Gender differences in the consequences of depressive symptomatology for educational attainment, social support, and health risk behavior during the transition from adolescence to young adulthood: implications for health disparities in mid to late life

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Needham, Belinda LeeAnn

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Using data from three waves of the National Longitudinal Study of Adolescent Health, I examine the association between mental health problems experienced early in the life course and factors that impact physical health later in the life course, including educational attainment, social support, and health risk behavior. In addition, I consider whether these associations are conditioned by gender, an important aspect of social structural context. I find that adolescent depression is associated with increased odds of failure to complete high school for girls but not for boys. Among high school graduates of both genders, depressive symptomatology is associated with failure to enter college. In each case, trouble paying attention in school, grade point average, and educational expectations mediate the association between symptoms of depression and school termination. Next, I find that social support and depressive symptomatology interact with one another in a dynamic fashion across the transition from adolescence to young adulthood. Parental support during adolescence is inversely associated with initial symptoms of depression for girls and boys, although adolescent girls with low levels of parental support begin the study period with significantly higher levels of depressive symptomatology than their male counterparts. Furthermore, elevated symptoms of depression during adolescence negatively impact parent-child relationships during young adulthood. This association is stronger for girls than boys. Finally, I find that the association between depressive symptomatology and health risk behaviors is bidirectional. Adolescents who are initially more depressed begin the study period with substantially higher rates of binge drinking and drug use than their better-adjusted peers, yet they are less vulnerable to increases in these health risk behaviors across the transition to young adulthood. Also, adolescents who start out with higher than average cigarette, alcohol, and drug use experience a faster rate of decline in symptoms of depression over time compared to those who start out with lower levels of substance use. This association is more pronounced for girls than boys. Despite their faster rate of decline in depressive symptoms, girls and boys who have higher initial levels of substance use report higher levels of depressive symptomatology at all three time points.