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Associations between birth order with mental wellbeing and psychological distress in midlife: findings from the 1970 British Cohort Study (BCS70)

Associations between birth order with mental wellbeing and psychological distress in midlife: findings from the 1970 British Cohort Study (BCS70)
Associations between birth order with mental wellbeing and psychological distress in midlife: findings from the 1970 British Cohort Study (BCS70)
Background
Previous research indicated that birth order was associated with physical health outcomes in adulthood. However, evidence on its association with mental health was lacking. The aim of this study was to investigate if birth order was associated with mental wellbeing and psychological distress at mid-life, stratified by gender, and taking into account confounding factors in childhood and adulthood.

Method
The sample consisted of 9,354 participants of the 1970 British Cohort Study (BCS70). The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), the Malaise Index and attending a doctor’s consultation in the past year for a mental health issue at age forty-two were used to assess mental wellbeing and psychological distress in midlife. Birth order was ascertained via a parental questionnaire and referred to the numerical birth position of the participants. The associations between birth order, mental wellbeing and psychological distress were tested using linear and logistic regression adjusting for birth characteristics: smoking during pregnancy, maternal age, mother’s marital status, father’s employment, region of birth, parental years of education and parental social class, and factors at age 42: years of education, employment status and partnership status. Potential mediating variables including breastfeeding and birthweight at birth and parental separation and conduct disorder measured at age ten were also taken into account.

Results
We find no evidence to support an association between birth order and midlife psychological distress or attending a doctor’s consultation in both men and women. In unadjusted analysis, there was an association between birth order four and above and a reduced WEMWBS score of -0.79 (95% CI -1.57, -0.02) in men only. This association was attenuated after adjusting for birth characteristics and mediators at birth (0.86, 95% -1.78, 0.07) but was maintained once conduct disorder at age 10 was accounted for (-1.19, 95% CI -2.28, -0.09). However, this association was attenuated once again after adjusting for employment status, years in education and partnership status in adulthood (-1.04, 95% CI -2.11, 0.03).

Conclusions
In this study, birth order was not associated with psychological distress or having a mental health issue at midlife. Accounting for employment status, years of education and partnership status in adulthood attenuated the relationship between birth order and mental wellbeing.
1932-6203
Stannard, Sebastian
99ffc90e-bf03-4cd4-9e63-a023491b1d36
Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Stannard, Sebastian
99ffc90e-bf03-4cd4-9e63-a023491b1d36
Berrington, Ann
bd0fc093-310d-4236-8126-ca0c7eb9ddde
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382

Stannard, Sebastian, Berrington, Ann and Alwan, Nisreen (2019) Associations between birth order with mental wellbeing and psychological distress in midlife: findings from the 1970 British Cohort Study (BCS70). PLoS ONE, 14 (9), [e0222184]. (doi:10.1371/journal.pone.0222184).

Record type: Article

Abstract

Background
Previous research indicated that birth order was associated with physical health outcomes in adulthood. However, evidence on its association with mental health was lacking. The aim of this study was to investigate if birth order was associated with mental wellbeing and psychological distress at mid-life, stratified by gender, and taking into account confounding factors in childhood and adulthood.

Method
The sample consisted of 9,354 participants of the 1970 British Cohort Study (BCS70). The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), the Malaise Index and attending a doctor’s consultation in the past year for a mental health issue at age forty-two were used to assess mental wellbeing and psychological distress in midlife. Birth order was ascertained via a parental questionnaire and referred to the numerical birth position of the participants. The associations between birth order, mental wellbeing and psychological distress were tested using linear and logistic regression adjusting for birth characteristics: smoking during pregnancy, maternal age, mother’s marital status, father’s employment, region of birth, parental years of education and parental social class, and factors at age 42: years of education, employment status and partnership status. Potential mediating variables including breastfeeding and birthweight at birth and parental separation and conduct disorder measured at age ten were also taken into account.

Results
We find no evidence to support an association between birth order and midlife psychological distress or attending a doctor’s consultation in both men and women. In unadjusted analysis, there was an association between birth order four and above and a reduced WEMWBS score of -0.79 (95% CI -1.57, -0.02) in men only. This association was attenuated after adjusting for birth characteristics and mediators at birth (0.86, 95% -1.78, 0.07) but was maintained once conduct disorder at age 10 was accounted for (-1.19, 95% CI -2.28, -0.09). However, this association was attenuated once again after adjusting for employment status, years in education and partnership status in adulthood (-1.04, 95% CI -2.11, 0.03).

Conclusions
In this study, birth order was not associated with psychological distress or having a mental health issue at midlife. Accounting for employment status, years of education and partnership status in adulthood attenuated the relationship between birth order and mental wellbeing.

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More information

Accepted/In Press date: 23 August 2019
e-pub ahead of print date: 17 September 2019

Identifiers

Local EPrints ID: 434101
URI: http://eprints.soton.ac.uk/id/eprint/434101
ISSN: 1932-6203
PURE UUID: a73fe494-92b6-42ce-b473-2c4532c2fe98
ORCID for Ann Berrington: ORCID iD orcid.org/0000-0002-1683-6668
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463

Catalogue record

Date deposited: 12 Sep 2019 16:30
Last modified: 17 Mar 2024 02:40

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Contributors

Author: Sebastian Stannard
Author: Ann Berrington ORCID iD
Author: Nisreen Alwan ORCID iD

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