Peer-reviewed article

Adverse childhood experiences, bullying victimization, and depressive symptoms among Chinese adolescents: the moderating role of perceived social support.

Qingyuan Liu, Yuan Li, Cong Wang, Yunyun Zhao, Wanqi Ren et al. · 26 May 2026

Abstract

BACKGROUND: Adverse childhood experiences (ACEs) and bullying victimization are prevalent psychosocial stressors associated with adolescent depressive symptoms. However, less is understood about their co-occurrence, whether distinct exposure profiles confer differential risk, and the role of perceived social support in moderating the impact of ACEs and bullying on depression. This study addresses these gaps within a large cohort of Chinese adolescents. METHODS: A cross-sectional survey was conducted with 5,724 middle school students (mean age = 13.5 years) in Anhui Province, China. Participants completed self-report measures on ACEs, peer victimization, depressive symptoms, and perceived social support. Linear regression analyses explored the relationships between ACEs, bullying victimization, and depressive symptoms, as well as the moderating effect of perceived social support. Latent class analysis (LCA) identified patterns of co-occurring ACEs and victimization, with subsequent regression models examining associations with depressive symptoms and the moderating effect of social support. RESULTS: Among the participants, 65.5% reported experiencing at least one ACE, and 30.0% reported bullying victimization. Linear regression indicated that both ACEs and bullying victimization significantly elevated the risk of depressive symptoms, with emotional abuse and relational bullying showing the strongest associations. LCA revealed four distinct exposure profiles: a low-risk group with minimal exposure to ACEs and victimization; a family adversity group with high household adversity but low victimization; a victimization group with high peer victimization but relatively low ACE exposure; and a high-risk group with elevated probabilities of both ACEs and bullying victimization. Linear regression further showed that the combined ACEs and bullying victimization group had the highest depressive symptom scores, and LCA identified a high-risk subgroup with both ACEs and victimization, which also exhibited high depressive symptoms. Perceived social support significantly moderated the relationship between ACEs and depressive symptoms, but did not moderate the relationship between bullying victimization and depressive symptoms. CONCLUSIONS: Both ACEs and bullying victimization independently and cumulatively contribute to adolescent depressive symptoms. Perceived social support may serve as a protective factor against ACE-related depressive symptoms, though its role in buffering the effects of bullying victimization is less pronounced. Interventions should be tailored to specific risk profiles, addressing both familial and peer-related adversities to mitigate adolescent depression.