Millennium Cohort Study Research Articles

Do you like school? Social class, gender, ethnicity and pupils' educational enjoyment.

This study investigates structural inequalities in educational enjoyment in a contemporary cohort of United Kingdom (UK) primary school children. Foundational studies in the sociology of education consistently indicate that the enjoyment of education is stratified by social class, gender, and ethnicity. Analysing data from the UK Millennium Cohort Study, which is a major cohort study that tracks children born at the start of the 21st century, we examine children's enjoyment of both school and individual academic subject areas. The overarching message is that at age 11 most children enjoy their education. The detailed empirical analyses indicate that educational enjoyment is stratified by gender, and there are small differences between ethnic groups. However, there is no convincing evidence of a social class gradient. These results challenge orthodox sociological views on the relationship between structural inequalities and educational enjoyment, and therefore question the existing theoretical understanding of the wider role of enjoyment in education.

Sleep health among US Navy afloat versus ashore personnel in the Millennium Cohort Study.

Despiteemerging public concern regarding the sleep health of military personnel over the past two decades, there remains a dearth of research examining sleep health among naval personnel assigned to sea duty. This study examined sleep metrics (e.g. fatigue, short sleep duration) and mental (e.g. posttraumatic stress disorder, depression) and physical health (e.g. type 2 diabetes, bodily pain) outcomes among naval personnel with recent sea duty (i.e. afloat) compared with naval personnel with recent shore duty (i.e. ashore). Prevalence ratios and mean differences for all outcomes were estimated and adjusted for demographic and military variables, and subsequently stratified by obesity. Sleep metrics were similar between afloat and ashore sailors except for short sleep duration, while sailors with recent shore duty had poorer physical health compared with those with recent sea duty. Stratified analyses suggested naval personnel with obesity had a higher proportion of nearly all adverse sleep-related health outcomes than those without obesity. Among participants without obesity, afloat personnel were more likely to report very short sleep (≤ 5 hours) and fewer hours of average nightly sleep, but were less likely to report physical health outcomes compared with ashore personnel. These findings suggest potential differences in sleep metrics and sleep-related health outcomes between afloat and ashore naval personnel. Additional research examining sleep outcomes using more objective measures is required to further investigate these findings, which may inform strategies to foster consolidated sleep despite environmental and occupational challenges in order to maintain high-performing naval personnel.

Childhood Trajectories of Paternal and Maternal Psychological Distress and Decision-making in Early Adolescence

Decision-making is important for adolescent wellbeing, and predictive of several other outcomes. While past research demonstrates the role of maternal psychological distress in adolescent decision-making, the role of paternal psychological distress remains relatively unexplored. This study examined the association between trajectories of paternal and maternal psychological distress, jointly modelled, in childhood and child decision-making in early adolescence. Using data from 9846 families of the Millennium Cohort Study, we identified paternal and maternal psychological distress trajectories across child ages 3–11 using joint group-based trajectory modelling and explored their associations with offspring decision-making at age 11 with multiple linear regression models. Paternal and maternal psychological distress was measured with the Kessler-6 scale, while adolescent decision-making was assessed using the Cambridge Gambling Task. We identified 2 trajectories for fathers (‘low distress’ and ‘moderate-increasing distress’) and 4 for mothers (‘minimal distress’, ‘low distress’, ‘moderate-increasing distress’ and ‘severe distress’). When jointly modelled, paternal and maternal trajectories predicted decision-making in fully adjusted models. Compared to the ‘low distress’ paternal trajectory, the ‘moderate-increasing distress’ paternal trajectory was associated with less delay aversion, although this effect disappeared when examining only two-parent biological families. Compared to the ‘minimal distress’ maternal trajectory, the ‘moderate-increasing distress’ trajectory predicted slower deliberation time, whereas the ‘severe distress’ trajectory predicted greater risk-taking. There were no gender differences in these paths. Consistently moderate and high levels of maternal distress during childhood are associated with increased decision latency and greater risk-taking, respectively, in early adolescence.

Emotional problems across development: examining measurement invariance across childhood, adolescence and early adulthood.

Emotional problems (anxiety, depression) are prevalent in children, adolescents and young adults with varying ages at onset. Studying developmental changes in emotional problems requires repeated assessments using the same or equivalent measures. The parent-rated Strengths and Difficulties Questionnaire is commonly used to assess emotional problems in childhood and adolescence, but there is limited research about whether it captures a similar construct across these developmental periods. Our study addressed this by investigating measurement invariance in the scales' emotional problems subscale (SDQ-EP) across childhood, adolescence and early adulthood. Data from two UK population cohorts were utilised: the Millennium Cohort Study (ages 3-17 years) and the Avon Longitudinal Study of Parents and Children (4-25 years). In both samples we observed weak (metric) measurement invariance by age, suggesting that the parent-rated SDQ-EP items contribute to the underlying construct of emotional problems similarly across age. This supports the validity of using the subscale to rank participants on their levels of emotional problems in childhood, adolescence and early adulthood. However strong (scalar) measurement invariance was not observed, suggesting that the same score may correspond to different levels of emotional problems across developmental periods. Comparisons of mean parent-rated SDQ-EP scores across age may therefore not be valid.

Non-parental Childcare During Early Childhood and Problem Behaviour Trajectories from Ages 5 to 14 Years.

Using data from the nationally representative Millennium Cohort Study, this study examined the association between age of starting and weekly hours in formal childcare between birth and 5years with internalising and externalising behaviour trajectories from ages 5 to 14years in England (N = 6194 children). Associations were analysed using multilevel general linear regression models, with adjustment for socio-economic position, maternal mental health, demographics, and child temperament. Later entry was associated with more internalising behaviours at age 14years. Children who spent > 40h per week in childcare between birth and 3years displayed more externalising behaviour at 5years than children who did not attend childcare. Controlling for socio-economic position and parental mental health attenuated findings.

Proximity to high streets, social isolation and social support in British adolescents: A longitudinal analysis of sociospatial influences on social connectedness using geospatial data

High streets have been shown to be central to socio-economic activity, given their diverse residential, leisure, and commercial activities. This study explores the link between adolescent social isolation and proximity to, and land use mix in, high streets. Hypothesising that greater distance from high streets might increase social isolation, measured via social activities, friend contact frequency, and social support, we used multilevel modelling with data from the Millennium Cohort Study. We did not observe a relationship between proximity to high streets and these social isolation indicators, suggesting that high streets may either not significantly influence adolescent social engagement or that young people are willing to travel greater distances.

Describing the geographical linkage between the UK Millennium Cohort Study and crime incidents in England and Wales

BackgroundEnhancing longitudinal cohort studies by linking routine external data to them is increasingly used to evaluate how local environments impact participants' outcomes (e.g. crime on adolescents' perception of security and victimisation). ObjectiveTo describe the geographical linkage between the UK Millennium Cohort Study (MCS) and street-level crime incidents reported to the Police in England and Wales, and to estimate crime count and rates around MCS participants' residences. MethodsEight years of monthly street-level police data were linked to the residential postcodes of MCS participants living in England and Wales in surveys 5, 6 and 7 to create individual-level variables of neighbourhood crime counts and rates (28,724 surveys and 11,365 individuals). Radial buffers around participants' residences were created at ages 11, 14 and 17. Crime counts and rates were created prior to the month of interview (at 1, 3, 6, 9, and 12 months prior). A homogenisation of crime categories reported in the police data was conducted to evaluate changes over time and areas. Multivariate models were used to study the association between MCS participants' demographic characteristics and derived measures of neighbourhood crime. ResultsWhile total crime rates and counts around MCS participants remain stable over the period, they hide heterogeneous upward and downward trends in specific sub-categories, with violence and sexual offences showing a larger increase. We observe a negative socioeconomic gradient between household income deciles, recorded at age 11, and subsequent exposure to neighbourhood crime. ConclusionLinking routine crime data to longitudinal studies, such as the MCS, which follow children and their families through a critical period of development, can provide a new resource to understand how local crime impacts child and adolescent outcomes.

The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression: findings from three UK prospective population-based cohorts.

Adverse childhood experiences (ACEs) are well-established risk factors for self-harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co-occurring self-harm and depression. Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14-18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E-Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four-category outcome: no self-harm or depression, self-harm alone, depression alone and self-harm with co-occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self-harm and depression in adolescence. The majority of ACEs were associated with co-occurring self-harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co-occurring self-harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10-1.25) and MCS (1.18, 1.11-1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co-occurring self-harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long-term exposure to ACEs contributing to risk of self-harm and depression in adolescence.

To persist or not? Examining the relations between parental education, self‐regulation, school engagement and persistence in post‐compulsory education

AbstractThere are few longitudinal studies of adolescent students’ choice to persist in post‐compulsory education. Hence, the present study introduces a longitudinal model that describes the interplay between sociological and psychological explanations of adolescents’ choice to persist in post‐compulsory education in the UK. Data on parental education, early childhood self‐regulation (age 5), sustained school engagement (ages 7, 11, 14) and persistence in education after the end of compulsory schooling (age 17) were utilised. The sample comprised 8333 (51.1% females, 89.5% white) children from the Millennium Cohort Study. Statistical analyses included state–trait modelling, longitudinal mediation and multigroup moderation. A trait–state–occasion model was run to disentangle the trait from state variance in school engagement. Afterwards, two hypotheses were formulated, namely the ‘instilment’ and the ‘differential’. The ‘instilment’ hypothesis involved a longitudinal predictive model, whereby parental education predicted early childhood self‐regulation which, in turn, predicted sustained school engagement which predicted students’ choice to persist. The ‘differential’ hypothesis examined whether higher vs. lower parental education changed the nature of the predictive relations between self‐regulation, sustained school engagement and persistence. The results were in favour of an ‘instilment’ hypothesis, whereby higher parental education was translated to higher levels of early self‐regulation which predicted higher sustained engagement, which, in turn, predicted greater probability of persisting in post‐compulsory education. The findings suggest a pathway from early childhood experiences to educational outcomes via the development of a trait of engaging with school.

The Relationship Between Time Spent on Social Media and Adolescent Cigarette, E-cigarette, and Dual Use: A Longitudinal Analysis of the UK Millennium Cohort Study.

To estimate the effect of social media use in 14 year olds on risk of and inequalities in cigarette, e-cigarette, and dual use at 17 years, using the UK-representative Millennium Cohort Study (born 2000-2002). The relationship of time spent on social media (using questionnaires [n = 8987] and time-use-diaries [n = 2520]) with cigarette, e-cigarette, and dual use was estimated using adjusted odds ratios (AORs) or relative risk ratios (ARRRs). Effect modification was examined (using parental education as an indicator for socioeconomic circumstances) by comparing adjusted risk differences within low and high-parental education groups. Analyses accounted for prespecified confounders (identified via directed acyclic graphs), baseline outcome measures (to address reverse causality), sample design, attrition, and item-missingness (through multiple imputation). Time spent on social media was associated with increased risk of cigarette, e-cigarette, and dual use in a dose-response manner. Social media use for ≥2 hours/day (vs. 1-<30 minutes) was associated with increased cigarette (AOR 2.76 [95% confidence interval 2.19 to 3.48]), e-cigarette (3.24 [2.59 to 4.05]), and dual use (ARRR 4.11 [2.77 to 6.08]). The risk of cigarette use among 30 minutes-<1 hour/day users (vs. non-users) were smaller in those with high versus low parental education (ARDs 1.4% vs. 12.4%). Similar findings were observed across the higher time categories. Analyses using time-use-diaries, in complete case samples, and with additional adjustment for baseline outcome measures generally revealed similar findings. After accounting for observed confounders and potential reverse causality, findings suggest social media use increases the risk of cigarette, e-cigarette, and dual use in a dose-response manner. Guidance addressing adolescent online safety should be prioritized. This study's identification of a dose-response relationship and differential effects across socioeconomic groups, could assist in the development of guidance on time spent on social media. The adverse effects of social media use on adolescent cigarette, e-cigarette, and dual use supports legislation aimed at promoting adolescent online safety. Study findings strengthen calls to prohibit social media marketing of nicotine-related products and importantly highlight the need to increase awareness and understanding of the underlying algorithms which drive adolescent exposure to nicotine-related content on social media to ensure they are functioning in a way that best serves the adolescent population.

Childhood Transitions Between Weight Status Categories: Evidence from the UK Millennium Cohort Study.

Assessing the cost-effectiveness of interventions targeting childhood excess weight requires estimates of the hazards of transitioning between weight status categories. Current estimates are based on studies characterized by insufficient sample sizes, a lack of national representativeness, and untested assumptions. We sought to (1) estimate transition probabilities and hazard ratios for transitioning between childhood weight status categories, (2) test the validity of the underlying assumption in the literature that transitions between childhood bodyweight categories are time-homogeneous, (3) account for complex sampling procedures when deriving nationally representative transition estimates, and (4) explore the impact of child, maternal, and sociodemographic characteristics. We applied a multistate transition modeling approach accounting for complex survey design to UK Millennium Cohort Study (MCS) data to predict transition probabilities and hazard ratios for weight status movements for children aged 3-17. Surveys were conducted at ages 3 (wave 2 in 2004), 5 (wave 3 in 2006), 7 (wave 4 in 2008), 11 (wave 5 in 2012), 14 (wave 6 in 2015), and 17 (wave 7 in 2018) years. We derived datasets that included repeated body mass index measurements across waves after excluding multiple births and children with missing or implausible bodyweight records. To account for the stratified cluster sample design of the MCS, we incorporated survey weights and jackknife replicates of survey weights. Using a validation dataset from the MCS, we tested the validity of our models. Finally, we estimated the relationships between state transitions and child, maternal, and sociodemographic factors. The datasets for our primary analysis consisted of 10,399 children for waves 2-3, 10,729 for waves 3-4, 9685 for waves 4-5, 8593 for waves 5-6, and 7085 for waves 6-7. All datasets consisted of roughly equal splits of boys and girls. Under the assumption of time-heterogeneous transition rates (our base-case model), younger children (ages 3-5 and 5-7 years) had significantly higher annual transition probabilities of moving from healthy weight to overweight (0.033, 95% confidence interval [CI] 0.026-0.041, and 0.027, 95% CI 0.021-0.033, respectively) compared to older children (0.015, 95% CI 0.012-0.018, at ages 7-11; 0.018, 95% CI 0.013-0.023, at ages 11-14; and 0.018, 95% CI 0.013-0.025 at ages 14-17 years). However, the resolution of unhealthy weight was more strongly age-dependent than transitions from healthy weight to non-healthy weight states. Transition hazards differed by child, maternal, and sociodemographic factors. Our models generated estimates of bodyweight status transitions in a representative UK childhood population. Compared to our scenario models (i.e., time-homogeneous transition rates), our base-case model fits the observed data best, indicating a non-time-homogeneous pattern in transitions between bodyweight categories during childhood. Transition hazards varied significantly by age and across subpopulations, suggesting that conducting subgroup-specific cost-effectiveness analyses of childhood weight management interventions will optimize decision-making.

Variation in Breastfeeding Initiation and Duration by Mode of Childbirth: A Prospective, Population-Based Study.

Introduction: Despite known benefits of breastfeeding, including prevention against infections for infants, in the presence of numerous barriers, less than half of infants in high-income countries breastfeed for 6 months. One potential barrier to breastfeeding is birth by cesarean section (C-Section), which can invoke long-term difficulties. However, our structured literature review found that existing empirical research does not fully elucidate this relationship due to differences in operationalization of C-section and breastfeeding, omission of important confounders, and failure to exclude those who did not initiate breastfeeding (or use time-to-event analyses). In this article, we attempt to overcome these limitations. Methods: We analyzed data from 14,414 mother-infant dyads enrolled in the United Kingdom-based prospective Millennium Cohort Study, beginning in 2001. Using multivariable logistic regression, we examined the association between mode of birth (vaginal, emergency C-section, and elective C-section) and likelihood of breastfeeding initiation. We then applied adjusted Accelerated Failure Time survival models to examine the associations between mode of birth and duration of any and exclusive breastfeeding. Results: Those with planned (but not emergency) C-section were less likely to initiate breastfeeding (odds ratio: 0.84, 95% confidence interval [CI]: 0.71-0.99) relative to vaginal births. However, those with either planned or unplanned C-section discontinued both any and exclusive breastfeeding sooner than vaginal births. This effect was more pronounced for those with planned C-section (time ratio [TR]: 0.75, 95% CI: 0.64-0.89) than unplanned C-section (TR: 0.85, 95% CI: 0.74, 0.97) compared with vaginal births. Conclusions: Through application of rigorous methods, this study provides compelling evidence that breastfeeding duration may be impeded by C-section birth. The findings suggest that additional support for mothers who intend to breastfeed and have a C-section birth may be warranted.

The Study of Adolescent Resilience (SOAR): a research protocol

BackgroundAdolescence is a particularly sensitive period of development for military-connected youth, given the socioemotional and physical changes that occur against the backdrop of the military career of their parent(s). Military-connected adolescents face unique stressors relative to their civilian counterparts, such as military relocations, parental absence due to deployments and trainings, and parental military-related physical and mental injury. These stressors may change family dynamics and disrupt social support networks, which can have lasting implications for adolescent health and well-being. At present, very little is known about how the current generation of military-connected adolescents are faring regarding their psychological and physical health, academic achievement, and educational or career aspirations. As part of the Biden-Harris Administration's commitment to military families, the U.S. Department of Defense pledged to address these major knowledge gaps by supporting the Study of Adolescent Resilience (SOAR). SOAR's longitudinal design provides a powerful tool for evaluating the effects of military family life on adolescent well-being into early adulthood.Methods and designSOAR is embedded within the larger Millennium Cohort Study, the first U.S. population-based prospective study to investigate long-term health effects of military service among active duty service members. Nearly 40,000 Millennium Cohort participants with adolescent children were invited to complete a web-based self-report survey that included items across interpersonal, socioenvironmental, and health domains, among others. Military parents provided referral information for their adolescent child and another primary parental figure, when available, to be invited to SOAR. This approach allowed survey data to be linked between these three family members (service member, spouse, and adolescent) to promote a comprehensive, family systems-based understanding of military-connected adolescent experiences and determinants of health, risk, and resilience.DiscussionResearch findings will shed light on the enduring impact of military life on adolescents and the nature of associations between military-specific experiences and psychosocial health and well-being. Further, this research will assess modifiable risk and protective factors that may elucidate differences in military-connected adolescent psychosocial development and physical health, academic achievement, and educational and military career aspirations over time.ConclusionsFindings gleaned from this research will be used to inform existing policy and programs designed to promote adolescent resilience.

Childhood attention-deficit hyperactivity disorder: socioeconomic inequalities in symptoms, impact, diagnosis and medication.

Children from disadvantaged backgrounds are at greater risk of attention-deficit hyperactivity disorder (ADHD)-related symptoms, being diagnosed with ADHD, and being prescribed ADHD medications. We aimed to examine how inequalities manifest across the 'patient journey', from perceptions of impacts of ADHD symptoms on daily life, to the propensity to seek and receive a diagnosis and treatment. We investigated four 'stages': (1) symptoms, (2) caregiver perception of impact, (3) diagnosis and (4) medication, in two data sets: UK Millennium Cohort Study (MCS, analyticn ~ 9,000), with relevant (parent-reported) information on all four stages (until 14 years); and a population-wide 'administrative cohort', which includes symptoms (child health checks) and prescriptions (dispensing records), born in Scotland, 2010-2012 (analytic n ~ 100,000), until ~6 years. We described inequalities according to maternal occupational status, with percentages and relative indices of inequality (RII). The prevalence of ADHD symptoms and medication receipt was considerably higher in the least compared to the most advantaged children in the administrative cohort (RIIs of 5.9 [5.5-6.4] and 8.1 [4.2-15.6]) and the MCS (3.08 [2.68-3.55], 3.75 [2.21-6.36]). MCS analyses highlighted complexities between these two stages, however, those from least advantaged backgrounds, with ADHD symptoms, were the least likely to perceive impacts on daily life (15.7% vs. average 19.5%) and to progress from diagnosis to medication (44.1% vs. average 72.5%). Despite large inequalities in ADHD symptoms and medication, parents from the least advantaged backgrounds were less likely to report impacts of ADHD symptoms on daily life, and their children were less likely to have received medication postdiagnosis, highlighting how patient journeys differed according to socioeconomic circumstances.

Problems in peer relationships and low engagement in romantic relationships in preterm born adolescents: effects of maternal warmth in early childhood.

This study examined whether maternal warmth in early childhood moderates the association between preterm birth and problems in peer relationships and low engagement in romantic relationships in adolescence. We studied 9193 individuals from the Millennium Cohort Study in the United Kingdom, 99 (1.1%) of whom were born very preterm (VPT; < 32weeks of gestation) and 629 (6.8%) moderate-to-late preterm (MLPT; 32-36weeks gestation). Maternal warmth was reported by the mothers when their children were 3years old. Peer relationship problems were reported by both the participants and their mothers at 14 and 17years. Further, participants reported their engagement in romantic relationships at 14 and 17years. All outcome variables were z-standardized, and the moderation effect was examined via hierarchical linear regressions. Compared to full-term birth, both MLPT and VPT birth were associated with lower engagement in romantic relationships at 17years of age (b = .04, p = .02; b = .11, p = .02, respectively), and VPT birth was associated with increased peer relationship problems at 14 (b = .29, p = .01) and 17years of age (b = .22, p = .046). Maternal warmth in early childhood was similarly associated with lower peer relationship problems in MLPT, VPT and full-term born adolescents. However, there was no influence of maternal warmth on engagement in romantic relationships at 17years of age. There is no major modifying effect of maternal warmth in early childhood on the association between PT birth and peer relationship problems and low engagement in romantic relationships at 14 and 17years of ages.

Self-Harm Among 17-Year-Old Adolescents With/Without Disabilities in the United Kingdom.

Background: Self-harm is a critical public health issue for adolescents/young adults. Aims: To estimate the prevalence of self-harm among adolescents with/without disabilities in the United Kingdom. Method: Secondary analysis of data collected at age 17 in the UK's Millennium Cohort Study. Results: Prevalence of self-harm was significantly greater among adolescents with disabilities for suicide attempts and six forms of self-harming behaviors. The lifetime prevalence of suicide attempts was 5.3% (4.5-6.3) among adolescents without disabilities, 21.9% (18.2-26.2) among adolescents with less limiting disabilities, and 25.5% (17.2-35.9) among adolescents with more limiting disabilities. Adjusted prevalence rate ratios ranged from 5.13 (3.58-7.36) for those with mental health limitations to 1.48 (0.65-3.35) for those with mobility limitations. Similar patterns were observed for the 12-month prevalence of six self-harming behaviors. Limitations: Further studies are needed to identify potential mediators of the association between disability and self-harm that are potentially modifiable. Conclusion: Adolescents with disabilities are at markedly greater probability of suicide attempts and self-harming behaviors than their peers.

Causal effect of parental reading on later development of children: Demonstrating a Bayesian approach.

This study examined the relationship between early parental treatment, specifically reading to young children and later cognitive development with a Bayesian perspective. Previous research established a positive link between parental reading to infants and their cognitive development, such as receptive vocabulary, reading comprehension and motivation to read. Using data from the Millennium Cohort Study, this study analysed individuals aged 9 months to 14 years to investigate the effects of early reading to young children on nine cognitive variables. Bayesian statistical analysis controlled for pre-existing differences and covariates to establish a causal association between reading and cognitive development. The results indicated that reading to infants and toddlers positively impacted their cognitive development beyond reading skills. These findings demonstrate the usefulness of the Bayesian approach in determining scientific significance and underscore the importance of early literacy interventions in promoting cognitive development.

Social support and mental well-being among people with and without chronic illness during the Covid-19 pandemic: evidence from the longitudinal UCL covid survey

PurposeAn immediate research priority recovering from the COVID-19 pandemic is well-being among some of our most vulnerable—people with chronic illness. We studied how mental health changed among people with and without chronic illness throughout the pandemic and the mediating role of social support.MethodsWe used the 3-waves of COVID-19 survey within the Millennium Cohort Study (MCS, age 19, N = 5522) and MCS Parent (MCSP, age > > 19, N = 7479) samples, with additional pre-pandemic measures of some outcomes and exposure. Using Structural Equation Panel Models with Full Information Maximum Likelihood estimation to address missing data, we studied differences between respondents with a chronic illness and without, regarding depressive symptoms and mental well-being, with social provision, social support, and loneliness as potential mediators.ResultsMental well-being (SWEMWBS) and psychological distress (Kessler-6) worsened significantly during the pandemic relative to baseline for people with and without chronic illness, while the latter group had substantially better well-being at all waves and the baseline regarding both outcomes. When the lockdown was lifted during wave-2, mental well-being temporarily rebounded, and distress waned among people without chronic illness but continued to worsen among people with chronic illness. Social support partially mediated the link between chronic illness and mental well-being.ConclusionsThe large mental well-being gap between people with and without chronic illness persisted during the pandemic. However, social support and provision can partially narrow this gap, hence should be employed in future pandemic management.

Posttraumatic stress disorder, Veterans Health Administration use, and care-seeking among recent-era U.S. veterans.

The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans. Analyses were conducted among 19,691 active duty military personnel enrolled in the Millennium Cohort Study who separated from the military between 2000 and 2012 and were weighted to the 1,130,103 active duty personnel who separated across this time period. VHA utilization was identified from electronic medical records in the year before survey completion, and PTSD care-seeking and PTSD symptoms were assessed through self-report on the 2014-2016 survey; thus, the observation period regarding care-seeking and VHA use encompassed 2013-2016. Veterans with probable PTSD were more likely to use VHA services than those without probable PTSD, aOR = 1.12, 95% CI [1.01, 1.24], although the strongest association with recent VHA use was a depression diagnosis, aOR = 2.47, 95% CI [2.26, 2.70]. Among veterans with probable PTSD, the strongest predictor of care-seeking was recent VHA use compared to community care, aOR = 4.01, 95% CI [3.40, 4.74); reporting a diagnosis of depression was the second strongest predictor of PTSD care-seeking, OR = 2.99, 95% CI [2.53, 3.54]. However, the absolute number of veterans with probable PTSD who were not seeking care was approximately equivalent between veterans using VHA services and those not using VHA services. Additionally, certain groups were identified as being at risk of not seeking care, namely Air Force veterans and veterans with high physical and mental functioning despite substantial PTSD symptoms.

The onset of mental health disparities in sexual minority and majority youth: evidence from the UK Millennium Cohort Study.

Decades of research shows that sexual minority youth (SMY) display heightened risk for mental health problems, although the onset of such disparities remains unclear. The Millennium Cohort Study is the largest nationally representative longitudinal study of adolescents in the United Kingdom. In this study, participants (N = 10,047, 50% female) self-reported their sexual identity at age 17 and had parent-reported mental health data, from the Strengths and Difficulties Questionnaire, reported across five waves at ages 5, 7, 11, 14, and 17. Multilevel linear spline models, stratified by sex, were used to examine mental health trajectories between sexual identity groups (completely heterosexual, mostly heterosexual, SMY). SMY showed heightened peer problems from the baseline assessment at age five, increasing over time, and heightened emotional problems from age 11, increasing over time. Mostly heterosexual youth showed heightened emotional problems at age 11 in males, and at age 17 in females. Findings are discussed in light of the literature on minority stress and gender conformity in youth. The use of parent-reported mental health data means that estimates are likely to be conservative. We conclude that interventions supporting SMY should start early and be available throughout adolescence.