Depression Among Early Adolescents Attending a School in a Deprived Neighborhood: A Multi-Group Path Analysis of Social Stress, Support, and Context in Addis Ababa, Ethiopia

Abstract

Early adolescence (10–14) is a period of heightened vulnerability to depression, shaped by socially patterned stressors. Evidence from low and middle income countries remains limited. This quantitative phase of a critical realist mixed methods study examined how neighborhood, family, and school contexts were associated with depressive symptoms among early adolescents. The study was informed by Pearlin's Stress Process Model and Archer's Morphogenetic Approach within a critical realist framework, which conceptualizes social phenomena as generated by underlying mechanisms rather than fixed regularities. Data were collected from 830 adolescents in a highly deprived area of Addis Ababa using validated measures; 77.7% screened positive for depressive symptoms. Structural equation modeling identified strong tendencies linking neighborhood disorder to depressive symptoms, both directly and indirectly through reduced social support. Family and school stressors also showed direct and indirect pathways, with variations by gender, family structure, and socioeconomic status. These findings map patterned tendencies that inform the qualitative phase, which will investigate the underlying social processes and forms of reflexive response shaping adolescents’ experiences of stress and depression.