Abstract
BACKGROUND: Adolescents in out-of-home care face higher mental health risks and exhibit significant behavioural difficulties associated with these risks. Resilience processes involve a complex interplay between individual, family and community characteristics, enhancing mental well-being while reducing the risk of depression and anxiety. Despite its significance, research on resilience factors in Thai adolescents in out-of-home care remains limited. METHODS: This cross-sectional study explored the factors influencing resilience among adolescents living in five out-of-home care facilities in Bangkok. A total of 407 participants were recruited through cluster sampling. Eligible participants were required to be within 10-19 years, able to read, write, or communicate effectively and provide written informed consent. Data collection was conducted using a self-report questionnaire, which included several standardised tools: the Youth Risk Behavior Survey to evaluate safety, the Inventory of Parent and Peer Attachment to assess attachment to caregivers and peers, the 9-item Resilience Inventory to measure resilience levels, the Patient Health Questionnaire for Adolescents to assess depression, and the Generalized Anxiety Disorder questionnaire to assess anxiety. Data were analysed using Pearson correlation and multivariate linear regression. RESULTS: Peer attachment demonstrated the strongest positive association with resilience (B=1.486, p<0.001), followed by caregiver attachment (B=0.561, p=0.014). Higher depressive symptoms (B=-0.236, p=0.011) and suicidal risk (B=-2.276, p=0.008) were significantly associated with lower resilience. Factors such as extracurricular activities, sense of safety and physical or mental health conditions were not significantly associated with resilience in multivariate analysis. CONCLUSION: Adolescents in out-of-home care with strong relationships with caregivers and peers displayed greater resilience and lower rates of depression and suicidal risk. These findings highlight the importance of supportive relationships in fostering resilience and improving mental health outcomes in this population.