Associations of Social Capital with Mental Disorder Prevalence, Severity, and Comorbidity among U.S. Adolescents.

Abstract

Objective: To examine cross-sectional associations between social capital constructs and 1) adolescent lifetime mental disorders, 2) severity of functional impairment, and 3) psychiatric comorbidity.Method: Data were from the National Comorbidity Survey Adolescent Supplement, a nationally representative mental health survey of 6,483\xa0U.S. adolescents aged 13-18\xa0years. Information from fully-structured diagnostic interviews, including adolescent and caregiver reports, was used to measure seven social capital constructs and lifetime DSM-IV mental disorders (mood, anxiety, behavior, substance use and eating disorder classes). Disorder severity was divided into severe vs. mild/moderate. Comorbidity was measured as the number of different classes of lifetime mental disorders.Results: Adjusted for socio-demographics and caregivers mental health, the most consistent associations with adolescent mental disorder were for supportive friendships (any disorder OR\xa0=\xa00.95, 95%CI\xa0=\xa00.91-0.99), family cohesion (OR\xa0=\xa00.81, 95%CI\xa0=\xa00.75-0.86), school bonding (OR\xa0=\xa00.76, 95%CI\xa0=\xa00.71-0.81), and extracurricular participation (OR\xa0=\xa00.90, 95%CI\xa0=\xa00.86-0.95), although results differed by disorder class. Caregiver-reported neighborhood trust and reciprocity and caregiver community involvement were less consistently associated with mental disorder. Medium levels of adolescent-reported affiliation with neighbors was associated with lower odds of mood (OR\xa0=\xa00.81, 95%CI\xa0=\xa00.66-0.98) and anxiety (OR\xa0=\xa00.78, 95%CI\xa0=\xa00.64-0.96) disorder, while high levels were associated with higher odds of behavior disorder (OR\xa0=\xa01.47, 95%CI\xa0=\xa01.16-1.87). Several associations were stronger for severe vs. mild/moderate disorder and with increasing comorbidity.Conclusion: Although we cannot infer causality, our findings support the notion that improving actual and/or perceived social capital, especially regarding friendships, family, and school, (e.g., through multimodal interventions) could aid in the prevention and treatment of both individual adolescent mental disorders and psychiatric comorbidity.