To the left: Karina Grigorian. To the right: her thesis. Photo of Karina Grigorian: Maxim Thoré/Bildbyrån

Titel: Social connectedness and mental health problems from adolescence to young adulthood: Findings from a Swedish cohort
Respondent: Karina Grigorian, Institutionen för folkhälsovetenskap, Stockholms universitet
Opponent: Sakari Suominen, professor, Department of Public Health, University of Turku, Finland
Betygsnämnd: Michael Gähler, professor vid Sociologiska institutionen, Stockholms universitet; Karin Engström, docent  vid Institutionen för global folkhälsa, Karolinska Institutet, samt Björn Högberg, docent vid Institutionen för socialt arbete, Umeå universitet. Suppleant: Viviane Schultz Straatmann, docent vid Institutionen för folkhälsovetenskap, Stockholms universitet.
Ordförande: Bitte Modin, Institutionen för folkhälsovetenskap, Stockholms universitet.
Handledare med närvaro- och yttranderätt vid första delen av betygsnämndens sammanträde: Sara Brolin Låftman (huvudhandledare), docent vid Institutionen för folkhälsovetenskap, Stockholms universitet, och Viveca Östberg, professor vid Institutionen för folkhälsovetenskap, Stockholms universitet.

Abstract

Youth mental health lays the foundation for health and well-being across the life course. Mental health problems, such as psychosomatic complaints, depression and anxiety, are recognised as significant challenges in young people’s lives that can have both immediate and long-term consequences. Social connectedness, i.e., the degree to which individuals feel belonging and integration within their social networks, plays an important role in shaping youth mental health. This is true, especially during late adolescence and young adulthood, which are life stages characterised by important social transitions.

This thesis aims to contribute to an increased understanding of mental health problems across adolescence and young adulthood by examining their development as well as exploring how various aspects of social connectedness contribute to these issues during these life stages. Drawing on repeated survey data and linked register information, the studies in this thesis investigate common indicators of mental health problems – psychosomatic complaints, depression, and anxiety – and their associations with different aspects of social connectedness.

Study I explored the link between psychosomatic complaints during adolescence and depressive and anxiety symptoms in young adulthood. The findings revealed graded associations between the frequency, number, and persistence of psychosomatic complaints, and later depression and anxiety symptoms. This suggests that adolescent psychosomatic complaints may serve as a marker for underlying issues that could evolve into and manifest as depression and anxiety in young adulthood. Therefore, if left unaddressed, frequent, numerous, and persistent psychosomatic complaints in adolescents may develop into or contribute to more serious mental health problems in the future.

Study II focused on parenting practices and psychosomatic complaints across middle and late adolescence. Although social circles widen during adolescence, to include peers, friends, and teachers, parental relationships remain fundamental. This study examined three core parenting practices – parental support, knowledge, and rule-setting – and demonstrated an especially important role of parental support. While no evidence was found for a longitudinal impact of parenting practices on later psychosomatic complaints, increases in parental support and knowledge over time were linked to a decrease in youth psychosomatic complaints, with parental support showing the most consistent association. These findings highlight the importance of parental support for adolescent mental health.

Study III explored the relationship between belonging, loneliness, and psychosomatic complaints in late adolescence and emerging adulthood. This study regards belonging and loneliness as related, yet distinct constructs. Belonging and loneliness were analysed separately and as the cross-combinations of these, in accordance with the dual-continuum model of belonging and loneliness. The findings revealed that belonging was negatively associated, and loneliness positively associated with psychosomatic complaints in cross-sectional analyses. Furthermore, individuals in the so-called socially distressed group – those experiencing high loneliness and low belonging – exhibited both cross-sectional and prospective associations with increased psychosomatic complaints.

Study IV further explored how loneliness is prospectively linked to depression and anxiety in emerging adults. In this study, the association of loneliness with self-reported depressive and anxiety symptoms, as well as with clinical psychiatric diagnoses based on registry information, was investigated. Loneliness in late adolescence was shown to be associated with a higher likelihood of both self-reported depressive and anxiety symptoms and depression and anxiety diagnoses in young adulthood, even when accounting for sociodemographic characteristics and indicators of earlier depression and anxiety.

This thesis emphasises the important role social connectedness plays in youth mental health throughout adolescence and young adulthood. The individual studies offer empirical evidence on how various aspects of social connectedness – that is, social support, belonging, and loneliness – are linked to mental health problems in young people. These aspects may not only play a role in current mental health challenges but can also have long-term implications for mental health, translating into adulthood.

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