Does Social Support Moderate the Link between Neighborhood Level Stressors and Generalized Anxiety in Middle School Children?

Background/purpose: Positive mental health is significant for children and adolescents to reach developmental milestones, and disruptions in pediatric mental health are associated with functioning difficulties. Mental health difficulties during adolescence remain a prevalent problem in this country. More than 1 of 3 U.S. adolescents have a lifetime prevalence of anxiety disorder. Adolescents face a variety of stressors at the micro and mezzo level that can negatively impact mental well-being, including neighborhood level stressors. Evidence suggests that social support can alleviate the impact of stress. At this point, it remains unclear if social support can also buffer neighborhood level stressors in adolescents. Thus, building on the buffer theory of social support, we tested the hypothesis that environmental stressors negatively affect anxiety symptoms of early adolescents and that levels of perceived social support can mitigate those negative effects.

Methods: Data were collected in January 2020 using the SSP from 458 school students (45% girls, 50% boys, 5% preferred not to respond) in two middle schools in rural North Carolina. The majority of the sample was African American (53%), 36% were Other People of Color, and 9% identified as White. The following stressor variables were included: A 5-item variable assessing negative teen behaviors (e.g., “Get in trouble with the police”), a 9-item neighborhood crime variable (e.g., “Someone was shot/stabbed in the past month”), as well as a 9-item School Safety variable (e.g., “Students carrying weapons like a knife ”). Two dichotomous variables assessing loss of close friend or family member over the last year were also included. Anxiety as measured by the GAD-7 was the outcome variable (e.g., “How often have you been bothered by the following over the past 2 weeks? - Worrying too much about different things.”). Social support was assessed using a 6-item scale (e.g., “I have someone who praises me for what I do.”) and a dichotomous moderator variable with low/high social support was created performing a mean split. Mplus version 8.6 was used to conduct structural equation modeling with latent variables.

Results: The model fit was good for the multiple group model (χ2 = 1317.98, df = 1163, p = 0.0010, RMSEA = 0.024; CFI = 0.988). Overall, social support did not buffer the effects of stressors on students’ generalized anxiety symptoms. The means of anxiety were not significantly different across the low and high support groups. There was a significant relationship for the high social support group, with more neighborhood crime leading to a lowered perception of school safety (β = -0.171, p = .002). All three social environmental stressors were associated with anxiety.

Conclusion: Findings revealed that social support did not moderate the link between a variety of environmental stressors and anxiety symptoms. Despite limitations, e.g., a lack of heterogeneity of students’ race, results underline that environmental stressors deserve more attention when providing mental health services. Results have important practice implications, particularly for school social workers. Prevention and intervention efforts aimed at improving mental health outcomes in students might benefit from acknowledging and addressing environmental stressors.