Summary: Positive relationships with parents and other adults during childhood significantly contribute to better mental health in adulthood. Analyzing data from the Boricua Youth Study, researchers found that children with at least one nurturing adult relationship had lower risks of depression, anxiety, and stress later in life.
This study, focusing on marginalized and minoritized youth, highlights the importance of supportive adult connections as a resilience factor against mental disorders. Surprisingly, family religiosity was linked to increased stress in those with high adverse childhood experiences (ACEs), suggesting the need for broader resilience strategies beyond traditional predictors.
Positive adult-child relationships during childhood are associated with reduced depression, anxiety, and stress in adulthood.
The study emphasized the need for interventions that foster supportive relationships for children facing adversity.
None of the resilience factors studied were associated with substance use disorder, indicating the complexity of resilience and mental health.
Source: Columbia University
A Columbia University study found that positive relationships with parents and other adults during childhood are associated with better mental health in adulthood, regardless of exposure to adverse childhood experiences.
The findings, published in JAMA Psychiatry Dec. 27, 2023, suggest that interventions promoting supportive adult connections during childhood could pay dividends in young adult population health, reducing the sociocultural risk of mental disorders, such as depression and anxiety.
“For kids, an extremely important resilience factor is a warm, nurturing relationship with a parent, caregiver, or other adult,” said lead study author Sara VanBronkhorst, MD, MPH, voluntary faculty in psychiatry at Columbia.
“Our study demonstrates that children who have at least one positive, committed adult-child relationship are less likely to experience depression, anxiety and perceived stress later in life.”
The study sought to address an important gap in research by focusing on marginalized and minoritized youth who are more likely to experience multiple adversities and gain insight into sociocultural factors that would bolster their resilience over a lifetime.
To identify markers of resilience, the investigators examined data from 2,000 participants in the Boricua Youth Study (BYS), a longitudinal study following three generations of families for 20 years, led by Cristiane Duarte, PhD, MPH, the Ruane Professor for the Implementation of Science for Child & Adolescent Mental Health at Columbia, who is also senior author of the JAMA Psychiatry paper.
All participants in BYS are of Puerto Rican descent, about half originally residing in the island of Puerto Rico and others residing in the South Bronx, New York.
The researchers assessed for adverse childhood experiences, or ACEs, at three points during childhood. These experiences can include things like physical or emotional abuse, neglect, caregiver mental illness, death or incarceration, and household violence.
They also measured seven sociocultural factors associated with resilience, which included social relationships (maternal warmth and friendships) and sources of meaning (familism and family religiosity).
Mental health outcomes were measured during young adulthood and included generalized anxiety disorder, major depressive disorder, substance use disorder, and perceived stress.
As hypothesized, they found that the measures of social relationships, apart from peer relationships, were associated with less depression and anxiety, and less perceived stress in young adulthood.
Surprisingly, the researchers discovered that family religiosity, often thought to be protective, was associated with more—not less— perceived stress among young adults who had experienced high ACEs. Of note, while there were associations between resilience factors and later stress, depression, and anxiety, none of the resilience factors studied were associated with substance use disorder.
“With factors such as religiosity, the story may be more nuanced,” said Dr. VanBronkhorst. “One explanation for this unexpected finding could be that religious families may experience higher levels of shame and guilt related to ACEs, such as parental substance use or incarceration.”
The researchers said that the fact that several markers associated with resilience did not confer protection underscores the importance of preventing ACEs and highlights the need to find other ways of supporting children experiencing adversity in the context of marginalization and minoritization.
“We may need to look beyond traditional predictors of resilience,” Dr. Duarte said. “Future studies could look at the roles, for example, of financial resources, racism, and social equity on resilience.”
Dr. VanBronkhorst, who in addition to her role at Columbia works as a child and adolescent psychiatrist at Network180, a community mental health clinic, sees many children with high ACEs.
“The parents I work with see their kids struggling, they want to form these positive relationships, but so much gets in the way,” she said.
“We should be helping them with parenting classes and family therapy; we can educate teachers and community members. But we should also be looking at larger, structural, interventions that could reduce the experiences of adversities and the causes of stress that interfere with adults forming bonds that can buffer children from stress.”
In this study we wanted to acknowledge that resilience cannot be reduced to individual attributes that one may be born with,” Dr. Duarte added. “Resilience is a process. To engage in this process, children and caregivers need access to resources in their environment that foster strong, responsive relationships and meaningful experiences.”
About this mental health and neurodevelopment research news
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.
Design, Setting, and Participants
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.
Main Outcomes and Measures
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.
Conclusions and Relevance
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.