title: Adverse adolescent relationship histories and young adult health: cumulative effects of loneliness, low parental support, relationship instability, intimate partner violence, and loss.
abstract: OBJECTIVE
  To examine the associations between adverse interpersonal relationship histories experienced during adolescence and health in young adulthood in a large, nationally representative sample.
  
  
  METHODS
  Using data from Waves I, II, and III of the National Longitudinal Study of Adolescent Health, multiple adverse relationship experiences were examined, including high loneliness, low perceived parental support, frequent transitions in romantic relationships (relationship instability), exposure to intimate partner violence, and loss by death of important relationship figures. These histories are assessed, both individually and in a relationship risk index, as predictors of self-reported general health and depressive symptoms at Wave III (ages, 18-27), controlling for baseline (Wave I) health and for demographic and health behavior covariates.
  
  
  RESULTS
  Net of baseline health and covariates, each type of relationship risk (experienced between Wave I and Wave III) was related to either depression or general health at Wave III, with the strongest effects seen for exposure to intimate partner violence. In addition, a cumulative relationship risk index examining the extent to which youth experienced high levels of multiple relationship risk factors revealed that each additional adverse relationship experience increased the odds of reporting worse mental and general health at Wave III, with increases occurring in an additive manner.
  
  
  CONCLUSIONS
  Multiple types of adverse relationship experiences predicted increases in poorer general health and depressive symptoms from adolescence to early adulthood. Consistent with a cumulative risk hypothesis, the more types of adverse relationship a youth experienced, the worse were their young adult health outcomes.
authors.affiliation: Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, Evanston, Illinois 60208, USA. ek-adam@northwestern.edu
authors.forename: Emma K
authors.initials: EK
authors.lastname: Adam
authors.forename: Laura
authors.initials: L
authors.lastname: Chyu
authors.forename: Lindsay T
authors.initials: LT
authors.lastname: Hoyt
authors.forename: Leah D
authors.initials: LD
authors.lastname: Doane
authors.forename: Johanne
authors.initials: J
authors.lastname: Boisjoly
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Duncan
authors.forename: P Lindsay
authors.initials: PL
authors.lastname: Chase-Lansdale
authors.forename: Thomas W
authors.initials: TW
authors.lastname: McDade
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008132:Loneliness; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D010287:Parent-Child Relations; D012747:Sexual Partners / Q000523:psychology; D012944:Social Support; D013179:Spouse Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult