Perceived stress trajectories from adolescence to adulthood: The role of sex and social status

Abstract Background Stress is widely associated with adverse health outcomes. Increasing levels of perceived stress have over the past decades been observed among adolescents, particularly among females. While low social status is associated with elevated stress levels, life-course trajectories of this association remain unclear. This study examines trajectories of perceived stress levels by sex and social status from adolescence into adulthood (ages 15-32). Methods A longitudinal cohort of individuals born in 1989 (N = 3681) was followed from age 15 to 32 (year 2004-2021) using survey data from five time points, supplemented with register data. Perceived stress levels were analysed across social status groups (low, middle, and high) using multiple measures of social status: parental educational level, labour market participation, household income, and subjective social status in society and in school. Stress trajectories were identified using Group-Based Trajectory Modelling, and relative odds ratios (ROR) of membership in trajectory groups by social status at age 15 were estimated using logistic regression models. Results Sex differences in perceived stress levels were observed at ages 15, 18, and 21, but diminished in adulthood due to decreasing perceived stress levels among females. Low social status at age 15 was consistently associated with higher perceived stress levels across all social status measures. Three trajectories of perceived stress levels were identified among males (low-stable, mid-stable, and increasing) and four trajectories among females (low-stable, mid-stable, increasing, and high mid-peak). Low social status was associated with higher ROR of being in all other trajectories than the low-stable trajectory, for both sexes, regardless of social status measure. Conclusions Individuals with low social status consistently reported higher levels of perceived stress than those with middle or high social status from age 15 to 32, with a similar pattern for both sexes. Key messages • Social status at age 15 strongly impacts perceived stress levels from adolescence into early adulthood. • Preventive measures should focus on individuals with low social status to reduce high-stress trajectories.