The impact of cerebral visual impairment (CVI) on mental well-being and physical health in adults: An exploratory study

Exercise improves health and well-being for nurses, but work schedules and stressors can hinder self-care, leading to physical and mental health issues and increased nursing shortages. This study aims to evaluate the effectiveness of a tailored exercise program for improving physical and mental wellbeing among staff nurses in Kuwait Hospital, Sharjah. OBJECTIVES: To evaluate the physical and mental well-being of staff nurses and assess the effectiveness of a tailored exercise program in enhancing their overall well-being. METHOD: A quasi-experimental one-group pre-test and post-test design with 124 staff nurses selected through non-probability convenient sampling. The nurses participated in a tailored exercise program involving warm-up, strengthening/aerobic, and cool-down exercises before each shift for 2 months, and data was collected using a structured interview schedule and a 40-item Well-Being Measuring tool. Results: The mean postinterventional level of physical and mental health wellbeing was significantly greater than that of the mean pre-interventional level of physical and mental health well-being. The paired ‘t’ test computed between pre-interventional and post-interventional levels of physical and mental health wellbeing was statistically significant at the 0.05 level. The calculated 't' value (7.2992) exceeds the table value. Hence, the null hypothesis (H0) is rejected. It indicates that a tailored exercise program is an effective measure in improving physical and mental health well-being among staff nurses. Conclusion: The tailored exercise program demonstrated measurable success in elevating participants' quality of life, emotional resilience, and physical health. The results showed a positive impact on physical and mental well-being. Therefore, it is crucial to focus on and implement such exercise programs among nurses, the largest workforce team in a hospital, targeting their well-being. Keywords: Physical well-being, Mental well-being, Tailored exercise, Work-related stressors

Mental health disorders including depression and anxiety are major contributors to global disease burden. Evidence indicates that nutrition may play a role in supporting mental health, with most investigations centred on one-carbon metabolism related B-vitamins (1). Recently it has been reported that polyphenol supplementation, particularly those high in anthocyanins (such as blueberries) may improve mood states, including depressive symptoms and anxiety (2). This pilot study aimed to investigate the influence of a combined multivitamin and blueberry extract multinutrient (Vitals+, Heights, UK) on B-vitamin biomarkers and mental wellbeing in healthy adults.14 healthy adults (8 males, mean age ±SD 38 ±10 yrs) were recruited. Exclusion criteria were: coeliac disease, mental health condition, pregnancy or breastfeeding or taking nutritional supplements in the past 3 months. Participants received an 8-month supplementation of Vitals+ once a day. The supplement contained, among other nutrients, thiamine (B1), riboflavin (B2) and vitamin B6 at a dose of 30mg each, 500μg of 5-Methyltetrahydrofolate (B9) and 25μg methylcobalamin (B12) alongside 80mg blueberry extract. B-vitamin biomarker status and mental state were assessed pre-post intervention.Functional biomarkers of vitamin B1, B2 and B6 were measured using the Erythrocyte Transketolase (ETKac), Erythrocyte Glutathione Reductase (EGRac) and Erythrocyte Glutamic Oxaloacetic Trans-aminase (EGOTac) activation coefficient assays, respectively. Folate was measured in red blood cells (RBCF) and holotranscobalamin in serum was utilised for B12 assessment. Mental wellbeing was assessed using three validated questionnaires: the Profile of Mood States (POMS), Perceived Stress Scale (PSS) and the General Health Questionnaire-12 (GHQ-12). Differences in outcome measure were assessed pre-post intervention using paired samples t-tests (p<0.05 was considered significant).At baseline 71% of participants had suboptimal/deficient thiamine status (ETKac ≤ 1.25) whereas 50% were riboflavin deficient (EGRac ≥1.40). Mean values ±SD for EGOTac, RBCF and holotranscobalamin were above the threshold for deficiencies, (1.37±0.12), (654±203 nmol/L) and (70±35 pmol/L) respectively, with no cases of deficiency for these nutrients. There was a significant improvement in thiamine (p=0.024), riboflavin (p<0.001), folate (p<0.001) and B12 (p=0.021) status post intervention but no change in vitamin B6 (p=0.167) biomarker status. For mental wellbeing outcomes, a trend towards significant improvement by 4-points was reported in the GHQ-12 (p=0.062), with a 30% reduction in participants fulfilling the criteria suggestive of psychological distress. There was no significant change in PSS (p=0.179) or total POMS (p=0.167). However, when subdomains of POMS were investigated, significant decreases in fatigue (p=0.028), confusion (p=0.017), self-esteem (p=0.022) and tension (p=0.047) were observed.At baseline B6, folate and B12 status was adequate however thiamine and riboflavin deficiencies were prevalent. Vitals+ normalised thiamine and riboflavin status and further improved biomarker status of other one-carbon metabolism related B-vitamins. The multinutrient may present an easily accessible intervention to improve B-vitamin status and mental health and wellbeing in adults.

BackgroundYoung adults and especially those with pre-existing mental health conditions, such as disordered eating and self-harm, appear to be at greater risk of developing metal health problems during the COVID-19 pandemic. However, it is unclear whether this increased risk is affected by any changes in lockdown restrictions, and whether any lifestyle changes could moderate this increased risk.MethodsIn a longitudinal UK-based birth cohort (The Avon Longitudinal Study of Parents and Children, ALSPAC) we assessed the relationship between pre-pandemic measures of disordered eating and self-harm and mental health during the COVID-19 pandemic in 2657 young adults. Regression models examined the relationship between self-reported disordered eating, self-harm, and both disordered eating and self-harm at age 25 years and depressive symptoms, anxiety symptoms and mental wellbeing during a period of eased restrictions in the COVID-19 pandemic (May–July 2020) when participants were aged 27–29 years. Analyses were adjusted for sex, questionnaire completion date, pre-pandemic socioeconomic disadvantage and pre-pandemic mental health and wellbeing. We also examined whether lifestyle changes (sleep, exercise, alcohol, visiting green space, eating, talking with family/friends, hobbies, relaxation) in the initial UK lockdown (April–May 2020) moderated these associations.ResultsPre-existing disordered eating, self-harm and comorbid disordered eating and self-harm were all associated with the reporting of a higher frequency of depressive symptoms and anxiety symptoms, and poorer mental wellbeing during the pandemic compared to individuals without disordered eating and self-harm. Associations remained when adjusting for pre-pandemic mental health measures. There was little evidence that interactions between disordered eating and self-harm exposures and lifestyle change moderators affected pandemic mental health and wellbeing.ConclusionsYoung adults with pre-pandemic disordered eating, self-harm and comorbid disordered eating and self-harm were at increased risk for developing symptoms of depression, anxiety and poor mental wellbeing during the COVID-19 pandemic, even when accounting for pre-pandemic mental health. Lifestyle changes during the pandemic do not appear to alter this risk. A greater focus on rapid and responsive service provision is essential to reduce the impact of the pandemic on the mental health of these already vulnerable individuals.Plain English summaryThe aim of this project was to explore the mental health of young adults with disordered eating behaviours (such as fasting, vomiting/taking laxatives, binge-eating and excessive exercise) and self-harm during the COVID-19 pandemic. We analysed data from an established study that has followed children from birth (in 1991 and 1992) up to present day, including during the pandemic when participants were 28 years old. We looked at the relationship between disordered eating and/or self-harm behaviours from before the pandemic and mental health problems (symptoms of depression and anxiety) and mental wellbeing during the pandemic. We also explored whether there were any lifestyle changes (such as changes in sleep, exercise, visiting green space) that might be linked to better mental health and wellbeing in young adults with disordered eating and self-harm. We found that young adults with prior disordered eating and/or self-harm had more symptoms of depression and anxiety, and worse mental wellbeing than individuals without prior disordered eating or self-harm. However, lifestyle changes did not appear to affect mental health and wellbeing in these young adults. Our findings suggest that people with a history of disordered eating and/or self-harm were at high risk for developing mental health problems during the pandemic, and they will need help from mental health services.

Introduction: Cerebral visual impairment (CVI) is the most common cause of visual impairment in developed nations. The purpose of this study was to understand the entry-level education and training received by optometrists and ophthalmologists, as well as current practice patterns. Methods: Online surveys were distributed to optometry and ophthalmology program directors and practicing optometrists and ophthalmologists. Data collection occurred between May 2020 and August 2020. Results: Surveys were completed by 48 program directors and 334 eye care professionals in North America, Europe, Oceania, and Asia, with most in North America. Less than half of the program directors reported (48%, 23/48) providing formal CVI didactic education. No program provided more than 2 hr of classroom instruction, 83% offered 1–2 hr, and 17% offered less than 1 hr. Although some clinical instruction was offered by 92% (44/48) of programs, exposure to patients with CVI occurred infrequently. Over one-half of the practitioners reported moderate familiarity with CVI. However, only 31% (102/334) of practitioners reported receiving formal classroom CVI instruction; of those, 56% (57/102) had 2 hr or less. Sixty-five percent (218/334) reported diagnosing children with CVI infrequently in their practices, with only 24% making CVI diagnoses on a daily or weekly basis. Discussion: Given the diverse and heterogenous characteristics of CVI, it is challenging to prepare future clinicians to evaluate and manage children with CVI with only 1–2 hr of lecture and minimal clinical exposure. This missed opportunity during formal education has significant implications for early diagnosis and timely intervention. To adequately prepare practitioners for comprehensive care of individuals with CVI, it is imperative to improve the quality and scope of didactic and clinical training. Implications for Practitioners: The results indicate the need for more comprehensive CVI education for optometrists and ophthalmologists during training as well as throughout practice with continuing education.

IntroductionCerebral Visual Impairment (CVI) is the most common cause of visual impairment in children in the developed world and appears to be more prevalent in children with additional support needs (ASN). There is an urgent need for routine screening for CVI, particularly in children with ASN, however, current screening questionnaires for CVI have limited validation. The aim of this study was to evaluate two screening tools: the Five Questions and the CVI Questionnaire. Additionally, the distribution of CVI across neurodevelopmental disorders is unknown. This too was investigated.MethodsAn online survey was completed by 535 parents. The survey was advertised via social media, CVI websites and parent email systems of four schools. The survey comprised of the Five Questions, the CVI Questionnaire and additional questions regarding the child’s diagnoses. Whether or not a child had a diagnosis of CVI and/or additional neurodevelopmental disorders was based on parental report.ResultsBased on parent reports, both the screening tools accurately screened for CVI diagnoses in children. The Five Questions and the CVI Questionnaire have construct validity (as determined through factor analysis), high internal consistency (as determined by Cronbach’s alpha) and convergent validity (as determined by correlation analysis of the raw scores of each questionnaire). This study also highlights that among children with neurodevelopmental disorders, a large proportion have parent-reported CVI (23%-39%) and potential CVI (6.59–22.53%; as identified by the questionnaires).ConclusionThe current study demonstrates that the Five Questions and CVI Questionnaire have good convergent validity, internal consistency and a reliable factor structure and may therefore be suitable as screening tools. The study also highlights that reported or potential CVI is evident in a large proportion of children with neurodevelopmental disorders.

Cerebral Palsy (CP) is a group of non-progressive brain disorders causing movement, posture, and motor function impairments. Cerebral Visual Impairment (CVI) affects visual pathways, affecting clarity of vision, visual fields, and occulomotor incoordination. Symptoms vary in nature and severity due to the complexity of the visual cortex. Physiotherapy (PT) is essential for treating CP, promoting physical, mental, and social well-being. Physical therapists also teach parents, how to care for their children at home, including feeding, bathing, dressing, and other activities. CVI is often linked to CP and can lead to various visual problems, including reduced visual guidance of movement. To effectively manage this condition, a multidisciplinary approach is required, as children with CVI often have neurological deficits in addition to their visual problems. Visual function assessment involves measuring thresholds or limits for each eye, while functional vision assessment is conducted in the child’s environment with both eyes open. Levels of vision can be classified into light perception, intermittent fixation, reliable focus, constant attention to small objects, and reliable visual acuity. Children with Visual Difficulties (CVI) exhibit distinct visual behaviours and require proper training. Sensory room training improves gross and fine motor abilities, and early intervention reduces issues associated with these diseases. Physical therapy interventions are very important for this population’s health and wellness, which can be focused on acquiring and improving independence in motor abilities, visual function, coordination, balance and general health improvement. Children with CVI are at danger of developing neurological dysfunction. An early intervention and adequate training for young CP children with CVI can improve motor abilities and reduce issues associated with these diseases. The following review will help to understand briefly about visual impairments in patients with CP, mainly focusing on new therapeutic interventions following visual impairments that are effective and easily administered.

Background: The effects of digital screen use on the physical and mental health of a child are a debated area of research. Studies have established few harmful effects, but the usage among children remains to be high. There is less understanding of the pattern of the digital screen and application usage and its impact on physical and mental health in our population. Aims: To study the pattern of digital screen use among children (5-15 years) and its impact on their physical and mental health. Setting and design: Cross-sectional study conducted in a tertiary care hospital. Materials and Methods: Sociodemographic details of parents and their children, screen time-related questions, pediatric symptom checklist (PSC) for screening of mental health issues, and questions regarding physical health issues in children due to screen use. Statistical Analysis: Data was analyzed using R language. Results: There is a significant association between parents’ education, gender, and the number of children with screen time. YouTube followed by WhatsApp are the commonly used digital applications and smartphones followed by Smart TVs are the commonly used digital gadgets. The physical issues are less than the clinical cut-off values but significantly associated with screen time. Sleep disturbance and avoiding outdoor activity are frequently reported due to screen use. Conclusion: The study highlights the common usage pattern of various digital gadgets and applications among children and their parents; also the demographic factors of parents relating to increased screen time in children. There are no significant clinical mental health issues reported by parents, but a significant association is found between digital screen use with physical and mental health issues.

People with chronic mental health conditions (CMHC) commonly experience social issues (e.g., social isolation and stigma), and emotion regulation difficulties, which impede their recovery. One option for promoting social connectedness and enhanced emotional states is facilitating arts-based groups (ABG) for people with CMHC. The current thesis aimed to advance understanding of how ABG can facilitate improved mental wellbeing outcomes, in the context of people pursuing mental health recovery, by exploring the social and emotional impacts of participating in a choir and a creative writing group. Furthermore, to provide a theoretical framework for studying ABG, the ‘social cure’ approach, based on social identity theory and self-categorisation theory, was applied (Haslam, Jetten, Cruwys, Dingle, & Haslam, 2018).This thesis began by systematically reviewing the literature on the mental health and wellbeing outcomes of group singing for people with a mental health condition (Chapter 2). Across seven longitudinal studies there were consistent findings indicating that group singing has a positive impact on mental health and wellbeing. Furthermore, six qualitative studies uncovered related perceived benefits to choir participation including enhanced emotional states, a sense of belonging, and self-confidence. Regarding creative writing groups, no previous studies had empirically tested the benefits of participating in creative writing in a group setting for people with CMHC.To assesses the longitudinal impact of ABG on mental wellbeing, 34 choir members and 25 creative writing group members (Mage = 46 years, 51% female, 86% mental health diagnosis) were recruited from a community organisation. In Chapter 3 the quantitative data from this year-long investigation was explored. Regardless of whether participants were in the choir or creative writing group, their mental wellbeing improved (d = .52). In accordance with the social cure approach, improvements in mental wellbeing were related to greater identification with the groups. Thus, participating in the group only benefited participants’ mental wellbeing, when the group became a meaningful part of their identity. The processes through which identification with the ABG leads to mental wellbeing were examined in a qualitative analysis of interviews from the same sample, in Chapter 4. Participants reported gaining psychological resources – belonging, support, agency, esteem, purpose, and enjoyment – which aligns with the benefits of gaining a shared group identity. These two empirical studies provide support for the social cure theoretical framework in explaining how ABG participation aids mental health recovery.In Chapter 5 the impact of participating in the ABG on participants’ emotions throughout a group day was examined, as well as exploring participants’ emotion regulation strategies. This study included members of a community choir (not experiencing CMHC) as a comparison group. The average scores on measures of emotion regulation revealed that compared with the comparison choir, people with CMHC were more likely to actively look for problems in their current situation. Despite this, all participants experienced an increase in positive emotions and decrease in negative emotions during the arts-based activity. In addition, it was found that people with CMHC reported preferring to talk to other people or doing something active to improve their emotional state than withdrawing or being alone. Therefore, these findings suggest that engaging in ABG could help people with CMHC to regulate their emotions.In the final empirical chapter, the social and emotional impact of performances by the choir on their audience was assessed to explore the potential impact of recovery choir performances on mental health stigma in the community. In the first study 322 first year psychology students from an Australian university watched video clips of the choir embedded into an online survey in a between-subjects experiment with four conditions: recovery choir singing / recovery choir not singing / comparison choir singing / comparison choir not singing. The second study replicated this design with 403 UK residents. These studies found that watching the choir singing increased the audience members’ positive emotions toward the choristers. Furthermore, positive emotions mediated the effect of watching choir singing on social acceptance and connectedness with the performers. Additionally, in a field study, 50 audience members of a live performance by the recovery choir were surveyed before and after the concert, again demonstrating that audiences’ positive emotions toward the choristers increased. These studies demonstrate that choir performances by people with CMHC can increase affiliative feelings toward the choristers.In summary, this thesis indicates that ABG can have a meaningful impact on the mental wellbeing of people with CMHC, and the broader community’s feelings toward them. Thus, this thesis supports the implementation of ABG in mental health care as an intervention which has the potential to maintain the mental wellbeing of people with CMHC living in the community. The thesis concludes with ideas for the future directions in research and evidence-based practice with ABG from the social cure perspective as part of a growing movement in social prescribing for mental health conditions.

Youth sport programme structures and processes can directly influence participation outcomes, including mental health and well-being. Researchers have found that programme quality and basic needs satisfaction foster psychosocial outcomes; however, limited research has examined the mechanisms that facilitate mental health. The purpose of this study was to examine relationships between programme quality, basic needs satisfaction, and mental well-being in competitive youth sport. Youth (N = 160, 89 males, 71 females; M age = 15.36, SD = 2.50) completed questionnaires at mid-season, with questions related to quality of their sport programming, and at programme end, with questions pertaining to basic needs satisfaction and mental well-being. Structural equation modelling was used to test the direct relationships between programme quality and mental well-being (r = .46, p < .001; model 1) and between basic needs satisfaction and mental well-being (r = .63, p < .001; model 2). Using several fit indices, results showed an adequate fit of both models to the data, suggesting that programme quality significantly predicted basic needs satisfaction and basic needs satisfaction significantly predicted mental well-being. Bootstrapping analysis was used to test if basic needs satisfaction mediated the relationship between programme quality and mental well-being. Results supported mediation, with a large effect (k 2 = 0.28). The study findings help to emphasise the value of structuring youth sport programmes to satisfy basic needs, which may have positive implications on youth mental health. This is important because supporting mental well-being at an earlier age may facilitate mental health and well-being in adulthood.

There is growing interest in the role of compassion in promoting health and well-being, with cross-sectional data showing an inverse correlation with loneliness. This is the first longitudinal study examining both compassion toward others (CTO) and compassion toward self (CTS) as predictors of mental and physical health outcomes including loneliness, across adult lifespan. We followed 552 women and 538 men in San Diego County for up to 7.5 (mean 4.8 and SD 2.2) years, using validated rating scales for CTO, CTS, and loneliness. Linear mixed-effects models were employed to examine age- and sex-related trajectories of CTO and CTS over time. Linear regression models were used to evaluate baseline and longitudinal relationships of CTO and CTS with mental well-being, physical well-being, and loneliness. CTS and CTO were weakly intercorrelated. Women had higher baseline CTO than men. While CTO was stable over time and across the lifespan, CTS scores had an inverse U-shaped relationship with age, peaking around age 77. There were significant baseline × slope interactions of both CTO and CTS predicting improvements in physical well-being in adults <60 years old. Increases in CTO and CTS predicted improvements in mental well-being. Higher baseline CTO and CTS as well as increases in CTO and CTS scores predicted lower loneliness scores at follow-up. Thus, CTO and CTS were associated with better mental well-being and loneliness across the adult lifespan, and physical well-being in younger adults, and are promising targets for interventions to improve health outcomes.

Positive mental health and wellbeing in adults with cystic fibrosis: A cross sectional study

BackgroundFor promoting mental health and well-being of individuals, it is important to investigate its association with personal values. However, in Eastern Asian countries, no study has yet investigated the association between personal values in adolescence and mental health and well-being in adulthood. To fill that research gap, we conducted a cross-sectional study based on two online surveys of working populations in Japan and the United States.MethodsA total of 516 workers from each of the two countries, aged 30–49 years, completed a questionnaire that measured personal values in adolescence, current psychological distress, health-related quality of life, and subjective well-being (satisfaction and happiness). Personal values were measured by items based on Schwartz’s theory of basic values and people’s commitment to those ten values. Multiple group path analysis was performed to examine the associations between personal values in adolescence and health-related outcomes, grouped by country.ResultsCare, graduating from school, and commitment to values were associated with better mental health and well-being in Japanese participants. Belief and challenging were associated with better mental health and well-being in US participants. On the other hand, financial success was associated with poor mental health and well-being in Japanese participants. Avoiding causing trouble and positive evaluation were associated with poor mental health and well-being in the US participants.ConclusionsCertain personal values and commitment to those values in adolescence may be associated with mental health and well-being in adulthood. To address the limitations of this study, future studies should use a longitudinal design and investigate the interactions among the types of personal values and commitment to the values.

It is well known that the socio-economic status (SES) has a great impact on adult and childhood well-being. Comparatively little research has been conducted on the relationship of adolescents' subjective well-being to SES. Recent studies though, display a tendency for a strong relationship between adolescences' subjective physical, mental and social well-being to SES. We therefore wanted to find out whether an association exists between SES and subjective physical, mental and social well-being among adolescents as well as between SES and individual school marks. The cross-sectional data of 450 German adolescent students (average age 11 years old) were analysed. The data included socio-demographic variables, school marks and selected subscales of three well-established questionnaires [KIDSCREEN, Kid-Kindl® and the German version of the Strengths and Difficulties Questionnaire (SDQ-deu)]. The Hamburg Social School Index (HSSI) was used as an indicator of SES. Significant differences between SES and physical (T = -2.04; p < 0.05) as well as social well-being ('Social Support and Peers' with T = -2.04; p < 0.05) of adolescents were found. Generally, no relations between SES and mental well-being were found. School marks also differed between low and high school SES [German (T = 3.13; p < 0.05), English (T = 5.38; p < 0.01), Mathematics (T = 3.16; p < 0.05) and Sports (T = 2.10; p < 0.05)]. As health in adolescence is a predictor for health in adulthood, health promotion and prevention need to start early (primary school) to improve physical and social well-being in low SES families and schools.

Introduction: The physiological and psychological effects of Om chanting are gaining popularity. However, limited research has focused on the acoustic effects of Om chanting and how the produced sounds and vibrations influence both mental and vocal physiological states. Aim: This study explores the effects of 10 days of Omkar mantra chanting on voice quality and psychological well-being in Indian adults without prior regular chanting experience. Materials and Methods: A quasi-experimental study was conducted online in India involving 100 healthy adults (aged 20- 45 years) over 10 days in three batches, from November 2023 to December 2023. Participants attended daily 30-minute Omkar chanting sessions. Four participants were excluded due to unclear audio recordings. Voice parameters and psychological well-being were assessed using PRAAT software, the World Health Organisation-Five Well-being Index (WHO-5), and the Subjective Vitality Scale, before and after the intervention. Data were analysed using paired sample t-tests to evaluate changes in voice parameters, vitality, and overall well-being. The level of significance was fixed at 0.05. Results: After 10 days of Omkar chanting, participants experienced significant improvements in their vocal quality, including reduced fundamental frequency (F0) for “A kara” (females: 223.06 to 216.58 Hz; males: 138.65 to 129.23 Hz) and “U kara” (females: 223.40 to 216.22 Hz; males: 138.40 to 131.13 Hz), as well as decreased jitter and shimmer values, reflecting increased vocal stability. There were significant increases in the mean WHO-5 scores (from 15.19 to 21.88) and mean vitality scores (from 23.76 to 35.34), (p-value &lt;0.001), suggesting a positive impact on psychological well-being. These results indicate the beneficial effects of Omkar chanting on vocal health and psychological well-being in adults with no prior chanting experience. Conclusion: Omkar mantra chanting positively improves vocal stability, resonance, and mental health in adults aged 20- 45 years. These findings suggest that incorporating mantra chanting into daily routines can be a simple yet effective tool for enhancing both vocal health and mental well-being, making it beneficial for those seeking natural practices for stress reduction and overall well-being.

Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p < 0.001) explained most of the variation in mental health, while gender (21.32%, p < 0.001) explained most of the variation in health, and emotional support (23.34%, p < 0.001) explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs had a more than two-fold increased risk of being mentally unhealthy (RRTotal Effect = 2.75, 95% CI: 2.19–3.10), an 89% increased risk of being unhealthy (RRTotal Effect = 1.89, 95% CI: 1.47–1.99), and a 42% increased risk of having a low level of well-being in adulthood (RRTotal Effect = 1.42, 95% CI: 1.29–1.52). Social support and behavioral factors mediate 11–18% (p < 0.01) of these effects. The study advances the theoretical understanding of how CTEs influence adult mental health, health, and well-being.