Expanding Concepts of Youth Adversity: Relationships With a Positive Patient Health Questionnaire–2

Introduction: Research suggests that diverse examples of adverse childhood experiences (ACEs) may link to health. This study examines relationships between conventional (abuse, neglect, household dysfunction) and expanded examples (bullying, safety perceptions) of ACEs and adolescent mental health among youth participating in a statewide school-based survey. Methods: Logistic regression was used to determine whether 10 types of conventional ACEs and 11 types of additional ACEs were associated with the odds of youth meeting cutoff scores for a positive Patient Health Questionnaire–2 (PHQ-2) after adjustment for demographic covariates and known mental health problems. Results: Individual and cumulative measures for conventional and expanded ACEs were significantly associated with youth odds of meeting criteria for a positive PHQ-2. Increasing frequency of bullying harassment was associated with a 1.5- to 5-fold increase in the odds of a positive PHQ-2. Discussion: Findings support consideration of broad concepts for adversity as relevant for youth mental health.