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Comment & Response
November 18, 2019

Fostering Resilience Among Youths Exposed to Adverse Childhood Experiences—Reply

Author Affiliations
  • 1National Clinician Scholars Program, University of California, Los Angeles
  • 2Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California
  • 3Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California
  • 4David Geffen School of Medicine, Department of Pediatrics, University of California, Los Angeles
  • 5Children’s Discovery and Innovation Institute, Mattel Children’s Hospital, University of California, Los Angeles
  • 6Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles
JAMA Pediatr. 2020;174(1):101-102. doi:10.1001/jamapediatrics.2019.4384

In Reply We thank Wong et al and Riehm and Feder for their comments on our study1 reporting the association of team sports participation in adolescence and long-term mental health outcomes among individuals exposed to adverse childhood experiences (ACEs). To address the comments by Wong et al requesting clarification of the timing of the main variables, we assessed team sports participation prior to the mental health outcomes. Team sports participation was determined in wave I (1994-1995), when respondents were in grades 7 to 12, and the 3 mental health outcomes were assessed in wave IV (2008), when respondents were aged 18 to 26 years. Current depressive symptoms pertained to the preceding 7 days and therefore occurred after adolescent team sports participation. Diagnosis of depression and anxiety were based on the question, “Has a doctor, nurse, or other health care provider ever told you that you have/had: depression/anxiety?” In a small number of cases, the diagnoses of depression or anxiety occurred prior to participation in team sports. In Table 1 of the article, we reported the number of individuals who received a diagnosis of depression (126 [2.4%]) and anxiety (43 [0.9%]) before wave I and the mean (SD) age at diagnosis of depression (20.5 [5.5] years) and anxiety (22.64 [4.9] years). In addition, eTable 1 in the Supplement presented the association between team sports and each mental health outcome after accounting for baseline mental health at wave I. As stated in the article, the association between participation in team sports and mental health remained significant for anxiety and was nearly significant for depression diagnosis and current depressive symptoms.

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