Relationship between poverty and symptoms of depression and anxiety among adolescents in Nepal: Examining the mediating effect of external and internal resilience

This study aimed to examine the mediating effect of two types of resilience (internal, with factors such as problem solving and perseverance, and external resilience, with factors such as social support and sense of belonging) among adolescents affected by family poverty in Nepal in relation to symptoms of depression and anxiety. Participants identified as living in deprived conditions ( n = 491) in a cross-sectional survey completed measures about poverty, depressive and anxiety symptoms, and external and internal resilience. Mediation analyses were performed using poverty scores as the predictor, internal and external resilience as mediators, and depression and anxiety scores as outcomes, tested through parallel and serial mediation models. External resilience emerged as the only pathway across both parallel and serial mediation models. External resilience showed significant indirect effects for both depression (β = 0.797, 95 % CI: 0.181–1.677) and anxiety (β = 0.557, 95 % CI: 0.101–1.237). No sequential mediation was found. Although the total association of poverty with depression and anxiety was not significant—likely due to participants' homogeneity in poverty—external resilience accounted for 54.33 % of the association with depression and 31.61 % with anxiety, contributing to total indirect effects of 66.79 % and 38.25 %, respectively. This study expands the evidence on the mediating effect of external resilience in the association between poverty and depression and anxiety in Nepali adolescents. The mediating effect was stronger for depressive outcomes than for anxiety. Factors of external resilience are discussed as a critical target for mental health interventions among adolescents living in poverty. • Considering the sample lived in homogenously deprived conditions, there was no direct association between poverty and depression and/or anxiety. • External resilience appeared to be the only functional pathway between poverty and depression and anxiety in Nepali adolescents who were homogenously poor. • External resilience, encompassing factors such as a sense of belonging and support from family/peer/school, especially mediated the relationship between poverty and symptoms of depression and anxiety in adolescents. • Internal resilience, including factors such as perseverance and coping, did not significantly mediate the relationship between poverty and internalizing problems, suggesting that these might be less relevant for depression and anxiety in the context of adolescents in Nepal.