The association of adverse family experiences, physical activity, and depression in a national sample of US adolescents

Problems: Sufficient engagement in physical activity could foster resilience in adolescents and help alleviate the impact of adverse family experiences (AFEs), such as depression. However, the association between cumulative AFEs exposure, physical activity, and depression remains unclear. The aims of this study are to determine the relationship between AFEs and adolescent depression and whether physical activity moderates this relationship. Methods: Secondary analyses were conducted on 29,617 adolescents aged 12–17 years from the 2016–2017 National Survey of Children's Health. Binomial logistic regression was used to examine the relationship among AFEs, child depression, and physical activity. Covariates include individual-level, social-level, and societal-level factors. Findings: This study reveals that 7.3% of US adolescents had a depression diagnosis. The odds of having a depression diagnosis among US children were 1.6 times (adjusted OR: 1.6, 95% CI: 1.37–1.86) greater for adolescents with one type of AFEs, and 3.4 times greater (adjusted OR: 3.39, 95% CI: 2.78–4.13) for adolescents with three or more AFEs, compared with children living without AFEs. Physical activity for 1–3 days per week remained a significant, substantial protector of childhood depression among children with at least one type of AFEs (adjusted OR: 0.73, 95% CI: 0.62–0.87). Conclusions: These results suggest a clinical concern for adolescents with more AFEs. Trauma-informed care to address multiple types of trauma and physical activity interventions to reduce depression symptoms may be particularly important.