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Adolescent Mental Health and Family Economic Hardships: The Roles of Adverse Childhood Experiences and Family Conflict

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Abstract

Rising and economically disproportionate rates of adverse mental health outcomes among children and youth warrant research investigating the complex pathways stemming from socioeconomic status. While adverse childhood experiences (ACEs) have been considered a possible mechanism linking socioeconomic status (SES) and child and youth psychopathology in previous studies, less is understood about how family environments might condition these pathways. Using data from a longitudinal, multiple-wave study, the present study addresses this gap by examining the direct relationships between family economic status and youth internalizing and externalizing symptoms, if ACEs mediate these relationships, and if conflictual family environments moderate these direct and indirect relationships. The data were obtained from 5510 youth participants [mean age at baseline = 9.52 (SD = 0.50), 47.7% female, 2.1% Asian, 10.3% Black, 17.6% Hispanic, 9.8% Multiracial/Multiethnic, 60.2% White] and their caretakers from the baseline, 1-year, and 2-year follow up waves. Conditional process analysis assessed the direct, indirect, and moderated relationships in separate, equivalent models based on youth- versus caregiver-raters of ACEs and youth psychopathology to capture potential differences based on the rater. The results of both the youth- and caregiver-rated models indicated that lower family economic status directly predicted higher levels of externalizing symptoms, and ACEs indirectly accounted for higher levels of internalizing and externalizing symptoms. Additionally, family conflict moderated some, but not all, of these relationships. The study’s findings highlight that lower family economic status and ACEs, directly and indirectly, contribute to early adolescent psychopathology, and conflictual family environments can further intensify these relationships. Implementing empirically supported policies and interventions that target ACEs and family environments may disrupt deleterious pathways between SES and youth psychopathology.

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Acknowledgements

The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, U24DA041147, U01DA041093, and U01DA041025. A full list of supporters is available at https://abcdstudy.org/federal-partners.html. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/Consortium_Members.pdf. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This paper reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators. The ABCD data repository grows and changes over time. The ABCD data used in this report came from https://doi.org/10.15154/1519007.

Funding

This work was supported by National Institute of Mental Health (K23MH121792-01 to N.R.K.).

Data Sharing and Declaration

Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9–10 and follow them over 10 years into early adulthood. The ABCD data used in this report came from https://doi.org/10.15154/1519007.

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Authors and Affiliations

  1. University of Kentucky, 619 Patterson Office Tower, Lexington, KY, 40506-0027, USA

    Sheila Barnhart & Antonio R. Garcia

  2. Washington University School of Medicine, Box 1125, One Brookings Drive, St. Louis, MO, 63130, USA

    Nicole R. Karcher

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  1. Sheila Barnhart
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Contributions

S.B. led the conceptualization of the study, directed efforts in its design and coordination, interpretation of the data, and drafted the paper and paper revisions; A.G. participated in the design, assisted in interpretation of the data, and assisted in drafting the paper and paper revisions; N.K. participated in the design, performed the statistical analysis, assisted in interpretation of the data, and helped to draft the paper and paper revisions. All authors read and approved the final paper.

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Correspondence to Sheila Barnhart.

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All procedures were approved by the IRB for each of the ABCD sites. All procedures comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Parents provided written informed consent and all children provided assent.

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Barnhart, S., Garcia, A.R. & Karcher, N.R. Adolescent Mental Health and Family Economic Hardships: The Roles of Adverse Childhood Experiences and Family Conflict. J Youth Adolescence 51, 2294–2311 (2022). https://doi.org/10.1007/s10964-022-01671-9

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