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Explaining US Adolescent Depressive Symptom Trends Through Declines in Religious Beliefs and Service Attendance

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Over the past decade, US adolescents’ depressive symptoms have increased, and changing religious beliefs and service attendance may be contributing factors. We examined the contribution of religious factors to depressive symptoms among 417,540 US adolescents (grades: 8, 10, 12), years:1991–2019, in survey-weighted logistic regressions. Among adolescents who felt religion was personally important, those who never attended services had 2.23 times higher odds of reporting depressive symptoms compared to peers attending weekly. Among adolescents who did not feel that religion was important, the pattern was reversed. Among adolescents, concordance between importance of religion and religious service attendance may lower risk of depressive symptoms. Overall, we estimate that depressive symptom trends would be 28.2% lower if religious factors had remained at 1991 levels.

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Data are available through Monitoring the Future, which is largely publicly available.

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SAS code is not available, kept in secure data enclave under MTF guidance.


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These analyses are funded by Grant R01DA048853 (PI: Keyes) and with support from the Columbia Center for Injury Science and Prevention (R49-CE003094). Additionally, Dr. Martins reports funding from Grant R01DA037866, and Dr. Hasin reports funding from Grant R01DA048860. Funders had no role in the conduct of research or the preparation of this article. Funders had no role in study design, in the collection, analysis and interpretation of data, in the writing of the article, or in the decision to submit it for publication.

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Correspondence to Noah T. Kreski.

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No potential competing interest was reported by the authors.

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The Monitoring the Future study is approved by the IRB of University of Michigan.

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Parents were informed of the study and provided the option to decline participation on their child’s behalf.

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See Fig. 3 and Tables 3, 4, 5, 6, 7, 8, 9 and 10.

Fig. 3
figure 3

Observed trend in high (score > 15) depressive symptoms (blue line) among US adolescents from 1991 to 2019, and projected trend in high depressive symptoms (red line) if US religious service attendance and importance had remained fixed at 1991 levels

Table 3 Sample characteristics, N = 417,540
Table 4 Demographic characteristics for included adolescents and those excluded for insufficient depressive symptom data
Table 5 Unadjusted and *adjusted odds ratios for the association between religious attendance and importance with depressive symptoms (Score > 10; Score > 12)
Table 6 Sensitivity Analysis – Unadjusted Odds Ratios and 95% Confidence Intervals for the Associations between Religious Attendance and Depressive Symptoms for Each Level of Religious Importance
Table 7 Sensitivity Analysis – Adjusted* Odds Ratios and 95% confidence intervals for the associations between religious attendance and depressive symptoms for each level of religious importance
Table 8 Percentages of religious service attendance and personal importance of religion by region
Table 9 Lagged analysis of prevalence of at least monthly religious service attendance predicting mean depressive symptom score
Table 10 Lagged analysis of prevalence of religion being personally unimportant predicting mean depressive symptom score

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Kreski, N.T., Chen, Q., Olfson, M. et al. Explaining US Adolescent Depressive Symptom Trends Through Declines in Religious Beliefs and Service Attendance. J Relig Health 61, 300–326 (2022).

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