Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Financial Strain, and Societal Stressors - Emerging adults in the United States are experiencing high rates of anxiety, depression, suicidality, and psychosis. Economic stress, social isolation, and the loss of traditional support systems during early adulthood can disrupt developmental milestones, including leaving home, pursuing education, starting a career, and achieving financial independence. Recent societal challenges have also highlighted persistent financial strains and neighborhood and community characteristics (e.g., rural or urban settings) that may intersect with social environments to either heighten risk or promote resilience. The genetically informative Early Steps Multisite (ESM) study, comprising 731 families with lower incomes, presents a unique opportunity to examine developmental processes across childhood, adolescence, and emerging adulthood. Families were recruited from Women, Infant, and Children centers in Eugene, OR; Pittsburgh, PA; and Charlottesville, VA, and were randomly assigned to receive the Family Check-Up (FCU) intervention from child age 2 to 10.5, or to participate in study assessments without intervention. Follow-up assessments were conducted at the ages of 14, 16, and 19, including surveys of mental health and genotyping. With rich longitudinal data on family, neighborhood, and community contexts, as well as mental health outcomes, the ESM study is well-positioned to assess resilience and risk processes from childhood to adulthood. The three study aims are: (1) to investigate how economic and social risks shape developmental trajectories of mental health, and whether protective ecological factors mitigate these risks; (2) to test genetic moderation of these processes; and (3) to evaluate the long-term preventive impact of the FCU intervention on adult mental health in the context of recent large-scale societal stressors. Continuing this study with assessments at ages 22 and 24, and including structured diagnostic interviews of depression, anxiety, and psychosis, will provide unique data on the persistence of early intervention effects on mental health into adulthood.
