Community, family, peer, and personal factors associated with adolescent mental health in Nicaraguan post-crisis context.

Using cross-sectional and longitudinal data from a drug and violence prevention program of Nicaraguan adolescents, this study offers a unique look into personal, family, peer, and communal factors for depression and post-traumatic stress symptoms (PTSD). This study draws on primary socialization theory to hypothesize that family, peer, and community factors have a significant impact on youth mental health outcomes. A total of 4631 adolescents (ages 10-17, 49% female) completed self-report surveys in schools. Path models showed that cross-sectionally, parental factors including parental monitoring, parental relationship satisfaction, family expressiveness, and peer factors such as friend support were negatively associated with PTSD and depression, whereas adolescent alcohol use and externalizing behaviors, engagement in prosocial behaviors with peers, and exposure to community violence were positively associated with PTSD and depression, controlling for age, sex, region, and intervention effects. A longitudinal model showed that alcohol use pre-crisis predicted PTSD post-crisis. Findings have practical implications for intervention by highlighting the importance of protecting adolescents from exposure to community violence as well as providing multiple layers of support during crisis.