The role of social support in the association between adolescent emotional and behavioral problems and quality of life in young adulthood in youth residential care leavers

BACKGROUND: Adults with a history of residential out-of-home care (care leavers) often experience emotional and behavioral problems, which can negatively impact quality of life (QoL) into adulthood. Social support can improve mental health and reduce psychological symptoms. However, longitudinal studies examining how early emotional and behavioral problems are associated with the QoL of young adult care leavers are lacking. This study investigated the relationship between emotional and behavioral problems in adolescence and QoL in young adulthood, as well as the mediating and/or moderating role of social support. METHODS: A total of 220 care leavers (Mage at baseline = 15.9 years, SD = 2.1; Mage at follow−up = 26.1 years, SD = 2.8, 32.9% female) were surveyed at baseline during their out-of-home placement regarding emotional and behavioral problems via the “Achenbach System of Empirically Based Assessment” (ASEBA) and with the “Multidimensional Scale of Perceived Social Support” (MSPSS) and the “World Health Organization Quality-of-Life Questionnaire” (WHOQoL-BREF) at follow-up. Structural equation modeling was used to examine the mediating and moderating role of MSPSS on the relationship of ASEBA and WHOQoL-BREF. RESULTS: Symptom severity during adolescence was significantly negatively associated with QoL in all four domains (psychological, physical, social, and environmental). In the mediation model, the total direct effect of emotional and behavioral problems on QoL was significant (β = -0.315, p = .001, 95% CI [-0.501, -0.128]). Social support significantly partially mediated (β = -0.142, p = .028, 95% CI [-0.269, -0.015]) and moderated (β = 0.136, p = .026, 95% CI [0.011, 0.261]) the relationship between emotional and behavioral problems in adolescence and QoL in adulthood. CONCLUSIONS: The study shows that higher levels of adolescent emotional and behavioral problems are associated with reduced psychological, physical, social, and environmental adult QoL among residential care leavers. Social support has a compensatory and protective effect on this relationship, highlighting the importance of strengthening social networks, particularly during the transition to adulthood, to improve the QoL of care leavers.