Benevolent early life experiences, known as BCEs, are enabling experiences before the age of 18 that foster positive perceptions of safety, security, connectedness, and predictability during development (Narayan et al., 2018). BCEs, such as access to supportive adults or having good neighbors, have been found to have a positive impact on the development and well-being of adults who were exposed to hardship during their childhood (Narayan et al., 2018; Crandall et al., 2019; Daines et al., 2021). For this reason, BCEs are associated with resilience (i.e., the capacity for positive outcomes – such as mental health – despite exposure to significant risk; Masten, 2014). However, little is known about the potential long-term protective effects of BCEs on the mental health outcomes of young adults in South Africa. This paper redresses this existing research gap among a sample of emerging adults aged 18–26 years old.

The mental health outcomes of adolescents and youth globally are an important cause for concern, with mental health disorders contributing significantly to the global burden of disease (Wies et al., 2021). Depression, which is a leading contributor to this burden, has shown alarming upward trends among youth (Thapar et al., 2022). While only a limited number of studies have investigated mental illness among young people in sub-Saharan Africa (Steel et al., 2022), a narrative review of 37 of these studies showed a median point depression prevalence of 26.9% for sub-Saharan young people aged 10–19 in general and 29% for those with experiences of significant risk exposure (e.g., violence or poverty) (Jörns-Presentati et al., 2021). This incidence is comparable to that reported in global prevalence studies (Shorey et al., 2022). Protecting the health and well-being of young adults is important, not least because this has been linked with socio-economic development (Nyundo et al., 2020). This is because of the association between the mental health of youth cohorts and other outcomes such as their self-esteem, interaction with their family members and peers, and gainful employment.

Likewise, there is concern about the mental health of South African young people. The available nationally representative data on mental health in South Africa comes from the National Income Dynamics Study (NIDS). The 2014–2015 data reveals that 26% of the population have significant depressive symptoms (Mungai and Bayat, 2019), which is similar to the prevalence among youth aged 15–24 (Somefun and Simo Fotso, 2020). Despite the high prevalence of depression among young people in South Africa, significant barriers exist in accessing mental health services (Craig et al., 2022). Stigma surrounding mental health issues is widespread, particularly in rural areas, and many young people may be reluctant to seek help due to fear of discrimination or judgment (Guttikonda et al., 2019). The shortage of mental health professionals and limited resources also make it challenging for young people to access adequate treatment and support in South Africa (Mokitimi et al., 2019). Studies have posited that prevention of mental health disorders is important because of the effect they have in later adulthood (Sorsdahl et al., 2021).

The causes of depression among youth in South Africa are diverse and complex. Socioeconomic factors such as poverty, unemployment, and social inequality are significant contributors to depression among young people (Hatcher et al., 2019; Somefun and Simo Fotso, 2020). Many young people in South Africa experience high levels of stress and anxiety due to the challenges of daily life, including violence, crime, and social isolation (Scorgie et al., 2017; Sui et al., 2021). In addition to the external factors contributing to depression, there are also internal factors that can lead to depression among young people. Genetic predisposition (Alshaya, 2022), past traumatic experiences, and chronic stress (Thapar et al., 2022) can all increase the risk of developing depression. The impact of the COVID-19 pandemic has also contributed to the increase in depression among young people in South Africa (Haag et al., 2022). The pandemic has resulted in increased social isolation, economic uncertainty, and disrupted education, which has taken a toll on the mental health of young people (Theron L. et al., 2021).

As summarized in Table 1, most young adults reported minimal to mild symptoms of depression. Most reported positive childhood experiences as well as high levels of family adversity. 86.4% of the sample reported all 10 BCEs.

Model 1 investigated the unadjusted association between the composite measure of BCEs and depression. As shown in Table 2, there was no significant association between the combined BCE scores and depression. Participants with high BCEs had lower odds of being moderately depressed compared to their counterparts with low BCEs, but this association was not statistically significant.

Model 2 (see Table 3) investigated the unadjusted association between individual BCE item scores and depression. As shown in Table 3, three specific items (i.e., having at least one good friend, comforting beliefs, and being comfortable with themselves) were significantly associated with lower odds of moderate depression.

Table 4 shows the adjusted association between the combined BCE scores and depression. There was no significant association between combined BCE scores and depression. Gender was significantly associated with moderate and severe depression: young males had lower odds of depression compared to their female counterparts.

For the adjusted association (Table 4), there was no significant association between individual BCE item scores and depression.

This study examined whether reported BCEs were associated with depression levels reported by young adults in the South African RYSE sample. No previous African study has explored the potentially protective effects of BCEs for African young adults. In African contexts, including South Africa, young people in chronically resource-constrained communities are at elevated risk for depression and have little access to mental health supports (Tomita et al., 2017; Haag et al., 2022). This reality compels attention to ordinary resources (like BCEs) that might mitigate this mental health risk.

Studying benevolent childhood experiences (BCEs) and their relationship with depression among young adults in a violent and chronically disadvantaged setting in South Africa is crucial for several reasons. Firstly, by examining the role of BCEs in this setting, we can gain insights into the potential protective factors that may mitigate the negative impact of violence and ongoing disadvantage on adolescent mental health. Exposure to violence and ongoing disadvantage are associated with continuous traumatic stress (Eagle and Kaminer, 2013). Put differently, we can identify which BCEs, if any, have a mental health advantage when young people are exposed to continuous traumatic stress Identifying specific BCEs that are associated with lower rates of depression can inform interventions and programs aimed at promoting resilience and well-being in similar contexts.

In addition, this research contributes to the growing body of literature on the impact of childhood experiences on mental health outcomes, particularly in challenging environments. It provides an opportunity to expand our understanding of the complex interplay between BCEs, violence, and depression among young adults, filling gaps in knowledge and enriching the field of mental health research. This is particularly important when exposure to significant stress is protracted.

Our results are unexpected. There was no support for our expectation that young people reporting higher cumulative levels of BCEs would report better mental health, even though young people reported high levels of BCEs. This finding is surprising given the widespread poverty, violence, and other challenges that many South African children face and the understanding that socioeconomic context can negatively impact access to childhood resources, such as caring parents or predictable family routines (Conger and Donnellan, 2007). However, several factors may explain why these young adults reported benevolent experiences in their childhood.

Firstly, South Africa has a rich cultural tradition that places a strong emphasis on community and family (Ramphele, 2012). This cultural emphasis may have contributed to the positive childhood experiences reported by the emerging adults in this study. For example, close family ties and social support from extended family members may have provided a buffer against the negative effects of poverty and other stressors.

Secondly, the emerging adults in this sample may have been more likely to perceive their childhood experiences positively due to a cognitive bias known as the “positivity effect.” The positivity effect refers to the tendency for individuals to remember and focus on positive events and experiences more than negative ones (Reed and Carstensen, 2012). This bias may have influenced the way that the emerging adults in this study remembered and reported their childhood experiences, leading to an overestimation of benevolent experiences.

Finally, it is possible that the emerging adults in this sample reported high benevolent childhood experiences because of social desirability bias. Social desirability bias refers to the tendency for individuals to present themselves in a positive light in social situations (Latkin et al., 2017). The emerging adults in this study may have felt pressure to report positive childhood experiences in order to conform to social norms and expectations.

Regarding our surprise that BCEs showed no significant protective effects, it is possible that cumulative positive childhood experiences were not sufficient to mitigate the compound risks participants were exposed to and experienced (i.e., a chronically stressed community in combination with high levels of family adversity). Because this exposure continued into early adulthood (a demanding developmental stage that is associated with heightened psychological distress when developmental milestones cannot be met; Arnett, 2000), it possibly negated the protective effects of a healthy childhood. There has been some concern that resilience studies that focus narrowly on single adaptive outcomes (e.g., negligible symptoms of depression) might have misrepresented the notion that resilience is commonplace (Infurna and Luthar, 2018). Perhaps the opposite applies in this case: BCEs might have demonstrated protective effects if we had investigated more than a single adaptive outcome, or at least an outcome that might fit better to the studied context.

We posited that feelings of safety and adult support would have pronounced protective mental health effects for young adults in our sample compared to other BCEs. Our expectation related to the prominence of relational resources – especially nurturing or mentoring care from an adult – to the resilience of South African young people (Van Breda and Theron, 2018), including older adolescents’/young adults’ mental health (Theron et al., 2022). However, the BCEs associated (albeit non-significantly) with lower levels of depression for young adults in our study were: having at least one good friend, comforting beliefs and being comfortable with oneself. Certainly, prior resilience studies in South Africa do acknowledge the enabling value of personal strengths (such as self-acceptance; Van Breda and Theron, 2018), good friends (with emphasis on these friends being trustworthy and prosocial; e.g., Van Breda and Dickens, 2017; Singh and Naicker, 2019) and comforting beliefs (typically faith-based ones; e.g., Mhaka-Mutepfa and Maundeni, 2019). Given this, we were surprised that the association reported was non-significant.

Overall, we wondered whether we might have found significant associations for the cumulative BCEs and/or single BCEs if the scale had included additional positive childhood items that resonate with African culture. The measured BCEs may not have been context specific enough or too broad to have captured important nuances in participants’ experiences. For instance, African children are socialized to value interdependence with people beyond their immediate social connections (family, friends, neighbors and teachers), to appreciate organized religion and spiritual practices (Brittian et al., 2013; Balton et al., 2019), and to engage in cultural rituals (e.g., coming of age celebrations) (Ramphele, 2012). All the aforementioned are potential sources of positive childhood experiences not documented in the Narayan et al. (2018) BCE scale. Similarly, African children in resource-constrained communities might not be familiar with daily routines that include regular mealtimes, but they are likely to be familiar with daily routines that include opportunities to contribute constructively to their household (e.g., chores) and to engage informally in cultural/sporting activities with other children in the neighborhood. It would be valuable to trial BCE items that better fit African children’s context and determine the associations of such contextually relevant items with mental health outcomes.

The multisystemic resilience literature is encouraging attention to resources in the physical environment, too (Ungar and Theron, 2020). This relates to growing understandings that the built environment (e.g., quality housing) and natural environment (e.g., green spaces to play) matter for young people’s positive outcomes (Adams et al., 2017; Pillay, 2017). Children’s positive childhood social experiences are often intertwined with these spaces (e.g., opportunities to play; Adams et al., 2017). It might, therefore, be valuable to adapt the BCE scale so that is both contextually relevant and appreciative of the spaces/places that facilitate positive childhood experiences (e.g., Have you had spaces where you could play safely?).

Previous studies have suggested that BCEs may have a significant positive impact on mental health outcomes (Narayan et al., 2019; Karatzias et al., 2020; Doom et al., 2021; Hou et al., 2022), but our findings did not support this hypothesis. Our study, which was the first to use a sample of youth in South Africa to examine these associations, encourages attention to how context might shape the protective effects of BCEs. While BCEs may play a role in shaping cultural and social identity, they may not have a significant impact on mental health outcomes in the absence of other factors like large-scale redress of structural violence. Further research is needed to better understand the complex interplay of cultural, social, and psychological factors that inform contextually meaningful BCEs and contribute to mental health outcomes among youth, also in Africa.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by Health Sciences Research Ethics Board, Dalhousie University, #2017-4321 and Faculty of Health Sciences Research Ethics Committee, University of Pretoria, #UP17/05/01. The patients/participants provided their written informed consent to participate in this study.

OS and LT contributed equally to the conceptualization of the manuscript and the background of the study. OS was responsible for the data analysis and interpretation of results. LT and JH contributed to the interpretation of the results. All authors of the manuscript contributed to the study design, data collection, data analysis, interpretation of results, manuscript preparation, involved in the manuscript preparation, reviewed, and approved the final version of the manuscript for submission.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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