Examining the Pathways between Parent and Adolescent Mental Health through Family Functioning and Parenting Practices in Vulnerable Populations: A Cross-Sectional Study

Abstract

Conflict-affected children are at greater risk of emotional and behavioral difficulties. A socioecological perspective emphasizes examining their mental health within the family systems in which they are embedded. Lebanon, marked by recurrent conflict and hosting large refugee populations, provides a relevant context for examining associations between family systemic factors and parent and child mental health. The current study examined the association between parent and adolescent mental health in conflict-affected populations and how this relationship is linked to key family systemic processes, including parenting practices and overall family functioning. The study utilized baseline secondary data from a multi-site randomized controlled trial (RCT) in Lebanon of a family intervention (Sawa Aqwa–Stronger Together), with 345 Lebanese, Syrian, and Palestinian adolescents aged 12–17 and their parents. Findings indicated that maternal mental health significantly predicted adolescent mental health, including internalizing and externalizing symptoms, while paternal mental health was not associated with overall adolescent mental health but was a strong predictor of internalizing symptoms. Exposure to adverse and potentially traumatic events also emerged as robust predictors. Family functioning was a consistent predictor of adolescent mental health, whereas parenting practices were not. Mediation analysis indicated that both family functioning and parenting practices mediated the association between maternal and adolescent mental health. These findings highlight the central role of family functioning, parenting practices, and parent mental health in shaping adolescent mental health in conflict-affected populations, with implications for family-based prevention and intervention strategies.