Imagine stepping into the shoes of a 15-year-old for a day. What would be some of the stressful events you experience? Would you ask for help or cope with the stress on your own?
Exposure to stressful life events (SLE) in childhood has been linked to higher chances of developing depression and anxiety in adult life (Turner & Lloyd, 2004). For example, a recent Mental Elf blog highlighted the association between child maltreatment and depression. However, childhood maltreatment is not the only SLE experienced by a child. In Latin America several reasons place children at high risk of exposure to trauma and adversities (Myers et al., 2015).
To cope with stress, adolescents with depressive symptoms utilise positive and negative coping mechanisms, such as self-protection and avoidance, as mentioned in Nina Higson-Sweeney’s blog (2023). Another blog points out that compared to adults, adolescents seem to use mental health services less frequently, despite their potential benefits.
Interested in learning more about young people’s mental health, Hudson and colleagues (2025) set out to investigate the role of coping mechanisms in the development of depression and/or anxiety in young Latin Americans exposed to SLEs. As a person who has experienced parental loss at a very young age, I am curious to know which coping mechanism might have worked for me as a kid trying to cope with a major life event.
Adolescents seem to use mental health services less frequently than adults.
Methods
A case-control study was conducted with participants recruited through a collaborative project between Buenos Aires, Bogotá and Lima. Participants included in the study were aged 15-16– or 20-24-years old and lived in the most deprived areas of those cities.
The case group consisted of participants who scored high in self-reported questionnaires estimating depression and anxiety levels, while the rest of participants joined the control group. Self-reported questionnaires were also used to measure the number of lifetime and past-year SLEs and the coping strategies utilised by participants.
Statistical analysis was conducted using logistic regression to test whether SLEs and coping strategies are associated with participant’s mental health status. Potentially confounding factors were also considered in the analysis.
Results
The study included 2,402 participants (1,437 cases and 965 controls). When adjusted for all variables, compared to the control group, people in the case group were:
- less likely to use positive cognitive restructuring (OR 0.66; 95% CI 0.57 to 0.75)
- less likely to use problem-focused coping (OR 0.82; 95% CI 0.73 to 0.93)
- more likely to use avoidance (OR 1.33; 95% CI 1.19 to 1.50)
Both lifetime and past-year SLEs were linked to increased odds of depression and/or anxiety. Lastly, the study showed statistically weak evidence that support-seeking (p=0.09), problem-focused coping (p=0.08) and positive restructuring (p=0.09) were modifying the relationship between depression/anxiety and lifetime SLEs.
Support seeking could modify the relation between depression/anxiety and lifetime SLEs
Conclusions
The authors conclude that active coping strategies, such as positive cognitive restructuring, problem-focused coping and support seeking could act as protective factors against depression/anxiety associated with lifetime SLEs, while passive coping strategies including avoidance and distraction have no such effect.
Finally, even though past-year SLEs were strongly related to depressive/anxiety symptoms, no association was observed between past-year SLEs and coping mechanisms, which might indicate that impacts of trauma take time to manifest and influence coping responses.
Trauma might take time manifest and influence coping responses.
Strengths and limitations
The current research contributes to our understanding of depression in young people and coping in a Latin American context, with data drawn from three capital cities. Another strength of this research is the involvement of young people with lived experience in the design and preparation of this study, as well as the rigorous control and adjustments for possible confounding variables.
However, a study without limitations does not exist. The main drawback of this research are the measurement tools. Self-reporting questionnaires were used to investigate SLEs from the past and coping strategies used, which might have introduced recall bias (Lee et al., 2007). Additionally, levels of depression and anxiety were not estimated by professionals through structured interviews, rather from participants themselves, which might have led to cases being over- or undetected and overall mental health status of participants being inaccurate (Eack et al., 2006).
Another limitation regarding the methodology is that case-control studies do not allow causal inference. The research might also face problems with external validity, since the sample came from deprived areas of three cities in Latin America (Buenos Aires, Bogotá and Lima), which might not represent the broader picture of Latin America’s population. The inclusion of rural populations may have strengthened the study, as they often face distinct adversities and may employ different coping strategies.
Use of self report measures is a limitation.
Implications for practice
The main finding from this research is that active coping mechanisms, especially problem-focused strategies can mitigate the impact of SLEs in young people’s mental health in Latin America settings. However, longitudinal studies are needed to confirm the above findings. So what can be done now to intervene?
The authors suggest that schools and community organisations will be a good setting for delivering interventions to young people who have been exposed to SLEs and are at high risk of developing mental health problems. Drawing upon my personal experience, I agree that schools play a crucial role in raising awareness and normalising major life events. As a child I felt relieved when I realised that single-parent families were common and that I was not the only one in my school growing up without a father.
In my opinion, another implication could be the creation of peer support groups, which can promote and teach coping strategies as well as reduce stigma around mental health (Halsall et al., 2022). These may be more feasible in low- and middle-income countries due to cost effectiveness (Simmons et al., 2023).
This study offers a timely reminder that how young people respond to adversity matters, not just what they experience. Translating these findings into practice means equipping schools, community services and families in Latin America with the tools to actively foster cognitive restructuring and problem-focused approaches, rather than waiting for unhelpful but understandable avoidance patterns to take hold.
Finally, more research using longitudinal designs with improved assessment would help confirm the causal story this cross-sectional study implies. In the meantime, the study strengthens the case for early, active intervention and for trusting that young people, given the right support, can build genuine resilience in the face of adversity.
University of Glasgow MSc Students
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Edited by
Simon Bradstreet.
Links
Primary paper
Georgie Hudson, Catherine Fung, Diliniya Stanislaus Sureshkumar, Carlos Gómez-Restrepo, José Miguel Uribe-Restrepo, Karen Ariza-Salazar, Francisco Diez-Canseco, Liliana Hidalgo-Padilla, Mauricio Toyama, Luis Ignacio Brusco, Natividad Olivar, Santiago Lucchetti, Stefan Priebe, James Kirkbride (2025). Do coping mechanisms moderate the effect of stressful life events on depression and anxiety in young people? A case-control study from Latin America. BMJ Mental Health, 28(1).
Other references
Eack, S. M., Greeno, C. G., & Lee, B. J. (2006). Limitations of the patient health questionnaire in identifying anxiety and depression in community mental health: Many cases are undetected. Research on Social Work Practice, 16(6), 625–631. https://doi.org/10.1177/1049731506291582
Halsall, T., Daley, M., Hawke, L., Henderson, J., & Matheson, K. (2022). “You can kind of just feel the power behind what someone’s saying”: a participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08743-3
Lee, W., Bindman, J., Ford, T., Glozier, N., Moran, P., Stewart, R., & Hotopf, M. (2007). Bias in psychiatric case-control studies. Literature survey. British Journal of Psychiatry, 190, 204–209. https://doi.org/10.1192/bjp.bp.106.027250
Myers, H. F., Wyatt, G. E., Ullman, J. B., Loeb, T. B., Chin, D., Prause, N., Zhang, M., Williams, J. K., Slavich, G. M., & Liu, H. (2015). Cumulative burden of lifetime adversities: Trauma and mental health in low-SES African Americans and latino/as. Psychological Trauma: Theory, Research, Practice, and Policy, 7(3), 243–251. https://doi.org/10.1037/a0039077
Paris, J. (2020). Other Disorders in Which Overdiagnosis Is a Risk. In J. Paris (Ed.), Overdiagnosis in Psychiatry: How Modern Psychiatry Lost Its Way While Creating a Diagnosis for Almost All of Life’s Misfortunes, (2 ed.). Oxford Academic. https://doi.org/10.1093/med/9780197504277.003.0010
Simmons, M. B., Cartner, S., MacDonald, R., Whitson, S., Bailey, A., & Brown, E. (2023). The effectiveness of peer support from a person with lived experience of mental health challenges for young people with anxiety and depression: a systematic review. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-04578-2
Turner, R. J., & Lloyd, D. A. (2004). Stress burden and the lifetime incidence of psychiatric disorder in young adults: racial and ethnic contrasts. Archives of general psychiatry, 61(5), 481–488. https://doi.org/10.1001/archpsyc.61.5.481
