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

Given 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. We 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. The 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). The cross-sectional study design limited the inference of causal relationships between variables. These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems. • China's early adolescents have higher prevalence of anxiety, depression and perceived stress. • Consistency between resilience and social support levels is associated with fewer mental health problems in adolescents. • The lower the level of social support is than resilience, the higher the adolescent's perceived stress. • Consistency of psychological resilience and social support has a greater impact on girls' mental health. • This study emphasizes the importance of balanced developmental protective factors for adolescent mental health. [ABSTRACT FROM AUTHOR]