Well-being and health behaviour by parental socioeconomic status

Background: The aim of the study was to investigate the impact of parental socioeconomic status (SES) on subjects' well-being and health behaviour in adolescence, early adulthood and adulthood, and whether these impacts remained after controlling for the person's own SES. Methods: All 16-year-old ninth-grade school pupils of one Finnish city completed questionnaires at school. Subjects were followed up using postal questionnaires when aged 22 and 32 years. Results: Females of manual class origin had lower self-esteem and more distress symptoms from adolescence to adulthood than those from a non-manual background. Lower self-esteem was found among males from manual class families in adolescence and early adulthood. In both genders, no significant class differences were found in depression, health status or prevalence of chronic illness. Unhealthier behaviours regarding smoking and physical activity were more prevalent among both genders of manual class origin, and females of this group had higher rates of overweight and higher body mass index scores. After controlling for the person's own SES, the effect of parental SES diminished but remained significant for smoking in both genders and for physical activity in males up to 22 years, and for self-esteem and BMI in females up to 32. Conclusions: This follow-up study contributes to the health inequality debate investigating parental SES differences in health behaviour and somatic health, and particularly in psychological health, which is relatively rarely investigated. The results indicate that parental SES has effects on early adult and adult well-being and health behaviour other than those mediated by current SES. Accepted: 11 November 2002 Correspondence to Taina Huurre, Lic.Ed., Ph.D.     

Parental divorce, adolescence, and transition to young adulthood: a follow-up study.

In a long-term study of the effects of divorce, children in a Finnish town who had completed questionnaires in school at age 16 were followed up with postal questionnaires at age 22. Depression in young adulthood was found to be slightly more common among children from divorced families. In addition, the life trajectories of children in divorced families revealed more stressful paths and more distress in both adolescence and young adulthood.     

Developmental trajectories of the socioeconomic status of occupational aspirations during adolescence

IntroductionProminent theories of career development suggest age-related changes in adolescents' occupational aspirations. However, little is known about how exactly and to what extent, adolescents' aspirations change, particularly regarding the socioeconomic status (SES) of aspired occupations. We aim at extending our knowledge of the developmental trajectories of the SES of occupational aspirations and potential gender differences in those trajectories.MethodsWe used longitudinal data from the German National Educational Panel Study (NEPS) consisting of a large and representative sample of secondary school students (N = 5,964, 50% females) from Grades 8 to 10 (age 14–16). Data were collected via a paper and pencil survey which was carried out in classrooms.ResultsOur analysis of a latent growth curve model revealed that adolescents experienced small increases in the SES of occupational aspirations from Grades 8 to 10. Multi-group models reveal that females initially aspired to higher-SES occupations and their aspirations exhibited larger growth over time compared to males.ConclusionsOur findings are in line with those from other countries but not with all, indicating some cross-cultural variabilities. Within cultures, the developmental trajectories of the SES of occupational aspirations seem to be similar across age-cohorts in the last 30 years. Despite women aspire to higher-SES occupations during adolescence, they often obtain lower-SES occupations than men in adulthood. Future research is needed to better understand the link between gender differences in the SES of occupational aspirations in adolescence and gender differences in the SES of occupational attainment in adulthood.     

Child Psychiatric Symptoms in Consecutive Suicides Among Young People

Fifty-eight consecutive suicides, 42 men and 16 women, 15–29 years, were investigated by systematic, retrospective interviews with next-of-kin. Thirty-one subjects (53%), who committed suicide later in adolescence or young adulthood had anamnestic data of psychiatric symptoms before the age of 10 years and 14 (24%) had been in contact with child and adolescent psychiatric outpatient or inpatient care before the age of 18 years. This was equally common in males and females. Aggressive symptoms predominated. Eight of 42 (19%) males but no females were found to have indications of neuropsychiatric dysfunction such as childhood hyperactivity with aggressive rages. In early compulsory school years, there were signs of disciplinary problems and bad intellectual and social functioning. Child psychiatric symptoms may be interpreted as a risk factor for the process leading to suicide in adolescents and young adults.     

Psychological functioning and health-related quality of life in adulthood after preterm birth

The aim of this study was to determine if preterm birth is associated with socioeconomic status (SES), psychological functioning, and health-related quality of life (HRQoL) in adulthood. We used prospective follow-up of 192 adult offspring of mothers who took part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (66 born at term [33 males, 33 females] 126 born preterm [66 males, 60 females]). Cognitive functioning was assessed using the Wechsler Abbreviated Scale of Intelligence. Working memory and attention was assessed using the Benton Visual Retention Test, the Paced Auditory Serial Addition Test, and the Brown Attention Deficit Disorder Scale. Psychiatric morbidity was assessed using the Beck Depression Inventory II, the State-Trait Anxiety Inventory, and the Schizotypy Traits Questionnaire. Handedness was assessed using the Edinburgh Handedness Inventory. HRQoL was assessed using the Short Form-36 Health Survey. Moderately preterm birth (median gestation 34wks, mean birthweight 1946g [SD 463g]) was not related to later marital status, educational attainment, SES, cognitive functioning, working memory, attention, or symptoms of anxiety or schizotypy at 31 years of age. Preterm birth was associated with fewer symptoms of depression and higher levels of satisfaction in three of the eight HRQoL domains measured (bodily pain, general health perception, and social functioning). Adults who were born moderately preterm have SES, psychological functioning, and HRQoL consistent with those who were born at term. This good long-term outcome cannot be extrapolated to those with early childhood disability or very low birthweights.     

Research on psychosomatic complaints by senior high school students in Tokyo and their related factors

The purpose of this study was to clarify the relationships between psychosomatic complaints of senior high school students in Tokyo and the cognition they receive from their fathers, mothers, friends, teachers, and schoolwork and between their complaints and lifestyle habits. The subjects were 168 first-grade students (58 males and 110 females) at a Tokyo Metropolitan senior high school. In June 1996, a collective survey was carried out, using questionnaires. Moreover, I conducted a longitudinal study to investigate the variation of their complaints over the 3 years at the school. The females had more psychosomatic complaints than the males. There was the relationship between their psychosomatic complaints and the cognition they receive from their fathers, mothers and teachers, the relationship between their psychosomatic complaints and their schoolwork, the relationship between their psychosomatic complaints and their ingestion conditions at meals, or sleeping hours. As for the their complaints, they had more complaints at admission than at the completion of their first grade and at graduation.     

Fatigue, depressive symptoms, and anxiety from adolescence up to young adulthood: a longitudinal study

Fatigue is a common complaint among adolescents. We investigated the course of fatigue in females during the transition from adolescence to young adulthood and examined psychological, immunological, and life style risk factors for development of fatigue and chronic fatigue syndrome (CFS)-related symptoms. Six hundred and thirty-three healthy females (age 14.63 ± 1.37 years) filled out questionnaires measuring fatigue severity, depressive symptoms, anxiety, chronic fatigue syndrome (CFS)-related symptoms, sleep features, and life style characteristics at baseline and 4½ years thereafter. Of 64 participants LPS- and CD2CD28-induced cytokine data at baseline were available. The best predictor of fatigue in young adulthood was previous fatigue severity. In participants who were non-fatigued during adolescence and who experienced a notable increase in fatigue, fatigue development was preceded by emotional problems and CFS-related complaints during adolescence. Increases as well as decreases in fatigue severity were accompanied by respectively increase and decrease in depressive symptoms and anxiety, suggesting that these symptoms cluster and co-vary over time. Higher interferon (IFN)-γ, higher IFN-γ/interleukin (IL)-4 ratio, lower tumor necrosis factor-α and lower IL-10 at baseline were related to fatigue severity at follow up. The rise in total number of CFS-related symptoms at follow up was predicted by anxiety and decreased physical activity during adolescence. Sleep and substance use were associated with fatigue severity and anxiety and depression. In conclusion, vulnerability to develop fatigue and associated symptoms in young adulthood can to a certain extent be identified already years before the manifestation of complaints.     

Psychosomatic symptoms among 14–16 year old Finnish adolescents

Summary The occurrence of psychosomatic symptoms and their associations with school performance and some sociodemographic characteristics (family structure, number of siblings, birth order, the parents' socioeconomic status) was studied among all eighth-grade pupils (n=2246) in secondary schools in a Finnish town. The same pupils were re-examined twice: after 5 months and after 17 months. The mean age of the pupils at the beginning of the study was 14.5 years. Girls experienced more psychosomatic symptoms than boys throughout the study, but there was an increase in symptoms among both sexes during the follow-up. Transient symptoms were common, but about one tenth of adolescents reported frequent symptoms throughout the follow-up. Higher levels of psychosomatic symptoms were observed in pupils with non-intact family structure and in those with poor school performance. There was a systematic though small increase in symptoms as the number of siblings increased. Children from working class families reported slightly greater scores than children from higher social classes.     

Short-term and long-term influences of family arguments and gender difference on developing psychological well-being in Taiwanese adolescents

Adolescent mental health is crucial for social competence and accomplishment in later life. The World Health Organization (WHO) estimates that approximately 20% of adolescents suffer from psychological symptoms. However, improving family risk and school environments can largely promote adolescent mental health. A longitudinal survey was conducted to investigate adolescent psychological well-being (PWB) status and associated factors in adolescents 15–20 years of age. Family and school context variables were interviewed and recorded. A total of 2896 participants were included from high, middle, and less urbanized resident areas in Northern Taiwan with completed interview data. Using multivariate regression analysis, factors associated with adolescent PWB at various stages included quarrelsome parents, quarrels with parents, severed friendships, and cigarette and alcohol use. In all three adolescent stages, females yielded higher psychological symptom scores than did males, and diverse weights of risk factors on PWB were observed between genders. Family arguments and cigarette and alcohol use were found to have more pronounced effects on outcomes among females than males. Whereas males are more sensitive to severed friendships than females, cigarette and alcohol use showed more harmful effects on mental health in earlier adolescence than in later life. Moreover, family arguments and severed friendships in earlier adolescence were found to have lasting effects on PWB in later adolescence. In this study, gender differences were observed in the temporal relationship on adolescent mental health. Variables of family arguments and severed friendships exhibited short-term and long-term effects on adolescent mental health across the early to late developmental stages. The family argument environment and regulating cigarette and alcohol use are worthy of focus to promote adolescent mental health.     

Childhood socioeconomic status and inflammation: A systematic review and meta-analysis

Recent research suggests that risk for chronic diseases of aging including cardiovascular disease, diabetes, and even cancer can be programmed early in the lifespan as a result of exposure to chronic stressors like low socioeconomic status (SES) that are hypothesized to promote a pro-inflammatory response in immune cells that results in chronic, systemic inflammation. The present paper conducted a meta-analysis to establish whether exposure to low (versus higher) SES in childhood and adolescence is associated with higher levels of inflammation (as measured by C-reactive protein, IL-6, and fibrinogen) concurrently and in adulthood. We conducted meta-analyses with both unadjusted bivariate associations between SES and inflammation and with adjusted associations that controlled for a range of covariates including demographic factors, body mass index, smoking, physical activity and current SES. A systematic review of Pubmed and PsycINFO identified a total 35 studies (26 with unadjusted and 31 adjusted effect sizes) to be included in the meta-analysis. Random-effects meta-analysis showed that individuals who were exposed to low SES in childhood and adolescence had significantly higher levels of inflammatory markers (r = −0.07, p < .001, 95% CI = −0.09, −0.05). This association remained significant in adjusted analyses (r = −0.06, p < .001, 95% CI = −0.09, −0.03). However, the relationship between childhood SES and inflammation was non-significant in a meta-analysis with longitudinal studies that all controlled for adulthood SES (r = −0.03, p = .356, 95% CI = −0.08, 0.03). Future longitudinal research should utilize measurement of inflammatory markers at multiple time points to further examine the complex relationships between SES and health both in childhood and adulthood.     

Predictors of mental distress in early adulthood: a five-year follow-up of 709 high-school students

Mental health risk factors in adolescence were examined as predictors of mental distress in early adulthood. A cohort of 709 Finnish adolescents was studied in 1990 (mean age 16.8) and in 1995. Trait anxiety, defence styles, life events, self-esteem and somatic symptoms were evaluated as predictors of high scores in the General Health Questionnaire in adulthood. Females (36%) were more likely to be distressed than males (23%). High trait anxiety and somatic symptom scores among adolescent females, and high immature defence style scores among males predicted mental distress. Males with low trait anxiety in adolescence had less distress. The results indicate trait anxiety as an important predictor of mental distress. Gender differences in other predictors suggest gender differences in coping.     

Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood

BACKGROUND: Data from a community-based longitudinal investigation were used to investigate whether adolescents with eating disorders are at an elevated risk for physical and mental disorders during early adulthood. METHODS: Psychosocial and psychiatric interviews were administered to a representative community sample of 717 adolescents and their mothers from 2 counties in the state of New York in 1983, 1985 to 1986, and 1991 to 1993. In 1983, the mean age of the youths was 13.8 years. RESULTS: Adolescents with eating disorders were at a substantially elevated risk for anxiety disorders, cardiovascular symptoms, chronic fatigue, chronic pain, depressive disorders, limitations in activities due to poor health, infectious diseases, insomnia, neurological symptoms, and suicide attempts during early adulthood after age, sex, socioeconomic status, co-occurring psychiatric disorders, adolescent health problems, body mass index, and worries about health during adulthood were controlled statistically. Problems with eating or weight during adolescence predicted poor health outcomes during adulthood, regardless of whether an eating disorder had been present. Only 22% of the adolescents with current eating disorders had received psychiatric treatment within the past year. CONCLUSION: Eating disorders during adolescence may be associated with an elevated risk for a broad range of physical and mental health problems during early adulthood.     

Personality strengths in adolescence and decreased risk of developing mental health problems in early adulthood

The aim of this study was to investigate whether personality strengths during adolescence are associated with decreased risk of developing psychiatric disorders, educational or occupational problems, violent or criminal behaviors, and interpersonal difficulties during early adulthood. A representative community sample of 688 mothers from upstate New York and their offspring was interviewed in the period of 1985-1986 (mean offspring age = 16 years) and in that of 1991-1993 (mean offspring age = 22 years). Results showed that youths with numerous personality strengths at the mean age of 16 years were at a decreased risk of developing psychiatric disorders, educational and occupational problems, interpersonal difficulties, and criminal behaviors at the mean age of 22 years. These associations remained significant after controlling for age, sex, socioeconomic status, verbal intelligence, preexisting psychiatric disorders, and corresponding problems at the mean age of 16 years. Although youths with fewer personality strengths who experienced numerous stressful events were at elevated risk of developing psychiatric disorders during early adulthood, those with a higher number of personality strengths at the mean age of 16 years did not share this vulnerability. We conclude that personality strengths during adolescence may contribute to a decreased risk of developing a wide range of adverse outcomes during early adulthood. Systematic evaluation of character strengths may improve the clinical assessment of adolescents.     

Can differences in stress perception and coping explain sex differences in depressive symptoms in adolescents?

A four-year longitudinal study explored the different contribution of low self-esteem, different types of stressors, conflict in close relationships and avoidant coping to the explanation of depressive symptomatology in adolescents. One hundred and ninety adolescents, 101 females and 89 males, participated in four annual assessments using diverse instruments. ANOVAs repeated measurements revealed a higher stress level, more conflicts with mothers and more avoidant coping in females as compared to males at the age of 14 years. Males showed fewer depressive symptoms and higher positive self-esteem at all times. Multiple regression analysis revealed that stress and avoidant coping in early and mid-adolescence explained a significant proportion of depressive symptoms among females in late adolescence. Among males, only the level of conflicts with friends in early adolescence contributed to their level of depressive outcome in late adolescence.     

Depressive symptoms in adolescence as predictors of early adulthood depressive disorders and maladjustment

OBJECTIVE: The authors examined the association between self-reported depressive symptoms in adolescence and mental well-being in early adulthood. METHOD: A questionnaire assessing psychosocial well-being was given to a group of subjects (N=651) in their last 3 years of high school (mean age=16.8 years) and again when these subjects reached early adulthood (mean age=21.8 years). Diagnostic interview data were obtained from a subgroup of the young adults (N=245). Adolescents' depressive symptoms were analyzed in relation to their early adulthood mental health outcome data. RESULTS: Depressive symptoms in adolescence predicted early adulthood depressive disorders (major depression and dysthymia), comorbidity, psychosocial impairment, and problem drinking. CONCLUSIONS: Depressive symptoms in adolescence deserve attention as a potential risk for early adulthood mental disorders.     

Prognosis of adolescent partial syndromes of eating disorder

BACKGROUND: Partial syndromes of eating disorder are common in adolescents but the health significance of these syndromes remains uncertain. AIMS: To document the health and social adjustment in young adulthood of females assessed as having a partial syndrome of eating disorder in adolescence. METHOD: A community sample of 1943 participants was tracked over 10 years in an eight-wave cohort study. A partial syndrome was defined as the fulfilment of at least two DSM-IV criteria for either anorexia or bulimia nervosa at one assessment or more between the ages of 15 years and 17 years. RESULTS: Partial syndromes were found in 9.4% of 15- to 17-year-old female participants and 1.4% of males. There were few instances of progression of partial syndromes to fully fledged anorexia and bulimia nervosa. However, among those with partial syndromes depressive and anxiety symptoms were two to three times higher in young adulthood, substance misuse was common, and a majority of those with a partial syndrome of anorexia nervosa were still underweight in their mid-20s. CONCLUSIONS: Given the level of subsequent psychopathology and social role impairment, there may be justification for initiating trials of preventive and early clinical intervention strategies for adolescent partial syndromes.     

Beyond treatment effects: comorbid psychopathologies and long-term outcomes among substance-abusing delinquents

Secondary analyses of a randomized clinical trial controlled for treatment condition effects and examined the impact of comorbid psychopathologies on the mental health, physical health, and criminal behavior of 80 substance abusing delinquents approximately 5 years later in emerging adulthood. Overall, emerging adults with a comorbid disorder during adolescence scored higher on psychopathology, criminal behavior, and health problems. Participants with both internalizing and externalizing disorders exhibited more negative outcomes than those with a comorbid externalizing disorder. For the entire sample, more internalizing diagnoses forecasted higher internalizing and aggression scores, more criminality, and poorer physical health. More externalizing disorders predicted higher internalizing, delinquency, and criminality scores, but was unrelated to physical health. More internalizing diagnoses for females but not males predicted greater criminality, and especially more aggressive crimes in emerging adulthood.     

The prospective association of socioeconomic status with C-reactive protein levels in the CARDIA study

Better health is a well-documented benefit of having a higher socioeconomic status (SES). Inflammation may be one pathway through which SES influences health. Using 2658 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, we examine whether two measures of SES assessed at baseline (mean age, 32±4years)-years of education and household income-predict change in C-reactive protein (CRP) concentrations over the course of 13years. We also examine whether four health-related behaviors-smoking, fruit and vegetable consumption, physical activity, and alcohol consumption-mediate the prospective association of SES with CRP. Both higher education and household income predicted smaller increases in CRP over the 13years of follow-up independent of age, sex, race, CARDIA center, body mass, medical diagnoses, medications, and hormone use (among women). Associations did not differ by race or sex. When examined in separate analyses, smoking and fruit and vegetable intake each accounted for a significant proportion of the respective effects of education and household income on CRP change, and physical activity a significant proportion of the effect of household income. These findings suggest that poor health behaviors among persons of lower socioeconomic status can have long-term effects on inflammation.     

Long–term Psychosocial effects of parental divorce

OBJECTIVE: The purpose of this 16-year follow-up study was to investigate whether 32-year-old adults who had experienced parental divorce before 16 years of age (n = 317) differed in psychosocial well-being or life trajectories from those from non-divorced two-parent families (n = 1069).METHOD: The data were obtained from a follow-up survey of a Finnish urban age cohort from the age of 16 till 32 years (n = 1471). The long-term impact of parental divorce on a variety of outcomes in adulthood, including psychological well-being, life situation, health behaviour, social networks and support, negative life events and interpersonal problems, was assessed.RESULTS: Females from divorced compared to non-divorced families reported more psychological problems (higher scores in the Beck Depression Inventory, General Health Questionnaire and Psychosomatic Symptoms Score) and more problems in their interpersonal relationships. These differences were not found among males. Shorter education,unemployment, divorce, negative life events and more risky health behaviour were more common among subjects of both genders with a background of parental divorce.CONCLUSIONS: The study revealed that parental divorce is an indicator of sufficient stress in childhood for its influences to persist well into adulthood, possibly with wider scope among females. It is important to recognise specific needs of children in the divorce process in order to prevent or minimize negative consequences and chain reactions during their subsequent life.     

Naming skills of children born preterm in comparison with their term peers at the ages of 9 and 16 years

The linguistic abilities of children born preterm at 32 weeks' gestation or earlier at Kuopio University Hospital during 1984 to 1986 were evaluated during successive phases of a prospective study. The study protocol included the Rapid Automatic Naming test and Wechsler Intelligence Scale for Children - Revised at 9 years of age and a modified Stroop Color-Word test and the Wechsler Intelligence Scale - Revised at the age of 16 years. Fifty-one children born preterm (26 males, 25 females) and 51 age-matched and sex-matched term controls (26 males, 25 females) were studied at the age of 9 years. At the age of 16 years, 40 children born preterm (19 males, 21 females) and 31 term controls (14 males, 17 females) participated in the study. The children born preterm scored significantly lower in two naming tasks than the controls at the age of 9 years. However, there was no difference between the study groups in naming skills at the age of 16 years or in verbal IQ in either study phase. Maternal education level was not associated with naming skills. Thus, the consequences of preterm birth seem to be minor in relation to linguistic skills during school age and diminish by adolescence.