Environmental Risk Factors for the Development ofAdolescent Anxiety and Depression Symptoms: A SystematicReview

Introduction: An adolescent’s environment can contribute to the development of the symptoms of mental health disorders such as anxiety and depression. These mental health conditions often lead to detrimental psychosocial and academic outcomes during adolescence and may persist throughout adulthood. Methods: In this study, a systematic review identified environmental risk factors for the development of anxiety and depressive symptoms in adolescents in the U.S. using PRISMA 2020 reporting guidelines (published in BMJ) and the American Psychological Association PsycINFO and PsycARTICLES databases. Inclusion criteria consisted of studies published in peer-reviewed journals between January 2013 and June 2023, that were empirical and quantitative, studied human participants aged 13-19 years in the United States, and identified environmental risk factors for anxiety and/or depression symptoms. Studies were excluded if any inclusion criterion was not met. Bronfenbrenner’s ecological systems theory provided for categorical interpretation of the identified risk factors into microsystem, mesosystem, and exosystem domains. We evaluated the resulting 29 studies for methodological quality using a Modified Downs and Black Checklist. This study was registered with PROSPERO (CRD420251011576) Results: Risk factors included negative life events, victimization, trauma burden, peer rejection, discrimination, neighborhood/community factors, socioeconomic factors, family factors, and substance use. Discussion: Using the ecological systems approach, this study identified risk factors that adolescents experience in the home, school, neighborhood, community, and global environment. Conclusion: A greater number of risk factors from the microsystem and mesosystem domains were identified to contribute to the development of adolescent anxiety and depression symptoms than from the exosystem domain