Young Adult Health Outcomes Research Articles

Associations among perceived stress and mindfulness on post-concussion cognitive and mental health outcomes in young adults with a concussion history

ABSTRACT Background Despite evidence suggesting perceived stress negatively impacts post-concussion outcomes and that mindfulness may improve that relationship, research has not investigated those connections. Methods This cross-sectional, observational study included 80 young adults with a concussion history who completed a single study visit including the following measures: 1) demographics and concussion, mental health, and mindfulness histories; 2) perceived stress [Perceived Stress Scale (PSS-10)]; 3) mindfulness [Five Facet Mindfulness Questionnaire (FFMQ)]; and 4) post-concussion cognitive and mental health outcomes – neurocognitive performance (CNS Vital Signs), psychological symptoms [Brief Symptom Inventory-18 (BSI-18)], and QOL [Patient-Reported Outcomes Measurement Information System (PROMIS®)]. First, separate regression models determined the association among perceived stress and post-concussion cognitive and mental health outcomes. Second, linear regression models determined the association among mindfulness and post-concussion cognitive and mental health outcomes. Third, to test the moderation effect, models included a perceived stress and mindfulness interaction term. Results Higher perceived stress was significantly associated with higher psychological symptoms (p < 0.001) and lower QOL (p < 0.05). Higher mindfulness was significantly associated with lower psychological symptoms (p < 0.001) and higher QOL (p < 0.05). No moderation models were significant. Conclusion Future research is necessary to further understand mechanisms impacting post-concussion interventions aimed to improve outcomes and life post-concussion.

Effect of Pediatric Obesity Treatment on Long-Term Health

Data regarding the long-term impact of treating childhood obesity on the risk of obesity-related events, including premature mortality, are limited. To evaluate the long-term effect of different responses to pediatric obesity treatment on critical health outcomes in young adulthood. The study included a dynamic prospective cohort of children and adolescents with obesity within The Swedish Childhood Obesity Treatment Register (BORIS) and general population comparators, linked with national registers. Baseline data were collected between 1996 and 2019. Formal analyses for this study was conducted in 2023. Outcomes were assessed from individuals aged 18 to 30 years (2005 to 2020). Participants included children and adolescents aged 6 to 17 years receiving at least 1 year of obesity treatment. General population comparators were matched on a ratio of 1:5 on sex, year of birth, and geographical area. Pediatric obesity treatment response was based on changes in body mass index standard deviation score and categorized as poor, intermediate, and good response and obesity remission. Obesity-related events included type 2 diabetes (T2D), dyslipidemia, hypertension, depression or anxiety, and weight-loss bariatric surgery. Additionally, mortality was assessed. Of 6713 individuals (3777 male [56%] and 2936 female [44%]), the median age at obesity treatment initiation was 12.1 (quartile 1; quartile 3: 10.1; 14.3) years and treatment duration was 3.0 (1.8; 4.9) years. For T2D, hypertension, dyslipidemia, weight-loss bariatric surgery, and depression or anxiety outcomes, unadjusted incidence rates tended to decrease with better treatment response and the lowest estimate was observed among general population comparators. Compared with poor response, obesity remission or a good response in obesity treatment was associated with reduced risk of mortality (adjusted hazard ratio [HR], 0.12; 95% CI, 0.03-0.46). Good response was also associated with lower risk of TD2 (HR, 0.42; 95% CI, 0.23-0.77), dyslipidemia (HR, 0.31; 95% CI, 0.13-0.75), and bariatric surgery (HR, 0.42; 95% CI, 0.30-0.58). Obesity remission showed similar reduced risk, but also a reduced risk of hypertension (HR, 0.40; 95% CI, 0.24-0.65). Treatment response was not associated with depression or anxiety. In this study, beneficial pediatric obesity treatment response yielded enduring health benefits, markedly lowering future morbidity and mortality risks in young adulthood.

A systematic review of pre-pandemic resilience factors and mental health outcomes in adolescents and young adults during the COVID-19 pandemic.

Adolescence and young adulthood are sensitive developmental periods to environmental influences. Investigating pre-emptive measures against stressors, such as those associated with the COVID-19 pandemic, on mental health is crucial. We aimed to synthesize evidence on pre-pandemic resilience factors shaping youth mental health outcomes during this period. For this pre-registered systematic review, we searched seven databases for longitudinal studies of youth populations affected by the COVID-19 pandemic, assessing a priori defined resilience factors at the individual, family, or community level before the pandemic. Studies required validated mental health or wellbeing measures collected both before and during the pandemic. Study quality was assessed using the corresponding NIH Quality Assessment Tool. From 4,419 unique records, 32 studies across 12 countries were included, using 46 distinct resilience measures. Due to the heterogeneity of study designs, we applied a narrative synthesis approach, finding that resilience factors were generally associated with better mental health outcomes both prior to and during the pandemic. However, most factors did not mitigate pandemic-related mental health effects. Nonetheless, family-level resilience factors emerged as promising under specific conditions. Study quality was generally fair, with concerns in resilience assessment and sampling quality. Future research should prioritize rigorous study designs and comprehensive resilience assessments.

Early life racial/ethnic discrimination effects on behavioral control and health outcomes in young adults.

Early life trauma has been shown to facilitate habitual behavior, which may predispose individuals toward perpetuating maladaptive behaviors. However, previous investigations did not account for other traumatic childhood experiences like racial/ethnic discrimination exposure, nor have they examined the interaction of trauma and habits on real-world adverse outcomes. To examine these effects, we recruited 96 young adults (20.06 ± 1.89 years old) in a study probing early life racial/ethnic discrimination influences on habitual learning, and the conjunctive influences of early life discrimination and habit on disordered eating and substance use. To measure habit responses, participants completed a noise avoidance task during which they responded to abstract stimuli via associated keyboard presses to avoid an aversive screaming sound, after which they performed a devaluation test to measure avoidance habit responses. Participants then completed a series of questionnaires examining early life racial/ethnic discrimination exposure, disordered eating and substance use, and other psychological characteristics. Hierarchical regression results showed that certain early life discrimination subtypes, particularly threat/aggression experienced due to racial/ethnic background, significantly predicted habitual responding above and beyond the effects of psychological confounds. Additionally, overall early life discrimination exposure positively predicted binge eating, but no variables of interest predicted alcohol and drug use. These results expand on extant literature showing the negative impacts of childhood stressors on behavioral control and real-world outcomes.

The Camden Study-A Pregnancy Cohort Study of Pregnancy Complications and Birth Outcomes in Camden, New Jersey, USA.

Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women. From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White participants; 98% using Medicaid in pregnancy). Study visits, including questionnaires, dietary assessments, and biospecimen collection, occurred in early and late pregnancy as well as at delivery. Medical records were abstracted, and a subset of mothers and infants participated in a six-week postpartum visit. Findings from the Camden Study have added to the understanding of adolescent and young adult maternal health and perinatal outcomes. These include associations of adolescent linear growth while pregnant with smaller neonatal birth size, low dietary zinc intake in early pregnancy with increased risk of delivery <33 gestational weeks, and higher circulating fatty acid levels with greater insulin resistance. More recent analyses have begun to unpack the biochemical pathways in pregnancy that may be shaped by race as an indicator of systemic racism. The Camden Study data and biorepositories are well-positioned to support future research aimed at better understanding perinatal health in under-represented women and infants. Linkages to subsequent health and administrative records and the potential for recontacting participants over 18-39 years after initial participation may provide key insights into the trajectories of maternal and child health across the life course.

Health care transition for autistic adolescents and young adults: A pilot rural and urban comparison survey study.

Autistic adolescents and young adults in rural areas face significant challenges in health care transition compared to their urban counterparts. Health care transition, the process of moving from pediatric to adult health care, is crucial for the long-term health outcomes of adolescents and young adults. Previous research indicates rural adolescents and young adults often have greater unmet medical and financial needs, affecting their transition experiences, but there was no study focusing on rural autistic adolescents and young adults' health care transition experiences. This pilot study provides a comparative analysis of the health care transition experiences of rural and urban autistic adolescents and young adults. Ninety-six urban and 84 rural participants (14-25 years old) participated in the study. Their average age was 19.67 years. Just over half of the participants had completed the transition to adult care, typically reporting finishing this process at around 18 years old. A majority had limited discussions with their doctors about transitioning, and those who had discussions often started these conversations late. It also reveals that the responses completed by or with parents of autistic adolescents and young adults tend to indicate that the adolescents and young adults would not make future medical decisions or are uncertain about it. The findings underscore the necessity for targeted support for autistic adolescents and young adults during their health care transition process, regardless of their residence. There is a clear need for targeted health care transition interventions for adolescents and young adults, parents, and health care providers to ensure autistic adolescents and young adults and their families receive adequate support during the health care transition process.

Longitudinal timing of physical activity and associated cardiometabolic and behavioral health outcomes in young adults.

This is the first study to examine longitudinal associations between self-selected timing of moderate-to-vigorous physical activity (MVPA) and health outcomes in young adults over 18 months. Young adults (N = 434, Mage = 23.9, SDage = 4.6 years) enrolled in a weight management trial recorded 4-7 days of ActiGraph wear time at ≥1 time point (baseline, months 6, 12, and 18). Time-of-day categories were based on quartiles of the temporal distribution of MVPA min/h at baseline: morning (06:00-11:59), afternoon (12:00-15:59), evening (16:00-18:59), and night (19:00-00:59). The proportion of weekly MVPA accumulated during each time category was the predictor in longitudinal linear mixed-effects models predicting body mass index (BMI) and total weekly MVPA. Longitudinal quasibinomial generalized estimating equations models predicted cardiometabolic risk. Interactions were tested, and marginal trend estimates were generated for sex and age subgroups. The analytic sample was 79% female and 49% non-Hispanic White, with a mean (±SD) weekly MVPA of 311 ± 167min at baseline. In adjusted models, there were no associations with BMI. Morning MVPA was inversely associated with cardiometabolic risk (OR [95% CI]: 0.99 [0.98-0.99]) for both sex and age groups. Evening MVPA was inversely associated with cardiometabolic risk for 26-35 year olds (0.98 [0.97-0.99]). Morning MVPA was associated with greater total MVPA across subgroups, and afternoon MVPA was associated with less total MVPA in women. Over 18 months, incremental health benefits may accrue with optimal activity timing in young adults. Activity-based interventions designed to improve cardiometabolic and behavioral healthoutcomes in young adults may be optimized by tailoring timing recommendations to demographic factors.

Childhood and Adolescent Depression Symptoms and Young Adult Mental Health and Psychosocial Outcomes

Depression is a leading cause of disability. The timing and persistence of depression may be differentially associated with long-term mental health and psychosocial outcomes. To examine if depression symptoms during early and middle childhood and adolescence and persistent depression symptoms are associated with impaired young adult outcomes independent of early risk factors. Data for this prospective, longitudinal cohort study were from the Québec Longitudinal Study of Child Development, a representative population-based Canadian birth cohort. The cohort consists of infants born from October 1, 1997, to July 31, 1998. This is an ongoing study; data are collected annually or every 2 years and include those ages 5 months to 21 years. The end date for the data in this study was June 30, 2019, and data analyses were performed from October 4, 2022, to January 3, 2024. Depression symptoms were assessed using maternal reports in early childhood (ages 1.5 to 6 years) from 1999 to 2004, teacher reports in middle childhood (ages 7 to 12 years) from 2005 to 2010, and self-reports in adolescence (ages 13 to 17 years) from 2011 to 2015. The primary outcome was depression symptoms at age 20 years, and secondary outcomes were indicators of psychosocial functioning (binge drinking; perceived stress; not being in education, employment, or training; social support; and experiencing online harrasment) at age 21 years. All outcomes were self-reported. Adult outcomes were reported by participants at ages 20 and 21 years from 2017 to 2019. Risk factors assessed when children were aged 5 months old were considered as covariates to assess the independent associations of childhood and adolescent depression symptoms with adult outcomes. The cohort consisted of 2120 infants. The analytic sample size varied from 1118 to 1254 participants across outcomes (56.85% to 57.96% female). Concerning the primary outcome, adjusting for early risk factors and multiple testing, depression symptoms during adolescence were associated with higher levels of depression symptoms (β, 1.08 [95% CI, 0.84-1.32]; P < .001 unadjusted and Bonferroni adjusted) in young adulthood. Concerning the secondary outcomes, depression symptoms in adolescence were only associated with perceived stress (β, 3.63 [95% CI, 2.66-4.60]; P < .001 unadjusted and Bonferroni adjusted), while both middle-childhood (β, -1.58 [95% CI, -2.65 to -0.51]; P = .003 unadjusted and P < .001 Bonferroni adjusted) and adolescent (β, -1.97 [95% CI, -2.53 to -1.41]; P < .001 unadjusted and Bonferroni adjusted) depression symptoms were associated with lower levels of social support. There were no associations for binge drinking; not being in education, employment, or training; or experiencing online harrasment. In this cohort study of Canadian children and adolescents, childhood and adolescent depression symptoms were associated with impaired adult psychosocial functioning. Interventions should aim to screen and monitor children and adolescents for depression to inform policymaking regarding young adult mental health and psychosocial outcomes.

Internal Strengths for Adverse Life Events.

In this study, a brief measure of four internal attributes found to protect against the impact of adverse life events on mental health was developed and validated. In addition, profiles of internal strengths that significantly predict mental health outcomes in young Chinese adults were identified. The results of exploratory and confirmatory factor analyses on data from 831 Chinese university students supported the proposed four-factor model of the ISALES. Participants in the current study fell into two clusters, with one cluster being higher than the other in all four internal strengths, with the former cluster demonstrating better overall mental health than those in the latter cluster. The ISALES is a promising instrument for use in clinical settings and may be used to identify individuals who are more 'at risk' of developing poor mental health in the aftermath of a negative life event. The use of the ISALES may permit tailored interventions and timely support to be provided to individuals within clinical settings.

A Cross-Sectional Analysis of Food Security, Race, and Sex on Cardiometabolic and Cognitive Health Outcomes in Young Adults With Overweight and Obesity

A Cross-Sectional Analysis of Food Security, Race, and Sex on Cardiometabolic and Cognitive Health Outcomes in Young Adults With Overweight and Obesity

Family Support in Transgender and Gender-Diverse Young Adults Seeking Telehealth for Hormone Therapy.

Background: Family support (FS) is a key social determinant of health for transgender and gender-diverse (TGD) young adults. We examined the association between FS and health outcomes in young adults seeking gender-affirming hormone therapy (GAHT) from a US telehealth service. Methods: Cross-sectional data from TGD young adults ages 18-24 (n = 7,740) who provided demographic information and information on FS at intake were analyzed. Relationships between FS, geography, insurance status, rates of depression, and smoking status were examined. Results: Less than half of respondents reported having FS. Patients with FS reported lower rates of depression and higher incidence of previous gender-affirming medical care (e.g., hormone therapy, surgeries), had lower rates of being uninsured, and were more likely to reside in the Northeast or WesternUnited States. Young adults assigned female at birth had higher rates of FS. Conclusion: FS may mitigate mental health disparities in TGD young adults including rates of depression. FS and insurance status are closely related in a geographically diverse population seeking telehealth services. The finding underscores the importance of FS as a social determinant of health and the unique characteristics of patients seeking telehealth services.

Adolescent predictors of young adult pain and health outcomes: results from a 6-year prospective follow-up study.

Adolescent chronic pain may lead to persistent disability and long-term health impairments in adulthood. However, our understanding of which youth are more likely to experience adverse outcomes remains limited. To address this gap, this longitudinal cohort study examined adolescent predictors of various dimensions of young adult health and functioning, including pain, physical health, depression, anxiety, social isolation, and sleep disturbance. As part of a previous clinical trial, we recruited a cohort of adolescents (ages 11-17 years, M age = 14 years) with non-disease-related chronic pain from 15 tertiary pain clinics in North America. Approximately 6 years later, 229 of the original 273 individuals (81% participation rate) completed a follow-up survey as young adults (ages 18-25 years, M age = 21 years). At the young adult follow-up, 73% reported continued chronic pain, with two-thirds experiencing moderate-to-severe pain interference. Youth reported several adverse health outcomes, including below-average physical health (37%), clinically elevated depression (42%), clinically elevated anxiety (48%), and sleep disturbances (77%). Multivariate regression analyses controlling for sociodemographic characteristics revealed that higher pain intensity, more pain locations, lower sleep quality, and greater anxiety symptoms in adolescence predicted worse pain outcomes in young adulthood. Moreover, lower sleep quality, greater anxiety symptoms, and worse family functioning predicted worse physical and psychosocial health in adulthood. These findings represent an important first step toward identifying ways to optimize psychological pain interventions. Tailored psychological pain interventions can directly target adolescent vulnerabilities, including mood, sleep, and family risk factors, with the potential to disrupt a lifelong trajectory of pain and suffering.

The Association of Body Image Perceptions with Behavioral and Health Outcomes among Young Adults.

This study was conducted on 5 March 2024, by the Universidad Europea de Madrid. This study aims to explore how body image perceptions influence health behaviors and mental and physical health outcomes among a specific group of 605 young adults aged 20 to 35 engaged in strength training regimes. To measure these perceptions, the Multidimensional Body-Self Relations Questionnaire (MBSRQ) was employed, an advanced tool that assesses multiple dimensions of body image through its subscales, including feelings of physical attractiveness, investment in one's appearance, and satisfaction with different body areas. Participants were segmented into two groups based on a median split of their self-reported body image. The survey assessed a diverse array of variables, including demographic details, physiological data, resistance training routines, and psychological attributes. In this revision, we consistently use the term 'dietary habits' to ensure clear and uniform language when discussing eating patterns. Notable differences were observed in dietary habits and exercise engagement, influenced significantly by body image perceptions. Negative body image was linked to less healthy dietary habits, diminished physical activity, and worse psychological outcomes, such as increased anxiety and depression. Conversely, a positive body image was associated with healthier dietary habits, more frequent physical activity, and better psychological health. The findings suggest that interventions aimed at improving body image could be crucial for enhancing overall health within this specific demographic. Due to the non-representative nature of the study group, conclusions are cautiously presented as applicable only to similar populations engaged in strength training. This study underscores the need for holistic strategies that encourage positive body image to improve both physical and psychological health outcomes in young adults.

The Prevalence of Sexually Transmitted Infections and Subsequent Association with Exposure to Childhood Violence and Mental Health Outcomes for Adolescents and Young Adults in Zimbabwe

Sexually transmitted infections (STIs) represent a major public health concern for young people in developing nations, impacting approximately two-thirds of individuals below the age of 25. This study examined the prevalence and the association between self-reported STIs, childhood violence exposure, and mental health outcomes among adolescents and young adults (13-24 years old) in Zimbabwe. Secondary data from the 2017 Zimbabwe Violence Against Children and Youth Survey (n=8,715) was utilized. Data analysis was performed using chisquare to determine the prevalence estimates for bivariate. Seven logistic regression models were used to examine the significant association between independent variables and outcomes for multivariate. About 45.5% of adolescents and young adults with self-reported STIs were exposed to multiple forms of childhood violence, 49.8% reported lifetime suicide risk, and 44.9% reported moderate-to-severe mental distress in the past 30 days. Furthermore, logistic regression results indicated that adolescents and young adults with self-reported STI diagnoses were more likely to be exposed to multiple forms of childhood violence, including physical, emotional, and sexual violence, as well as mental distress in the past 30 days and lifetime suicide risk compared to those without STIs. Therefore, this study underscores the importance of implementing comprehensive public health strategies to protect the wellbeing of adolescents and young adults with STIs. Interventions should also prioritize raising awareness, destigmatizing STIs, implementing and strengthening violence prevention policies, and addressing mental health problems through community mental health treatment programs in Zimbabwe. Keywords: Childhood violence, Emotional violence, Exposure, Mental distress, Physical violence, Sexual violence, Sexually transmitted infections (STIs), Suicide risk, Zimbabwe.

Influence of Covid-19 Social Restriction Measures on Sexual Behaviours and Reproductive Health Outcomes of Young Adults in Rivers State, Nigeria

Influence of Covid-19 Social Restriction Measures on Sexual Behaviours and Reproductive Health Outcomes of Young Adults in Rivers State, Nigeria

Latent Heterogeneity of Online Sexual Experiences and Associations With Sexual Risk Behaviors and Behavioral Health Outcomes in Chinese Young Adults: Cross-Sectional Study.

Online sexual experiences (OSEs) are becoming increasingly common in young adults, but existing papers have reported only on specific types of OSEs and have not shown the heterogeneous nature of the repertoire of OSEs. The use patterns of OSEs remain unclear, and the relationships of OSEs with sexual risk behaviors and behavioral health outcomes have not been evaluated. This study aimed to examine the latent heterogeneity of OSEs in young adults and the associations with sexual risk behaviors and behavioral health outcomes. The 2021 Youth Sexuality Study of the Hong Kong Family Planning Association phone interviewed a random sample of 1205 young adults in Hong Kong in 2022 (male sex: 613/1205, 50.9%; mean age 23.0 years, SD 2.86 years) on lifetime OSEs, demographic and family characteristics, Patient Health Questionnaire-4 (PHQ-4) scores, sex-related factors (sexual orientation, sex knowledge, and sexual risk behaviors), and behavioral health outcomes (sexually transmitted infections [STIs], drug use, and suicidal ideation) in the past year. Sample heterogeneity of OSEs was analyzed via latent class analysis with substantive checking of the class profiles. Structural equation modeling was used to examine the direct and indirect associations between the OSE class and behavioral health outcomes via sexual risk behaviors and PHQ-4 scores. The data supported 3 latent classes of OSEs with measurement invariance by sex. In this study, 33.1% (398/1205), 56.0% (675/1205), and 10.9% (132/1205) of the sample were in the abstinent class (minimal OSEs), normative class (occasional OSEs), and active class (substantive OSEs), respectively. Male participants showed a lower prevalence of the abstinent class (131/613, 21.4% versus 263/592, 44.4%) and a higher prevalence of the active class (104/613, 17.0% versus 28/592, 4.7%) than female participants. The normative class showed significantly higher sex knowledge than the other 2 classes. The active class was associated with male sex, nonheterosexual status, higher sex desire and PHQ-4 scores, and more sexual risk behaviors than the other 2 classes. Compared with the nonactive (abstinent and normative) classes, the active class was indirectly associated with higher rates of STIs (absolute difference in percentage points [Δ]=4.8%; P=.03) and drug use (Δ=7.6%; P=.001) via sexual risk behaviors, and with higher rates of suicidal ideation (Δ=2.5%; P=.007) via PHQ-4 scores. This study provided the first results on the 3 (abstinent, normative, and active) latent classes of OSEs with distinct profiles in OSEs, demographic and family characteristics, PHQ-4 scores, sex-related factors, and behavioral health outcomes. The active class showed indirect associations with higher rates of STIs and drug use via sexual risk behaviors and higher rates of suicidal ideation via PHQ-4 scores than the other 2 classes. These results have implications for the formulation and evaluation of targeted interventions to help young adults.

Adolescent School Belonging and Mental Health Outcomes in Young Adulthood: Findings from a Multi-wave Prospective Cohort Study

School belonging, sometimes referred to as school belonging or school connectedness, involves dimensions like positive affect towards school, relationships with teachers, and feeling socially valued. Previous research points to immediate benefits for students’ mental health and wellbeing; however, evidence on the potential long-term benefits of school belonging for mental health—once young people leave the school setting—is limited. This study used data on 1568 adults from the Australian Temperament Project (ATP), a 16-wave longitudinal study which has tracked participants since infancy. The short form of the Australian Council for Educational Research (ACER) School Life Questionnaire was used to assess secondary school belonging at age 15–16 years whilst young adult mental health symptoms were evaluated using the Depression, Anxiety and Stress Scales (DASS-21) at 19–20, 23–24, and 27–28 years. Generalised Estimating Equation models were used to examine the link between secondary school belonging and mental health symptoms in young adulthood. Results showed that higher levels of all aspects of school belonging were associated with lower mental health symptoms across young adulthood (β range − 0.05 to − 0.20). Associations were similar by gender. These findings underscore the importance of adolescent school belonging and in particular school status in reference to feeling socially valued, as a long-term protective factor that can mitigate against later depression, anxiety, and stress.

Retracted: Handgrip Strength-Related Factors Affecting Health Outcomes in Young Adults: Association with Cardiorespiratory Fitness.

[This retracts the article DOI: 10.1155/2021/6645252.].

Household Income and Offspring Education Explain Blacks' Diminished Returns of Parental Education.

High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities' diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. The study confirmed the role of our proposed serial mediators for Blacks' weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.

Sociocultural Risk and Resilience in the Context of Adverse Childhood Experiences

Knowledge about childhood resilience factors relevant in circumstances of marginalization and high numbers of adverse childhood experiences (ACEs) can improve interventions. To identify sociocultural resilience factors in childhood that are associated with better young adult mental health in the context of ACEs. This cohort study examined 4 waves of data from the Boricua Youth Study, which included Puerto Rican children from the South Bronx, New York, and San Juan, Puerto Rico. Participants were aged 5 to 17 years at waves 1 through 3 (2000-2003) and aged 15 to 29 years at wave 4 (2013-2017). Linear and logistic regression models tested the associations of 7 childhood resilience factors and their interaction with ACEs on young adult mental health outcomes. Data were analyzed from June 2021 to October 2023. Perceived stress, major depressive disorder and/or generalized anxiety disorder (MDD/GAD), and substance use disorder (SUD) in young adulthood. Among a total 2004 participants, the mean (SD) age at wave 4 was 22.4 (2.9) years; 1024 participants (51.1%) were female, and 980 (48.9%) were male. Positive parent-child relationships and nonparental adult support during childhood were associated with both lower perceived stress (β = -0.14; SE = 0.02; P < .001; β = -0.08; SE = 0.03; P = .003, respectively) and lower odds of MDD/GAD (adjusted odds ratio [aOR], 0.84; 95% CI, 0.73 to 0.97; aOR = 0.81; 95% CI, 0.69 to 0.95, respectively) in young adulthood. Maternal warmth reported during childhood was also associated with lower young adult perceived stress (β = -0.11; SE = 0.02; P < .001). None of the resilience factors were associated with SUD. The resilience factors familism, friendships, and family religiosity were not associated with any of the mental health outcomes. ACEs were associated with poorer mental health outcomes; however, none of the resilience factors exhibited interactions consistent with being protective for ACEs. Unexpectedly, higher family religiosity was associated with more perceived stress in the presence of higher ACEs. The results of this study suggest that promoting positive relationships with adults during childhood may reduce later young adulthood stress and MDD/GAD. However, there is still a need to identify sociocultural childhood protective factors for ACEs. Caution should be taken in assuming what resilience factors are relevant for a given group, as higher family religiosity (one postulated resilience factor) was unexpectedly associated with a stronger, rather than a weaker, association between ACEs and perceived stress in young adulthood.