This cohort study examines whether positive adolescent family relationships are associated
with reduced depressive symptoms among females and males as they enter midlife. How
are adolescent family relationships associated with trajectories of depressive symptoms
from adolescence into midlife for women and men? In this cohort study of 18 185 individuals
(9233 females and 8952 males), those who experienced positive adolescent family relationships
had significantly lower levels of depressive symptoms from early adolescence to midlife
(late 30s to early 40s) than did those who experienced less-positive family relationships.
The findings suggest an association of early intervention in family relationships
during adolescence with better mental health into adulthood and midlife. National
longitudinal studies that examine the linkages between early family experiences and
sex-specific development of depression across the life course are lacking despite
the urgent need for interventions in family settings to prevent adult depression.
To examine whether positive adolescent family relationships are associated with reduced
depressive symptoms among women and men as they enter midlife. This study analyzed
data from the National Longitudinal Study of Adolescent to Adult Health, which used
a multistage, stratified school-based design to select a prospective cohort of 20 745
adolescents in grades 7 to 12 from January 3, 1994, to December 26, 1995 (wave 1).
Respondents were followed up during 4 additional waves from April 14 to September
9, 1996 (wave 2); April 2, 2001, to May 9, 2002 (wave 3); April 3, 2007, to February
1, 2009 (wave 4); and March 3, 2016, to May 8, 2017 (sample 1, wave 5), when the cohort
was aged 32 to 42 years. The study sample of 8952 male adolescents and 9233 female
adolescents that were analyzed was a US national representation of all population
subgroups by sex, race/ethnicity, socioeconomic status, and geography. Adolescent
family cohesion and low parent-child conflict. Levels of depressive symptoms (Center
for Epidemiologic Studies–Depression Scale [CES-D]) from ages 12 to 42 years were
used to estimate propensity score–weighted growth curve models to assess sex differences
in trajectories of depression by levels of positive adolescent family relationships.
A total of 18 185 individuals (mean [SD] age at wave 1, 15.42 [0.12] years; 9233 [50.8%]
female) participated in the study. Females and males who experienced positive adolescent
family relationships had significantly lower levels of depressive symptoms from early
adolescence to midlife than did those who experienced less positive adolescent family
relationships. For example, depressive symptoms were lower among those with high levels
of family cohesion compared with those with low cohesion between 12 (1.26 lower CES-D
score; 95% CI, 1.10-1.42) and 40 (0.78 lower CES-D score; 95% CI, 0.50-1.06) years
of age among females and between 12 (0.72 lower CES-D score; 95% CI, 0.57-0.86) and
37 (0.21 lower CES-D score; 95% CI, 0.00-0.41) years of age among males. The reduction
in depressive symptoms associated with positive adolescent family relationships was
greater for females than males during the adolescent and early adulthood years (ie,
early 20s) (eg, low-high cohesion difference in mean CES-D score, −1.26 [95% CI, −1.42
to −1.10] for females and −0.72 [95% CI, −0.86 to −0.57] for males at 12 years of
age; low-high cohesion difference in mean CES-D score, −0.61 [95% CI, −0.69 to −0.53]
for females and −0.40 [95% CI, −0.48 to −0.31] for males at 20 years of age), after
which females and males benefited equally from positive adolescent relationships throughout
young adulthood to midlife. The findings suggest that positive adolescent family relationships
are associated with better mental health among females and males from early adolescence
to midlife. Interventions in early family life to foster healthy mental development
throughout the life course appear to be important.