Depressive Symptoms, Alcohol Use, and Body Mass Index from Adolescence to Adulthood: Moderation by Gender and Race

Depressive symptoms, alcohol use, and body mass index (BMI) frequently co-occur, yet their longitudinal associations from adolescence into adulthood remain unclear. This study examined their prospective associations by distinguishing between-person differences from within-person changes and testing variations by gender and race. Data came from four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health). The analytic sample comprised 5734 participants (51.4% female; 56.7% non-Hispanic white) followed from ages 11–19 to ages 24–32. Multigroup cross-lagged panel models (CLPMs) and random intercept cross-lagged panel models (RI-CLPMs) assessed associations across four gender–racial groups: white males, white females, non-white males, and non-white females. All three variables demonstrated significant stability over time. Higher adolescent depressive-symptom levels were associated with higher subsequent alcohol-use scores at both the between-person and within-person levels. Higher BMI in young adulthood was associated with higher subsequent depressive-symptom levels at the between-person level. At the within-person level, higher-than-usual depressive-symptom levels were associated with lower subsequent BMI only among white females during adolescence. Within-person associations between alcohol use and BMI also varied developmentally: higher-than-usual alcohol-use scores were associated with higher subsequent BMI earlier in development, whereas negative associations emerged in both directions in adulthood. Several associations differed across gender–racial groups. Overall, the findings demonstrate complex, developmentally specific associations among depressive symptoms, alcohol-use frequency, and BMI, underscoring the importance of distinguishing between-person from within-person processes and considering gender, race, and developmental stage.