Journal of Youth and Adolescence

, Volume 46, Issue 12, pp 2407–2420 | Cite as

Explaining the Association between Early Adversity and Young Adults’ Diabetes Outcomes: Physiological, Psychological, and Behavioral Mechanisms

  • Kandauda A. S. Wickrama
  • Dayoung Bae
  • Catherine Walker O’Neal
Empirical Research


Previous studies have documented that early adversity increases young adults’ risk for diabetes resulting in morbidity and comorbidity with adverse health conditions. However, less is known about how inter-related physiological (e.g., body mass index [BMI]), psychological (e.g., depressive symptoms), and behavioral mechanisms (e.g., unhealthy eating and sedentary behavior) link early adversity to young adults’ diabetes outcomes, although these mechanisms appear to stem from early stressful experiences. The current study tested the patterning of these longitudinal pathways leading to young adults’ diabetes using a nationally representative sample of 13,286 adolescents (54% female) over a period of 13 years. The findings indicated that early adversity contributed to elevated BMI, depressive symptoms, and stress-related health behaviors. The impact of these linking mechanisms on hierarchical diabetes outcomes (i.e., prediabetes and diabetes) remained significant after taking their associations with each other into account, showing that these mechanisms operate concurrently. The findings emphasize the importance of early detection for risk factors of young adults’ diabetes in order to minimize their detrimental health effects.


Young adults Diabetes Early adversity Health-risk mechanisms 



This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( No direct support was received from grant P01-HD31921 for this analysis.

Author’s Contributions

K.A.S.W. conceived of the study, conducted the preliminary analyses, and drafted the manuscript; D. B. participated in the design, analyses, and interpretation of the data; C.W.O. participated in manuscript preparation and revisions. All authors read and approved the final manuscript.


This study was not funded.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Human Development and Family ScienceThe University of GeorgiaAthensUSA
  2. 2.Center for Family ResearchThe University of GeorgiaAthensUSA
  3. 3.Department of Human Development and Family ScienceThe University of GeorgiaAthensUSA

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