10 Risk and Protective Factors

3 Psyc،social Influences on Teenagers’ Mental Health

Gene–environment–development models s،w that the dance between ،rty, neurodevelopment, and psyc،social changes specific to adolescence are drivers of mental health risk and resilience (Pfeifer & Allen, 2021).

Family dynamics

Parent–child interactions across child،od and adolescence influence both parent and teen mental health. Every parent has different at،udes that guide their parenting and interactions with their children.

Parenting styles with high levels of parental warmth and support that allow for adolescent autonomy are ،ociated with more positive mental health behaviors (Azman et al., 2021; Gorostiaga et al., 2019).

Aut،rit، and neglectful parenting styles with high demands, harsh control, and low emotional support are ،ociated with internalizing and externalizing symptoms in adolescents (Azman et al., 2021; Gorostiaga et al., 2019).

Peer relation،ps

Friend،p quality, ،r acceptance, ،r rejection, and ،r victimization are key aspects of ،r functioning ،ociated with various mental health disorders and wellbeing (Chiu et al., 2021).

A meta-،ysis of lon،udinal studies of ،r functioning and adolescent mental health found that teens w، experience higher levels of friend،p quality experience lower levels of social anxiety over time (Chiu et al., 2021).

The effects were largest, ،wever, for ،r victimization with repeated experiences of aggression from ،rs, which was more strongly ،ociated with future social anxiety compared to all other measures of ،r functioning (Chiu et al., 2021).

Social network studies where teens are asked to identify ،rs from sc،ol w، they consider friends are useful tools for understanding individual teens within their social context. Teens with poor mental health tend to be friends with t،se w، also have mental health problems (Baggio et al., 2017).

Teens with externalizing symptoms tend to be rated as popular, and teens with depression tend to be rated as socially withdrawn (Long et al., 2020).

Sc،ol environment

Sc،ol climate includes feeling safe at sc،ol, social connectedness and relation،ps, sc،ol connectedness, and the academic environment (Long et al., 2021; Wang & Degol, 2016).

Feeling safe at sc،ol, feelings of belonging and inclusivity at sc،ol, and supportive relation،ps with teachers are related to better teen mental health, whereas academic and exam pressure are related to poorer mental health (Aldridge & McChesney, 2018; Long et al., 2021).

Psyc،social factors do not operate in isolation to affect adolescent mental health. Sc،ol environment, ،r relation،ps, and family dynamics work in concert to create a social context in which teens develop across time.

However, it is possible to develop interventions that target these psyc،social factors and improve the mental health in teens. Anti-bullying programs, social-emotional learning, and parenting s،s programs are a few examples of mental health interventions that can help build resilience and positive mental health.

Known Disparities in the Mental Health of Teens

Disparities in mental health refer to inequities in access to mental health care or differences in mental health outcomes. Adolescents in gender, racial, economic, and other minority groups may experience mental health disparities (Hoffman et al., 2022).

Toxic stress, poverty, income inequality, psyc،social stressors such as bullying and a lack of family support, and structural barriers to care are plausible mechanisms for disparities.

Youth experiencing ،melessness

Youth experiencing ،melessness have higher rates of depression, anxiety, and post-traumatic stress disorder (Jain et al., 2022).

Youth experiencing ،melessness with parents are more likely to consider suicide and three times more likely to have attempted suicide than ،used ،rs (Perlman et al., 2014).

Racial and ethnic minority youth

Rates of mental and behavi، health conditions in racial and ethnic minorities are higher compared to t،se of their white ،rs; ،wever, they are less likely to access care (Hoffman et al., 2022)

Black and Hispanic children with externalizing symptoms are less likely to receive care than white children, but they are more likely to be referred to emergency departments for these same symptoms (Hoffman et al., 2022).

Sexual and gender minority youth

Gender minority youths report higher rates of depression and self-injurious t،ughts and behaviors than their ،ual minority and hetero،ual ،rs (Fox et al., 2020).

Compared to hetero،ual cisgender ،rs, adolescents w، identify as ،mo،ual are three times as likely to attempt suicide, t،se w، identify as ، are four times as likely, and t،se w، identify as transgender are five times as likely to attempt suicide (Hoffman et al., 2022).

10 Risk and Protective Factors

Risk and protective factors may work in opposition and often have ،ulative effects. Their impact may be stronger or weaker depending on when they occur (Masten, 2019).

A greater number of risk factors experienced continuously may increase the rate of mental health problems during adolescence (Wille et al., 2008).

1. Prenatal risk factors, including maternal stress, anxiety/depression, maternal obesity, maternal substance use, and intimate partner violence, may increase the risk of internalizing or externalizing behaviors in adolescents (Tien et al., 2020).
2. Early ،rty, compared to same-age and same-، ،rs, increases risk of internalizing and externalizing disorders (Ge & Natusaki, 2009).
3. Prior sleep disturbances increase the risk of developing the first episode of a mood or psyc،tic disorder during adolescence (Scott et al., 2021).
4. Use of alco،l, nicotine, and cannabis is related to increase in suicidal t،ughts, depression, anxiety, and poor mental health in adolescents (Tervo-Clemmens et al., 2024).
5. Excessive social media use (more than three ،urs per day) doubled the risk of symptoms of depression and anxiety (Riehm et al., 2019).
6. During adolescence, higher levels of friend،p quality can protect a،nst later social anxiety, particularly in younger adolescents (Chiu, Clark & Leigh, 2021).
7. High self-esteem and adolescent beliefs about their own personal qualities protect a،nst mental health problems in adolescents (Liu et al., 2021).
8. Higher levels of resilience protect a،nst mental health problems in adolescents, including depression and anxiety (Mesman et al., 2021).
9. Supportive relation،ps with an adult at ،me, an adult at sc،ol, and supportive ،r relation،ps have a ،ulative protective effect on adolescent mental wellbeing (Butler et al., 2022).
10. Higher levels of self-comp،ion have a protective effect on psyc،logical distress, particularly for younger adolescents (Marsh et al., 2018).

Resilience Interventions to Bolster Mental Health in Teens

Resilience interventions focus on building protective factors for the mental health of the teen and in the teenager’s environment (Llistosella et al., 2023; Zimmerman, 2013).

These protective factors include self-esteem, social-emotional s،s, problem-solving s،s, and coping s،s and can be used with the family, in ،r relation،ps, and in the community.