Background: Emotional and behavioural problems (i.e., mental health difficulties and their decomposition into internalizing and externalizing symptoms) often emerge in adolescence and can persist into adulthood if not addressed. Identifying modifiable social-cognitive processes that influence the persistence of psychopathology across the lifespan is thus essential.
Method: Using data from the Millennium Cohort Study, a nationally representative birth cohort of UK youths born in 2000-2002, we examined whether social safety at age 14 mediated the association between mental health difficulties at age 11 and mental health difficulties at age 17. The sample included 10,782 participants (50% female, 20% non-White, 21% in poverty).
Results: Mental health difficulties (total symptoms) at age 11 predicted both mental health difficulties at age 17 (b = .41, p < .001) and negative social safety schemas at age 14 (b = .02, p < .001). Negative social safety schemas in mid-adolescence partially mediated the persistence of difficulties from early to late adolescence (ab = .01, p < .001). In sex-stratified analyses, we found that negative social safety mediated the persistence of internalizing problems only for females and the persistence of externalizing problems only for males.
Conclusions and relevance: These findings highlight the important role of social safety schemas in the persistence of adolescent emotional and behavioural problems over time. Based on these results, investments in improving early adolescent mental health by bolstering social safety perceptions may be effective for reducing mental health risks.
Keywords: adolescence; gender differences; longitudinal studies; mental health; social safety.
© 2025 The Author(s). British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.
