Depressive Symptoms, Adverse Childhood Experiences, and Sleep Quality: Black Americans in the Rural South

Abstract

Purpose: Adverse childhood experiences (ACEs) and low utilization of mental health services due to distrust of the healthcare system and stigma contribute to poor mental health outcomes, especially for individuals living in rural areas. Evidence mounts that ACEs and mental health conditions contribute to poor sleep, yet ACEs remain understudied in rural southern communities where Black Americans face disproportionate racial and socioeconomic disparities.  This study examined whether ACEs and depressive symptoms predict sleep quality in rural Black Americans, identified the types and frequency of ACEs reported among those with depressive symptoms, and explored correlations between sleep quality and ACEs overall and by specific type. 

Method: Participants (N = 75), Black/African American adults who completed a series of questionnaires, including a demographic survey, Patient Health Questionnaire (PHQ-9), modified ACEs, and answered two questions assessing components of sleep quality, including sleep duration and satisfaction.

Findings: Of the 75 participants, 56% (n = 42) reported depressive symptoms. Among those with depressive symptoms, 40.5% (n = 17) reported having parents that had separated or divorced, and 23.8% (n = 10) reported not feeling loved by anyone in the family, and that family did not look out for each other. Sleep duration was shorter for participants who reported living with someone experiencing substance use or mental illness, p < .05. Adverse childhood experiences and depressive symptoms were not associated with sleep quality, all p >.05.

Conclusion: Community-focused interventions, specifically trauma-informed care models, are needed to address the potential impact of specific ACEs on mental health outcomes within rural Black Americans.