Do coping mechanisms moderate the effect of stressful life events on depression and anxiety in young people? A case–control study from Latin America

• Published in: BMJ mental health 2025-01, Vol.28 (1), p.e301087
• Main Authors: Hudson, Georgie, Fung, Catherine, Sureshkumar, Diliniya Stanislaus, Gómez-Restrepo, Carlos, Uribe-Restrepo, José Miguel, Ariza-Salazar, Karen, Diez-Canseco, Francisco, Hidalgo-Padilla, Liliana, Toyama, Mauricio, Brusco, Luis Ignacio, Olivar, Natividad, Lucchetti, Santiago, Priebe, Stefan, Kirkbride, James B
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Alcohol use; Anxiety - epidemiology; Anxiety - psychology; Anxiety disorders; Case-Control Studies; Child & adolescent psychiatry; Child abuse & neglect; Child and Adolescent Mental Health; Coping; Data Interpretation, Statistical; Depression; Depression & mood disorders; Depression - epidemiology; Depression - psychology; Female; Health insurance; Humans; Industrialized nations; Informed consent; Insurance policies; Latin America - epidemiology; Life Change Events; Male; Mental depression; Mental disorders; Mental health care; Meta-analysis; Neighborhoods; Original Research; Peru - epidemiology; Social support; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Teenagers; Trauma; Young Adult
• ISSN: 2755-9734; 2755-9734
• DOI: 10.1136/bmjment-2024-301087

BackgroundStressful life events (SLEs) are associated with increased risk of depression or anxiety. Coping mechanisms may moderate this relationship but little is known on this topic in young people or in Latin America.AimTo investigate whether coping strategies predict odds of depression and/or anxiety and moderate the relationship between SLEs and depression and/or anxiety in young people in Peru, Lima and Bogotá.MethodUsing case–control data from people aged 15–24, we used logistic regression to examine associations between coping mechanism, SLEs and caseness for depression or anxiety, adjusting for sociodemographic and socioeconomic factors. We included interaction terms to model whether this association varied depending on coping mechanisms (positive cognitive restructuring, problem focused, support seeking, distraction, avoidant).ResultsWe included 1437 cases and 965 controls. Cases reported less use of positive cognitive restructuring (OR 0.66; 95% CI 0.57 to 0.75) and problem-focused coping (OR 0.82; 95% CI 0.73 to 0.93), and more use of avoidance than controls (OR 1.33; 95% CI 1.19 to 1.50) in adjusted models. They had greater odds of reporting lifetime (OR 1.07; 95% CI 1.04 to 1.10) and past-year (OR 1.05; 95% CI 1.01 to 1.10) SLEs than controls. We found weak but consistent evidence of effect modification; the association between lifetime SLEs and case–control status was stronger in those who used less support seeking (p=0.09), problem-focused coping (p=0.08) or positive cognitive restructuring (p=0.09).ConclusionsRelationships between SLEs, coping mechanisms and depression/anxiety appear similar in these Latin American cities to other contexts. Active coping strategies may ameliorate the impact of SLEs on mental health of young people.