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- Title
Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach.
- Authors
Kim, Eric S.; Wilkinson, Renae; Okuzono, Sakurako S.; Chen, Ying; Shiba, Koichiro; Cowden, Richard G.; VanderWeele, Tyler J.
- Abstract
Background: Several intergovernmental organizations, including the World Health Organization and United Nations, are urging countries to use well-being indicators for policymaking. This trend, coupled with increasing recognition that positive affect is beneficial for health/well-being, opens new avenues for intervening on positive affect to improve outcomes. However, it remains unclear if positive affect in adolescence shapes health/well-being in adulthood. We examined if increases in positive affect during adolescence were associated with better health/well-being in adulthood across 41 outcomes. Methods and findings: We conducted a longitudinal cohort study using data from Add Health—a prospective and nationally representative cohort of community-dwelling U.S. adolescents. Using regression models, we evaluated if increases in positive affect over 1 year (between Wave I; 1994 to 1995 and Wave II; 1995 to 1996) were associated with better health/well-being 11.37 years later (in Wave IV; 2008; N = 11,040) or 20.64 years later (in Wave V; 2016 to 2018; N = 9,003). Participants were aged 15.28 years at study onset, and aged 28.17 or 37.20 years—during the final assessment. Participants with the highest (versus lowest) positive affect had better outcomes on 3 (of 13) physical health outcomes (e.g., higher cognition (β = 0·12, 95% CI = 0·05, 0·19, p = 0.002)), 3 (of 9) health behavior outcomes (e.g., lower physical inactivity (RR = 0·80, CI = 0·66, 0·98, p = 0.029)), 6 (of 7) mental health outcomes (e.g., lower anxiety (RR = 0·81, CI = 0·71, 0·93, p = 0.003)), 2 (of 3) psychological well-being (e.g., higher optimism (β = 0·20, 95% CI = 0·12, 0·28, p < 0.001)), 4 (of 7) social outcomes (e.g., lower loneliness (β = −0·09, 95% CI = −0·16, −0·02, p = 0.015)), and 1 (of 2) civic/prosocial outcomes (e.g., more voting (RR = 1·25, 95% CI = 1·16, 1·36, p < 0.001)). Study limitations include potential unmeasured confounding and reverse causality. Conclusions: Enhanced positive affect during adolescence is linked with a range of improved health/well-being outcomes in adulthood. These findings suggest the promise of testing scalable positive affect interventions and policies to more definitively assess their impact on outcomes. Leveraging data from the U.S Add Health project, Eric Kim and colleagues explore how mood during adolescence influences health and well-being outcomes in adulthood. Author summary: Why was this study done?: Intergovernmental organizations, including the World Health Organization and United Nations, are advocating for the inclusion of well-being indicators in policy-making, alongside traditional economic measures like GDP. This trend, along with the growing understanding of positive affect's benefits for health and well-being, creates exciting opportunities for intervening on positive affect to enhance outcomes, but, existing research primarily focuses on adult populations, and although some progress has been made, it remains unclear if positive affect assessed in adolescence shapes health/well-being in adulthood. Thus, there is a need to understand this knowledge gap to help inform relevant policies and interventions. What did the researchers do and find?: In our longitudinal cohort study of U.S. adolescents from the Add Health project, we examined if increases in positive affect over 1 year during adolescence were associated with better health/well-being outcomes on 41 indicators in adulthood. In our analyses, we used data from 11,040 participants in Wave IV and 9,003 participants in Wave V, prioritizing the latest available data from Wave V whenever possible, and including Wave IV data when Wave V data was unavailable. The study, which spanned from adolescence (age 15.28) to adulthood (ages 28.17 or 37.20), found that higher positive affect is generally associated with better outcomes in various areas, including physical health, health behavior, mental health, psychological well-being, and social and civic engagement. What do these findings mean?: Our findings indicate that fostering positive affect during adolescence could lead to a broad spectrum of improved health and well-being outcomes in adulthood, underscoring its potential value in youth-focused policies and interventions. The implications for practice include the potential development of targeted strategies to enhance positive affect among adolescents as a means to promote long-term health and well-being. However, limitations such as possible unmeasured confounding factors, possible reverse causality, and reliance on self-reported data suggest that these findings should be approached as preliminary, highlighting the need for further research in this area.
- Subjects
WORLD Health Organization; UNITED Nations; AFFECT (Psychology); LONELINESS; HEALTH behavior; WELL-being; ADULTS; PSYCHOLOGICAL well-being; ADOLESCENCE
- Publication
PLoS Medicine, 2024, Vol 21, Issue 4, p1
- ISSN
1549-1277
- Publication type
Article
- DOI
10.1371/journal.pmed.1004365