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. We 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
We analyzed longitudinal data of 3,529 adolescents from the Young Lives study (1,741 female [49.3%]). Household consumption expenditure and adolescents’ subjective assessment of household wealth were measured at age 15. The mediators – adolescents’ positive relations 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
We found no evidence that adolescents’ positive relations 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 in high-income countries. Further research is needed that addresses our study limitations and to also explore other potential mechanisms, including different aspects of social relationships, that might influence mental health outcomes for adolescents living in poverty across different settings.