Journal of Child and Adolescent Mental Health最新文献

{"title":"School-based mental health interventions in sub-Saharan Africa: A scoping review of effectiveness and evaluation practices.","authors":"Muhammed Shuaib Abolakale, Margaret Funke Omidire","doi":"10.2989/17280583.2026.2727419","DOIUrl":"https://doi.org/10.2989/17280583.2026.2727419","url":null,"abstract":"<p><strong>Background: </strong>Mental health challenges among adolescents in sub-Saharan Africa are rising amid limited access to services. Schools are increasingly recognised as viable platforms for delivering mental health interventions, especially in low-resourced settings.</p><p><strong>Objective: </strong>This scoping review synthesises evidence on school-based mental health interventions implemented across sub-Saharan Africa, focusing on their effectiveness, delivery models, and evaluation practices.</p><p><strong>Methods: </strong>Guided by PRISMA 2020, a comprehensive search was conducted across four databases (Scopus, PsycINFO, Web of Science, and EBSCOhost) for studies published between 2010 and 2024. Inclusion criteria were empirical studies evaluating school-based mental health interventions targeting adolescents (aged 10 to 19 years) in sub-Saharan Africa. Fifteen studies met the criteria and were narratively synthesised.</p><p><strong>Results: </strong>The most targeted conditions were depression, anxiety, and posttraumatic stress disorder. Effective intervention types included cognitive behavioural therapy, psychoeducation, economic empowerment, and family-strengthening programmes. Most interventions were delivered by non-specialists (e.g., teachers and lay counsellors) and showed significant positive effects on mental health outcomes. However, evaluation methods varied widely, with inconsistent use of standardised tools and limited follow-up assessments. Barriers included stigma, infrastructural limitations, and inadequate cultural adaptation.</p><p><strong>Conclusion: </strong>School-based mental health interventions in sub-Saharan Africa demonstrated a strong potential to support adolescent well-being, especially when tailored to local contexts and delivered by trained non-specialists. However, methodological gaps and underrepresentation of certain countries persist. Future efforts should prioritise standardisation, longitudinal evaluation, digital delivery innovation, and broader geographic coverage. These findings have critical implications for education and health policy across the region.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-21"},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising indicated prevention for child anxiety and depression: A 12-month follow-up for cluster-randomised factorial 2 x 2 x 2 trial.","authors":"Carina Lisøy, Simon-Peter Neumer, Trine Waaktaar, Tore Wentzel-Larsen, Jo Magne Ingul, Frode Adolfsen, Solveig Holen, Elisabeth Valmyr Bania, Lene-Mari Potulski Rasmussen, Kristin Ytreland, Ida Mari Haug, Joshua Patras, Anne Mari Sund, Kristin Martinsen","doi":"10.2989/17280583.2026.2729473","DOIUrl":"https://doi.org/10.2989/17280583.2026.2729473","url":null,"abstract":"<p><strong>Background: </strong>Early intervention can reduce the burden of internalising problems for children and adolescents, yet access remains limited. The field must ensure preventive interventions that are both durable and scalable. One promising approach is developing interventions that are less resource- intensive yet retain components that are active in the long-term, enabling both sustained effects and wider reach.</p><p><strong>Methods: </strong>Through a 2 x 2 x 2 cluster-randomised factorial trial (www.clinicaltrials.gov NCT04263558) aimed at optimising an indicated child-focused group-intervention for internalising problems, we assessed the 12-month post-intervention effects of three components: (i) intervention delivery format (16-session group-format versus a blended format integrating eight group sessions with eight automated web-based sessions), (ii) parental involvement (five parent group sessions versus a psychoeducational parent brochure), and (iii) a measurement feedback system (symptom development tracking on versus tracking off). Respondents were 564 school children (aged 8 to 12 years) with heightened anxiety or depression symptoms, and 554 parents. The primary outcomes were children´s symptoms of depression and anxiety (child- and parent-report).</p><p><strong>Results: </strong>We did not find superiority of a group format over a blended delivery format. Furthermore, there was no evidence that parental participation in five group sessions significantly enhanced child outcomes compared to parents receiving a psychoeducational brochure. Finally, no significant main effects were observed for adding a measurement feedback system to track child symptom development during the intervention.</p><p><strong>Conclusions: </strong>Several components or intervention aspects may optimise indicated interventions for child and adolescent internalising problems. Despite no component amplifying intervention effects, there is optimism in recognising that a simpler combination of components might produce interventions as promising as more resource-demanding ones.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT04263558..</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-20"},"PeriodicalIF":1.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the links between stress perception, anxiety, and smartphone addiction in adolescents: A two-wave longitudinal study.","authors":"Wei Gu, Yuqiu Chen, Hao Zhang, Yang Liu, Xiaoqiu Yin, Lin Cai","doi":"10.2989/17280583.2026.2733649","DOIUrl":"https://doi.org/10.2989/17280583.2026.2733649","url":null,"abstract":"<p><strong>Background: </strong>The rise of smartphone addiction among adolescents, especially in China where internet and mobile usage are notably high, has prompted concerns about its impacts on mental health and social skills. Previous research has mainly used cross-sectional approaches, which are limited in establishing causality.</p><p><strong>Methods: </strong>This longitudinal study spanned two waves over three months and involved 926 Chinese adolescents. Smartphone addiction, stress perception, and anxiety were measured using the Smartphone Addiction Scale-Short Version, Stress Perception Scale, and Depression Anxiety Stress Scales-21, respectively. Multiple linear regression and cross-lagged panel models were used to analyse the data.</p><p><strong>Results: </strong>The findings demonstrated significant positive associations between stress perception and smartphone addiction both cross-sectionally and longitudinally. There was also a bidirectional relationship between stress perception and anxiety, with initial stress perception predicting greater smartphone addiction and anxiety in subsequent measurements. Anxiety mediated the relationship between stress perception and smartphone addiction in cross-sectional data, but not in the longitudinal data.</p><p><strong>Conclusions: </strong>These findings lend partial support to the Compensatory Internet Use Theory. Specifically, perceived stress emerged as a temporally stable predictor of smartphone addiction, whereas anxiety functioned only as a concurrent pathway. As such, smartphone use appears to serve as a compensatory coping response to stress rather than to anxiety, underscoring the need for clinical interventions targeting stress appraisal and emotion regulation.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between mental well-being, body composition, and physical activity among adolescents in the Eastern Cape, South Africa.","authors":"Zizipho Siduli, Maya Maria van Gent, Rudolph Leon van Niekerk","doi":"10.2989/17280583.2026.2730332","DOIUrl":"https://doi.org/10.2989/17280583.2026.2730332","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical developmental period during which health behaviours are established and may influence physical and mental well-being across the life course. However, evidence on the associations between body composition, physical activity, and mental well-being among South African adolescents remains limited.</p><p><strong>Aim: </strong>The study aimed to determine the association between mental well-being, body composition, and physical activity among adolescents in the Eastern Cape, South Africa.</p><p><strong>Method: </strong>Adolescents (<i>n</i> = 266, mean age = 15 years, SD = 1.238 years; female = 58.27%) from two districts in the Eastern Cape were randomly selected to participate in this quantitative cross-sectional study. We collected data through anthropometric measurements, bioelectrical impedance analysis, the International Physical Activity Questionnaire, and the Mental Health Continuum Short Form. Data were analysed using SPSS version 28. Statistical significance was set at <i>p</i> < 0.05 with a 95% confidence interval. Logistic regression was used to examine the association between metabolic risk and mental well-being, as well as to assess the extent to which body composition components and physical activity predict mental well-being.</p><p><strong>Results: </strong>Most participants (65.4%) fell in the normal body mass index (BMI) category. An average of 502.70 minutes (SD = 574.20 minutes) per week of physical activity was displayed by the total sample. Body fat percentage emerged as the only statistically significant predictor of mental well-being.</p><p><strong>Conclusions: </strong>Although most adolescents exceeded the recommended 300 minutes of physical activity per week, neither physical activity nor BMI predicted mental well-being. Instead, body fat percentage was the only significant predictor, indicating that higher body fat was associated with poorer mental well-being. These findings suggest that body composition, rather than overall physical activity levels or BMI alone, plays a critical role in adolescent mental well-being.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-based digital mental health interventions: A scoping review.","authors":"Sneha Santosh-Thomas, Abhishek Aggarwal, Tucker Chandler, Sarah Dremann, Stacy Phillips, Esperanza Lopez, Mark D Weist, Brian P Daly","doi":"10.2989/17280583.2026.2721998","DOIUrl":"https://doi.org/10.2989/17280583.2026.2721998","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, the mental health of children and adolescents is a public health concern. Schools are a primary access point for youth mental health support, yet traditional delivery models remain constrained by limited resources, shortage of specialised professionals, and high counsellor caseloads. Digital mental health interventions may help address these gaps by offering scalable, accessible, and less-stigmatising support.</p><p><strong>Aim: </strong>This review aimed to map and characterise school-based digital mental health interventions for children and adolescents by examining intervention characteristics, implementation, and intervention outcomes.</p><p><strong>Methods: </strong>A comprehensive search of peer-reviewed studies (2008-2025) was conducted across PsycNet, ERIC, and PubMed, using the PRISMA-ScR Checklist. Eligible studies evaluated a digital mental health intervention delivered in a school setting among K-12 students and reported at least one implementation and/or mental health outcome.</p><p><strong>Results: </strong>Across 40 studies, most were conducted in high-income countries and used randomised designs. Web-based, structured cognitive behavioural therapy (CBT) modules in classroom settings predominated. Intervention delivery ranged from teacher-led to self-directed use, with some hybrid clinician-supported models. Findings were heterogeneous for internalising symptoms (e.g., depression and anxiety), with evidence of benefit in some CBT-oriented interventions but mixed effects in universal programmes. In contrast, mental health literacy, stigma, and well-being outcomes showed more consistent positive effects. Engagement and implementation quality appeared closely linked to effectiveness.</p><p><strong>Conclusion: </strong>School-based digital mental health interventions can improve mental health literacy and stigma-related outcomes when grounded in CBT. Future research should prioritise standardised outcome measurement (e.g., fidelity, adoption), theory-to-component linkages, co-design elements, and hybrid effectiveness-implementation, particularly in low-and middle-income settings.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-46"},"PeriodicalIF":1.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting internet addiction in adolescents: The interplay of digital self-efficacy, digital literacy, and positive emotion regulation in online gaming dependency.","authors":"Morvarid Barimani, Zahra Dasht Bozorgi","doi":"10.2989/17280583.2026.2730338","DOIUrl":"https://doi.org/10.2989/17280583.2026.2730338","url":null,"abstract":"<p><strong>Background: </strong>Internet addiction among adolescents engaged in online gaming is a pressing public health issue.</p><p><strong>Objective: </strong>This study examined the predictive roles of digital self-efficacy, digital literacy, and positive emotion regulation in internet addiction among adolescents with online gaming dependence.</p><p><strong>Method: </strong>Using a cross-sectional correlational design, we sampled 503 male adolescents aged 13 to 18 years from counselling centres in Ahvaz, Iran, in 2024. We used convenience sampling based on predefined criteria for gaming dependence. We collected data using validated tools, including the Online Gaming Questionnaire, the Internet Addiction Test, the Digital Self-Efficacy Scale, the Digital Literacy Questionnaire, and the Positive Emotion Regulation Scale. Statistical analyses, performed with SPSS version 26, included Pearson correlations and multiple regression analyses.</p><p><strong>Results: </strong>There were significant negative correlations between digital self-efficacy (<i>p</i> < 0.01), digital literacy (<i>p</i> < 0.01), and internet addiction, suggesting that greater digital competencies may reduce addiction risk. Conversely, difficulties in positive emotion regulation were positively correlated with internet addiction (<i>p</i> < 0.01), indicating that emotional regulation challenges heighten addiction risk. The model accounted for 33% of the variance in internet addiction (<i>p</i> < 0.01). Specifically, digital self-efficacy and positive emotion regulation were significant predictors, though digital literacy's unique contribution was non-significant (<i>p</i> = 0.267).</p><p><strong>Conclusion: </strong>These findings highlight the protective roles of digital self-efficacy and effective positive emotion regulation, supporting targeted interventions such as educational workshops to enhance these competencies and mitigate internet addiction among male adolescents with online gaming dependence.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional disparities and impact of mental health literacy on help-seeking intention among Chinese rural and urban adolescents: An empirical study.","authors":"Zhihui Song, Peiling Xing, Zihan Chen, Rong Yan","doi":"10.2989/17280583.2026.2721986","DOIUrl":"https://doi.org/10.2989/17280583.2026.2721986","url":null,"abstract":"<p><strong>Background: </strong>Mental health literacy plays a crucial role in shaping adolescents' help-seeking intentions. However, regional disparities, specifically between rural and urban areas, in mental health literacy and help-seeking intentions, and their interrelationships, remain underexplored among Chinese adolescents.</p><p><strong>Objective: </strong>This study aims to investigate the potential rural-urban differences in mental health literacy and help-seeking intentions and further examine the potential impact of mental health literacy on help-seeking intentions among Chinese adolescents.</p><p><strong>Methods: </strong>Junior high school students (urban: 70; rural: 70) aged 13 to 16 years were randomly selected as participants. The Adolescent Mental Health Literacy Assessment and modified General Help-seeking Questionnaire were employed to measure mental health literacy and help-seeking intentions, respectively. Covariance and <i>t</i>-tests were utilised to analyse regional differences. Pearson's correlation and multiple linear regression were conducted to explore mental health literacy's impact on help-seeking intentions. <i>Results</i>: Adolescents from the urban site exhibited significantly higher mental health literacy than those from the rural site, whereas differences in formal and informal help-seeking intentions were not significant after covariates were considered. Preferences for help-seeking resources varied descriptively, with urban adolescents favouring mental health counsellors and the rural group favouring teachers. Specific dimensions of mental health literacy predicted both professional and non-professional help-seeking intentions.</p><p><strong>Conclusion: </strong>Findings highlight a significant rural-urban difference in adolescents' mental health literacy, while formal and informal help-seeking intentions were not significantly different after controlling for covariates. Specific aspects of mental health literacy partially predicted help-seeking intentions, emphasising the importance of targeted mental health education and developmental factors, such as age, in promoting effective help-seeking.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the edge: A meta-ethnography of healthcare professionals' experiences supporting suicidal adolescents.","authors":"Sophie Blunden, Daniela Di Basilio","doi":"10.2989/17280583.2026.2705181","DOIUrl":"https://doi.org/10.2989/17280583.2026.2705181","url":null,"abstract":"<p><strong>Background: </strong>Suicide is the third leading cause of death among adolescents. Healthcare professionals are paramount in suicide recognition, management, and prevention. Therefore, understanding their experiences is essential to identifying effective strategies as well as healthcare professionals' needs.</p><p><strong>Objective: </strong>This review synthesised existing qualitative research on professionals' experiences of supporting adolescents with suicidal thoughts.</p><p><strong>Method: </strong>A systematic search of PsycInfo, Medline Complete, Academic Search Ultimate, AMED and CINAHL was completed, resulting in the inclusion of 17 qualitative studies. Studies were synthesised using meta-ethnography.</p><p><strong>Results: </strong>A conceptual model was developed, highlighting three primary areas, including (i) the adolescent's world, (ii) health care professionals as practitioners and people, and (iii) organisational challenges, which interact and influence the therapeutic relationship and professionals' experiences of working with adolescents.</p><p><strong>Conclusion: </strong>Clinical implications include the need for training and support for healthcare professionals, holistic and integrative care, and clearer referral pathways to protect healthcare professionals' well-being and improve care provision.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"1-27"},"PeriodicalIF":1.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the psychometric properties of the WHO-5 Well-being Index in conflict-affected humanitarian contexts.","authors":"María Cecilia Dedios-Sanguineti, Felipe Buitrago-Rubiano, Mónica González-Gort, Imrana Buba, Diana Ihring, Crystal Stewart, Camilla Fabbri","doi":"10.2989/17280583.2026.2652959","DOIUrl":"10.2989/17280583.2026.2652959","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents living in conflict-driven humanitarian contexts face heightened risks of violence and abuse, which can significantly affect their immediate and long-term well-being. The evaluation of interventions to support adolescent well-being in these settings requires a validated, simple, yet robust measure of the broad construct of psychological well-being.</p><p><strong>Objective: </strong>This study aimed to validate the WHO-5 Well-being Index, a short, self-reported instrument designed to assess subjective psychological well-being, for use with adolescents in two conflict- affected humanitarian contexts, including Colombia and Nigeria.</p><p><strong>Method: </strong>Participants (<i>N</i> = 172) were aged 13 to 17 years and resided in Colombia (<i>n</i> = 90) or Nigeria (<i>n</i> = 82). Exploratory and confirmatory factor analyses were conducted to assess the WHO-5 Index psychometric properties.</p><p><strong>Results: </strong>A one-factor structure of the WHO-5 Well-being Index was supported, showing high internal consistency (<i>α</i> and ω > 0.80), excellent convergent validity (assessed with the Kidscreen-27 scale, <i>r</i> = 0.797, <i>p</i> < 0.01), and acceptable discriminant validity (assessed with the PHQ-9 scale, <i>r</i> = -0.343, <i>p</i> < 0.001). Confirmatory factor analysis supported the one-factor model, initially with poor fit (CFI = 0.972, TLI = 0.944, RMSEA = 0.105). After accounting for covariance between items 3 and 4, the model fit improved significantly (CFI = 0.998, TLI = 0.994, RMSEA = 0.034).</p><p><strong>Conclusion: </strong>This study reaffirms the WHO-5 Well-being Index as a valid instrument to assess the well-being of Spanish- and Hausa-speaking adolescents who have experienced family separation, abuse, violence, neglect, and/or exploitation in humanitarian contexts.</p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"256-271"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interconnected effects of witnessing household violence, food insecurity, and mental health among peri-urban Cape Town youth: A mediation analysis.","authors":"Miriam Hartmann, Marie C D Stoner, Danielle Giovenco, Anna Mia Ekström, Abigail M Hatcher, Yanga Zembe Zondi, Nontembeko Qwabe, Audrey Pettifor, Linda-Gail Bekker, Anna E Kågesten","doi":"10.2989/17280583.2025.2579960","DOIUrl":"10.2989/17280583.2025.2579960","url":null,"abstract":"<p><p><i>Background:</i> In sub-Saharan Africa, young people face high burdens of food insecurity and sexual and gender-based violence (SGBV), both linked to poor mental health.<i>Objective:</i> This study tested whether food insecurity predicts common mental disorders through household SGBV, and conversely, whether SGBV predicts common mental disorders through food insecurity.<i>Method:</i> Data were drawn from 534 participants aged 13 to 25 years in the longitudinal Bidirectional, Upbeat communication and Differentiated Distanced care for Young people (BUDDY) cohort study in Cape Town (2021-2022), surveyed at baseline, three months follow-up, and six months follow-up.<i>Results:</i> At six months follow-up, 24% reported common mental disorder symptoms, 52% had experienced food insecurity, and 33% had witnessed household SGBV. When food insecurity was modelled as the primary exposure, it was not associated with common mental disorders at six months follow-up (OR = 1.00; <i>p</i> = 0.99), and SGBV did not mediate this relationship (Average Direct Effect (ADE) = -0.05; Average Causal Mediated Effect (ACME) = 0.02). In contrast, when witnessing SGBV was the exposure, it was strongly associated with common mental disorders (OR = 2.19; <i>p</i> = 0.006). Food insecurity at three months follow-up was more common among those exposed to SGBV at baseline (OR = 1.55; 95% CI [1.06-2.27]; <i>p</i> = 0.024). Mediation analysis indicated most of SGBV's effect on common mental disorders was direct (ADE = 0.17; 95% CI 0.05-0.30), with only a small proportion mediated by food insecurity (5%).<i>Conclusion:</i> Findings were contrary to our primary hypothesis that food insecurity would drive common mental disorders via SGBV. Instead, household SGBV emerged as the stronger predictor of common mental disorders, with food insecurity playing a modest role. Preventing household violence may be critical to improving youth mental health, while research should further examine food insecurity'<b>s mental health impacts across contexts and timeframes.</b></p>","PeriodicalId":45290,"journal":{"name":"Journal of Child and Adolescent Mental Health","volume":" ","pages":"356-370"},"PeriodicalIF":1.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}