Positive Mental Health in Adolescents: Implications of Cognitive–Emotional Processes and Social Support

Background: Adolescence is a key period of development characterized by emotional, cognitive, and social changes that impact positive mental health (PMH). While social support is a well-established protective factor, cognitive and emotional processes, such as cognitive fusion and regulation of distress, also play a critical role. Objective: This study aimed to examine the relationship among various cognitive (i.e., cognitive fusion), emotional (i.e., regulation of distress), and social determinants (i.e., social support) in adolescents’ PMH, as their interplay could reflect theoretical models highlighting how these factors jointly shape adolescents’ mental health. Methods. A cross-sectional study was conducted with 505 adolescents (aged 13–15 years) in Spain. Participants completed online questionnaires assessing sociodemographic variables, cognitive fusion, regulation of distress, PMH, and social support from friends. Descriptive statistics, correlation analyses, and mediation and moderated mediation models were conducted, adjusting for relevant covariates. Results: Cognitive fusion was negatively correlated with regulation of distress, PMH, and social support, whereas regulation of distress showed a positive association with both PMH and social support. Mediation analysis indicated that regulation of distress significantly mediated the relationship between cognitive fusion and PMH. Furthermore, peer support moderated this mediated relationship: higher levels of support mitigated the negative impact of regulation of distress on PMH. Sociodemographic analyses revealed that girls, non-national students, and those receiving educational support showed less favorable outcomes. Conclusions: Cognitive, emotional, and social variables jointly influence adolescents’ PMH. Emotional regulation serves as a mediator of cognitive fusion and PMH, while social support from peers mediates the impact of psychological distress. Targeted interventions should prioritize emotional regulation strategies and enhancing peer support, especially among more vulnerable groups.