Emerging Stressors and Adolescent Depression and Anxiety: Associations and Cumulative Burden Among Kenyan Adolescents

Depression and anxiety among young people are rising globally, and one proposed explanation is that the stressor environment of adolescence has changed. Emerging stressors—person-level exposures born of connectivity, technological change, and collective crises—are increasingly linked to adolescent distress in high-income countries; sub-Saharan Africa, where these exposures are spreading fastest, remains almost entirely unstudied. We examined whether emerging stressors across two domains—digital (problematic social-media use, online appearance comparison) and global (climate-change anxiety, pandemic-related stress, exposure to ethnic-political violence)—were associated with depression (PHQ-8) and anxiety (GAD-7) among Kenyan adolescents in two cross-sectional school studies (N = 5,592; Mage = 15.9 years; 49.8% female; 74 schools), and whether risk accumulated as stressors co-occurred; exploratory analyses tested body-esteem mediation and moderation by gender and structural disadvantage. After establishing scalar measurement invariance across samples, symptoms were regressed on each stressor within its study, using covariate-adjusted linear and logistic mixed-effects models with school random intercepts, estimated in 20 multiply imputed datasets with false-discovery-rate correction; we report standardized βs (per SD) and odds ratios for clinically elevated symptoms (≥ 10). Cumulative burden was the count of co-occurring stressors (top-tertile exposure). Clinically elevated depression (28.1%) and anxiety (24.5%) were common and did not differ between samples. Every stressor was independently associated with both outcomes (βs = 0.20–0.36; odds ratios = 1.39–1.92 per SD), with climate-change anxiety strongest (βs = 0.33–0.36). The odds of clinically elevated symptoms roughly doubled with each additional co-occurring stressor (odds ratios = 1.86–2.32), monotonically, in both samples. Indirect effects through body esteem were significant but small (0.04–0.09) relative to direct paths (~0.30), and associations were not moderated by gender, socioeconomic status, or family structure. Emerging stressors are consistently associated with adolescent depression and anxiety in Kenya, and their burden accumulates as exposures co-occur. Future studies should test longitudinal associations and all stressor domains.