Adverse Childhood Experiences and Depressive Symptoms Among Older Korean Americans in Affordable Senior Housing: The Moderating Role of Social Networks and Family Solidarity

Abstract

Despite growing evidence of the long-term mental health effects of adverse childhood experiences (ACEs), little is known about protective factors that buffer this relationship among older adults. This study examined personal (e.g., sense of mastery), interpersonal (e.g., social networks and family solidarity), and community (e.g., social cohesion) resources as potential moderators of the association between ACEs and depressive symptoms among older Korean Americans residing in affordable senior housing. Survey data from 315 residents (mean age = 79.4) revealed significant interactions between ACEs and both social networks and family solidarity: stronger social and familial ties buffered the adverse effects of ACEs on depressive symptoms. These findings suggest that close social and family connections serve as key coping resources rooted in Korean cultural values. The study underscores the importance of fostering relationships in senior housing programs that promote engagement, peer support, and family involvement for individuals affected by ACEs.

Keywords

adverse childhood experience mental health social networks family solidarity older immigrants

Get full access to this article

View all access options for this article.

References

Brinker

Cheruvu

V. K.

(2017). Social and emotional support as a protective factor against current depression among individuals with adverse childhood experiences. Preventive Medicine Reports, 5, 127–133. https://doi.org/10.1016/j.pmedr.2016.11.018

Brody

D. J.

Pratt

L. A.

Hughes

J. P.

(2018, February). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 (Data brief no. 303). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/data/databriefs/db303.pdf

Bronfenbrenner

(1979). The ecology of human development: Experiments by nature and design. Harvard University Press.

Budiman

Ruiz

N. G.

(2021, April 29). Key facts about Asian origin groups in the U.S. Pew Research Center. https://www.pewresearch.org/short-reads/2021/04/29/key-facts-about-asian-origin-groups-in-the-u-s/

Cagney

K. A.

Glass

T. A.

Skarupski

K. A.

Barnes

L. L.

Schwartz

B. S.

Mendes de Leon

C. F.

(2009). Neighborhood-level cohesion and disorder: Measurement and validation in two older adult urban populations. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64(3), 415–424. https://doi.org/10.1093/geronb/gbn041

Centers for Disease Control and Prevention & Kaiser Permanente . (2016). The ACE study survey data. U.S. Department of Health and Human Services. [Unpublished data].

Centers for Disease Control and Prevention . (2024, October). Adverse childhood experiences. https://www.cdc.gov/aces/site.html

Chang

K.-S.

(2010). South Korea under compressed modernity: Familial political economy in transition. Routledge. https://www.taylorfrancis.com/books/9780203854396

Choi

Kim

Lee

(2016). Effects of nativity, length of residence, and county-level foreign-born density on mental health among older adults in the US. The Psychiatric Quarterly, 87(4), 675–688. https://doi.org/10.1007/s11126-016-9418-2

10.

Cohen

Wills

T. A.

(1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310

11.

Esterline

Batalova

(2022, April 14). Korean immigrants in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/korean-immigrants-united-states

12.

Fässberg

M. M.

Cheung

Canetto

S. S.

Erlangsen

Lapierre

Lindner

Wærn

Gallo

J. J.

Wong

Duberstein

Wærn

(2016). A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging & Mental Health, 20(2), 166–194. https://doi.org/10.1080/13607863.2015.1083945

13.

Felitti

V. J.

Anda

R. F.

Nordenberg

Williamson

D. F.

Spitz

A. M.

Edwards

Marks

J. S.

(1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8

14.

Fillenbaum

G. G.

(2013). Multidimensional functional assessment of older adults: The duke older Americans resources and services procedures. Psychology Press. https://doi.org/10.4324/9780203771563

15.

Folstein

M. F.

Folstein

S. E.

McHugh

P. R.

(1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6

16.

Gonyea

J. G.

Curley

Melekis

Levine

Lee

(2018). Loneliness and depression among older adults in urban subsidized housing. Journal of Aging and Health, 30(3), 458–474. https://doi.org/10.1177/0898264316682908

17.

Guo

Steinberg

N. S.

Dong

Tiwari

(2018). A cross-sectional study of coping resources and mental health of Chinese older adults in the United States. Aging & Mental Health, 22(11), 1448–1455. https://doi.org/10.1080/13607863.2017.1364345

18.

Guo

Stensland

(2018). A systematic review of correlates of depression among older Chinese and Korean immigrants: What we know and do not know. Aging & Mental Health, 22(12), 1535–1547. https://doi.org/10.1080/13607863.2017.1383971

19.

Haczkewicz

K. M.

Shahid

Finnegan

H. A.

Moninn

Cameron

C. D.

Gallant

N. L.

(2024). Adverse childhood experiences (ACEs), resilience, and outcomes in older adulthood: A scoping review. Child Abuse & Neglect, 168(Pt 1), Article 106864. https://doi.org/10.1016/j.chiabu.2024.106864

20.

Han

S. A.

Kwak

J. H.

Pae

C. U.

Steffens

Park

M. H.

(2008). Validation of the patient health Questionnaire-9 Korean version in the elderly population: The Ansan Geriatric study. Comprehensive Psychiatry, 49(2), 218–223. https://doi.org/10.1016/j.comppsych.2007.08.006

21.

Hong

Casado

B. L.

Harrington

(2011). Validation of Korean versions of the Lubben social network scales in Korean Americans. Clinical Gerontologist, 34(4), 319–334. https://doi.org/10.1080/07317115.2011.572534

22.

Jang

Tang

(2022). Loneliness, age at immigration, family relationships, and depression among older immigrants: A moderated relationship. Journal of Social and Personal Relationships, 39(6), 1602–1622. https://doi.org/10.1177/02654075211061279

23.

Jang

Choi

E. Y.

Rhee

M. K.

Park

N. S.

Chiriboga

D. A.

Kim

M. T.

(2020). Determinants of self-rated cognitive health among older Korean Americans. The Gerontologist, 60(2), 250–258. https://doi.org/10.1093/geront/gnz134

24.

Jang

Park

N. S.

Park

Chiriboga

D. A.

Haley

W. E.

Kim

M. T.

(2023). The mental health benefit of friend networks in older Korean Americans: The conditioning effect of family type. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 78(1), 143–153. https://doi.org/10.1093/geronb/gbac109

25.

Kang

N. R.

Kwack

Y. S.

Song

J. K.

Kim

M. D.

Park

J. H.

Kim

B. N.

Moon

D. S.

(2021). The impact of maternal adverse childhood experiences on offspring’s internalizing and externalizing problems. Psychiatry Investigation, 18(11), 1050–1057. https://doi.org/10.30773/pi.2021.0343

26.

Kim

Chartier

K. G.

Wike

T. L.

McDonald

S. E.

(2021b). Adverse childhood experience patterns, major depressive disorder, and substance use disorder in older adults. Aging & Mental Health, 25(3), 484–491. https://doi.org/10.1080/13607863.2019.1693974

27.

Kim

M. T.

Lee

J. Y.

Yoon

Kim

K. B.

Jang

(2015). Sources of response bias in older ethnic minorities: A case of Korean American elderly. Journal of Cross-Cultural Gerontology, 30(3), 269–283. https://doi.org/10.1007/s10823-015-9266-9

28.

Kim

S. C.

Manchester

Lewis

(2019). Post-war immigration experiences of survivors of the Korean War. Journal of Aggression, Maltreatment & Trauma, 28(8), 977–995. https://doi.org/10.1080/10926771.2017.1392388

29.

Kim

Lee

Park

(2022). Patterns of adverse childhood experiences and depressive symptoms: Self-esteem as a mediating mechanism. Social Psychiatry and Psychiatric Epidemiology, 57(2), 1–11. https://doi.org/10.1007/s00127-021-02129-2

30.

Kim

Ryou

Choi

Kim

J. W.

(2021a). Profile analysis of sexual assault experiences among adult women and their implications for mental health. Psychiatry Investigation, 18(4), 312–323. https://doi.org/10.30773/pi.2020.0141

31.

Kroenke

Spitzer

R. L.

Williams

J. B.

(2001). The PHQ‐9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

32.

Lee

S. H.

Lee

(2022). Effectiveness of social support for community-dwelling elderly with depression: A systematic review and meta-analysis. Healthcare, 10(9), 1598. https://doi.org/10.3390/healthcare10091598

33.

Liu

Qiu

Tang

Huang

Gao

Wang

Zhang

(2024). Association of adverse childhood experiences with poor health condition among middle-aged and elderly adults in the United States: A nationally retrospective cohort study. Psychiatry Research, 338, Article 115977. https://doi.org/10.1016/j.psychres.2024.115977

34.

Lubben

Blozik

Gillmann

Iliffe

von Renteln Kruse

Beck

J. C.

Stuck

A. E.

(2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist, 46(4), 503–513. https://doi.org/10.1093/geront/46.4.503

35.

Luo

M. S.

Chui

E. W. T.

L. W.

(2020). The longitudinal associations between physical health and mental health among older adults. Aging & Mental Health, 24(12), 1990–1998. https://doi.org/10.1080/13607863.2019.1655706

36.

Park

N. S.

Jang

Chiriboga

D. A.

Chung

(2020). The role of social networks on depressive symptoms: A comparison of older Koreans in three geographic areas. International Journal of Aging & Human Development, 92(3), 364–382. https://doi.org/10.1177/0091415020905553

37.

Park

N. S.

Jang

Yoon

J. W.

Chung

Chiriboga

D. A.

(2022). Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion. Health & Social Care in the Community, 30(6), e4909–e4919. https://doi.org/10.1111/hsc.13903

38.

Park

Lee

Chung

Jang

(2026). The impact of adverse childhood experiences on depressive symptoms in later life: Mediating role of self-perceptions of aging in low-income older Korean immigrants. Journal of Gerontological Social Work, 69(1), 79–90. https://doi.org/10.1080/01634372.2025.2510577

39.

Pearlin

L. I.

Schooler

(1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2–21. https://doi.org/10.2307/2136319

40.

Petruccelli

Davis

Berman

(2019). Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis. Child Abuse & Neglect, 97, Article 104127. https://doi.org/10.1016/j.chiabu.2019.104127

41.

Pudrovska

Schieman

Pearlin

L. I.

Nguyen

(2005). The sense of mastery as a mediator and moderator in the association between economic hardship and health in late life. Journal of Aging and Health, 17(5), 634–660. https://doi.org/10.1177/0898264305279874

42.

Reiner

Steinhoff

(2024). The association of social networks and depression in community-dwelling older adults: A systematic review. Systematic Reviews, 13(1), 161. https://doi.org/10.1186/s13643-024-02581-6

43.

Robison

Schensul

J. J.

Coman

Diefenbach

G. J.

Radda

K. E.

Gaztambide

Disch

W. B.

(2009). Mental health in senior housing: Racial/ethnic patterns and correlates of major depressive disorder. Aging & Mental Health, 13(5), 659–673. https://doi.org/10.1080/13607860802607298

44.

Schuster

T. L.

Kessler

R. C.

Aseltine

R. H.

(1990). Supportive interactions, negative interactions, and depressed mood. American Journal of Community Psychology, 18(3), 423–438. https://doi.org/10.1007/BF00938116

45.

Shin

Park

S. Y.

Cho

Chiu

Y. L.

Bang

Bernstein

K. S.

(2010). Validation of patient health questionnaire-9 Korean version (PHQ-9K) scale for screening depression among Korean Americans in community settings. Journal of Theory Construction & Testing, 14(2), 45.

46.

Stahl

S. T.

Rodakowski

Saghafi

E. M.

Park

Reynolds

C. F.

Dew

M. A.

(2016). Systematic review of dyadic and family‐oriented interventions for late‐life depression. International Journal of Geriatric Psychiatry, 31(9), 963–973. https://doi.org/10.1002/gps.4434

47.

Swedo

E. A.

Aslam

M. V.

Dahlberg

L. L.

Niolon

P. H.

Guinn

A. S.

Simon

T. R.

Mercy

J. A.

(2023). Prevalence of adverse childhood experiences among US adults: Behavioral risk factor surveillance system, 2011–2020. MMWR. Morbidity and Mortality Weekly Report, 72. https://doi.org/10.15585/mmwr.mm7226a2

48.

Von Cheong

Sinnott

Dahly

Kearney

P. M.

(2017). Adverse childhood experiences (ACEs) and later-life depression: Perceived social support as a potential protective factor. BMJ Open, 7(9), Article e013228. https://doi.org/10.1136/bmjopen-2016-013228

49.

Wilson-Genderson

Heid

A. R.

Cartwright

Pruchno

(2022). Adverse childhood experiences, adult trauma, and depressive symptom trajectories. Aging & Mental Health, 26(11), 2170–2178. https://doi.org/10.1080/13607863.2021.1978926

50.

Zhang

Hong

Takeuchi

D. T.

Mossakowski

K. N.

(2012). Limited English proficiency and psychological distress among Latinos and Asian Americans. Social Science & Medicine, 75(6), 1006–1014. https://doi.org/10.1016/j.socscimed2012.05.012