A prospective study of the association between living with an adult who misuses alcohol during childhood and major depressive disorder in adulthood: Evaluating the role of child maltreatment, sex, school bonding, and neighborhood bonding

Purpose: This prospective cohort study evaluated (1) the association between living with adult alcohol misuse during childhood and chronicity of major depressive disorder (MDD) during one’s thirties, (2) whether the association is explained by child maltreatment, and (3) whether the association is moderated by sex, school bonding, and neighborhood bonding during childhood.

Methods: Longitudinal data from the Seattle Social Development Project that followed participants from grade 9 (~15 years old) to age 39 were analyzed. Exposure to living with adult alcohol misuse during childhood was measured during the grade 9 interview and was based on the question “Have you ever lived with an adult who in your judgment was an alcoholic or a problem drinker (while you were living with them)?” [1=yes; 0=no]. The depression outcome was an ordinal categorical variable (0, 1, or 2 or more times meeting MDD diagnostic criteria across three time-points in the thirties). Ordinal logistic regression was used to evaluate the three aims of the study. Results: Living during childhood with an adult who misused alcohol was associated with 63% higher odds for a one-unit increase in number of MDD diagnoses during one’s thirties (OR = 1.63; 95% CI: 1.05, 2.52), adjusted for covariates. There was a 49% reduction in the odds ratio and the association was no longer statistically significant when child maltreatment was included in the model (OR= 1.32; 95% CI: 0.84, 2.07). Sex, school bonding, and neighborhood bonding did not moderate the association (p>0.05).

Conclusions: Exposure to living with an adult who misuses alcohol during childhood was associated with greater chronicity of MDD in adulthood, and child maltreatment appeared to explain this association. Interventions that reach families with alcohol misuse in the home may be important to mitigate long-term mental health challenges into later adulthood. Future research should continue to examine potential modifiable environmental factors that could potentially mitigate the long-term negative impacts of exposure to adult alcohol misuse on mental health.