social support.