The different role of adversity before and after birth in adolescent depression

Early adversity is strongly linked to adolescent depression, but there is limited research on the impact of indirect exposure to adversity before birth and the distinct role of adversity before and after birth. A total of 1911 Chinese adolescents (48.8 % males; ages 11 to 19, Mean = 13.96) reported early adversities before and after birth, depression, negative self-cognition and perceived school climate. Structural equation model was used to test the association between early adversity before/after birth and adolescent depression, with negative self-cognition serving as a mediator and school climate as a moderator. Adversity before birth was related to adolescent depression through the full mediating role of negative self-cognition. Furthermore, it was more associated with negative self-cognition in schools with a more favorable climate. Adversity after birth was related to adolescent depression through the partial mediating role of negative self-cognition, and school climate played a nonsignificant moderating role in the mediating path. Early adversity was measured through adolescent reports, possibly generating recall bias. The cross-sectional design should be taken into consideration when drawing conclusions about causality. Adversities before and after birth are associated with adolescent depression in distinct ways. The more association between adversity before birth and negative self-cognition in a favorable school climate supports the “healthy context paradox.” Interventions that target depression should focus on promoting a positive school climate and helping adolescents who have experienced early adversity bolster positive self-cognition.