Do coping mechanisms moderate the effect of stressful life events on depression and anxiety in young people? A case-control study from Latin America

Authors:
  • CFCatherine Fung
    Catherine Fung
  • DSDiliniya Stanislaus Sureshkumar
    Diliniya Stanislaus Sureshkumar
  • CRCarlos Gomez Restrepo
    Carlos Gomez Restrepo
  • MUMiguel Uribe
    Miguel Uribe
  • KSKaren Ariza Salazar
    Karen Ariza Salazar
  • FCFrancisco Diez Canseco
    Francisco Diez Canseco
  • LHLiliana Hidalgo
    Liliana Hidalgo
  • MGMauricio Toyama Galla
    Mauricio Toyama Galla
  • LBLuis Brusco
    Luis Brusco
  • NONatividad Olivar
    Natividad Olivar
  • SLSanti Lucchetti
    Santi Lucchetti
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Abstract
Background: Stressful life events (SLEs) are associated with increased risk of depression or anxiety. Coping mechanisms may moderate this relationship but little is known on this topic in young people or in Latin America. Aim: To investigate whether coping strategies predict odds of depression and/or anxiety and moderate the relationship between SLEs and depression and/or anxiety in young people in Peru, Lima, and Bogotá. Method: Using case-control data from people aged 15-24, we used logistic regression to examine associations between coping mechanism, SLEs, and caseness for depression or anxiety, adjusting for sociodemographic and socioeconomic factors. We included interaction terms to model whether this association varied depending on coping mechanisms (positive cognitive restructuring, problem-focused, support-seeking, distraction, avoidant). Results: We included 1437 cases and 965 controls. Cases reported less use of positive cognitive restructuring (OR: 0.66; 95% CI: 0.57-0.75) and problem-focused coping (OR: 0.82; 95% CI: 0.73-0.93), and more use of avoidance than controls (OR: 1.33; 95% CI: 1.19-1.50) in adjusted models. They had greater odds of reporting lifetime (OR: 1.07; 95% CI: 1.04-1.10) and past-year (OR: 1.05; 95% CI: 1.01-1.10) SLEs than controls. We found weak, but consistent evidence of effect modification; the association between lifetime SLEs and case-control status was stronger in those who used less support-seeking (p=.09), problem-focused coping (p=.08), or positive cognitive restructuring (p=.09). Conclusions: Relationships between SLEs, coping mechanisms and depression/anxiety appear similar in these Latin American cities to other contexts. Active coping strategies may ameliorate the impact of SLEs on mental health of young people.