Summary: Children and adolescents who report having a strong relationship with their parents have better long-term health outcomes, a new study reports.
Researchers from Children’s Hospital of Philadelphia (CHOP) have found that adolescents who report strong relationships with their parents have better long-term health outcomes.
Study findings, published today in JAMA Network Open, suggest that investments in improving parent–adolescent relationships could help improve general health, mental health and sexual health while also reducing substance use in young adulthood.
Prior research shows that positive characteristics of parent-adolescent relationships are associated with improved mental health, sexual health and overall general health, while also reducing the risk of substance abuse and cardiovascular issues.
However, these studies have often been limited by small sample sizes, short-term outcomes, differing measures for parent–adolescent relationship characteristics, lack of diversity and a focus only on relationships with mothers rather than relationships with mothers and fathers.
To help address these issues, this study used data from the National Longitudinal Study of Adolescent to Adult Health. Researchers tested whether adolescents’ reports of specific, measurable characteristics of their relationships with mother- and father-figures with whom they live were linked to health outcomes measured 14 years later. The researchers looked at data from more than 15,000 adults who were initially enrolled in the study in the mid-1990s when they were between 12 and 17 years old.
“Our goal was to establish a clearer understanding of how different characteristics of mother-adolescent and father-adolescent relationships might be associated with a wide range of favorable outcomes in young adulthood,” said senior study author Carol A. Ford, MD, Chief of the Craig-Dalsimer Division of Adolescent Medicine and the Orton P. Jackson Endowed Chair in Adolescent Medicine at CHOP.
In this study, the researchers looked at characteristics such as reported parental warmth, communication, time together and academic expectations as assessed when the participants were between 12 and 17 years old. When those same participants were 24 to 32 years old, they reported on current levels of stress, depression, optimism, nicotine dependence and substance abuse and other measures of general health.
The study controlled for age, race, ethnicity, family structure and other factors and separated the data based on relationships with mother and father figures who lived in the home. More than 10,000 participants were analyzed for the study.
The study found that participants who reported higher levels of mother-adolescent and father-adolescent warmth, communication, time together, academic expectations, relationship or communication satisfaction and inductive discipline reported significantly higher levels of general health in young adulthood. Similarly, they reported significantly higher levels of optimism and romantic relationship quality, and lower levels of stress and depressive symptoms as young adults.
Higher levels of adolescent-reported parental warmth, time together and relationship or communication satisfaction were also significantly associated with lower levels of nicotine dependence and substance abuse in young adulthood as well as lower odds of unintended pregnancy.
“The overall pattern of these results suggests strong relationships between adolescents and their mothers and fathers leads to better health and well-being in young adulthood,” Ford said. “Efforts to strengthen parent-adolescent relationships may have important long-term health benefits.”
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Original Research: Open access.
“Associations between mother-adolescent and father-adolescent relationships and young adult health” by Carol A. Ford et al. JAMA Network Open
Associations between mother-adolescent and father-adolescent relationships and young adult health
Studies linking the quality of parent-adolescent relationships with young adult health outcomes could inform investments to support these complex relationships.
To evaluate whether consistently measured, modifiable characteristics of parent-adolescent relationships are associated with young adult health across multiple domains.
Design, Setting, and Participants
This cohort study used data from waves I (1994-1995; ages 12-17 years) and IV (2008-2009; ages 24-32 years) of the US National Longitudinal Study of Adolescent to Adult Health. Of 20 745 adolescents enrolled in wave I, 15 701 of 19 560 who were eligible completed wave IV (response rate, 80.3%). Data analyses were conducted from February 2019 to November 2020.
Parental warmth, parent-adolescent communication, time together, relationship and communication satisfaction, academic expectations, and maternal inductive discipline as reported at wave I by adolescent participants.
Main Outcomes and Measures
Wave IV participant-reported self-rated health, depression, stress, optimism, nicotine dependence, substance abuse symptoms (alcohol, cannabis, or other drugs), unintended pregnancy, romantic relationship quality, physical violence, and alcohol-related injury. Separate regression models were run for mother-adolescent and father-adolescent relationships while controlling for age, biological sex, race and ethnicity, parental educational level, family structure, and child maltreatment experiences.
A total of 10 744 participants (mean [SD] age at wave IV, 28.2 [1.8] years; 52.0% female; 67.3% non-Hispanic White) and 8214 participants (mean [SD] age at wave IV, 28.2 [1.8] years; 50.8% female; 71.9% non-Hispanic White) had valid sampling weights and complete data for mother-adolescent and father-adolescent relationship characteristics, respectively.
Adolescents who reported higher levels of mother-adolescent warmth (β = 0.11 [95% CI, 0.06-0.15]), communication (β = 0.02 [95% CI, 0.00-0.04]), time together (β = 0.07 [95% CI, 0.05-0.09]), academic expectations (β = 0.05 [95% CI, 0.02-0.08]), relationship or communication satisfaction (β = 0.07 [95% CI, 0.04-0.10]), and inductive discipline (β = 0.03 [95% CI, 0.01-0.05]) reported significantly higher levels of self-rated general health in young adulthood.
Adolescents who reported higher levels of father-adolescent warmth (β = 0.07 [95% CI, 0.03-0.11]), communication (β = 0.03 [95% CI, 0.01-0.05]), time together (β = 0.06 [95% CI, 0.03-0.08]), academic expectations (β = 0.04 [95% CI, 0.01-0.06]), and relationship satisfaction (β = 0.07 [95% CI, 0.04-0.10]) also reported significantly higher levels of self-rated general health in young adulthood.
Adolescents reporting higher levels of all exposures also reported significantly higher levels of optimism and romantic relationship quality in young adulthood (β coefficient range, 0.02 [95% CI, 0.00-0.04] to 0.24 [95% CI, 0.15-0.34]) and lower levels of stress and depressive symptoms (β coefficient range, −0.07 [95% CI, –0.12 to –0.02] to −0.48 [95% CI, –0.61 to –0.35]).
Higher levels of parental warmth, time together, and relationship or communication satisfaction were significantly associated with lower levels of nicotine dependence (odds ratio range, 0.78 [95% CI, 0.72-0.85] to 0.89 [95% CI, 0.81-0.98]) and substance abuse symptoms (incidence rate ratio range, 0.60 [95% CI, 0.50-0.73] to 0.94 [95% CI, 0.89-0.99]), as well as lower odds of unintended pregnancy (odds ratio range, 0.81 [95% CI, 0.74-0.88] to 0.93 [95% CI, 0.86-0.99]). Patterns were less consistent for physical violence and alcohol-related injury. Characteristics of mother-adolescent and father-adolescent relationships were similarly associated with young adult outcomes.
Conclusions and Relevance
The findings of this cohort study suggest that adolescents’ positive perceptions of their relationships with their mothers and fathers are associated with a wide range of favorable outcomes in young adulthood. Investments in improving parent-adolescent relationships may have substantial benefits for young adult population health.