Multiple Dimensions of Stratification in Adolescent Mental Health: A Mediated Moderation Analysis

Abstract

Utilizing data from the National Comorbidity Survey – Adolescent Supplement and a mediated moderation analysis in structural equation models, this research examines the relationship between socioeconomic status, race, gender, social support, and mental health in the adolescent population. In the United States, the prevalence of mental disorder, particularly social and behavioral disorders, has been steadily increasing in both the adult and adolescent population, with approximately half of all cases of disorder in adults presenting by early adolescence.

It has become increasingly clear that socioeconomic position greatly affects an adolescents’ likelihood of experiencing some form of mental illness; however, socioeconomic status is a complex variable that is often measured using education, income, occupation, or a scale, and it is unlikely that each of these measures affect mental health equally. Further, the effects of socioeconomic status are mediated varying forms of social support, such as the adolescents’ family, peer, and school emotional support, which can buffer or exasperate the effects of socioeconomic position. Finally, the relationship between socioeconomic position, social support and mental health is in many ways conditional upon race and gender.

This research combines these perspectives to produce a more nuanced understanding of the relationship between social characteristics, social support, and mental health. Findings demonstrate subjective social status was the strongest predictor of mental health, and that social support did mediate the relationship. Which measure of social support mediated the association depended upon the mental health outcome. Findings also demonstrate significant racial/ethnic and gendered differences in the relationship between socioeconomic status and social support which suggests the importance of an intersectionality theoretical and methodological approach.