Abstract
BackgroundMental health problems are leading contributors to the global disease burden in adolescents. This study aims to highlight (1) salient context-specific factors that influence stress and coping among school-going adolescents across two urban sites in India; and (2) potential targets for preventing mental health difficulties.MethodsFocus group discussions were undertaken with a large sample of 191 school-going adolescent boys and girls aged 11–17 years (mean = 14 years), recruited from low- and middle-income communities in the predominantly urban states of Goa and Delhi. Framework analysis was used to identify themes related to causes of stress, stress reactions, impacts and coping strategies.ResultsProximal social environments (home, school, peers and neighborhood) played a major role in causing stress in adolescents’ daily lives. Salient social stressors included academic pressure, difficulties in romantic relationships, negotiating parental and peer influences, and exposure to violence and other threats to personal safety. Additionally, girls highlighted stress from having to conform to normative gender roles and in managing the risk of sexual harassment, especially in Delhi. Anger, rumination and loss of concentration were commonly experienced stress reactions. Adolescents primarily used emotion-focused coping strategies (e.g., distraction, escape-avoidance, emotional support seeking). Problem-focused coping (e.g., instrumental support seeking) was less common. Examples of harmful coping (e.g., substance use) were also reported.ConclusionsThe development of culturally sensitive and age-appropriate psychosocial interventions for distressed adolescents should attend to the challenges posed by home, school, peer and neighborhood environments. Enhancements to problem- and emotion-focused strategies are needed in order to bolster adolescents’ repertoire of adaptive coping skills in stressful social environments.
Highlights
Mental health problems are leading contributors to the global disease burden in adolescents
Identification and successful management of mental health problems in the adolescent years can improve long-term health outcomes and social adjustment [2]. Such efforts require an in-depth understanding of environmental risks, signs and idioms of psychological distress, and coping strategies for vulnerable youth across different contexts
Themes have been organized into three broad categories: 1) descriptions of stress in relation to the ecological context (‘common ecological stressors’); 2) experienced reactions to stress (‘stress reactions’); and 3) commonly employed methods for coping (‘coping strategies’)
Summary
Mental health problems are leading contributors to the global disease burden in adolescents. This study aims to highlight (1) salient context-specific factors that influence stress and coping among school-going adolescents across two urban sites in India; and (2) potential targets for preventing mental health difficulties. Identification and successful management of mental health problems in the adolescent years can improve long-term health outcomes and social adjustment [2]. Such efforts require an in-depth understanding of environmental risks, signs and idioms of psychological distress, and coping strategies for vulnerable youth across different contexts. A persistent imbalance in this transactional stress-coping system contributes to the development and maintenance of a range of mental disorders, including both internalizing and externalizing difficulties [4, 5]
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