Early death perception in adolescence: identifying factors associated with change from pessimism to optimism about life expectancy.

US teens overestimate risk for early death. The purpose of this study was to identify factors associated with an adolescent's change from early death perception to a belief in living into adulthood. Data are from 9140 adolescents participating in waves 1 (1995) and 2 (1996) of the National Longitudinal Study of Adolescent Health. Logistic regression models were used to determine contexts of healthy and unhealthy change associated with the likelihood of early death perception change. Youth report of increased caring and connection to other adults and increased self-esteem were associated with greater likelihood of moving from pessimism to optimism about life expectancy (P=.003 and P=.038, respectively). Reductions in self-esteem and poorer perception of health were associated with decreased odds of death perception change (P=.017 and P=.011, respectively). Nurturing positive connections with adults and strategies that improve a youth's self-esteem offer 2 opportunities to facilitate adolescent early death perception change.