223 - Pre-adolescent positive childhood experiences and adolescent mental health and risk behaviors in a marginalized U.S. sample

Publication Number: 223.6201

Kristine H. Schmitz, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Kelly Noonan, Princeton University, Princeton, NJ, United States; Hope Corman, Rider University & National Bureau of Economic Research, Princeton Junction, NJ, United States; Manuel Jimenez, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, United States; Nancy Reichman, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States

Background: Positive childhood experiences (PCEs) include supportive relationships, social engagement, and safe environments. PCEs can foster resilience and promote health into adulthood, but few studies focus on marginalized groups. Non-marital childbearing in the U.S. is strongly linked to poverty and racial/ethnic minority status.

Objective: To investigate associations between pre-adolescent PCEs and adolescent mental health and risk behaviors among youth born out-of-wedlock.

Design/Methods: We conducted a secondary analysis of a U.S. cohort, the Future of Families and Child Wellbeing Study. By design, 75% of the children were born out-of-wedlock. PCEs were assessed at age 9, and adolescent depression, substance use, and delinquency were assessed at age 15. Youth-reported PCEs were closeness to a parent, school connectedness, positive peer interactions, extracurricular involvement, and neighborhood cohesion. We also considered having ≥3 of these PCEs (vs < 3 PCEs).

We limited the sample to children born out-of-wedlock to represent a population with a high proportion of under-resourced families. We estimated unadjusted and adjusted logistic regression models of associations between PCEs and adolescent depression, delinquency, and substance use. Adjusted models included child, parent, and family characteristics.

Results: We analyzed data from 1736 youth (54% non-Hispanic Black, 24% Hispanic, mean age was 9.3 years, and 74% reported income < 200% of the federal poverty level).

In logistic regression models (Table 1), youth reporting feeling close with a parent had significantly lower odds of depression (aOR 0.68 CI 0.50-0.92) and delinquency (aOR 0.69 CI 0.49-0.98). School connectedness was associated with lower odds of ever trying drugs (aOR 0.75 CI 0.58-0.97). Positive peer relationships were strongly associated with lower odds of depression (aOR 0.65 CI 0.50-0.84), delinquency (aOR 0.68 CI 0.50-0.92), ever smoking cigarettes (aOR 0.61 CI 0.38-0.97) or trying drugs (aOR 0.76, CI 0.60-0.96). Neighborhood cohesion as associated with lower odds of depression (aOR 0.64 CI 0.48-0.86). Having ≥3 PCEs was associated with lower odds of depression (aOR 0.68 CI 0.53-0.86) and ever trying drugs (aOR 0.79 CI 0.63-0.99).

Conclusion(s): These preliminary findings from a national sample of economically and racially/ethnically marginalized youth suggest strong protective associations between PCEs at age 9 and mental health and risk behaviors at age 15. Peer relationships appeared to be most impactful. Findings suggest a need for targeted interventions to bolster pre-adolescent PCEs to promote optimal adolescent health and wellbeing.

Table 1: Associations between pre-adolescent positive childhood experiences (PCEs) and adolescent mental health and risk behaviors (N=1726).
Notes: aOR = adjusted odds ratio, CI =confidence interval.
Models display the associations between positive childhood experiences (PCEs) at age 9 and depression, delinquency, and health risk behaviors at age 15, controlling for child sex, child’s race/ethnicity, primary caregiver’s education, primary caregiver’s age, parents’ marital/cohabiting status, family poverty level, and whether the child lived with a parent (vs. living with non-parent). Time-varying covariates were measured at 9 years.
*** p<0.01, ** p<0.05