Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach

Citation

Kim, Eric S.; Wilkinson, Renae; Okuzono, Sakurako S.; Chen, Ying; Shiba, Koichiro; Cowden, Richard G.; & VanderWeele, Tyler J. (2024). Positive affect during adolescence and health and well-being in adulthood: An outcome-wide longitudinal approach. PLOS Medicine. vol. 21 (4) , PMCID: PMC10986977

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.

URL

https://doi.org/10.1371/journal.pmed.1004365

Keyword(s)

Adolescence

Reference Type

Journal Article

Journal Title

PLOS Medicine

Author(s)

Kim, Eric S.
Wilkinson, Renae
Okuzono, Sakurako S.
Chen, Ying
Shiba, Koichiro
Cowden, Richard G.
VanderWeele, Tyler J.

Year Published

2024

Volume Number

21

Issue Number

4

Edition

April 2, 2024

DOI

10.1371/journal.pmed.1004365

PMCID

PMC10986977

Reference ID

10369