Importance: Although early maternal warmth strongly predicts adolescent health, questions remain about the biopsychosocial mechanisms underlying this association.

Objective: To understand how maternal warmth at 3 years of age shapes adolescent social safety schemas at 14 years of age and physical and mental health at 17 years of age.

Design, setting, and participants: The Millennium Cohort Study tracks approximately 19 200 children born from late 2000 to early 2002 in the UK. Participants were assessed from ages 3 to 17 years.

Exposure: Low maternal warmth (eg, lack of praise, negative tone of voice when speaking to the child) and maternal harshness (eg, using physical restraint, grabbing the child) were independently coded during a home visit (age 3 years).

Main outcomes and measures: Social safety (age 14 years) was measured by children's responses to 3 items (eg, "I have family and friends who help me feel safe, secure and happy"). Physical health was self-reported on a scale ranging from 1 (excellent) to 5 (poor) (age 17 years). Psychological distress (age 17 years) was assessed using the 6-item Kessler Psychological Distress Scale. Psychiatric problems (age 17 years) was a latent variable composed of self-disclosed clinical diagnosis of depression/anxiety, self-harm, and suicidal behaviors.

Results: The present sample included 8540 youths (52% female; 3.0% Black or Black British, 2.8% Indian, 6.7% Pakistani and Bangladeshi, 2.8% Mixed, 83% White, and 1.6% other). Data were analyzed from March 2024 to September 2024 using structural equation modeling. In models controlling for sex, ethnicity, income, neighborhood disadvantage, maternal mental health, and early cognitive ability, the paths from childhood maternal warmth (but not harshness) to social safety schemas at 14 years of age (b = 0.03; P < .001) and physical health at 17 years of age (b = 0.05; P = .02) were significant, suggesting that early maternal warmth enhances subsequent perceived social safety and physical health. Additionally, the paths from negative social safety schemas at 14 years of age to poorer physical health (b = 0.50; P < .001), psychological distress (b = 5.37; P < .001), and psychiatric problems (b = 0.21; P < .001) at 17 years of age were significant, suggesting that greater perceived social safety prospectively predicts better health. Social safety at 14 years of age mediated 20% to 100% of the effect of early maternal warmth on physical health, psychological distress, and psychiatric problems at 17 years of age (b = 0.01-0.15; P < .001 for all).

Conclusions and relevance: These results show that early-life maternal warmth affected adolescent health by influencing perceptions of social safety. Improving parent-child relationships and enhancing youths' perceptions of social safety may thus improve adolescent health.

重要性： 尽管早期母爱温暖对青少年健康具有强烈预测作用，但关于这种关联的生物心理社会机制仍存在疑问。

目的： 了解3岁时母亲的关爱如何影响14岁时的社会安全模式以及17岁时的身体和心理健康。

设计、地点与参与者： 千禧年队列研究追踪了约19200名在2000年底至2002年初出生的英国儿童。参与者从3岁到17岁的不同年龄段进行了评估。

暴露因素： 低母爱温暖（如缺乏表扬、对孩子说话时语气消极）和母亲严厉行为（如使用身体束缚、抓孩子等）在家庭访问期间（3岁时）独立编码。

主要结局与测量指标： 社会安全（14岁）通过儿童对3项问题的回答来衡量（例如，“我有家人和朋友帮助我感到安全、安心和快乐”）。身体健康的自我报告范围从1（非常好）到5（差）（17岁时）。心理压力（17岁）使用6项Kessler心理压力量表评估。精神健康问题（17岁）是一个由青少年自己披露的临床抑郁症/焦虑症、自伤行为和自杀倾向组成的潜在变量。

结果： 目前样本包括8540名青年（女性占52%；黑人或英国黑人占比3.0%，印度裔占比2.8%，巴基斯坦和孟加拉裔占比6.7%，混血占比2.8%，白人占比83%，其他种族占比1.6%）。研究数据于2024年3月至2024年9月使用结构方程模型进行分析。在控制了性别、种族、收入、社区劣势、母亲心理健康以及早期认知能力的模型中，从童年母爱温暖（而非严厉行为）到青少年期的社会安全模式（b = 0.03；P

结论与相关性： 这些结果显示，早期母爱温暖通过影响对社会安全感的感知从而影响青少年健康。因此，改善父母与子女之间的关系以及提高年轻人的社会安全感知可能会改善他们的身体健康状况。