Cumulative risk exposure and emotional symptoms among early adolescent girls

From early adolescence, girls and women report the highest rates of emotional symptoms, and there is evidence of increased prevalence in recent years. We investigate risk factors and cumulative risk exposure (CRE) in relation to emotional symptoms among early adolescent girls.

Four risk factors were found to have a statistically significant relationship with emotional symptoms among early adolescent girls: low academic attainment, special educational needs, low family income, and caregiving responsibilities. CRE was positively associated with emotional symptoms, with a small effect size.

Results identify risk factors (outlined above) that are associated with emotional symptoms among early adolescent girls, and highlight that early adolescent girls experiencing a greater number of risk factors in their lives are likely to also experience greater emotional distress. Findings highlight the need for identification and targeted mental health intervention (e.g., individual or group counselling, approaches targeting specific symptoms), for those facing greater risk and/or with emergent symptoms.

In early adolescence, evidence suggests that girls begin to experience greater levels of emotional symptoms (i.e., depressive and anxious symptoms) than boys, typically around the age of 12 years[1].1 Studies show this disparity exists throughout the lifespan; girls and women are twice as likely to report depressive symptoms and disorder from mid-adolescence compared to boys and men [1]. They are also more likely to experience anxious symptoms and disorders, though this fluctuates based on type of anxiety [2]. Depressive and anxious symptoms are distinct but strongly inter-related, with high comorbidity rates among adolescents [3]. Research indicates a significant increase in emotional symptoms and disorder among adolescent girls in recent years, in the United Kingdom [4,5,6,7] and other Western and non-Western countries [8, 9], necessitating urgent research into the factors associated with such difficulties. These studies consistently point to apparent increases in emotional difficulties as a whole (i.e., rather than just depressive or anxious symptomatology) and to increases only among girls, and not among boys in the same cohorts [4,5,6,7,8,9]. Effects have been observed across different points in adolescence, starting in early adolescence [6]. Typically these increases among girls are small, but as noted by Fink et al. [6] the effect is not negligible and warrants attention.

We set out to investigate the risk factors associated with emotional symptoms among girls aged 11–12 years, given evidence that such symptoms are increasing among girls. Furthermore, as risk factors tend to co-occur [10], we also examined whether exposure to a greater number of risk factors corresponds to increased symptoms. We focused on investigating possible factors associated with symptoms among a 2017 sample of adolescent girls, offering valuable insight into epidemiological patterns and levels of exposure for a vulnerable group at a recent timepoint, rather than factors that may be contributing to an increase in such symptoms, which currently are not well understood. We focused on symptoms rather than disorder given the reported increase in general symptomatology among girls [4,5,6,7]. Furthermore, evidence indicates that depression and anxiety symptoms go beyond those specified within constricted diagnostic criteria, suggesting that psychopathology is continuous and not narrowly expressed through distinct disorders [11, 12].

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