A cross‐sectional investigation into the role of intersectionality as a moderator of the relation between youth adversity and adolescent depression/anxiety symptoms in the community

• Published in: Journal of adolescence (London, England.) Vol. 96; no. 6; pp. 1304 - 1315
• Main Authors: Havers, Laura, Bhui, Kamaldeep, Shuai, Ruichong, Fonagy, Peter, Fazel, Mina, Morgan, Craig, Fancourt, Daisy, McCrone, Paul, Smuk, Melanie, Hosang, Georgina M., Shakoor, Sania
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-08-2024
• Subjects: ACEs; Adolescents; adversity; Anxiety; depression; Depression (Psychology); Disadvantaged; Emotional Problems; Gender; Health problems; Hyperactivity; Intersectionality; Males; Mental depression; Mental disorders; Mental health; moderation; Resilience; Socioeconomic status; Structural equation modeling; Structural Equation Models; Symptoms; Youth; anxiety; adversity; depression; ACEs; intersectionality; moderation
• ISSN: 0140-1971; 1095-9254; 1095-9254
• DOI: 10.1002/jad.12347

Background
Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in socially/societally disadvantaged individuals (e.g., females, low socioeconomic status [SES]), as well as neurodivergent individuals. The intersection of these characteristics may be important for the differential distribution of adversity and mental health problems, though limited findings pertain to the extent to which intersectional effects moderate this association.
Methods
Combined depression/anxiety symptoms were measured using the emotional problems subscale of the Strengths and Difficulties Questionnaire in 13–14‐year‐olds in Cornwall, United Kingdom in 2017‐2019. In a cross‐sectional design (N = 11,707), multiple group structural equation modeling was used to estimate the effects of youth adversity on depression/anxiety symptoms across eight intersectionality profiles (based on gender [female/male], SES [lower/higher], and traits of hyperactivity/inattention [high/low]). Moderation effects of these characteristics and their intersections were estimated.
Results
Youth adversity was associated with higher levels of depression/anxiety (compared to an absence of youth adversity), across intersectional profiles. This effect was moderated by gender (stronger in males; β = 0.22 [0.11, 0.36]), and SES (stronger in higher SES; β = 0.26 [0.14,0.40]); with indications of moderation attributable to the intersection between gender and hyperactivity/inattention (β = 0.21 [−0.02,0.44]).
Conclusions
Youth adversity is associated with heightened depression/anxiety across intersectional profiles in 13–14‐year‐olds. The stronger effects observed for males, and for higher SES, may be interpreted in terms of structural privilege. Preliminary findings suggest that vulnerability and resilience to the effects of youth adversity may partially depend on specific intersectional effects. Importantly, the current results invite further investigation in this emerging line of inquiry.