4.6 Article

Racial/Ethnic Differences in the Relationship Between Stressful Life Events and Quality of Life in Adolescents

Journal

JOURNAL OF ADOLESCENT HEALTH
Volume 68, Issue 2, Pages 292-299

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jadohealth.2020.05.055

Keywords

Racial/ethnic disparities; Health-related quality of life; Adolescent; Stressful life events

Funding

  1. Centers for Disease Control and Prevention [CCU409679, CCU609653, CCU915773, U48DP000046, U48DP000057, U48DP000056, U19DP002663, U19DP002664, andU19DP002665]

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This study revealed that stressfule life events have a negative impact on health-related quality of life among adolescents, with the relationship persisting from early adolescence to midadolescence. The negative association between family-related stress and HRQOL varied by racial/ethnic groups, indicating that Latinx adolescents may be particularly vulnerable to the time-lagged effects of such stress.
Purpose: Stressful life events (SLEs) increase allostatic load and require adaptation. Experiencing SLEs has been associated with decreased health-related quality of life (HRQOL) among adolescents. This study examined racial/ethnic and developmental differences in the relationship between SLEs and HRQOL from preadolescence to midadolescence. Methods: Data were from 4,824 participants in the Healthy Passages project, a population-based prospective longitudinal survey of fifth, seventh, and 10th grade adolescents in the U.S. HRQOL was measured with Pediatric Quality of Life Inventory and SLEs with items addressing family-related SLEs (e.g., the parent's death, separation, and divorce; family member's injury/illness; residential change; new child in the household). Results: Adolescents, regardless of race/ethnicity, reported the highest SLEs and the lowest HRQOL in early adolescence. Analysis of an autoregressive model with cross-lagged effects showed that the concurrent relationships between SLEs and HRQOL were significantly negative across preadolescence, early adolescence, and midadolescence in African-American, Latinx, and white groups. Furthermore, adolescents had a negative cross-lagged association from SLEs in early adolescence to HRQOL in pre adolescence, but this was not the case among the other racial/ethnic groups. Conclusions: Because the negative relationship between family-related SLEs and HRQOL persisted throughout stages of adolescent development, health services targeting adolescents should provide comprehensive family-centered care to alleviate the impact of family-related life stress. Relationships between family life stress and HRQOL varied by racial/ethnic groups, which should be considered by health professionals, teachers, and parents, and in prevention efforts. Latinx adolescents may be particularly vulnerable to time-lagged effects of such family-related stress. (c) 2020 Society for Adolescent Health and Medicine. All rights reserved.

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