ArticleBMC psychology2026
School protective factors and adolescent mental health in Nigeria: an investigation of cumulative effects, buffering mechanisms, and gender differences.
Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdolescent mental health disorders constitute a substantial public health concern in Nigeria, yet school-based protective factors remain understudied in sub-Saharan African contexts. This study examined cumulative associations between school protective factors and clinically diagnosed mental health outcomes, tested buffering effects against family adversity, and explored gender-differentiated pathways among Nigerian adolescents.
methodsA school-based cross-sectional survey was conducted using validated structured diagnostic instruments and standardised questionnaires. Data were analysed for 9,437 adolescents (mean age 15.61 years, 50.4% female) recruited through multistage stratified cluster sampling from 47 secondary schools across urban, semi-urban, and rural Lagos State. Mental health outcomes (depression, anxiety, behavioural disorders, substance use disorders, suicidal ideation) were assessed with the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-Kid). School protective factors encompassed peer relationships, teacher support, school belonging, and absence of bullying. Adverse childhood experiences were measured using a standardised 10-item questionnaire. Multivariable logistic regression examined independent and cumulative protective associations, with interaction terms testing buffering effects and gender moderation.
resultsClear dose–response associations emerged across all outcomes: each additional protective factor was associated with 42–54% lower odds of mental health conditions (adjusted odds ratios 0.46–0.58, all p < 0.001). Cumulative protection showed the strongest associations with suicidal ideation (OR = 0.48, 95% CI 0.41–0.57) and substance use disorders (OR = 0.46, 95% CI 0.37–0.58). School protective factors buffered the impact of adverse childhood experiences more strongly among high-ACE adolescents (interaction ORs 0.41–0.73, all p < 0.05). Among adolescents with high ACE exposure (≥ 3), depression prevalence decreased from 31.2% with low protection to 18.4% with high protection (41% relative risk reduction). Gender-stratified analyses suggested stronger protective associations for females with depression and for males with anxiety.
conclusionsSchool-based protective factors demonstrate robust dose-dependent associations with lower prevalence of clinically significant mental health conditions among Nigerian adolescents, with particularly strong buffering against family adversity. These cross-sectional findings provide initial evidence supporting school-centred mental health promotion strategies in sub-Saharan Africa. Longitudinal research is essential to establish temporal ordering, test causal mechanisms, and evaluate intervention effects.
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