title: Life course models of economic stress and poor mental health in mid-adulthood: Results from the prospective Northern Swedish Cohort.
abstract: OBJECTIVE
  The aim was to analyse the association between economic stress during youth and adulthood, and poor mental health through life course models of (1) accumulation of risk and (2) sensitive period.
  
  
  METHODS
  The study was based on the Northern Sweden Cohort, a 26-year prospective cohort (N = 1010 in 2007; 94% of those participating in 1981 still alive) ranging from adolescence to middle age. Economic stress was measured at age 16, 21, 30 and 42 years. Two life course models of accumulation of risk and sensitive period were analysed using ordinal regression with internalized symptoms of mental health as outcome.
  
  
  RESULTS
  Exposure of economic stress at several life course periods was associated with higher odds of internalized mental health symptoms for both women and men, which supports the accumulated risk model. No support for a sensitive period was found for the whole sample. For men, however, adolescence appears to be a sensitive period during which the exposure to economic stress has negative mental health consequences later in life independently of economic stress at other ages.
  
  
  CONCLUSIONS
  This study confirms that the duration of economic stress between adolescence and middle age is important for mental health. In addition, the results give some indication of a sensitive period of exposure to economic stress during adolescence for men, although more research is needed to confirm possible gender differences.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden sofia.elwer@vll.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Elwér
authors.affiliation: Department of Public Health and Clinical Medicine, Unit of Social Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Hammarström
authors.affiliation: Department of Social Work, Umeå University, Umeå, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Strandh
authors.affiliation: Department of Public Health and Clinical Medicine, Unit of Social Medicine, Umeå University, Umeå, Sweden.
authors.forename: Per E
authors.initials: PE
authors.lastname: Gustafsson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008960:Models, Psychological; D011446:Prospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: Life course; accumulation of risk; economic stress; gender; internalized symptoms; longitudinal cohort; mental health; ordinal regression; sensitive period