Family Living Conditions and Mental Health Outcomes of Adolescents With Special Health Care Needs: Moderating Effect of Family Resilience.

To assess the moderating effect of family resilience on the relationship between adverse family living conditions and anxiety and depression among adolescents with special health care needs (ASHCN). We conducted a secondary analysis of data of 13,097 ASHCN (aged 10-17 years old) from the combined 2022 and 2023 National Survey of Children's Health (NSCH), representing a total population of 8,069,879 ASHCN. Measures included demographics, parent-proxy-reported diagnosed anxiety and depression, functional difficulties, family structure, family resilience, and family living conditions. The data were analyzed using survey-weighted descriptive statistics and logistic regression models combined with marginal effects analysis. Family resilience mitigated the negative influence of a maximum of two cumulative adverse family living conditions on the likelihood of having parent-proxy-reported diagnosed depression among ASHCN. When looking at the effects of each separate family living condition, family resilience moderated the effect of household dysfunction and adverse childhood experiences on the likelihood of having parent-proxy-reported diagnosed depression. The study found no moderating effects of family resilience on the relationship between living conditions and the likelihood of having parent-proxy-reported diagnosed anxiety. Consideration of family resilience and living conditions among ASHCN intervenes to reduce the incidence of negative health outcomes like anxiety or depression among these vulnerable youth.