The aim of this study is to explore the association between grandparental socioeconomic disadvantages and grandchild psychiatric disorders, the role of parental socioeconomic and psychosocial factors in this association, as well as potential gender differences. We utilized a cohort study design using data from the Stockholm Birth Cohort Multigenerational Study, including 11,299 individuals born in 1953 (parental generation), their 22,598 parents (grandparental generation), and 24,707 adult children (grandchild generation). Grandparental and parental socioeconomic disadvantages, respectively, included low income, non-employment, and overcrowding. Parental psychosocial disadvantages included single parenthood, psychiatric disorders, and criminality. Psychiatric disorders in the grandchildren were reflected by hospitalizations due to mental and behavioral disorders from age 18 to 30 (1986–2019). Analyses were performed within the Structural Equation Modeling framework. We found an association between grandparental socioeconomic disadvantages and grandchild psychiatric disorders (standardized total effect 0.155, 95% confidence interval [CI] 0.099–0.211), which was mediated through parental psychosocial disadvantages (standardized mediating effect 0.101, 95% CI 0.073–0.130). The mediation was more pronounced via psychosocial disadvantages among mothers than fathers. These findings indicate that psychosocial disadvantages among parents, especially mothers, reflect an important mediating mechanism, and addressing such disadvantages may help mitigate social inequalities in mental health across generations.

Mental health problems contribute substantially to the disease burden in Sweden and worldwide. Such problems are not evenly distributed in the population and are, to a large extent, socially determined. The overall aim of the current thesis is to investigate the multigenerational associations and mechanisms between socioeconomic and psychosocial disadvantages and mental health problems, as well as potential gender differences. Drawing on data from the Stockholm Birth Cohort Multigenerational Study that encompasses local and national survey- and register-based data across three generations, and through employing structural equation modeling techniques, a series of four empirical studies was conducted. Study I demonstrated multigenerational transmission of low income through the patriline (from paternal grandfathers to fathers) to grandchildren, and multigenerational transmission of psychiatric disorders through both the patriline and matriline (from maternal grandmothers to mothers) to grandsons. The patriline-grandson transmission of psychiatric disorders partially operated via low income of the fathers. Additionally, grandparents’ psychiatric disorders influenced their children’s and grandchildren’s income. Study II provided further insights into multigenerational patterns of disadvantages by showing that combinations of grandparental socioeconomic and parental psychosocial disadvantages elevated the risks of grandchild psychiatric disorders. Importantly, improved socioeconomic and psychosocial circumstances across previous generations predicted lower probabilities of psychiatric disorders among grandchildren. Study III established the mediating role of psychosocial disadvantages in the parental generation, particularly among mothers, in the association between grandparental socioeconomic disadvantages and grandchild psychiatric disorders. Study IV delved deeper into the mechanisms underlying this multigenerational mediation pattern by identifying parental childhood experiences (i.e., family relationship quality, peer relationships, and educational performance) as important determinants of parental adulthood psychosocial disadvantages and grandchild psychiatric disorders. Parental childhood peer relationships and educational performance mattered more among fathers, whereas family relationship quality played a more important role among mothers. These empirical studies extend our understanding of the multigenerational transmission patterns of disadvantages, and how multiple factors in the parental generation act as mechanisms linking grandparental socioeconomic disadvantages to grandchild mental health problems. Accordingly, public health efforts to improve mental health of future generations could benefit from a multigenerational perspective.

Previous research has begun to unravel the mechanisms by which multiple factors in the parental generation link grandparental socioeconomic disadvantages to grandchild psychiatric disorders. This study aims to further disentangle such multigenerational mechanisms by exploring the role of parental childhood factors. We utilized a three-generational cohort study design with data from the Stockholm Birth Cohort Multigenerational Study. The sample included 2,708 individuals born in 1953 (parental generation, G1), their 5,416 parents (grandparental generation, G0), and 5,967 children (grandchild generation, G2). Using structural equation modeling (SEM), we analyzed the mediating role of G1 protective factors during childhood (i.e., high family relationship quality, positive parenting styles, high educational performance, positive peer relationships) and G1 adult psychosocial disadvantages (i.e., single parenthood, psychiatric disorders, and criminality) in the association between G0 socioeconomic disadvantages (i.e., low income, non-employment, and overcrowding) and G2 psychiatric disorders (i.e., measured as hospitalizations due to mental and behavioral disorders between ages 18 and 30). The association between G0 socioeconomic disadvantages and G2 psychiatric disorders was mediated through the paths from G1 childhood family relationship quality, peer relationships, and educational performance to G1 adult psychosocial disadvantages. Peer relationships and educational performance in childhood mattered more among G1 fathers, whereas family relationship quality in childhood played a more important role among G1 mothers. The findings indicate that parental childhood factors – specifically family relationship quality, peer relationships, and educational performance – serve as important resilience resources in disrupting the multigenerational transmission of disadvantages, with implications for mental health of future generations.

Purpose There is a lack of multigenerational research on the extent to which mental health is informed by transmission of multiple disadvantages across previous generations. This study aims to investigate how family socioeconomic and psychosocial disadvantages cluster and transition over grandparental and parental generations, and how this might be associated with grandchild psychiatric disorders.

Methods We utilized a cohort study with data following three generations from the Stockholm Birth Cohort Multigenerational Study, including 11,299 individuals born in 1953 (parental generation), their 22,598 parents (grandparental generation), and 24,707 adult children (grandchild generation). Family disadvantages as exposures were measured across two periods– grandparental adulthood (parental childhood) and parental adulthood (grandchild childhood), and included socioeconomic (i.e., low income, non-employment, overcrowding, and single parenthood) and psychosocial aspects (i.e., single parenthood, teenage motherhood, psychiatric disorders, and criminality of father). Psychiatric disorders in the adult grandchildren as outcome were defined by hospitalizations with a main or contributing diagnosis reflecting mental and behavioral disorders from age 18 until 2019.

Results Multiple disadvantages within the grandparental and parental generations, respectively, predicted higher probabilities of grandchild psychiatric disorders. Multigenerational transmission is evident in that grandchildren with combinations of grandparental socioeconomic disadvantages and parental psychosocial disadvantages had comparably high probabilities of psychiatric disorders. Importantly, improved socioeconomic and psychosocial circumstances across previous generations predicted comparably low probabilities of grandchild psychiatric disorders.

Conclusion Mental health of future generations is informed by the transmission of multiple disadvantages across previous generations, and the transition from grandparental socioeconomic disadvantages into parental psychosocial disadvantages is particularly important.

There is a paucity of research examining the patterning of socioeconomic disadvantages and mental health problems across multiple generations. The current study therefore aimed to investigate the interconnected transmissions of socioeconomic disadvantages and mental health problems from grandparents to grandchildren through the parents, as well as the extent to which these transmissions differ according to lineage (i.e., through matrilineal/patrilineal descent) and grandchild gender. Drawing on the Stockholm Birth Cohort Multigenerational Study, the sample included 21,416 unique lineages by grandchild gender centered around cohort members born in 1953 (parental generation) as well as their children (grandchild generation) and their parents (grandparental generation). Based on local and national register data, socioeconomic disadvantages were operationalized as low income, and mental health problems as psychiatric disorders. A series of path models based on structural equation modelling were applied to estimate the associations between low income and psychiatric disorders across generations and for each lineage-gender combination. We found a multigenerational transmission of low income through the patriline to grandchildren. Psychiatric disorders were transmitted through both the patriline and matriline, but only to grandsons. The patriline-grandson transmission of psychiatric disorder partially operated via low income of the fathers. Furthermore, grandparents' psychiatric disorders influenced their children's and grandchildren's income. We conclude that there is evidence of transmissions of socioeconomic disadvantages and mental health problems across three generations, although these transmissions differ by lineage and grandchild gender. Our findings further highlight that grandparents' mental health problems could cast a long shadow on their children's and grandchildren's socioeconomic outcomes, and that socioeconomic disadvantages in the intermediate generation may play an important role for the multigenerational transmission of mental health problems.

Objective: To investigate the associations between low education and risk of mental disorders, substance use disorders and self-harm in different age-groups.

Methods: All subjects in Stockholm born between 1931 and 1990 were linked to their own or their parent's highest education in 2000 and followed-up for these disorders in health care registers 2001–2016. Subjects were stratified into four age-groups: 10–18, 19–27, 28–50, and 51–70 years. Hazard Ratios with 95% Confidence Intervals (CIs) were estimated with Cox proportional hazard models.

Results: Low education increased the risk of substance use disorders and self-harm in all age-groups. Males aged 10–18 with low education had increased risks of ADHD and conduct disorders, and females a decreased risk of anorexia, bulimia and autism. Those aged 19–27 years had increased risks of anxiety and depression, and those aged 28–50 had increased risks of all mental disorders except anorexia and bulimia in males with Hazard Ratios ranging from 1.2 (95% CIs 1.0–1.3) for bipolar disorder to 5.4 (95% CIs 5.1–5.7) for drug use disorder. Females aged 51–70 years had increased risks of schizophrenia and autism.

Conclusion: Low education is associated with risk of most mental disorders, substance use disorders and self-harm in all age-groups, but especially among those aged 28–50 years.

Background: Previous research has begun to unravel the mechanisms by which multiple factors in the parental generation link grandparental socioeconomic disadvantages to grandchild psychiatric disorders. This study aims to further disentangle such multigenerational mechanisms by exploring the role of parental childhood factors. 

Methods: We utilized a three-generational cohort study design with data from the Stockholm Birth Cohort Multigenerational Study. The sample included 2,708 individuals born in 1953 (parental generation), their 5,416 parents (grandparental generation), and 5,967 children (grandchild generation). We analyzed the mediating role of parental protective factors during childhood (i.e., high family relationship quality, positive parenting styles, high educational performance, and positive peer relationships) and psychosocial disadvantages during adulthood (i.e., single parenthood, psychiatric disorders, and criminality) in the association between grandparental socioeconomic disadvantages (i.e., low income, non-employment, and overcrowding) and grandchild psychiatric disorders (i.e., measured as hospitalizations due to mental and behavioral disorders between ages 18 and 30). 

Results: The association between grandparental socioeconomic disadvantages and grandchild psychiatric disorders was mediated through the paths from childhood family relationship quality, peer relationships, and educational performance to adulthood psychosocial disadvantages in the parental generation. Peer relationships and educational performance in childhood mattered more among fathers, whereas family relationship quality in childhood played a more important role among mothers. 

Conclusion: These findings indicate that parental childhood factors – specifically family relationship quality, peer relationships, and educational performance – serve as important resilience resources among children in the face of socioeconomic disadvantages, with implications for psychosocial outcomes later in life and psychiatric outcomes in the next generation.