To estimate the association between childhood adversity (CA) and depression in Chinese populations in studies using the Childhood Trauma Questionnaire (CTQ), a literature retrieval from established databases between 2005 and 2020 was conducted. A total 40 eligible studies with 145 effect sizes were included in subsequent analyses. Using a multi-level meta-analysis, we found a pooled effect size of r = 0.24, p < 0.001, CI = [0.20, 0.27] for the association between CA and depression. No publication bias was shown by Egger's test, t (160) = −0.27, p = 0.79. The between-study variance was moderate but significant, with 39.75% of the total variance attributable to differences between studies. Results of moderation analysis based on subtypes of CA showed that emotional abuse was associated most strongly with depression. In addition, results of moderation analysis focusing on geographic regions and CTQ subscales showed that the association between SA and depression was stronger in Southern than Central China. Our findings demonstrated clearly the advantages of using a multi-level approach to arrive at a more accurate estimate of pooled effect sizes. The differential associations between CTQ subscales and depression and the moderating effect of geographic regions on the association between sexual abuse and depression point clearly to the need of increased attention to the effects of CA subtypes and socio-cultural factors in future research on CA and mental disorders. These findings provide a preliminary empirical basis for researchers to address specific hypotheses of associations between CA subtypes and specific mental disorders in China.
Bibliographical noteFunding Information:
This research was supported by two General Research Funds (nos. 11608121 and 11614919) granted by the Research Grants Council of Hong Kong. I am grateful to Mr. Daryl Lee and Miss Monique Leung for their assistance in project management during the initial stage of the study. This research was supported by two General Research Funds (nos. 11608121 and 11614919) granted by the Research Grants Council of Hong Kong. All authors contributed substantially to the paper. The principle author Julian Lai contributed to the writing of the first draft, design of the study, literature search and screening and data analysis. Yi Huang contributed to meta-analysis and review of the first draft. Y Fan and H Y Man took part in literature search, screening and retrieval of eligible studies, and review of the first draft.
© 2023 The Authors
- Childhood Trauma Questionnaire (CTQ)
- Childhood adversity
- Multilevel meta-analysis