Distress in Adolescence in China: Concurrent Family and Community Characteristics and Pathways to Depression in Adulthood

Background and Purpose: Depression is a prevalent mental health condition with a typical onset in adolescence that often continues to adulthood. Existing research explored the etiological factors contributing to adolescent and adult depression, such as neural circuity, genetic inheritability, emotional/cognitive vulnerability, interpersonal relationships, and family cohesion. However, the findings about the roles of socio-demographic factors, family factors, and community factors are not consistent. Based on longitudinal data, this study examines the relationship between early-adolescence psychological distress and early-adulthood depression and explores the predicting roles of socio-demographic, family, and community factors on depression.

Methods: This study used both the baseline data (2010) and the third wave data (2016) from the China Family Panel Studies (CFPS), which is a national longitudinal social survey project. A total of 1,481 adolescents were included in the regression model. These adolescents were assessed for psychological distress in their early adolescence at 2010 and depression in early adulthood at 2016 and responded to other individual, family, and community measures at two time points. Structural equation modeling (SEM) was conducted to examine the pathways from early-adolescence distress, family factors, and community factors to early-adulthood depression.

Results: In the initial regression model, the predictors accounted for around 21% of the variance of depression (R² = .212). Specifically, social-demographic factors, including ethnic minority status (b = .050, SE = .269, p = .037), religious belief (b = .093, SE = .239, p < .001), and youth league membership (b = -.064, SE = .160, p = .010), were significantly associated with depression. The final structural equation model appeared to have a good overall fitness with the data (χ2 = 75.220, RMSEA= .030, CFI = .961, SRMR = .015). Results from SEM indicated that early-adolescence distress directly predicted early-adulthood depression without the influences of any mediators. Family-level factors, including father’s college education status, relationship with father, relationship with mother, and trust in parents, were indirectly associated with early-adulthood depression, whose associations were mediated by confidence in the future and self-rated health. In contrast, community-level factors, including community cohesion and trust in neighborhood, both directly and indirectly predicted early-adulthood depression, and such associations were mediated by life satisfaction.

Conclusions and Implications: The results of this study indicated a direct relationship between adolescent psychological distress and adult depression. At the same time, family-level factors and community-level factors predicted depression through different pathways. Based on these findings, intervention programs for adolescent psychological distress should be initiated to prevent it from developing into adulthood depression. Moreover, social work practitioners should be aware of the important influence of family-level and community-level factors, especially the roles of life satisfaction, confidence in the future, and self-rated health.