Preventing Adult Mental Health Problems from Early Childhood in the Contexts of Genetic Susceptibility, Poverty, Racism, and the COVID-19 Pandemic

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ABSTRACT Early adults are experiencing high rates of mental health issues, including anxiety, depression, suicidality, and psychosis. The overall goal of the NIMH-funded R01 Early Steps Multisite parent grant is to examine the impact of randomization to receipt of the Family Check-Up (FCU), or not, from child ages 2 to 10 on developmental pathways from early childhood to early adulthood, focusing on mental health disorders and symptomatology in emerging adults. Aligned with the third aim of the Early Steps parent grant, “to examine the long-term preventive effects of the FCU on mental health, in the context of growing up in poverty,” this supplement proposes an extension of this aim, specifically focusing on various aspects of living in poverty in early childhood (caregiver income, employment, education, and financial stress) as independent contributors to risk for self-reported mental health symptomology in adolescence and early adulthood, and if these relationships are mediated by maternal depression and caregiver competence in childhood, and moderated by the FCU intervention. We also plan to examine this model with mental health care utilization, for those experiencing mental health issues, in adolescence and adulthood as the outcome. Findings from this study will contribute to understanding of how specific aspects of growing up in poverty may exacerbate or ameliorate mental health symptomatology in adolescence and adulthood, and how the FCU may buffer the impact of childhood poverty on later mental health and utilization of mental health care. Overall, the research and training Dr. Chirimwami will receive as part of this diversity supplement will accelerate his transition to an independent research scientist by expanding his expertise in childhood poverty, work with underserved communities, the impact of the FCU intervention, longitudinal modeling, and scholarly and grant writing.