Adolescents' Relationships With Their Parents and Peers as Mediators Between Economic Circumstances and Emotional Symptoms: A Multicountry Longitudinal Analysis

OBJECTIVE: Adolescents' social relationships might partly explain the increased risk of mental health problems in adolescents living in poorer economic circumstances. There are few studies in low- and middle-income countries, where most of the world's adolescents live. This study investigated whether adolescents' relationships with their parents and peers mediated the association between their economic circumstances and emotional symptoms in Ethiopia, India, Peru, and Vietnam. METHOD: Longitudinal data of 3,529 adolescents from the Young Lives study (1,741 female [49.3%]) were analyzed. Household consumption expenditure and adolescents' subjective assessment of household wealth were measured at age 15. The mediators-adolescents' positive relationships with their parents and peers-were measured at age 19. The outcome-emotional symptoms, characterized by low mood and anxiety-was measured at age 22. Mediation was assessed through counterfactual g-computation formula, adjusting for baseline and intermediate confounders. RESULTS: No evidence was found that adolescents' positive relationships with their parents or peers mediated the association between economic circumstances and emotional symptoms in any country. Living in poorer economic circumstances was typically associated with more severe emotional symptoms. CONCLUSION: Adolescents' parent and peer relationships might not mediate the effects of poorer economic circumstances on emotional symptoms in these countries, contrasting with previous studies that highlight an important role of relationships in high-income countries. Further research is needed that addresses limitations of this study and to explore other potential mechanisms, including different aspects of social relationships, that might influence mental health outcomes for adolescents living in poverty across different settings. STUDY REGISTRATION INFORMATION: Socio-Economic Inequality in Adolescent Mental Health: Mediating Roles of Adolescents' Relationships With Their Peers and Parents Across Four Countries; https://osf.io/sb67c/overview.