Adolescence is a period of life with a potential to prevention of both current impairment and future illness; and promoting successful development into productive adulthood.

So far, findings concerning determinants of maladjustment outcomes in adolescence are often based on clinical samples or epidemiological samples with a wide age range (ranging from childhood to late adolescence). Middle adolescence (ages 14­17) is associated with changes both in family relationships and prevalence of mental problems possibly affecting the significance of family determinants in predicting maladjustment. The pathway from childhood to adolescence is suggested to be different among boys and girls. There are also implications of differences in prevalence and effect of risk and protective factors of maladjustment between the sexes.

The present study aimed at studying, whether family factors are specific or general risk factors of adolescent maladjustment, whether the associations between family factors and maladjustment are similar in boys and girls, and whether the parents are significantly involved in help-seeking for depression in middle adolescence. Community data from two studies was utilised in the present study: two data waves from the Adolescent Mental Health Cohort -Study (Aged 15­16 years, N= 3809 and aged 17­18 years, N=2070) and one cross-sectional sample from the School Health Promotion Study (aged 14­16 years, N=17643). Maladjustment outcomes studied were depression, anxiety, excessive psychosomatic symptoms, perceived health, frequent excessive drinking, use of other substances than alcohol, and harmful drinking. Also help-seeking for depression was investigated. Family factors studied included family structure, parental monitoring, life events occurring to the parents, financial difficulties in the family as perceived by the adolescent, and concerns of the parents and siblings about changes in the adolescent mood or behaviour. All variables were assessed with self-report questionnaires. Univariate associations between the independent and dependent variables were in each separate study tested with chi square statistics or crude odds ratios with 95% confidence interval. The variables most significantly associated with maladjustment in boys and girls were searched for with stepwise logistic regression models adjusting for socioeconomic background and comorbidity, where appropriate.

In all datasets available, girls reported internalising types of maladjustment (depression, anxiety and excessive psychosomatic symptoms) systematically more often than did boys. On the other hand, boys of all ages reported harmful drinking patterns more often than did girls. Family factors were associated with diverse maladjustment outcomes in middle adolescence. Some factors (parental monitoring, family structure) acted as general risks, whereas others (life events, indicators of socioeconomic status) were more specific risk factors. Some gender differences in the associations between family factors and maladjustment were found. Boys and girls seemed to have similar associations between family factors and maladjustment in univariate analyses. The pathways to maladjustment may be different, however, since some associations disappeared in multivariate analyses. Depression may be an important confounder in the association of perceived financial difficulties and frequent drinking among boys but not among girls, for example.

There were indicators of family members being important actors in help-seeking process of middle adolescents: concerns of the mother were significantly associated with help-seeking for depression even when depressive symptoms, perceived need for help and sociodemographic background were controlled for.

Results of the present study indicate that family determinants are significantly associated with maladjustment also in middle adolescence. Parents and health care professionals should not overestimate the independence of middle adolescent children. In society, families must be granted the resources needed to offer a sound and healthy growing environment for their adolescents.