Life Stressors as Mediators of the Relation Between Socioeconomic Position and Mental Health Problems in Early Adolescence: The TRAILS Study |
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| Authors: | Kennedy Amone-P'Olak Johan Ormel Martijn Huisman Frank C Verhulst Albertine J Oldehinkel Huibert Burger |
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| Institution: | 1. Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark;2. Research Center for Prevention and Health, Glostrup Hospital, University of Copenhagen, Denmark;3. Department of Health Science and Technology, University of Aalborg, Denmark;4. Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark;1. School of Geography and Planning, Sun Yat-Sen University, Guangzhou 510275, China;2. Guangdong Key Laboratory for Urbanization and Geo-Simulation, Sun Yat-Sen University, Guangzhou 510275, China;3. Institute of Geography, School of GeoSciences, University of Edinburgh, Edinburgh, UK;4. Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;5. School of Geography and Information Engineering, China University of Geosciences, Wuhan 430074, China;6. Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA;7. College of Economics, Ji Nan University, Guangzhou, China;8. Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong SAR, China;9. City University of Hong Kong Shenzhen Research Institute, Shenzhen, China;1. University of Groningen, University Medical Center Groningen, Department of Psychiatry, P.O. Box 30.001, 9700 RB Groningen, The Netherlands;2. University of Groningen, University Medical Center Groningen, Department of Epidemiology, P.O. Box 30.001, 9700 RB Groningen, The Netherlands;1. Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA;2. Harvard Medical School and the Center on the Developing Child at Harvard University, Cambridge, MA;3. Harvard T.H. Chan School of Public Health, Boston, MA;4. Erasmus University Medical Center, Rotterdam, The Netherlands;5. Harvard T.H. Chan School of Public Health, Boston, MA;6. King''s College London, UK;7. Mailman School of Public Health, Columbia University, New York, NY, and the New York State Psychiatric Institute, New York, NY;1. Department of Sociology, University Essex, Wivenhoe Park, Colchester CO4 3SQ, UK;2. Institutet för Framtidsstudier, Holländargatan 13, Stockholm, Sweden;3. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden |
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| Abstract: | ObjectiveLife stressors and family socioeconomic position have often been associated with mental health status. The aim of the present study is to contribute to the understanding of the pathways from low socioeconomic position and life stressors to mental problems.MethodIn a cross-sectional analysis using data from a longitudinal study of early adolescents (N = 2,149, 51% girls; mean age 13.6 years, SD 0.53, range 12–15), we assessed the extent of mediation of the association between family socioeconomic position and mental health problems by different types of life stressors in multiple regression models. Stressors were rated as environment related or person related. Information on socioeconomic position was obtained directly from parents, and internalizing and externalizing problem behaviors were assessed by reports from multiple informants (parents, self, and teachers).ResultsLow socioeconomic position was associated with more mental health problems and more life stressors. Both environment-related and person-related stressors predicted mental health problems independently of socioeconomic position. The associations between socioeconomic position and all mental health outcomes were partly mediated by environment-related life stressors. Mediation by environment-related and person-related stressors as assessed by linear regression amounted to 56% (95% confidence interval CI] 35%–78%) and 7% (95% CI ?25% to 38%) for internalizing problems and 13% (95% CI 7%–19%) and 5% (95% CI ?2% to 13%) for externalizing problems, respectively.ConclusionsEnvironment-related, but not person-related, stressors partly mediated the association between socio economic position and adolescent mental problems. The extent of mediation was larger for internalizing than for externalizing problems. Because the effect sizes of the associations were relatively small, targeted interventions to prevent impaired mental health may have only modest benefits to adolescents from low socioeconomic background. |
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