da Silva CTB, et al. – Using data from the 1993 Pelotas Birth Cohort (N=5,249; n=4,336 with complete mental health data), researchers examined the association of emotional symptoms (ESs) expression at ages 11 and 15 with carotid intima-media thickness (CIMT) at 18 years of age. They used the Strengths and Difficulties Questionnaire to evaluate ESs. Potential confounding between exposure and outcome was adjusted via utilization of a propensity score weighting procedure using generalized boosted regression model. In addition, the mediating impact, if any, of traditional cardiovascular risk factors on this link was investigated. Findings revealed a longitudinal association of ESs expression in adolescence, with a higher CIMT in young adults. This link was not mediated by traditional cardiovascular risk factors and was direct. Remarkably, enhanced effects of ESs on CIMT at age 18 were noted in association with male sex at age 15. In males vs females, mean increases of 5.83 μm vs 1.14 μm, respectively, were found to result from high expression of ESs.