3 Psychosocial Influences on Teenagers’ Mental Health
Gene–environment–development models show that the dance between puberty, neurodevelopment, and psychosocial changes specific to adolescence are drivers of mental health risk and resilience (Pfeifer & Allen, 2021).
Family dynamics
Parent–child interactions across childhood and adolescence influence both parent and teen mental health. Every parent has different attitudes 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 associated with more positive mental health behaviors (Azman et al., 2021; Gorostiaga et al., 2019).
Authoritarian and neglectful parenting styles with high demands, harsh control, and low emotional support are associated with internalizing and externalizing symptoms in adolescents (Azman et al., 2021; Gorostiaga et al., 2019).
Peer relationships
Friendship quality, peer acceptance, peer rejection, and peer victimization are key aspects of peer functioning associated with various mental health disorders and wellbeing (Chiu et al., 2021).
A meta-analysis of longitudinal studies of peer functioning and adolescent mental health found that teens who experience higher levels of friendship quality experience lower levels of social anxiety over time (Chiu et al., 2021).
The effects were largest, however, for peer victimization with repeated experiences of aggression from peers, which was more strongly associated with future social anxiety compared to all other measures of peer functioning (Chiu et al., 2021).
Social network studies where teens are asked to identify peers from school who they consider friends are useful tools for understanding individual teens within their social context. Teens with poor mental health tend to be friends with those who 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Teens with externalizing symptoms tend to be rated as popular, and teens with depression tend to be rated as socially withdrawn (Long et al., 2020).
School environment
School climate includes feeling safe at school, social connectedness and relationships, school connectedness, and the academic environment (Long et al., 2021; Wang & Degol, 2016).
Feeling safe at school, feelings of belonging and inclusivity at school, and supportive relationships 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).
Psychosocial factors do not operate in isolation to affect adolescent mental health. School environment, peer relationships, 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 psychosocial factors and improve the mental health in teens. Anti-bullying programs, social-emotional learning, and parenting skills 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, psychosocial stressors such as bullying and a lack of family support, and structural barriers to care are plausible mechanisms for disparities.
Youth experiencing homelessness
Youth experiencing homelessness have higher rates of depression, anxiety, and post-traumatic stress disorder (Jain et al., 2022).
Youth experiencing homelessness with parents are more likely to consider suicide and three times more likely to have attempted suicide than housed peers (Perlman et al., 2014).
Racial and ethnic minority youth
Rates of mental and behavioral health conditions in racial and ethnic minorities are higher compared to those of their white peers; however, 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 thoughts and behaviors than their sexual minority and heterosexual peers (Fox et al., 2020).
Compared to heterosexual cisgender peers, adolescents who identify as homosexual are three times as likely to attempt suicide, those who identify as bisexual are four times as likely, and those who 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 cumulative 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).
- 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).
- Early puberty, compared to same-age and same-sex peers, increases risk of internalizing and externalizing disorders (Ge & Natusaki, 2009).
- Prior sleep disturbances increase the risk of developing the first episode of a mood or psychotic disorder during adolescence (Scott et al., 2021).
- Use of alcohol, nicotine, and cannabis is related to increase in suicidal thoughts, depression, anxiety, and poor mental health in adolescents (Tervo-Clemmens et al., 2024).
- Excessive social media use (more than three hours per day) doubled the risk of symptoms of depression and anxiety (Riehm et al., 2019).
- During adolescence, higher levels of friendship quality can protect against later social anxiety, particularly in younger adolescents (Chiu, Clark & Leigh, 2021).
- High self-esteem and adolescent beliefs about their own personal qualities protect against mental health problems in adolescents (Liu et al., 2021).
- Higher levels of resilience protect against mental health problems in adolescents, including depression and anxiety (Mesman et al., 2021).
- Supportive relationships with an adult at home, an adult at school, and supportive peer relationships have a cumulative protective effect on adolescent mental wellbeing (Butler et al., 2022).
- Higher levels of self-compassion have a protective effect on psychological 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 skills, problem-solving skills, and coping skills and can be used with the family, in peer relationships, and in the community.
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