The interaction of adverse childhood experiences and gender as risk factors for depression and anxiety disorders in US adults: a cross-sectional study

Table 4 Additive Interaction of Adverse Childhood Experiences with Gender on Major Depressive Episode and Anxiety Disorder

	Number of Categories of Adverse Childhood Experiences
	0	1		2		3–5
Gender	Adjusted Prevalence % (95% CI)^a	Adjusted Prevalence % (95% CI)^a	Interaction Contrast (95% CI)^b P₁₁-P₁₀- P₀₁+ P₀₀	Adjusted Prevalence % (95% CI)^a	Interaction Contrast (95% CI)^b P₁₁-P₁₀- P₀₁+ P₀₀	Adjusted Prevalence % (95% CI)^a	Interaction Contrast (95% CI)^b P₁₁-P₁₀- P₀₁+ P₀₀
Major Depressive Episode^c
Males	P₀₀ = 7.9 (5.6, 10.3)	P₀₁ = 7.9 (4.8, 10.9)	14.9–12.3–7.9 + 7.9 = 2.6 (−3.0, 8.1)	P₀₁ = 10.5 (6.2, 14.7)	24.6–12.3–10.5 + 7.9 = 9.8 (2.8, 16.7)	P₀₁ = 12.3 (7.1, 17.5)	26.9–12.3–12.3 + 7.9 = 10.2 (1.8, 18.5)
Females	P₁₀ = 12.3 (9.8, 14.9)	P₁₁ = 14.9 (11.7, 18.1)	14.9–12.3–7.9 + 7.9 = 2.6 (−3.0, 8.1)	P₁₁ = 24.6 (20.3, 29.0)	24.6–12.3–10.5 + 7.9 = 9.8 (2.8, 16.7)	P₁₁ = 26.9 (21.3, 32.5)	26.9–12.3–12.3 + 7.9 = 10.2 (1.8, 18.5)
Anxiety Disorder^d
Males	P₀₀ = 4.7 (2.8, 6.7)	P₀₁ = 5.8 (3.0, 8.6)	13.0–7.2–5.8 + 4.7 = 4.7 (−0.3, 9.7)	P₀₁ = 7.9 (4.6, 11.2)	17.6–7.2– 7.9 + 4.7 = 7.2 (1.4, 12.9)	P₀₁ = 8.0 (3.6, 12.4)	21.9–7.2–8.0 + 4.7 = 11.4 (4.0, 18.9)
Females	P₁₀ = 7.2 (5.3, 9.2)	P₁₁ = 13.0 (9.8, 16.2)	13.0–7.2–5.8 + 4.7 = 4.7 (−0.3, 9.7)	P₁₁ = 17.6 (13.7, 21.4)	17.6–7.2– 7.9 + 4.7 = 7.2 (1.4, 12.9)	(P₁₁) = 21.9 (16.6, 27.2)	21.9–7.2–8.0 + 4.7 = 11.4 (4.0, 18.9)

^aWeighted and adjusted 12-month prevalence of the outcome (major depressive episode or anxiety disorder) in the group defined by gender and number of categories adverse childhood experiences (ACEs). The adjusted prevalences (95% CI) were standardized to the distribution of covariates in the entire study population: age, race, childhood socioeconomic disadvantage (SED) and current SED
^bThe interaction contrast (95% CI) is calculated using the following formula: (P₁₁-P₀₀)-[(P₁₀- P₀₀) + (P₀₁- P₀₀)]. This formula can be simplified to: P₁₁-P₁₀- P₀₁+ P_00. In the formula, P represents the covariate-adjusted prevalence of the outcome and the subscripts 0 and 1 represent the groups defined by the presence (1) or absence (0) of one of the two risk factors. For example, P₀₀ = male (0) with no ACEs (0) and P₁₁ = female (1) with ACEs (1). Reported contrast values may vary from calculated values due to rounding. Contrast value > 0 (and 95% CI that excludes 0) is interpreted as more than additive interaction between the two risk factors
^cAddition of all three interaction terms to the additive model: F(3, 4272) = 3.74; P = .011
^dAddition of all three interaction terms to the additive model: F(3, 4272) = 4.47, P = .004

ISSN: 1471-2458