Mental Health Status Of Adolescents Research Articles

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Effectiveness of a Web-Based Tailored Intervention (E-health4Uth) and Consultation to Promote Adolescents’ Health: Randomized Controlled Trial

BackgroundTo promote well-being and health behaviors among adolescents, 2 interventions were implemented at 12 secondary schools. Adolescents in the E-health4Uth group received Web-based tailored messages focused on their health behaviors and well-being. Adolescents in the E-health4Uth and consultation group received the same tailored messages, but were subsequently referred to a school nurse for a consultation if they were at risk of mental health problems.ObjectiveThis study evaluated the effect of E-health4Uth and E-health4Uth and consultation on well-being (ie, mental health status and health-related quality of life) and health behaviors (ie, alcohol and drug use, smoking, safe sex).MethodsA cluster randomized controlled trial was conducted among third- and fourth-year secondary school students (mean age 15.9, SD 0.69). School classes (clusters) were randomly assigned to (1) E-health4Uth group, (2) E-health4Uth and consultation group, or (3) control group (ie, care as usual). Adolescents completed a questionnaire at baseline and at 4-month follow-up assessing alcohol consumption, smoking, drug use, condom use, mental health via the Strengths and Difficulties Questionnaire (SDQ) and the Youth Self Report (YSR; only measured at follow-up), and health-related quality of life. Multilevel logistic, ordinal, and linear regression analyses were used to reveal differences in health behavior and well-being between the intervention groups and the control group at follow-up. Subsequently, it was explored whether demographics moderated the effects.ResultsData from 1256 adolescents were analyzed. Compared to the control intervention, the E-health4Uth intervention, as a standalone intervention, showed minor positive results in health-related quality of life (B=2.79, 95% CI 0.72-4.87) and condom use during intercourse among adolescents of Dutch ethnicity (OR 3.59, 95% CI 1.71-7.55) not replicated in the E-health4Uth and consultation group. The E-health4Uth and consultation intervention showed minor positive results in the mental health status of adolescents (SDQ: B=−0.60, 95% CI −1.17 to −0.04), but a negative effect on drug use among boys (OR 0.36, 95% CI 0.13-0.96). In the subgroup of adolescents who were at risk of mental health problems at baseline (and referred for a consultation with the nurse), the E-health4Uth and consultation group showed minor to moderate positive results in mental health status (SDQ: B=−1.79, 95% CI −3.35 to −0.22; YSR: B=−9.11, 95% CI −17.52 to −0.71) and health-related quality of life (B=7.81, 95% CI 2.41-13.21) at follow-up compared to adolescents in the control group who were at risk of mental health problems at baseline.ConclusionsFindings from this study support the use of the E-health4Uth and consultation intervention in promoting the well-being of adolescents at risk of mental health problems. Future research is needed to further evaluate the effects of the consultation as a standalone intervention, and the dual approach of further tailored eHealth messages and a consultation.Trial RegistrationNederlands Trial Register: NTR 3596; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3596 (Archived by WebCite at http://www.webcitation.org/6PmgrPOuv).

Associations between sleep habits and mental health status and suicidality in a longitudinal survey of monozygotic twin adolescents

Several epidemiological studies have indicated that there is a relationship between sleep habits, such as sleep duration, bedtime and bedtime regularity, and mental health status, including depression and anxiety in adolescents. However, it is still to be clarified whether the relationship is direct cause-and-effect or mediated by the influence of genetic and other traits, i.e. quasi-correlation. To examine this issue, we conducted a twin study using a total of 314 data for monozygotic twins from a longitudinal survey of sleep habits and mental health status conducted in a unified junior and senior high school (grades 7-12), located in Tokyo, Japan. Three-level hierarchical linear model analysis showed that both bedtime and sleep duration had significant associations with the Japanese version of the 12-item General Health Questionnaire (GHQ-12) score, suicidal thoughts and the experience of self-harm behaviours when genetic factors and shared environmental factors, which were completely shared between co-twins, were controlled for. These associations were statistically significant even after controlling for bedtime regularity, which was also associated significantly with the GHQ-12 score. These suggest that the associations between sleep habits and mental health status were still statistically significant after controlling for the influence of genetic and shared environmental factors of twins, and that there may be a direct cause-and-effect in the relationship in adolescents. Thus, late bedtime and short sleep duration could predict subsequent development of depression and anxiety, including suicidal or self-injury risk. This suggests that poor mental health status in adolescents might be improved by health education and intervention concerning sleep and lifestyle habits.

Mental health literacy and mental health status in adolescents: a population-based survey

This study aims to investigate the association between mental health literacy and the mental health status, particularly depression, among adolescents. This was a population-based health survey utilising a two-stage sampling technique. Mental health literacy was measured by the Australian National Mental Health Literacy and Stigma Youth Survey with the depression vignette only. Depression was assessed by the Depression sub-scale of the Depression, Anxiety, Stress Scale. Data were analysed using multiple logistic regression modelling techniques with adjustment for cluster sampling effect. A total of 1678 students responded to the survey providing usable information. Only 275 (16.4%) respondents were classified as having an adequate mental health literacy level with correct identification of depression and also intended to seek help, with 392 (23.4%) of the total sample correctly identified the vignette as depression. Two hundred and forty eight (14.8%) were classified to have moderate to severe depression. Multiple logistic regression analysis results suggested that young people who had experienced moderate to severe level of depression in the week prior to the survey were more likely to have an inadequate level of MHL (OR = 1.52, 95% C.I. = 1.01-2.31) after adjusting for a potential confounding factors and cluster sampling effects. Results suggested that mental health literacy level was associated with mental health status, particularly depression of young people. The results have important implications, both clinically and on a population level, on the prevention of mental health problems and for the improvement of the mental health status of adolescents.

Coping skills and mental health status in adolescents when a parent has cancer: A multicenter and multi-perspective study

ObjectiveParental cancer increases the risk of psychosocial problems in adolescents. We investigated the frequency and efficacy of adolescents' coping strategies and relationships between those strategies and mental health status. Age and gender differences regarding coping and mental health were also investigated. MethodsIn total, 214 adolescents from 167 families participated in a cross-sectional, multicenter study. All participants were recruited from standard oncological care. Among the participants, 52% utilized a child-centered intervention program. Adolescents' coping skills were measured using KIDCOPE. Mental health status was rated by adolescents and parents by the SDQ for symptomatology and the KIDSCREEN for well-being. ResultsWe found that 29% of the adolescents showed emotional and behavioral problems. We found gender differences in mental health status but not in coping. Adolescents used a broad spectrum of coping strategies. Active problem-solving, distraction, acceptance, wishful thinking and seeking social support were the most frequently used coping strategies. The utilization of certain coping skills was mediated by their perceived efficacy. Problem-focused or approach-oriented coping strategies generally are associated with better mental health, while avoidance-oriented coping are associated with worse mental health. Emotion-focused coping was associated with both lower and higher mental health. ConclusionThe strategies used by adolescents to cope with parental cancer are associated with their mental health. Problem-solving and approach-oriented coping strategies should be facilitated by psychological interventions regardless of age and gender. Age and gender differences in adolescents' mental health should be further investigated because these differences are not explained by differences in coping strategies.

Grieving experiences amongst adolescents orphaned by AIDS: Analysis from event history calendars

Mental health is an essential component of adolescent health and wellbeing. Mental health practitioners assess adolescents' mental health status to identify possible issues that may lead to mental health problems. However, very few of the tools used to assess the mental health status of adolescents include assessment for grieving and coping patterns. The current tools used for assessing an individual's mental health are lengthy and not comprehensive. The purpose of this study was to assess grieving patterns of adolescents orphaned by AIDS and to appraise the usefulness of an event history calendar as an assessment tool for identifying grieving experiences, in order to guide and support these adolescents through the grieving process. One hundred and two adolescents aged 14-18 years, who had been orphaned by AIDS, completed an event history calendar, reviewed it with the researcher and reported their perceptions of it. Thematic analysis of the event history calendar content revealed that it is an effective, time-efficient, adolescent-friendly tool that facilitated identification and discussion of the orphaned adolescents' grieving patterns. Crying, isolation, silence and violent outbursts were the main grieving patterns reported by adolescents orphaned by AIDS. The researcher recommends use of the event history calendar for identification of orphaned adolescents' grieving experiences. Early identification would enable mental health practitioners to support them in order to prevent the occurrence of mental illness due to maladaptive grieving.

Primary Care, Depression, and Anxiety: Exploring Somatic and Emotional Predictors of Mental Health Status in Adolescents

A growing body of research points to regular, comprehensive mental health screening in primary care practices as an effective tool, but a thorough and efficient approach is not yet widely used. The purpose of this report is to describe the pattern of mental health-related concerns, protective and social risk factors reported by adolescents during routine well-child visits in primary care settings, and their occurrence among teens that screen positive for either depression or anxiety with brief validated measures. A personal digital assistant-based questionnaire was administered as part of clinical care to adolescents 11 to 18 years old (N = 2184) attending preventive well-child visits in 13 pediatric and family medicine primary care practices in a northern New England practice-based research network over 18 months (2008 to 2009). Depressive and anxiety-related symptoms were assessed using the 2-question versions of the Patient Health Questionnaire and Generalized Anxiety Disorder scale, respectively. Analyses determined the role that the protective and social risk factors played in determining who screens positive for depression and anxiety. In the fully adjusted model, risk factors that were significant (P < .05) predictors for a positive screen of depression included substance use (adjusted odds ratio [AOR], 2.05); stress (AOR, 3.59); anger (AOR, 1.94); and worries about family alcohol and drug use (AOR, 2.69). Among protective factors, that is, those that reduce the risk of depression, age (AOR, 0.87 for younger patients); having parents who listen (AOR, 0.34); and having more assets (AOR, 0.65) were significant. Significant predictors of screening positive for anxiety included substance use (AOR, 1.97); stress (AOR, 6.10); anger (AOR, 2.31); trouble sleeping (AOR, 1.75), and the sex of the adolescent (AOR, 1.87 for girls). Although having parents who listen was still a significant protective factor for anxiety (AOR, 2.26), other assets were not significant. Comprehensive primary care mental health screening that considers both anxiety and depression while including strength-based and psychosocial support questions is a helpful adjunct to clinical practices and has been done routinely by using an electronic tool at the point of care. Because certain common somatic and emotional concerns can precede depression and anxiety, routine screening for these issues along with depression and anxiety screening is suggested.

Clarification of the factor structure of the 12-item General Health Questionnaire among Japanese adolescents and associated sleep status

If the factors affecting the mental health status of adolescents and their association with sleep status could be clarified, this information would be helpful for formulating lifestyle and healthcare guidance for the promotion of healthy growth and the prevention of mental problems in these individuals. The purpose of this study was to clarify (1) the factor structure of the 12-item General Health Questionnaire (GHQ-12), and (2) the associations between the factors extracted from this questionnaire and lifestyle, in particular sleep status, by using a representative sample population of Japanese adolescents. One hundred three thousand sixty hundred fifty self-administered questionnaires were collected from students enrolled in junior high and high schools in Japan. Of these questionnaires, 99,668 were analyzed. Sleep duration, subjective sleep assessment, bedtime, and insomnia symptoms of these students over the past month were studied to investigate sleep status. The factor analyses yielded two factors: depression/anxiety and loss of positive emotion. Sleep duration of less than 7h was found to be associated with both depression/anxiety and loss of positive emotion, whereas sleep duration of 8h or more was associated only with loss of positive emotion. Subjective sleep assessment and insomnia symptoms were associated with both depression/anxiety and loss of positive emotion. It was demonstrated that two underlying factors of mental health status were associated with differences in sleep status. In order to improve the mental health status of adolescents, it is important to provide guidance about sleep and lifestyle habits according to the mental health status of the individual.

Oiling a neglected wheel: An investigation of adolescent internalising problems in rural South Australia

Despite a paucity of research, adolescents living in rural areas appear to have a heightened risk for developing a mental health problem compared with their urban counterparts. The main objectives of this study were to contribute to building an evidence base of prevalence rates and determinants of internalising problems of adolescents in rural South Australia. A multidimensional Process Model was used as theoretical framework to enable an investigation of the various determinants from individual, family and community domains; specifically, the contribution of self-esteem, parental acceptance and elements of social capital at an individual level (ie participation in the local community and proactivity in a social context represented structural social capital, and feelings of trust and safety, and neighbourhood connections represented cognitive social capital). In this cross-sectional prospective study, a total of 388 Year 9 (2nd year of secondary school) students (208 females, 180 males) aged 13-15 years (mean age = 14.2 years) participated from 11 high schools within the Country Health South Australian area. These adolescents completed a battery of self-reported measures online at school. The results demonstrated that the adolescents experienced a 'normal' level of self-esteem and a 'moderate' level of perceived parental acceptance. The level of social capital was considered 'low' and the adolescents experienced a 'moderate' level of internalising symptoms. Based on the mean score of the Revised Child Anxiety & Depression Scales (RCADS), 25% of the adolescents experienced internalising symptoms ranging in severity from mild to severe, with no significant differences between males and females. Approximately 13% were considered above the clinical threshold, with 4% reporting experiencing severe symptoms. Relationships between all measures were investigated using Pearson product-moment correlations coefficients and associations between self-esteem, parental acceptance, social capital, and internalising problems were assessed using multivariate linear regressions. Both parental acceptance and social capital were found to predict self-esteem. Parental acceptance was also significantly associated with social capital. The linear contribution of self-esteem, parental acceptance and social capital was significantly related to internalising problems. Approximately 33% of the variance in internalising problems could be accounted for by the combination of the three predictors; however, self-esteem and parental acceptance were the significant contributors to the prediction of internalising problems. Social capital was not a significant predictor of internalising problems. The present study only begins to contribute to the lack of existing data on the mental health status of adolescents from rural areas of South Australia. Greater research is needed to enhance understanding of this overlooked population and also assist in providing evidence-based guidelines in establishing priorities for newly appointed Federally funded youth services in rural Australia. In light of the concerning rates of internalising problems demonstrated by the present study, coupled with the fact that young people from rural areas were not considered in previous National Mental Health Surveys, it seems timely to highlight the importance of including as many Australians as possible from rural and remote areas, in the approaching, subsequent National survey. This will provide a more accurate evidence-based representation of Australia's adolescent population to inform policy and facilitate the implementation of relevant strategies.

Self perception score from zero to ten correlates well with standardized scales of adolescent self esteem, body dissatisfaction, eating disorders risk, depression, and anxiety

The ability to quickly and reliably assess mental health status would assist health workers, educators and youth workers to provide appropriate early intervention for adolescents. To investigate the validity of a simple self perception score out of ten by correlating the self perception scores of adolescents from a normal, community sample of adolescents with their scores on standardized mental health measures. Study group was 470 early adolescent students aged 11.0-14.5 years from grades 7 and 8 in two secondary schools. Self perception was self reported using a score of zero to ten points, and the scores were then correlated with scores on the Harter Self Perception Profile, Beck Junior Depression, Speilberger State and Trait Anxiety and the Eating Disorders Inventory. A High Risk group (self perception < 5) was assessed to examine how many of these adolescents also had poor self esteem and risk for depression, anxiety, and eating disorders. Self perception scores correlated positively with self esteem and self concept subscales and it was negatively associated with depression, state and trait anxiety, and EDI scores. Of the 15.1% high risk adolescents in the overall sample, 78% scored below the group average on the mean of all Harter Self Concept scores; 70% scored above average for Beck Depression; 64% and 74% scored above average on Speilberger State/Trait Anxiety respectively; 80% scored higher than the average on the group mean EDI. A self perception score from zero to ten can be a simple and accurate way of gaining an initial insight into the current mental health status of adolescents.

Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial

Regular physical activity is associated with a reduced risk of all-cause mortality, and mortality due to cardiovascular disease and cancer. Among adolescents, physical activity is associated with benefits in the prevention and control of emotional distress, and improvement of self-esteem. Countries in transitional epidemiological scenarios, such as Chile, need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases. The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago, Chile. A quasi-experimental design was used to evaluate the effects of the program over one academic year. The study included 198 students aged 15 years old. Two ninth grade classes were randomly selected as the intervention group, with two classes of the same grade as controls. A social planning approach was used to develop the intervention. The program was designed and implemented based on student preferences, teachers' expertise and local resources. Changes in physiological and mental health status were assessed. After the intervention, maximum oxygen capacity achieved a significant increase of 8.5% in the intervention versus 1.8% in the control group (p < 0.0001). Speed and jump performance scores improved significantly more in the intervention versus the control group (p > 0.01). Anxiety score decreased 13.7% in the intervention group versus 2.8% in the control group (p < 0.01), and self-esteem score increased 2.3% in the intervention group and decreased 0.1% in the control group after the end of the program (p < 0.0001). No significant change was observed in the depressive score. Student participation and compliance with the program was > 80%. To conclude, a school-based program to improve physical activity in adolescents of low socioeconomic status, obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status.

The relationship of parenting style to self-reported mental health among two subcultures of Chinese

The results of this investigation with 127 youths (aged 16–22 years) from mainland China supported the association of recalled parent's styles (assessed by the EMBU) with adolescents' self-evaluated health status (measured by the SCL-90). Many psychosomatic symptoms and lower scores on indexes of general mental health were significantly related to higher levels of parental rejection and denial, punishing tendency, overprotection and overinvolvement and to lower levels of parental emotional warmth and comprehension. The association between parenting style and mental health status of adolescents can be generalized across genders and across the two Chinese subcultures studied (Han and Kejia ethnical groups) with moderate to fairly high confidence. The mental health status of participants suggests some differences between different subcultures or genders on several variables of the SCL-90.

The mental health status of adolescents released from custody: a preliminary study.

To describe the prevalence of mental health problems and the social circumstances of young offenders after their release from custody in a juvenile detention centre. The subjects were 37 adolescents from an original sample of 101 adolescents who had been remanded in a juvenile detention centre in Adelaide, South Australia. The adolescents were evaluated at the time of their initial detention in custody and again 1 year later. The adolescents reported having a large number of social and mental health problems after their release from custody. One year after their release, 32% of the adolescents scored above the recommended 'cut off' score on the Youth Self Report. This represents a rate of disorder three to four times higher than that reported by adolescents in the community and is comparable to the rate reported by adolescents attending mental health clinics. Adolescents remanded in juvenile detention centres experience continuing mental health problems after their release from custody. As well, they experience considerable social dysfunction. There is an urgent need for more active therapeutic follow-up of these young people.