• M A McIsaac, N King, V Steeves, S P Phillips, A Vafaei, V Michaelson, C Davison, and W Pickett.
• School of Mathematical and Computational Sciences, UPEI, Charlottetown, PEI, Canada; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada. Electronic address: mmcisaac@upei.ca.
• Prev Med. 2023 Apr 1; 169: 107451107451.

AbstractAdolescent girls consistently report worse mental health than boys. This study used reports from a 2018 national health promotion survey (n = 11,373) to quantitatively explore why such gender-based differences exist among young Canadians. Using mediation analyses and contemporary social theory, we explored mechanisms that may explain differences in mental health between adolescents who identify as boys versus girls. The potential mediators tested were social supports within family and friends, engagement in addictive social media use, and overt risk-taking. Analyses were performed with the full sample and in specific high-risk groups, such as adolescents who report lower family affluence. Higher levels of addictive social media use and lower perceived levels of family support among girls mediated a significant proportion of the difference between boys and girls for each of the three mental health outcomes (depressive symptoms, frequent health complaints, and diagnosis of mental illness). Observed mediation effects were similar in high-risk subgroups; however, among those with low affluence, effects of family support were somewhat more pronounced. Study findings point to deeper, root causes of gender-based mental health inequalities that emerge during childhood. Interventions designed to reduce girls' addictive social media use or increase their perceived family support, to be more in line with their male peers, could help to reduce differences in mental health between boys and girls. Contemporary focus on social media use and social supports among girls, especially those with low affluence, warrant study as the basis for public health and clinical interventions.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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