Could skin-deep resilience be an unintended consequence of academic motivation interventions?

Minority and low-income youth in the U.S. are at greater risk for a wide array of adverse life outcomes. For example, they are more likely to drop out of school, to be incarcerated, and to experience chronic diseases of aging such as cardiovascular disease in adulthood1-4. Despite these trends, a substantial number of low-income and minority youth manages to achieve good outcomes in the face of adversity, a phenomenon labeled resilience5. This fact suggests that if we can identify the factors that promote resilience in at-risk youth, then we could have important targets of intervention for reducing disparities by race or income in life outcomes. However, some of our recent research has revealed a paradox in presumably “resilient” youth. Prevailing approaches often assume that at-risk youth display resilience across domains; in other words, if they succeed in school and avoid behavioral problems, they also will have good health. But we have identified a subgroup of youth who challenge this notion. These youth, who typically come from disadvantaged backgrounds, appear resilient on the surface (via academic and mental health indicators), but ‘under the skin’ exhibit the highest levels of health risk, as reflected in allostatic load (a multi-system indicator of chronic disease risk) and epigenetic aging (a metric based on leukocyte DNA methylation profiles, which reflects the disparity between a person’s biological and chronological age). One possible explanation for this phenomenon that we have labeled ‘skin-deep resilience’ is that the same factors that help youth to succeed academically and psychosocially may also be exacting a toll on them physically. For example, engaging in high levels of sustained, effortful self-control may be important for promoting academic success but at the same time, may tax and exhaust physiological systems. For example, we find that among youth who come from lower socioeconomic status (SES) families, higher levels of self-control prospectively predict better psychosocial profiles (fewer internalizing and externalizing symptoms, less substance use), but worse biological profiles (higher levels of allostatic load and epigenetic aging) 6, 7. Higher SES youth do not show these divergent patterns of psychosocial and biological profiles. Similarly, among youth who grew up in low SES neighborhoods, those who make it to college (presumably through exerting high levels of effort and self-control) also show divergent patterns in terms of low levels of substance use but high levels of allostatic load8. We further find that skin-deep resilience is associated with clinical health outcomes in adulthood. Among youth who came from lower SES backgrounds, those who engaged in high levels of striving were more likely to have completed college, to have higher incomes, and to be less depressed, but at the same time, were more likely to have diabetes almost 20 years later9. In addition, among adults, those who grew up in lower SES households and were higher in conscientiousness (a personality trait that contains elements of self-control) were less depressed, had better social relationships, and higher educational attainment, but at the same time, were more likely to develop a diagnosis of upper respiratory illness following experimental inoculation with a respiratory virus 10. These patterns raise intriguing questions about current thinking and existing prescriptions and programs, particularly in the educational domain. For example, there are a number of experts who have advocated increasing academic mo