Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach

Abstract

BackgroundGiven the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health. MethodsWe used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis. ResultsThe higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = −1.83, P < 0.001; depression: a1 = −2.44, P < 0.001; and perceived stress: a1 = −1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = −1.97, P < 0.001; depression: a1 = −2.71, P < 0.001; perceived stress: a1 = −1.23, P < 0.001). LimitationsThe cross-sectional study design limited the inference of causal relationships between variables. ConclusionsThese results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.