A cross-sectional investigation into the role of intersectionality as a moderator of the relation between youth adversity and adolescent depression/anxiety symptoms in the community

Background: Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in disadvantaged (e.g., females, low socioeconomic status [SES]), as well as neurodivergent, groups. The intersection of these characteristics may moderate the impact of youth adversity on adolescent mental health. Aims: To investigate the moderating influence of intersectionality on the relation between youth adversity and depression and anxiety symptoms in adolescence. Methods: Depression and anxiety symptoms were measured in 13-14-year-olds in the HeadStart Cornwall cohort (N=12,067) using the emotional problems subscale of the Strengths and Difficulties Questionnaire. Multiple group structural equation modelling was used to estimate the effects of youth adversity on combined depression and anxiety symptoms across eight intersectionality profiles. Group assignment was based on gender (female/male), SES (lower/higher), and hyperactivity/inattention (high/low). Moderation effects attributable to these characteristics and their intersections were estimated. Results: Youth adversity was associated with higher levels of depression and anxiety (compared to an absence of youth adversity), across intersectional profiles. This association was moderated by gender (stronger in males than females (β=0.22 [0.11,0.36])), and SES (stronger in higher compared to lower SES (β=0.26 [0.14,0.40])); with indications of moderation attributable to the intersection of gender and hyperactivity/inattention (β=0.21 [-0.02,0.44]). Conclusions: Youth adversity detrimentally impacts the mental health of 13-14-year-olds, across intersectional profiles. Preliminary findings suggest that vulnerability and resilience to the negative impacts of youth adversity may partially depend on the intersection of individual characteristics. These results invite further investigation in this emerging field of research.