Abstract
Mental health problems are common during the transition from adolescence to young adulthood. Although perceived social support and mental health problems have been shown to be concurrently associated, longitudinal studies are lacking to document the directionality of this association, especially in emerging adulthood (late teens to late 20s). To test whether social support in emerging adulthood protects against later depression, anxiety, and suicidal ideation and suicide attempts after adjusting for a range of confounders, including prior mental health problems and family characteristics. This population-based cohort study included 1174 participants from the Quebec Longitudinal Study of Child Development. Participants underwent yearly or biennial assessment (starting from age 5 months to age 20 years). Data were collected from March 16, 1998, through June 1, 2018. Self-reported perceived social support was measured at age 19 years using the 10-item Social Provision Scale. Mental health problems, including depressive and anxiety symptoms as well as suicidal ideation and attempts, were measured at age 20 years. Social support and mental health problem raw scores were converted to z-scores to ease interpretation. Depressive and anxiety symptoms were categorized using validated cutoffs to determine clinical significance. The study consisted of 1174 participants (574 female [48.89%] and 600 male [51.11%] individuals). Emerging adults with higher levels of perceived social support at age 19 years reported fewer mental health problems 1 year later, even after adjusting for a range of mental health problems in adolescence at ages 15 and 17 years (eg, depressive and anxiety symptoms and suicidal ideation and attempts) and family characteristics (eg, socioeconomic status and family functioning and structure). Higher perceived social support was associated with fewer symptoms of depression (β = -0.23; 95% CI, -0.26 to -0.18; P = <.001 and odds ratio [OR], 0.53; 95% CI, 0.42-0.66 for severe depression) and anxiety (β = -0.10; 95% CI, -0.15 to -0.04; P < .001 and OR, 0.78; 95% CI, 0.62-0.98 for severe anxiety). Higher perceived social support was associated with a lower risk for suicide-related outcomes (OR, 0.59 [95% CI, 0.50-0.70] for suicidal ideation and OR, 0.60 [95% CI, 0.46-0.79] for suicide attempts). In this cohort study, emerging adults who perceived higher levels of social support reported experiencing fewer mental health problems 1 year later. These findings suggest that perceived social support may protect against mental health problems during the transition into adulthood, even in those who experience mental health problems in adolescence. Leveraging social support in prevention and treatment options may protect against mental health symptoms during this transition period.
Highlights
Perceived social support refers to the subjective availability of care and assistance received from social relationships and it is characterized by emotional support, instrumental support and informational support that can be provided from various sources, such as friends or family.[1]
Higher perceived social support was associated with fewer symptoms of depression (β = −0.23; 95% CI, −0.26 to −0.18; P =
Higher perceived social support was associated with a lower risk for suicide-related outcomes (OR, 0.59 [95% CI, 0.50-0.70] for suicidal ideation and OR, 0.60 [95% CI, 0.46-0.79] for suicide attempts)
Summary
Participants The Quebec Longitudinal Study of Child Development (QLSCD) is an ongoing population-based cohort that includes 2120 participants born from 1997 through 1998 in Quebec. Similar to previous studies that used this cohort, we selected comparison variables that have the potential to identify the most vulnerable participants and, in turn, those most likely to be lost at follow-up.[21,22] Participants who were underrepresented were more likely to be male, to be of non-Canadian ancestry, to have a younger mother at birth and/or with depressive symptoms, to come from a nonintact family, to have parents with a low socioeconomic status at age 5 months, and to have higher externalizing symptoms at age 29 months (eg, cannot sit still or is agitated) as measured by 10 items from the Behavior Questionnaire,[23] with scores ranging from 0 to 18 and high scores indicating higher levels of externalizing symptoms (eTable 1 in the Supplement). To minimize bias attributable to such differential attrition, we applied inverse probability weighting based on variables conditional to attrition in all analyses
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