Integrating Objective and Subjective Social Class to Advance our Understanding of Externalizing Problem Behavior in Children and Adolescents: A Conceptual Review and Model

Abstract

Extant research has identified both objective measures of socioeconomic status (SES) and subjective social class (SSC) as important predictors of psychosocial outcomes in childhood and adolescence, particularly with regard to externalizing symptoms. Given the importance of the associations with SES and SSC, a more nuanced and integrated conceptual understanding of early pathways of vulnerability implicated in the development and maintenance of youth externalizing problems is warranted. Thus, this review will: 1) operationalize both SES and SSC and their current standards of measurement; 2) examine current literature describing their respective associations with a range of externalizing symptoms in both children and adolescents; 3) review current theoretical models connecting SES and SSC and youth development and the strengths and limitations of those approaches; 4) propose a new conceptual socioecological model situating the impact of SES and SSC on youth externalizing problems in the context of parents and peers as a framework to further integrate existing research and guide future work; and 5) discuss potential clinical implications at the intersection of this work.

Objective measures of socioeconomic status (SES; e.g., income, occupation, education) have been linked to various outcomes across the lifespan, including academic achievement, obesity, substance abuse, brain structure, and various mental health disorders (e.g., Conger & Donnellan, 2007; Diemer et al., 2013; Luo & Waite, 2005). In addition to objective measures of SES, experiences of inequality are associated with higher rates of mental health problems, increased rates of crime, and poor health (Odgers, 2015; Payne et al., 2017). Consequently, research has increasingly emphasized the importance of identifying early pathways of vulnerability and resilience related to SES to address social disparities and mitigate deleterious outcomes later in life. Thus, understanding the early impact of SES on child psychopathology is imperative, particularly with regard to externalizing behavior problems, one of the most common mental health concerns in young children and adolescents (e.g., Hosokawa & Katsura, 2018; Piotrowska et al., 2015; Polanczyk et al., 2015). Externalizing behavior problems include those that impair a child or adolescent’s functioning (e.g., hyperactivity, impulsivity), are hostile or physically aggressive toward others, and/or violate rules of authority (e.g., adolescent substance use; Deater-Deckard et al., 1998; Lahey & Loeber, 1994; Schoemaker et al., 2013). Aside from their commonality, externalizing behaviors pose significant risk to society if maintained into adulthood with estimated individual societal costs of up to 2.3 million dollars in the United States alone (Petitclerc & Tremblay, 2009) highlighting the importance of understanding the mechanisms by which SES and associated inequality confer risk (e.g., Lawson et al., 2018; Martin et al., 2010; Russell et al., 2016).

One such factor, subjective social class (SSC), which has also been referred to as subjective social status (SSS) and subjective socioeconomic status, has come to the forefront of theory and research in this area. Social class is broadly operationalized as a relational construct that involves the categorization of individuals based on similarities in power, prestige, disposition, and practices and includes both objective (e.g., SES) and subjective metrics (e.g., Bourdieu, 1987; Kraus et al., 2011; Manstead, 2018). This review uses the term SSC to more specifically describe one’s perception of their own social standing based on indicators of socioeconomic status and other class related factors (e.g., social and cultural capital). Importantly, we recognize that SSC is also related to other status-based identities (e.g., race, ethnicity, gender). Notably, standards in terminology and definitions of status and class also vary within and between subfields and related theoretical and empirical literatures. We chose to use the term subjective social class in this review, rather than status, both for specificity and to differentiate between references to “social status” in other child literatures, including its common use in the peer relations literature. With our decisions about terminology in mind, data has shown that one’s perception of their social class or standing in relation to others in social hierarchies is related to outcomes across development, including hypertension, depression, and externalizing behaviors (Adler et al., 2008; Goodman et al., 2007). Compared to SES, evidence suggests that SSC may be an even more robust predictor of various psychosocial outcomes, particularly for certain populations, and may be malleable to change, contrary to the well-documented stability of SES across the life course (e.g., McLaughlin et al., 2012; Russell & Odgers, 2019; Singh-Manoux et al., 2003). This is significant considering both the long-term impact of SES and vulnerability conferred by low SSC (e.g., Goodman et al., 2015; Marmot et al., 2001; Steen et al., 2020). However, the bulk of the literature on SSC has focused on correlates of physical health and populations of adolescents and adults, leaving mechanisms of the early development of SSC and its impact relatively unknown. Thus, a more nuanced understanding of the pathways relating SES and SSC to child and adolescent mental health outcomes may provide some insight into potential targets of early intervention in order to mitigate mental health disparities.

Further consideration of theory and data at the intersection of SES, SSC, and externalizing problems must acknowledge and extend upon prior conceptual work as well. While seminal frameworks including the family stress model, family investment model, and interactionist approach highlight the impact of youth’s socioeconomic context, they largely take a dichotomous approach that considers lower and higher SES as more risk-related and protective respectively (Conger & Donnellan,2007). The integrative model (García Coll et al., 1996) more explicitly considers the impact of social stratification based on social positions (e.g., race, social class) via proposed mechanisms (e.g., racism, discrimination) on youth psychosocial development; yet, its comprehensive nature leaves more nuanced considerations of the impact of context (e.g., children’s SSC) on specific outcomes (e.g., externalizing behavior problems) absent. To address this gap, this review proposes a conceptual model that considers the interplay of SES and SSC, specifically in the context of social interactions, in the development and exacerbation of externalizing symptoms in both children and adolescents. First, a brief review of standards of measurement for both SES and SSC will be presented. Then, a summary of representative, rather than exhaustive, research on the influence of SES and SSC on externalizing disorders [e.g., Oppositional Defiant Disorder (ODD)] and symptoms (e.g., impulsivity, aggression, substance use) will be discussed. A narrative rather than systematic approach is used in order to consolidate empirical and theoretical literatures across disciplines including social, developmental, and clinical psychology with the goal of identifying gaps in current conceptualizations of the ecological context of early externalizing symptoms. Accordingly, various theoretical frameworks and socioecological models previously used to describe child and adolescent development within the context of SES and SSC will be briefly reviewed and a rationale for a new conceptual model elucidating the socially based pathways through which SES and SSC contribute to externalizing problem behavior from early childhood (age 3) to late adolescence (age 18) is then presented (e.g., Brennan et al., 2003; McManus & Suizzo, 2020; White & Renk, 2012). Clinical implications and future directions for consideration are discussed. We turn next to the operationalization of objective and subjective social class as they form a foundation for subsequent sections.

Measurement of Objective and Subjective Social Class

Socioeconomic status (SES) describes one’s social class or relative power and prestige within a social hierarchy and is generally determined by various sociodemographic variables (e.g., household income, education, and occupation; Bourdieu, 1987; Diemer et al., 2013). Standard assessments of SES are largely categorized into two domains: prestige-based measures and resource-based measures (Diemer et al., 2013). Prestige-based measures assess one’s relative position in socially stratified hierarchies (e.g., occupational prestige), while resource-based measures focus on indicators of one’s socioeconomic support such as income, wealth, and poverty (Diemer et al., 2013; Hoff & Laursen, 2019). Assessments range in their specificity, some including composite scores of various sociodemographic variables while others assess single indicators of SES separately (e.g., Adler et al., 2000; Conger & Donnellan, 2007; Hoff & Laursen, 2019). Of note, evidence suggests that single indicator measures may provide more robust and nuanced results than composite measures (Diemer et al., 2013; Hoff & Laursen, 2019). Research on children and adolescents most often utilizes SES as reported at the parent- level and may include information from all or one parent or legal guardian in the child’s household. Traditional measures of SES typically do not account for the effects of systemic discrimination and marginalization, though, it is important to consider this context and the complex relationship between indicators of SES and race and ethnicity when interpreting data (Adler & Rehkopf, 2008; Shaked et al., 2016).

Subjective social class (SSC) alternatively refers to one’s perceptions of their own social standing relative to others in their community and society (e.g., Adler et al., 2000; Goodman et al., 2001; Goodman et al., 2007). SSC is traditionally measured using the MacArthur Scale of Subjective Social Status, a pictorial based self-report measure where respondents rank themselves on rungs of a ladder with higher rungs representing a higher position in social hierarchies (Operario et al., 2004). The scale includes two ladders that correspond with two social reference groups: society and community. Importantly, the society ladder, sometimes referred to as the SES ladder, measures an individual’s SSC using socioeconomic indicators including educational attainment, occupational prestige, and income (i.e., society SSC) while the community ladder measures one’s community-based social standing in terms of occupying higher or lower status than others in their community (i.e., community SSC). Thus, the community ladder is a more global measure of SSC that considers one’s status in a more proximal class hierarchy and is not specific to objective measures of SES. An adapted version of the scale, the Subjective Social Status Scale-Youth Version was developed to address the differences in social reference groups between youth and adults (Goodman et al., 2001; Goodman et al., 2015). Youth are asked to report where they believe they fall in the social class continuum based on family level indicators of educational attainment, occupational prestige, and income, as well as their community and school, based on comparisons between themselves and their school peers (e.g., Castro et al., 2020; Rahal et al., 2020; Sweeting & Hunt, 2014). Factors including academic grades, respect, and popularity, are often used as indicators of one’s school based relative social class standing (Goodman et al., 2001). Thus, measures of school-based SSC may be more reflective of dimensions of peer group social status such as social dominance and social preference rather than socioeconomic status (Coie et al., 1982; Lease et al., 2002). However, as these constructs (i.e., society and community SSC) may be highly integrated and are related to an individual’s status in a social class hierarchy, it is important that discussions focus on both. Assessments of SSC in preschool age children have included self-reports of family resources relative to others (e.g., comparison of number of material possessions) and self-reports including developmentally appropriate references to experiences of status hierarchies (e.g., get to pick the games kids play at recess; Amir et al., 2019; Elenbaas, 2019; Mandalaywala et al., 2020). Researchers have assessed relative youth social status using measures such as neighborhood and school-based inequality and observer reports (e.g., parent, peer, teacher) of status positions (e.g., Goodman et al., 2007; Sorhagen & Wurster, 2017; Boyce, 2004). The primary focus of this review is the measurement of SSC as it relates to a family’s economic status, yet, the implications of intersecting status identities including race, ethnicity, and gender are recognized and will be further discussed later in this review (Crenshaw, 1989; Velez & Spencer, 2018).

The Impact of Objective Socioeconomic Status on Youth Externalizing Problem Behaviors

Decades of research have demonstrated an association between family SES and youth externalizing problems (e.g., Conger et al., 2010; Korous et al., 2018; Piotrowska et al., 2015). Additionally, SES has been linked to other factors indicated in the risk for externalizing problems, including neurocognitive abilities, neural responses to stimuli, and executive functioning (e.g., Noble et al., 2007; Stanger et al., 2013; Ursache et al., 2015). While not the focus of the current review, it is important to recognize the differential impact levels of SES, particularly low SES, may have on externalizing behavior problems in youth including experiences of poverty [below federal poverty level (FPL) as measured by family income and household size], deep poverty (less than 50% of the of the FPL), individual indicators of low SES (e.g., low educational attainment, low occupational prestige, low income), in addition to the chronicity and onset of low SES (e.g., experiencing poverty across childhood, experiencing low-income as an adolescent; Peverill et al., 2021; Shaw & Shelleby, 2014). Indeed, studies following children over time demonstrate that low SES and the chronicity of low SES matters. For example, longitudinal research has shown that children exhibit more externalizing symptoms when their family’s SES is low and improve as their SES increases (Dearing et al., 2006; Rekker et al., 2015). Although work on the main effects of SES on externalizing problems is critical for the success of efforts such as primary prevention, they still tell us little about how (i.e., mediators) and under what conditions (i.e., moderators) low SES is most likely to confer vulnerabilities. As such, much work in this area has turned to individual, family, and community factors that may mediate or moderate the link between SES and youth externalizing problems yielding an important but largely mixed literature to date. (e.g., Bøe et al., 2014; Hosokawa & Katsura, 2018; Letourneau et al., 2013; Piotrowska et al., 2019; Rekker et al., 2015; Sarsour et al., 2011).

With regard to individual factors, gender, age, and race and ethnicity have been examined (e.g., Letourneau et al., 2013; Piotrowska et al., 2015; Russel et al., 2016). Some research asserts a moderating effect of gender on SES such that low-income boys are at greater risk for experiencing externalizing symptoms while others report no significant relationship or opposite findings (e.g., Deater-Deckard et al., 1998; Letourneau et al., 2013; Luthar & Latendresse, 2005a; Reiss, 2013; Sullivan et al., 2019). Consistent with these mixed findings, Luthar and Latendresse (2005a) explored potential third variables that may help to explain the link between SES, externalizing problems, and gender in their study of both affluent and disadvantaged sixth graders. For low-income youth, girls experienced greater vulnerability for externalizing symptoms than boys in the context of low attachment to mothers and the absence of after school adult supervision. However, closeness to fathers was more protective for boys than girls. For affluent youth, closeness to mothers disproportionately benefited boys. While these findings are interesting it is important to note that students were recruited from disparate locations (e.g., inner-city middle school versus middle schools in an affluent community) in which the racial and ethnic representation largely varied. The low-income sample consisted of 80% racial-ethnic minority identifying students while the affluent sample contained approximately 7% racial-ethnic minority students. Thus, SES was largely confounded by location and race, potentially diminishing the generalizability of the results. However, based on evidence from this and other studies, it may be the case that gendered effects may be reflective of differential influences of particular variables, such as parent-child interactions, parental criticism, use of harsh discipline, and parenting stress that may reflect broader patterns of gender role socialization (e.g., Ashiabi & O’Neal, 2015; Brennan et al., 2003; Luthar & Latendresse, 2005a). In other words, family or societal level stereotypes of gender may influence how parents interact with youth (e.g., more likely to use harsh discipline with boys) or the level of protective factors available to youth (e.g., girls more likely to have intimate relationships outside the context of families) resulting in differential effects of vulnerability for externalizing symptoms in the context of varying SES (Deater-Deckard et al., 1998; Luthar & Latendresse, 2005a).

There is a fairly consistent finding in the broader literature that the mental health and well-being of young children may be greatly affected by low SES, given the critical nature of this sensitive developmental period (e.g., McLoyd, 1998; Reiss, 2013). Studies on age, SES, and externalizing problems like those on gender convey a slightly more mixed picture (e.g., Anderson et al., 2014; Chen et al., 2006; Korous et al., 2018; van Lier et al., 2007). For example, some evidence suggests that SES is more strongly associated with externalizing symptoms in early and middle childhood than later (Piotrowska et al., 2015; Reiss, 2013); however, other work suggest that other salient factors related to SES and externalizing symptoms may evolve during different periods of development (Hoeve et al., 2009; Korous et al., 2018). For example, while evidence suggests that one’s neighborhood environment, parent-child relationship, school, and peers influence their externalizing behaviors, these contexts exhibit various levels of influence across developmental periods (e.g., peer influence being more salient or varied for adolescents than young children). Thus, considering the nuances of children’s psychosocial development and evolution of salient influences (e.g., parents, peers, individual views, emerging SSC) may be of most importance when considering the effects of age on the association between SES and externalizing symptoms.

Similar to gender and age, methodological approaches emphasizing context over mean differences are of particular importance when considering youth race, ethnicity, SES and externalizing symptoms. At least in the representative studies reviewed here, there has not been a significant moderating effect of race or ethnicity on SES and externalizing symptoms; yet, low-SES samples consisted of mostly racial and ethnic minorities and affluent samples were more likely to be White (Rivenbark et al., 2019; Luthar & Latendresse, 2005a). An understanding of the cumulative effects of various vulnerability factors related to SES is relevant in the context of race and ethnicity such that racial and ethnic minority children have a higher prevalence than White children of experiencing sociocultural (e.g., low-SES) and parenting/caregiver (e.g., parental stress) factors that are associated with increased risk for externalizing behavior problems (Anton et al., 2015; Deater-Deckard et al., 1998; Korous et al., 2018). Thus, it is critical to situate these patterns in the context of racism, which fuels and exacerbates the link between race and ethnicity, SES, and externalizing problems (e.g., García Coll et al., 1996; Jackson et al., 2019, Pachter & Coll, 2009; Trent et al., 2019). Indeed, several recent meta-analyses investigating the relationship between SES and child psychosocial well-being (e.g., psychopathology, cognitive ability, achievement) found mixed results with regard to moderating effects of race and ethnicity (Korous et al., 2020; Peverill et al., 2021). Various explanations for these findings have been proposed including the variability in measurement of race and ethnicity across studies, which can limit meaningful comparisons of study conclusions (e.g., different standards in coding race and ethnicity, inconsistent measurement of multi-racial and ethnic participants; Korous et al., 2018; Peverill et al., 2021). These studies reveal gaps in current empirical knowledge and further suggest that future work including a more nuanced focused on mechanisms and pathway models explaining the association between SES and individual characteristics is imperative to our understanding of SES and child well-being.

In addition to individually based influences, theoretical models and empirical studies have explored indirect effects of SES on youth externalizing symptoms through family-based influences including parenting style, parenting stress, family support, parental monitoring, and family economic hardship (e.g., Anton et al., 2015; Letourneau et al., 2013; Roy et al., 2019). This is consistent with Patterson’s (1982) seminal work on the coercion model, which describes the etiology of externalizing problems through a mutually reinforcing pattern of parent-child conflict in which coercive or hostile behaviors are inadvertently reinforced and maintained over time. While some literature emphasizes the implications of these factors in the context of poverty or low-SES, studies using populations with greater diversity in SES have demonstrated similarities in vulnerability factors and outcomes across the income gradient (e.g., Ciciolla et al., 2017; Lin & Seo, 2017; Luthar & Latendresse, 2005a; Piotrowska et al., 2019). Research suggests that when considering particular outcomes (e.g., substance use) and predictive factors (e.g., parental criticism), youth at SES extremes may experience discrepancies in their levels of risk or protection (Ciciolla et al., 2017; Lyman & Luthar, 2014). For example, although low-income youth experienced more symptoms than affluent youth across domains including aggression, externalizing symptoms, somatic complaints, and internalizing symptoms, affluent youth demonstrated higher levels of substance use and peer envy (Lyman & Luthar, 2014). Additional evidence supports that while low-SES youth may be at greater risk for exposure to particular factors, such as a lack of parental physical presence, parental supervision, or parental monitoring, outcomes of the exposure are similar across SES (Luthar & Latendresse, 2005a, 2005b). Indeed, parental supervision and parent-child involvement have been shown to be key predictors of conduct problems and delinquency (Loeber & Stouthamer-Loeber, 1986).

Subjective Social Class and Youth Externalizing Problems

Subjective social class (SSC) has been identified as an important and unique predictor of youth outcomes including stress, substance use, and overall health (e.g., Goodman et al., 2001; Goodman et al., 2007; Rivenbark et al., 2019; Russell & Odgers, 2019). However, studies considering the early impact of SSC are generally concentrated in middle childhood and adolescence, with little empirical evidence investigating SSC in preschool age children. Empirical studies that do include populations of young children often characterize their awareness of inequality and preference for certain SES cues, yet, how these formulations may be integrated into their SSC is still unclear (e.g., Feddes et al., 2014; Mistry et al., 2015; Rizzo et al., 2018; Shutts et al., 2016). As such, discussions regarding the impact of society and community SSC on youth externalizing problems will be largely divided between those including young children and those including youth at all other points of development.

Early Childhood

The current state of the literature recognizes that children begin to distinguish status hierarchies in early childhood and use such information to guide their interactions with others however, little is known about how they consolidate this information to form their own status-based identities or how such identities are related to externalizing behaviors (e.g., Boyce, 2004; Mandalaywala et al., 2020; Shutts et al., 2016). In fact, few studies have used the aforementioned Subjective Social Status-Youth Version in children younger than 10 and research using adapted measures suggest that preschool age children are likely to over report their society SSC (e.g., as indicated by family SES and/or access to resources such as toys and clothes as compared to other children in society) in comparison to objective markers of their SES (e.g., Elenbaas, 2019; Goodman et al., 2001; Mandalaywala et al., 2020). However, young children’s pattern of reporting their community SSC is unclear as such measures (e.g., measures of their perceived access to power in social hierarchies such as choosing games to play with peers) are less frequently used or are confounded by the simultaneous measurement of society SSC (Mandalaywala et al. 2020). A multi-country study of children and adolescents age 4-18, used the society ladder found in the Subjective Social Status-Youth Version and demonstrated its reliability over time and strong correlation to another status measure, the Social Comparison Index (SCI), in which children describe their family as having more, the same, or less than other families with regards to particular items (Amir et al., 2019). However, this study is limited in its ability to make conclusions regarding early patterns of the development of society SSC as only approximately 12% of the sample population were age 8 or younger and no parental measures of SES were administered. Furthermore, evidence suggests that indicators of social class are culturally dependent such that factors other than income (e.g., access to food, number of material items) are more closely related to how individuals conceptualize their SSC in particular populations (Amir et al., 2019; Chen et al., 2019). Thus, the utility of the Subjective Social Status-Youth Version in assessing young children’s SSC, particularly as it relates to externalizing problems and cross-cultural assessment, remains uncertain. A lack of robust assessments of SSC in young children further limits researcher’s ability to make meaningful inferences when considering the impact of multiple status identities on young children and their formation of SSC.

Mandalaywala and colleagues (2020) reported that while young children (age 3-6) used gender and race as cues to social status (e.g., male gender and White race being associated with greater power and access to resources), they did not consolidate these cues with conceptualizations of their own status or SSC (i.e., access to resources and power in social hierarchies). Of importance, children only used gender stereotypes as an indicator of status when considering social power, not wealth, while the opposite was true for race. Further, White children who used race as a status cue reported lower SSC than White children who did not associate race with a cue to status. As objective measures of children’s SES were not collected, interpretations of this finding are unclear although Mandalalywala et al. (2020) suggest it may reflect more accurate reporting of SSC in these children or the use of direct social comparisons (e.g., White children only comparing themselves to other White children).

While research on children’s SSC and their mental health outcomes is still unclear, studies of parental SSC have demonstrated significant associations between parent society and community SSC, parental well-being, and child outcomes (e.g., Michelson et al., 2016; Roy et al., 2019; Sheridan et al., 2013). There is a paucity of research relating parental SSC to early childhood SSC and externalizing problems, yet one study in particular found a significant effect of parental society SSC on young children’s externalizing behaviors through pathways of parental depression and stress (Roy et al., 2019). Indeed, much of the literature considers the relationship between parental SSC and child outcomes as indicative of associations with broader factors of parental functioning, but it may be important to consider parental SSC and its impact on the early development of youth SSC in the context of parental socialization (Conger & Dogan, 2014). Early socialization messages may impact children’s conceptualizations of SES and its salience to their identity, perhaps further promoting the early development of society and community SSC.

Middle Childhood and Beyond

Youth reports of society and community SSC are related to various externalizing symptoms including substance use, hostility, inattention and conduct problems (e.g., Castro et al., 2020; Ritterman et al., 2009; Rivenbark et al, 2019). When considering society SSC, youth reports are correlated with both objective measures of family SES and parental society SSC (e.g., Goodman et al., 2001; Goodman et al., 2007, Mistry et al., 2015). However, correlations between youth and parent community SSC are unsurprisingly weak, given the different indicators (e.g., education versus grades) and reference group (i.e., community versus school) used in each measure (Goodman et al., 2001). Evidence suggests that SSC indicators (i.e., society, community) are differentially related to youth outcomes (e.g., Ritterman et al., 2009; Sweeting & Hunt, 2014). As they age, youth reported society SSC generally declines, becomes more stable, and is more strongly related to poor outcomes in addition to community SSC (e.g., Goodman et al., 2001; Goodman et al., 2007; Rivenbark et al, 2019). This developmental change may reflect adolescents’ growing awareness and understanding of social inequalities and indicate their formation of SSC as a status identity (Velez & Spencer, 2018). Theory and evidence related to status anxiety, or one’s experience of stress in relation to having low SSC, and stereotype threat, a social-psychological dilemma in which one may attempt to avoid confirming stereotypes, may be of particular importance when considering the impact of race, ethnicity, gender, and SSC as salient status identities that may interact (Heberle & Carter, 2015).

The literature reviewed here demonstrated relatively mixed findings regarding differences in reports of SSC and differential effects of SSC on youth externalizing symptoms based on variations in race, ethnicity and gender. The majority of research reported no significant differences between SSC or the effects of SSC on outcomes however, one study found that girls ranked themselves significantly higher on the school/community ladder than boys (e.g., Goodman et al., 2001; Goodman et al., 2007; Sweeting & Hunt, 2014). Results are more varied and nuanced with regard to race and ethnicity. Castro and colleagues (2020) conducted analyses in a sample of children ages 9-11 in low and middle-income families and reported disparate effects of community SSC on depressive symptoms and displays of hostility. For Black children, lower community SSC predicted increased hostility but was not associated with depressive symptoms while lower community SSC in White children predicted increased depressive symptoms with no significant association to hostility. McLaughlin et al. (2012) also found differential effects of community SSC across various disorders for Black, White, non-Hispanic, and Hispanic adolescents. Associations between community SSC and disorders (e.g., anxiety disorders, mood disorders, behavior disorders) experienced in the last year were strongest for White, non-Hispanic adolescents (p < .001) and Hispanic adolescents (p = .005) and were not significantly associated in Black youth. A longitudinal, cohort study of seventh-twelfth grade students revealed a complex association between adolescent society SSC, SES, and race and ethnicity (Goodman et al., 2007). A pattern of disconnected reporting was found in which some youth belonging to high SES groups reported low society SSC (65% White youth) and some in low SES groups reported high society SSC (82% black youth). Additionally, an interaction between parent education and race emerged with White youth reporting lower baseline society SSC than Black youth with similarly educated parents and Black youth from highly educated families reporting lower baseline society SSC than White youth with similarly educated parents. Taken together, research suggests there are interactions between race and ethnicity and indicators of SES and their association to both society and community SSC (Chen et al., 2019; Michelson et al., 2016). Thus, while SSC is a predictive indicator of a host of outcomes, it appears to have superior utility (over SES) in predicting outcomes for youth and disparate utility in predicting outcomes across race and ethnicity (e.g., Goodman et al., 2015; McLaughlin et al., 2012; Michelson et al., 2016; Shaked et al., 2016). Based on the theoretical and empirical findings reported thus far, the following discussions will focus on models integrating the literature on SES, SSC, and youth externalizing symptoms.

The Role of Parents and Peers in Models of SES, SSC, and Externalizing Symptoms

Bronfenbrenner’s bioecological systems framework asserts that children’s development occurs in the context of transactional processes between themselves and their surrounding environments both proximal and distal (Bronfenbrenner & Morris, 2007; Tudge et al., 2009). Garcia Coll and colleagues’ (1996) Integrative Model expands on this socioecological framework by further situating children’s development in the context of their experiences of social mechanisms, including racism, prejudice, discrimination, oppression, and segregation, related to their social positions (e.g., race, ethnicity, and social class). Based on these guiding models, children’s peers and parents, in addition to individual and environmental factors associated with and including their SES, serve as critical contexts by which children’s development of externalizing symptoms is impacted.

Parent Centered Models

The role of parents and their SES in children’s development can be conceptualized through models guided by social causation, social selection, and interactionist hypotheses (e.g., Borge et al., 2004; Conger & Donnellan, 2007; Martin et al., 2010; Schoon & Melis, 2019; Simons et al., 2016). Models guided by the social causation hypothesis, including the family stress model and family investment model, assert that risk for maladaptive functioning, including externalizing behavior problems, is increased through the experience of economic hardship (e.g., Conger & Donnellan, 2007; Masarik & Conger, 2017; Neppl et al., 2016). Conversely, the social selection or drift hypothesis posits that an individual’s characteristics, such as deficits characterized by mental health disorders, are related to their concentration in positions of low SES based on social constraints related to SES attainment (Anderson, 2018; Conger & Donnellan, 2007). When considering youth outcomes, models utilizing the social selection hypothesis often include longitudinal or intergenerational assessments. Collectively, these hypotheses form the interactionist model which proposes that individual development occurs through a dynamic relationship between both social causation and social selection (Conger & Donnellan, 2007; Martin et al., 2010). The following discussion will focus on assertions of these hypotheses to provide some insight for a model integrating SES and SSC in the discussion of family effects on child level outcomes.

Several models assert that SES (e.g., income, education, occupation) confers vulnerability or benefit to a family unit, thus impacting children’s outcomes. For example, the family stress model proposes that a family’s experience of economic hardship increases youth vulnerability for displaying externalizing behaviors through mediating factors such as parental stress, harsh parenting practices, and coercive family conflict (e.g., Conger & Conger, 2008; Conger et al., 1994; Korous et al., 2018; Roy et al., 2019; Shaw & Shelleby, 2014). Conversely, the extended investment model asserts that parental SES, specifically higher SES, serves as a protective factor by extending parents ability to address a multitude of children’s needs such as providing them with safe and secure housing, specialized support (e.g., tutoring), and quality learning materials to promote competent development (Conger & Dogan, 2014). Importantly, the extended investment model focuses on parents’ access to and provision of resources and does not assert that salient family factors, such as family conflict, are absent.

Research guided by the social selection hypothesis emphasizes that rather than indicators of SES (e.g., income), it is individual parental characteristics such as personality and genes that predict outcomes related to SES (e.g., educational attainment) in addition to factors related to parenting such as warmth and reliability (e.g., Conger & Donnellan, 2007; Conger & Dogan, 2014; Martin et al., 2010). Additionally, evidence suggests that parent’s own perceptions of their SSC impacts children’s early presentation of externalizing symptoms through indirect pathways of parental stress and depression (Roy et al., 2019). Some evidence suggests that parental SSC may further impact children through parents’ use of socialization messages related to SES (e.g., emphasis on academic competence) which are associated with youth outcomes (Conger & Dogan, 2014). Overall, this model provides one explanation for the influence of parental and environmental factors on adolescents’ experience of disadvantage (e.g., higher poverty school, low-income neighborhood, family economic disadvantage), their reports of lower SSC, and maladaptive outcomes including hostility, conduct problems, and substance use (e.g., Castro et al., 2020; Ritterman et al., 2009; Rivenbark et al., 2019).

Taken together, the presence of early family-based risk factors related to SES and youth characteristics are associated with childhood-onset externalizing symptoms which may be further exacerbated by youth development of low-SSC (Barker & Maughan, 2009; Rivenbark et al., 2019). Indeed, when considering low-SES youth in comparison to middle- and high-SES youth, evidence supports an increase in symptoms of psychopathology across time including somatic complaints, attention problems, delinquent behavior, and aggression (Wadsworth & Achenbach, 2005). Furthermore, evidence suggests that low-SES populations experience higher incidence rates of clinically elevated symptoms including thought problems, delinquent behavior, and aggressive behavior, but do not receive similar amounts of or gains associated with service provision as compared to middle- and high- income individuals (Wadsworth & Achenbach, 2005). Consequently, the evidence reviewed here supports an interactionist model of SES, SSC, and child externalizing behavior.

Peer Centered Models

Guided by social learning theory, early-starter models of externalizing problems suggest that the development of coercive behaviors between caregivers and children extends into broader social interactions resulting in further development of coercive cycles, diminished access to peer interactions, and social skill deficits (Barker & Maughan, 2009; Shaw & Shelleby, 2014). Children who maintain a pattern of coercive social interactions or aggression within their peer groups are likely to be socially rejected which in turn increases engagement in antisocial behavior and predicts later externalizing behavior problems across developmental periods (Guerra et al., 2004; Prinstein & Giletta, 2016). This bidirectional association may be particularly pertinent when considering early models of the relationship between SSC and externalizing symptoms. For example, aggressive and socially rejected children are at heightened risk for experiencing hostile attribution bias, or the propensity to interpret social stimuli as having hostile intent (Crick & Dodge, 1994; Lewis & Rudolph, 2014). Further, studies have demonstrated that children with externalizing symptoms exhibit disruptions in their neural and physiological response to threat which is related to engaging in behaviors of social dominance including reactive and retaliatory aggressive behaviors (e.g., McLaughlin et al., 2014; Ursache et al., 2015; White et al., 2016). Irrespective of objective measures, children’s perceptions of low SSC, in relation to society and their school community, are linked to increases in oppositional behaviors (e.g., Castro et al., 2020; Pardini et al., 2006; Russell & Odgers, 2019). This association may reflect that youth with low SSC engage in maladaptive behaviors in an effort to assert dominance and status within peer groups. Indeed, peer-perceived popularity is related to youths’ aggression (Pan et al., 2020; Lewis & Rudolph, 2014). Taken together, this body of research supports a transactional and cumulative model of early SSC in which the combination of early family-level vulnerabilities, children’s individual characteristics, and peer social interactions interact to instill perceptions of and behaviors related to status in turn, exacerbating maladaptive behavior patterns across time (e.g., Boyce, 2004; Brennan et al., 2003; Mrug & Windle, 2009; Prinstein & Giletta, 2016; Weinberg et al., 2019).

When considering the impact of peer relationships on youth externalizing symptoms, it is important to consider the contexts under which they occur and how youth SSC may develop in relation to peers in these contexts. Specifically, the context of relative inequality, experienced in one’s neighborhood and/or school, is significant as experiences of inequality, apart from poverty, are linked to increases in risk taking behaviors, antisocial behaviors, and substance use (e.g., Odgers, 2015; Payne et al., 2017; Sorhagen & Wurster, 2017). The literature reviewed here varied with some results suggesting that increases in relative neighborhood inequality (i.e., living in a neighborhood with higher relative SES) are related to increases in youth antisocial and delinquent behavior while others reported no changes or improvements in youth behavior (e.g., Anderson et al., 2014; Byck et al., 2015; Leventhal & Brooks-Gunn, 2003; Mrug & Windle, 2009; Odgers, 2015). Considering the school context, youth attending schools with relatively more affluent students are at risk for heightened drug use, property crime, intoxication, loneliness, and social dissatisfaction (Coley et al., 2018; Sorhagen & Wurster, 2017). Given that experiences of inequality are likely linked to low SSC, it may be the case that youth engage in externalizing behaviors in the context of inequality in an effort to increase their own status amongst peers. Furthermore, youth who have low SSC and engage in antisocial behaviors may be more likely to associate with deviant peer groups, further exacerbating their vulnerability for externalizing symptoms (Dodge et al., 2008; Ingoldsby et al., 2006).

Models regarding the influence of peers on older adolescents may vary from those of younger children, given the increases in autonomy and individualization experienced with age. Consequently, their engagement in specific externalizing behaviors, such as substance use, also differs. Of note, the body of literature on adolescent substance use is rich and more thorough than reviewed here. Current evidence regarding the influence of SES on substance use asserts that while potentially qualitatively different (e.g., achievement stress, competition, neighborhood context), vulnerability factors exist across the spectrum of SES and SSC may provide some insight into more nuanced associations (e.g., Bello et al., 2019; Hussong et al., 2020; Ritterman et al., 2009; Russell & Odgers, 2019). Studies of both high-and low-income adolescents support an association between measures of high community SSC, peer popularity, and substance use suggesting that peer approval and associations with deviant peers are one pathway through which adolescent substance use is exacerbated (e.g., Coley et al., 2018; Luthar & D’Avanzo, 1999; Ritterman et al., 2009). However, there is also evidence that supports a link between low SES and low community SSC and increased vulnerability for substance use (Bello et al., 2019; McLaughlin et al., 2012). This suggests that in the context of SES and community SSC, the function of adolescent substance use (e.g., substance use with deviant peers, substance use as a coping mechanism) may vary and is important to consider when attempting to delineate pathways to vulnerability. Importantly, this discussion focuses on substance use as a symptom of externalizing behavior however, it should be noted that the association between substance use and internalizing symptoms occur through similar pathways as outlined here (e.g., Hussong et al., 2011; Luthar & D’Avanzo, 1999; McMahon & Luthar, 2006). Thus, substance use may be a unique form of externalizing behavior in which SES, SSC, and peers contribute to use through adolescents’ motives for status or through the interaction of other comorbid symptoms that preclude or co-occur with use in certain contexts.

Conceptual Model Linking SES, SSC, and Externalizing Problems

Theory and research to date highlight that a number of factors, specifically in the contexts of parent and peer relationships, contribute to the associations between children and adolescent’s SES, SSC, and their externalizing symptoms (e.g., Korous et al., 2018; Letourneau et al., 2013; Odgers, 2015; Piotrowska et al., 2015; Wadsworth & Achenbach, 2005). What is not yet available is a unifying model that integrates the continuous nature of these contexts (e.g., range of SES, range of developmental periods, society and community SSC) in order to begin to more clearly describe their associations while identifying and in turn subsequently addressing current gaps in future theoretical and empirical work. Accordingly, this review proposes a conceptual developmental model to demonstrate the effects of SES and SSC on youth externalizing symptoms across a spectrum of sociodemographic variables (see Figure 1). Informed by bioecological systems theory (Bronfenbrenner & Morris, 2007) and the Integrative Model, (García Coll et al., 1996) and further guided by family systems and social learning perspectives, this framework proposes an equifinality approach to describe how individual factors (e.g., SES, age), parents (e.g., parental SSC, socialization practices), and peers (e.g., peer rejection, peer group membership) impact youth vulnerability for behavior problems as well as their early conceptualizations of society and community SSC (e.g., Amir et al., 2019; Piotrowska et al., 2019). Specifically, this model categorizes factors into two separate levels (i.e., Level 1 factors, Level 2 factors) in an effort to delineate the various pathways in which such factors contribute to externalizing behaviors across developmental time points. Level 1 factors include individual level characteristics (i.e., age, gender, race, ethnicity) parental SES, parental society and community SSC, parenting behaviors (e.g., socialization, harsh parenting), peer relationships (e.g., peer rejection), and one’s social environment (e.g., neighborhood). These factors are posited to exert the most influence on young children and help set the stage for cascading effects when Level 2 factors are taken into account. For example, the family stress model asserts that families experiencing low income (i.e., parental SES) and associated economic stress are more vulnerable to disruptions in parental well-being and parenting behaviors (e.g., coercive cycle of parent-child interactions) resulting in youth’s heightened vulnerability for developing externalizing symptoms. In this example, an interaction of Level 1 factors contributes to the early presentation of externalizing symptoms. Level 2 factors include the exacerbation, maintenance, or onset of Level 1 factors (e.g., early social skills deficits in early childhood evolve into persistent peer rejection in late childhood and early adolescence) in addition to the emergence of youth society and community SSC. The framework uses Level 2 factors to describe the onset of behavior problems in adolescence or the persistence of behavior problems from childhood. Continuing to utilize the family stress model as an example, this framework asserts that the maintenance of Level 1 factors (e.g., persistent low-SES, coercive cycle) across childhood increases youth’s vulnerability for experiencing externalizing symptoms into adolescence. As children age and Level 2 factors begin to exert influence, for example, their subjective perceptions of their class (i.e., society and community SSC) begin to form and stabilize, these factors interact with Level 1 factors to maintain or exacerbate existing symptoms (e.g., a child with low-SES develops low-SSC which contributes to poor social interactions and maintenance of externalizing symptoms). However, Level 1 factors may not emerge until late childhood or adolescence. The framework acknowledges this pattern of symptom presentation and includes the emergence of Level 1 factors at Level 2 to recognize the conceptual differences between child- and adolescent-onset externalizing symptoms. For example, an adolescent who previously did not express externalizing symptoms may develop high society SSC (e.g., based on parental wealth, education, and occupation) and community SSC (e.g., based on high academic grades and power in their school environment) and demonstrate heightened levels of externalizing symptoms (e.g., hostility toward peers, substance use) in an effort to assert and maintain their social standing. In this example, a Level 1 factor (parental SES), contributes to a Level 2 factor (youth society and community SSC) which in turn results in externalizing symptoms. Importantly, this model is conceptual and thus intended to be broad and inclusive, but not exhaustive. That said, it importantly moves away from theories that rely solely on economic hardship and family financial stress, instead providing a framework that contextualizes vulnerability and resilience factors as associated with SES and society and community SSC across a broad spectrum. Notably, this model characterizes externalizing behavior problems as a set of symptomologies (e.g., Conduct Disorder, Attention-Deficit/Hyperactivity Disorder, aggression, hostility, substance use) across developmental periods of early childhood to late adolescence in order to address the relative importance of SES, SSC, parents, and peers across time.

Fig 1.

Developmental Conceptual Model of the Relationship Between Objective and Subjective Social Class and Externalizing Symptoms

Several key factors of the reviewed literature are important to consider in advancing the field of study with the proposed framework in mind. First, with regard to youth SSC in early childhood, current measurement techniques are not consistent or clearly defined (Elenbaas, 2019; Mandalaywala et al., 2020). The Subjective Social Status-Youth Version for example has been used in samples of youth as young as 4 years old; however, future research may continue to assess its utility and developmental appropriateness for preschool age children in addition to its associations with early externalizing symptoms (Amir et al., 2019). Furthermore, future research should continue to consider important conceptual differences in the measurement of society and community-based SSC as well as how these constructs are related to one’s social identity. Current research tends to equate society and community SSC as the same construct in the measurement of subjective social class. However, it is important to recognize that community SSC is likely more reflective of one’s subjective social standing (e.g., power, prestige) within a proximal class hierarchy (e.g., classmates) while society SSC may more accurately reflect one’s perceptions of their access to economic resources relative to others (e.g., income, education). Additionally, how one’s community and society SSC is integrated into a more global social identity (i.e., intersecting identities that signal group membership and status and aid in social comparisons; Howard, 2000; Velez & Spencer, 2018), is important to consider in future investigations. The current study used the term subjective social class broadly, and society and community subjective social class more specifically to describe youth’s perception of their place in social hierarchies based on their SES (e.g., family income, education, and occupation) and social capital (e.g., occupying higher status positions, possessing more power than others in one’s proximal social groups). This approach considers the interrelationship of each construct and their association to one’s class-based standing with regard to both social and economic power. It is notable that terminology (e.g., social class, status, subjective social status) utilized both within and across fields such as psychology, sociology, and economics is often not well-defined or agreed upon (Kraus et al., 2017; Waters & Waters, 2016). Although the current approach contributes to rather than clarifies the disparate use of conceptually similar terms, this approach attempts to clearly define terminology used throughout while combining theoretical and empirical literatures across fields toward a better understanding of the psychosocial impact of SSC in children and adolescents.

Apart from the development and validation of developmentally appropriate measurement tools, it will be important for future studies to begin to use more comprehensive assessment techniques when considering the effects of SES and SSC. The inclusion of thorough, rather than simple categorical measures of salient identities (e.g., race, ethnicity, gender), in conjunction with measures of SSC and SES may aid in delineating the complex relationships between such identities and youth mental health. Further, as youth SES is measured at the parent level, it is imperative to consider how differences in parent-child race and ethnicity (e.g., adoptive families, multi-racial/ethnic families) may uniquely impact their experiences of privilege and marginalization and influence the effect of youth SES and SSC on externalizing symptoms. When considering measurement sources, research to date often relies on parent and teacher reports, occasionally in the absence of youth reports, to assess the presence of various symptoms and social behaviors. As evidence supports racial and ethnic discrepancies in teachers’ reports of various symptoms, researchers should consider the impact of racial bias when interpreting results obtained from observer reports and strive to use the most objective measures (Lau et al., 2004).

As the field aims to capture more nuanced information from parents and children, the broader family context should be considered. For example, in collecting measures of parental SES and SSC, it is common in the clinical and developmental literatures to collect SES from a single source, most often mothers, and the reviewed studies are no exception (e.g., Chen et al., 2006; Goodman et al., 2001; McLaughlin et al., 2012; Roy et al., 2019). This limits the ability to assess differential impacts that parental SSC may have on youth SSC and may misrepresent youth experiences of SES if one parent’s indicators are more prestigious than the other (e.g., higher educational attainment, higher occupational prestige) and are absent from analyses. Moreover, studies including only mothers perpetuates the underrepresentation of fathers in research on families and children, rendering the generalizability of results unclear (see Davison et al.,2017; Phares et al., 1998; Phares et al., 2005 for reviews).

Finally, future research may consider cross -cultural implications of indicators of SSC when developing and administering measures. Based on current research, measures of SSC may be most valid when they reference indicators (e.g., relative income, amount of food in the home) that are culturally relevant to the given population (Amir et al., 2019).

Clinical Implications

Current research has discussed the clinical implications of SES for youth with externalizing problems and their families. For example, data demonstrating an overrepresentation of low-SES youth in statistics on externalizing symptoms has led to advances in targeted treatments designed to improve engagement and outcomes (e.g., Brager et al., 2019; Gresl et al., 2014; Gross et al., 2009; Jones et al., 2014). Such work has been borne from the identification of particular needs and barriers often experienced by low-income families, including difficulty accessing and engaging in treatment, as well as perceived inappropriateness of some treatment techniques (e.g., strategies that do not address relevant cultural and environmental factors related to parenting such as parental stress related to racism, immigrant status, or living in resource deprived communities; Breitenstein et al., 2012; Gross et al., 2009). Such clinical developments may further increase treatment effectiveness for low-SES youth and their families. As research suggests that concepts of SSC emerge early in childhood and further develop as children age, parental social class socialization messages may be a potential target for intervention as well. Parents, in addition to peers, media, and other figures of authority serve as salient socializing agents for young children. Given theory and data demonstrating the occurrence and impact of negative socialization messages in the environment, early parental socialization messages pertaining to social class may be of particular importance (Jones et al., 2018). Specifically, parents who inadvertently convey messages that reinforce negative stereotypes or poor self-image in the context of one’s social class may increase their child’s vulnerability to cascading effects in later life (Jones et al., 2018). Thus, family-based interventions that promote adaptive integration of youth SSC (e.g., society and community SSC) and the meaning it has for their future may be protective. That is, messages that emphasize a youth’s strengths and capabilities and minimize negative deterministic messages related to their income and current social standing may be effective in mitigating poor outcomes related to low SSC. In addition to family-based intervention approaches, those targeting youth social skills may prove useful in preventing or improving low community SSC. Evidence suggests that early social skills deficits may play a critical role in the development of low community or school SSC and subsequent vulnerability for or exacerbation of externalizing symptoms (Barker & Maughan, 2009; Shaw & Shelleby, 2014). Thus, early intervention techniques may benefit from targeting children with externalizing problems who often have difficulty regulating their emotions, are impulsive, have low language ability, and are physically aggressive making them more vulnerable to unsatisfactory peer relationships. Given evidence suggesting the robust predictive ability and long-term effects of SSC, it is imperative that this construct be further considered in the treatment of childhood and adolescent externalizing problems behaviors.

Availability of data and material:

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