Gendered pathways to adolescent mental health: An empirical assessment of a new conceptual framework

Gender norms and roles are important determinants of physical and mental health in the key period of adolescence. Yet, the gendered pathways to mental health in adolescents are not fully understood. Using a conceptual framework for global adolescent mental health that we developed based on a Delphi process, we empirically investigated the associations between six gender-related constructs and adolescent mental health. We used an existing cross-sectional dataset from Ethiopia (2020) from the Gender and Adolescence: Global Evidence (GAGE) project to explore the associations between sex, gender norms, psychological competencies, gender attitudes, gender roles, with the latter two also serving as mediators, and psychological distress (GHQ-12), using Structural Equation Modelling (SEM). The SEM model contained measurements from 1,651 adolescents, including 901 girls and 750 boys, with a median age of 13 years. Out of 14 pathways tested, we found statistically significant associations between psychological competencies and psychological distress; sex and psychological distress; sex and gender attitudes; and between gender norms and psychological competencies, gender attitudes, and gender roles. Hence, the gender-related constructs were mostly associated with each other, rather than with psychological distress. The gender-related constructs were associated with each other rather than with psychological distress. The mechanisms underlying these relationships and a potential interplay of gender-related pathways require longitudinal investigation.