Competence in Coping with Stress in Adolescents from Three Regions of the World

Relationships Between Family Connectedness and Stress-Triggering Problems Among Adolescents: Potential Mediating Role of Coping Strategies

The aim of this study was to provide a better understanding of the mechanisms underlying the relationships between family connectedness, coping strategies, and stress-triggering problems in adolescents. To this end, it longitudinally examined the relationships between these three phenomena in a sample of New Zealand adolescents. Data were the three waves of the Youth Connectedness Project, in which 1,774 adolescents aged 10-17 completed a self-report survey three times at one-year intervals. Using random intercept longitudinal mediation path models, we tested whether and to what extent different coping strategies at T2 functioned as mediators between family connectedness at T1 and stress-triggering problems at T3. As predicted, statistical analyses indicated that family connectedness negatively predicted stress-triggering problems over time, and we found that maladaptive coping, but not adaptive coping, significantly mediated this relationship. This result suggests that family connectedness predicted a reduction in maladaptive coping one year later, and this lower level of maladaptation predicted a reduction in stress-triggering problems a subsequent year later. These and other related findings are important as they highlight several mechanisms shaping unfolding problematic situations experienced by adolescents. Contributions of the results to the existing body of knowledge about adolescents' stress and coping strategies are discussed, as well as their clinical implications for the prevention or reduction of stress experienced by adolescents.

Clustering of Activity-Related Behaviors in Relation to Self-Reported Causes of Stress among Pre-Adolescents: Results from a National Epidemiological Study

An epidemiological study was conducted among 1728 10–12-year-old students (55.1% girls) and their parents during 2014–2016 in Greece. This study aimed to identify the dominant clusters of physical activity/sedentariness among preadolescents and investigate their association with self-reported sources of stress. Children’s physical activity levels and sources of stress were evaluated using validated questionnaires that assessed daily hours of activities, both on weekdays and on weekends, including physical activity, screen-based sedentary time, and non-screen-based sedentary time. The k-means algorithm of cluster analysis was applied. Three clusters of children’s physical activity/sedentariness were revealed. Cluster 1 was characterized as “Inactive-Non sedentary”, cluster 2 as “Active –Non-screen sedentary”, and cluster 3 as “Inactive-Sedentary”. Parental needs/expectations were associated with physical activity patterns (p = 0.009), i.e., children assigned to the third and second clusters had 36% and 51% lower odds to be stressed due to parental requirements [(OR for cluster 3 = 0.64, 95% CI = 0.41–0.99), (OR for cluster 2 = 0.49, 95% CI = 0.32–0.76)], compared with their first-cluster counterparts. Considering the need to promote physical activity in early life stages, the identification of these complex activity-related patterns along with their significant interaction with parental expectations as a cause of stress could enhance the effectiveness of targeted behavior change interventions among those parent–child dyads most in need.

Associations Between Academic Stress, Mental Distress, Academic Self-Disclosure to Parents and School Engagement in Hong Kong

Numerous studies have indicated that academic stress is associated with various detrimental personal physical and emotional outcomes; however, relatively few studies have explored how academic stress affects adolescents' interactions with their significant others in families and schools, which are two important social systems for school-age adolescents. In addition, there are also few studies examining how academic stress influences adolescents' self-disclosure to parents and school engagement in East Asian districts particularly in Hong Kong, where the level of academic stress among adolescents is high. This study examines how academic stress affects mental distress, academic self-disclosure to parents and school engagement and explores gender differences in the risk for the outcomes of academic stress. One thousand and eight hundred and four students from eight secondary schools in Hong Kong participated in this study. The results indicate that academic stress has a significant association with all three outcomes, but the correlation with school engagement is positive, which is contrary to the findings of most previous studies. The possible reasons for such positive association are discussed. In addition, the model can be applied to both genders, but females are more susceptible to the detrimental outcomes of academic stress by suffering a higher level of mental distress. This study suggests that academic stress should be an important entry point to tackle adolescents' mental distress while interventions should be targeted at females who are experiencing a higher level of mental distress. In addition, in view of the significant associations between academic stress and self-disclosure to parents, as well as between academic stress and school engagement, suggestions are provided to families and schools on how to proactively provide support to those students who are experiencing academic stress.

Stability and change in a predictive model of emotional and behavioural problems from early adolescence to middle adulthood

The impact of negative life events, self-esteem, and coping behaviour are considered to be contributing factors in the development of emotional and behavioural problems. Differences in the predictive value of these three factors on emotional and behavioural problems from adolescence to adulthood have not yet been studied. Multiple linear regressions separate for the two sexes were used to assess whether the impact of negative life-events, self-esteem, and coping behaviour predicted emotional and behavioural problems at four discrete measurement points from early adolescence to middle adulthood in a cohort of N = 366 participants from a Swiss longitudinal community study. Mostly irrespective of sex, negative life-events and low self-esteem were significant predictors of internalizing problems, externalizing problems and total problem scores in adolescence as well as in adulthood. The explained variance in the model increased steadily from early adolescence to middle adulthood. While the impact of negative life-events was on the same level across all measurements until adulthood, the contribution of self-esteem increased steadily. There was a significant association, particularly in adolescent males, between avoidant coping and emotional and behavioural problems. The cross-sectional findings from this community study reflect long-term robust patterns in the associations of negative life-events, self-esteem, and avoidant coping with emotional and behavioural problems from adolescence to adulthood. Clinically, the three constructs represent actionable targets for optimizing assessment and intervention strategies across the adolescent life-span.

The Correlates of Academic Stress in Hong Kong

Most previous studies have attempted to explore how different personal, familial, or school factors are linked to academic stress in Western countries. However, relatively less research has incorporated these different factors into one model to examine the most crucial correlate(s) that predict academic stress, particularly in the East Asian context, where the level of academic stress among adolescents is high. This study examined how perfectionism, social-oriented achievement motivation, parental aspiration for achievement, parent–child relationship, emphasis on academics in school, and school climate work together to predict academic stress in Hong Kong. One thousand eight hundred and four students from eight secondary schools in Hong Kong participated in this study. The results indicate that perfectionism, social-oriented achievement motivation, parent–child relationships, and emphasis on academics in school have significant associations with academic stress, while perfectionism and social-oriented achievement motivation, the two factors from the personal domain, are the dominant drivers of academic stress. In addition, these findings applied to both genders. As the significant correlates come from the personal, familial, and school domains, this study recommends multilevel interventions for decreasing the level of academic stress. In addition, this study also suggests further research directions to examine the psychosocial mechanism between the correlates and academic stress.

Coping with Relationship Stress in Adolescence: A Decade in Review

At a moment in history when stress levels among adolescents are high and coping capacities are taxed, it seems timely and important to review a decade's accomplishments in elucidating how, and with what effects, adolescents cope with relationship stress. We provide an update on research about coping with parent, peer, and romantic stress and discuss the effectiveness of coping strategies across cultures, developmental periods, and levels of social stress. We explore relations between coping and other automatic and reflective responses to stress and highlight innovations in lab-based and ambulatory assessments. We recommend studies of variability in the success of coping at different intensities of relationship stress and research with real-time and repeated assessments to capture the process of coping.

Adolescents' somatic complaints in eight countries: what influence do parental rearing styles have?

Medically unexplained physical symptoms are frequently named by adolescents in both clinical and normative samples. This study analyzed the associations between parental rearing styles and adolescents' body complaints in diverse cultural contexts. In a cross-cultural study of 2415 adolescents from eight countries (Argentina, France, Germany, Greece, Pakistan, Peru, Poland, and Turkey), the associations of maternal and paternal support, psychological control, and an anxious parental monitoring style with youth body complaints were tested. Girls reported more somatic complaints than boys, the level of complaints differed between countries, and gender differences varied significantly between countries. Hierarchic multilevel models revealed that the expression of distress via body complaints, after controlling for country, gender, and sociodemographic status, was significantly associated with parental rearing styles. The negative impact of mothers' psychological control on body complaints generalize across countries. In addition, mothers' anxious monitoring had a negative impact on the offspring's health, whereas higher levels of paternal support and lower levels of paternal psychological control contributed to lower levels of somatic complaints. Sociodemographic variables such as family structure, standard of living, and employment status of the parents, did not turn out as significant in the final model. The findings point to the different roles of fathers and mothers play in adolescents' health and their complex interplay.

Coping Skills in Pre- and Early Adolescents: The Role of Temperament and Character

Coping skills represent cognitive, emotional, and behavioral resources to overcome developmental challenges and tasks. Based on Cloninger's model of personality, the main aim of this study was to analyze the relation among temperament, character, and coping skills in nonclinical pre- and early adolescents by also considering adolescents' gender and age. One hundred and thirty-eight Italian pre- and early adolescents (52.2% boys and 47.8% girls), aged between 10-14 years (M = 12.33 ± 0.87 SD), filled out the Junior Temperament and Character Inventory and the Children's Coping Strategies Checklist Revision 1. Regression and relative weights analyses showed that several of adolescents' personality dimensions did predict their coping skills. Specifically, Harm Avoidance was negatively related to Positive Reframing and Distraction; this latter (i.e., Distraction) was also negatively associated with Novelty Seeking, Self-Directedness, and Cooperativeness. On the contrary, Cooperativeness was positively related to the use of Problem Focus strategy, and Reward Dependence was positively related to Distraction and Social Support. Significant gender and age differences in personality as well as in coping skills emerged. Girls scored higher on Harm Avoidance, Reward Dependence, Persistence and Problem Focus, and boys scored higher on Novelty Seeking and Distraction. Moreover, pre-adolescents (10-12 years) reported lower scores on Novelty Seeking and higher on Problem Focus than early adolescents (13-14 years). Overall, the results suggest that bio-psycho-social individual factors linked to personality, gender, and age have an important role in shaping pre- and early adolescents' coping and adaptation responses. Practical implications of the results and future developments are discussed.

Sources of academic stress among Iranian adolescents: a multilevel study from Qazvin City, Iran

Background

Academic stress can cause mental and physical problems and affect adolescents’ healthy development. This study aimed to estimate academic stress and explore its sources at the individual- and school levels among school-going adolescents in the city of Qazvin, Iran.

Results

This cross-sectional study used a stratified cluster sampling to recruit 1724 students aged 12–19 years from 53 schools in Qazvin City. Data were collected using a validated self-administered questionnaire. The mean academic stress score was 45.7 (95% CI 45.2, 46.3). The stress level was statistically higher among older 47.5 (95% CI 46.7, 48.3) than younger 44.1 (95% CI 43.4, 44.9) adolescents. The main academic stressors included: future uncertainty 69.7 (95% CI 68.8, 70.7), academic competition 58.5 (95% CI 57.3, 59.6), and interaction with teachers 56.1 (95% CI 55.3, 56.9). Gender, educational period, school type, family socioeconomic status, and father’s education were associated with academic stress.

Conclusions

We conducted a multilevel study using a random sample of male and female students in the city of Qazvin, Iran. Results indicated moderate levels of stress among Iranian adolescents. The academic stress was associated with several individual and school-level variables. Students and their families and teachers need education on stress prevention methods and coping mechanisms. Future research should focus on developing and testing multilevel policies and interventions to improve students’ mental health and academic performance.

Individual Differences in Adolescent Coping: Comparing a Community Sample and a Low-SES Sample to Understand Coping in Context

Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles in two distinct samples of adolescents: a community sample of youth aged 11–16 years (N = 374, M_age = 13.14, 53% girls), and a low-SES sample of youth aged 12–18 years (N = 304, M_age = 14.56, 55% girls). The ten coping subscales of the Responses to Stress Questionnaire were included as indicators in the LPAs (problem solving, emotion regulation, emotion expression, acceptance, positive thinking, cognitive restructuring, distraction, denial, wishful thinking, and avoidance). Five profiles were identified in the community sample: Inactive, Low Engagement, Cognitive, Engaged, and Active Copers. All but the Low Engagement Copers profile were also identified in the low-SES sample, suggesting that adolescents employ similar coping strategies across contexts, but fewer low-SES adolescents engage in lower levels of coping. Profiles differed by gender and symptoms of internalizing psychopathology. Inactive copers in both samples were more likely to be male. Engaged Copers reported the lowest symptom levels whereas Active Copers reported higher symptoms. Cognitive Copers reported higher levels of anxious and depressive symptoms in the low-SES sample only, suggesting that this pattern of coping may be protective only in less stressful contexts. Elucidating within-person coping patterns is a promising avenue for targeting interventions to those most likely to benefit.

How Does Family Connectedness Contribute to Youths' Health? The Mediating Role of Coping Strategies

Family connectedness has important implications for adolescents' well-being, contributing to their physical, psychological, and social health. However, little is known about the mechanisms underlying these effects. The present longitudinal study examined the process by which family connectedness, as perceived by adolescents, predicted greater positive and fewer negative health behaviors in adolescents over time. In particular, we sought to determine whether adaptive and maladaptive coping strategies mediated the link between family connectedness and adolescents' self-reported health status. Data were obtained from 1,774 New Zealand adolescents aged 10-17 years, who completed a self-report survey three times at one-year intervals. With longitudinal mediation path models, we tested whether maladaptive and adaptive coping strategies at T2 functioned as mediators between family connectedness at T1 and overall health, vitality, sleep sufficiency, body satisfaction, substance use, and self-harm at T3. Findings revealed that family connectedness predicted greater levels of adaptive coping, which, in turn, predicted better health indicators but not decreases in ill-health indicators. Furthermore, family connectedness predicted lower maladaptive coping, which, in turn, predicted higher levels of positive health outcomes and fewer negative health outcomes. Results showed that the positive effect of family connectedness on adolescents' health occurred through increased use of adaptive coping strategies, decreased use of maladaptive coping strategies, or both. These results have important implications for practitioners working with adolescents and parents, as well as for health promotion program developers.

Carving out space for collective action: a study on how girls respond to everyday stressors within leisure participation

Purpose: Stress and achievement pressure constitute factors affecting young people’s mental health, especially among girls. Leisure participation holds the potential to be a collective space where young people can respond to stressors together. This study explores how girls collectively construct responses to daily stressors within the context of leisure participation.

Methods: Nine focus groups were conducted with 16 girls aged 14–21 who were active members in two sport organizations in northern Sweden. Data was collected by using participatory observations and photo-elicited focus group discussions.

Results: Our findings from the inductive thematic analysis were interpreted by combining the stress process model with social practice theory, resulting in three subthemes or responses: sharing sites of responsibility, resisting norms related to (gendered) youth and focused distraction. The subthemes were abstracted into the central theme of trustful belonging as a resource for collective responses, representing what pre-conditions need to be in place to make the responses possible.

Conclusion: Leisure participation is an important relational space for young people to respond to stressors by making use of everyday routines, and the agency these social practices hold. However, the effort needed to respond to these stressors brought additional pressure in terms of responsibilities, and achievements.

Who is the Most Stressed During the COVID-19 Pandemic? Data From 26 Countries and Areas

Background

To limit the rapid spread of COVID‐19, countries have asked their citizens to stay at home. As a result, demographic and cultural factors related to home life have become especially relevant to predict population well‐being during isolation. This pre‐registered worldwide study analyses the relationship between the number of adults and children in a household, marital status, age, gender, education level, COVID‐19 severity, individualism–collectivism, and perceived stress.

Methods

We used the COVIDiSTRESS Global Survey data of 53,524 online participants from 26 countries and areas. The data were collected between 30 March and 6 April 2020.

Results

Higher levels of stress were associated with younger age, being a woman, lower level of education, being single, staying with more children, and living in a country or area with a more severe COVID‐19 situation.

Conclusions

The COVID‐19 pandemic revealed that certain people may be more susceptible to experience elevated levels of stress. Our findings highlight the need for public health to be attentive to both the physical and the psychological well‐being of these groups.

Coping strategies among Iranian children with experience of Sarpol-e-Zahab earthquake: factor structure of children's Coping Strategies Checklist-revision1 (CCSC-R1)

Background

Stress-related situations play a significant role in children’s lives and result in different reaction in children. Among various methods of evaluating the stressful environment of children, 54-item Children’s Coping Strategies Checklist-Revision1 (CCSC-R1) has been developed as one of the most powerful tools for assessing different aspects of coping in children. The purpose of the present study is to find the psychometric properties of Persian CCSC-R1 and to identify the coping strategies used by Iranian children.

Method

Subjects included 401 female students aged between 9 and 13 who were subjected to the Sarpol-e-Zahab earthquake (in Northeast of Iran). Construct and convergence validities were examined with confirmatory factor analysis and correlated with Children’s Coping Behavior Questionnaire (CCBQ). Reliability was obtained by internal consistency. Using repeated analysis of variance, the status of coping strategies in children were achieved.

Results

Confirmatory factor analysis showed a good model fit to the four-factor structure, active coping, distracting action/distraction, avoidance, and support seeking strategies. The results also demonstrated that there was a strong relationship between four-factors of CCSC-R1 including their subscales and CCBQ. Internal consistency (Cronbach’s Alpha) for the four dimensions were in the range of 0.76 to 0.88. The findings also showed that Iranian children use active coping, especially optimism, more than other strategies in order to deal with their stressful situations.

Conclusions

It is concluded that CCSC-R1 is a valid and reliable instrument which could be employed for Iranian children. Furthermore, in the face of traumatic events, Iranian children acted same as people in individualistic cultures.

The Coping Scales From the German Stress and Coping Questionnaire for Children and Adolescents

Abstract. The coping scales from the Stress and Coping Questionnaire for Children and Adolescents (SSKJ 3–8; Lohaus, Eschenbeck, Kohlmann, & Klein-Heßling, 2018 ) are subscales of a theoretically based and empirically validated self-report instrument for assessing, originally in the German language, the five strategies of seeking social support, problem solving, avoidant coping, palliative emotion regulation, and anger-related emotion regulation. The present study examined factorial structure, measurement invariance, and internal consistency across five different language versions: English, French, Russian, Spanish, and Ukrainian. The original German version was compared to each language version separately. Participants were 5,271 children and adolescents recruited from primary and secondary schools from Germany ( n = 3,177), France ( n = 329), Russia ( n = 378), the Dominican Republic ( n = 243), Ukraine ( n = 437), and several English-speaking countries such as Australia, Great Britain, Ireland, and the USA (English-speaking sample: n = 707). For the five different language versions of the SSKJ 3–8 coping questionnaire, confirmatory factor analyses showed configural as well as metric and partial scalar invariance (French) or partial metric invariance (English, Russian, Spanish, Ukrainian). Internal consistency coefficients of the coping scales were also acceptable to good. Significance of the results was discussed with special emphasis on cross-cultural research on individual differences in coping.

Coping Strategies and Factors Related to Problematic Substance Use and Behavioral Addictions Among Adolescents and Young Adults with Cancer

Purpose: This study aimed to explore and identify the factors associated with problematic substance use (alcohol, tobacco, and cannabis) and behavioral addictions (internet and eating disorders) over time in adolescents and young adults (AYAs) treated for cancer. Methods: AYAs newly diagnosed with cancer, 15-25 years of age, completed a questionnaire during their hospitalization (T1), assessing their consumption of alcohol, tobacco, and cannabis (The Alcohol Use Disorders Identification Test; The Smoking Behavior Questionnaire; and The Cannabis Abuse Screening Test), their internet use (The Internet Addiction Test), their body preoccupations (The Eating Attitudes Test), as well as their coping strategies (Brief COPE) and emotional adjustment (The Hospital Anxiety and Depression Scale). Questionnaires were completed again 6 months later (T2). Results: Seventy-three AYAs were included at T1 and 21 AYAs at T2. Nearly one out of two (46.58%) AYAs had a problematic substance use or behavioral addiction after cancer diagnosis (T1). Problematic use of internet was frequently reported (23.29%), as well as harmful alcohol consumption or addiction (16.44%) and cannabis dependence (12.33%). The main factor related to problematic substance use was being older, while the main factor related to behavioral addiction was having a higher anxiety score. Substance use as a coping strategy was used more frequently by AYAs with problematic substance use and emotional support as a coping strategy was used more frequently by AYAs with a behavioral addiction. Conclusions: High rates of problematic substance use and behavioral addiction were reported in our sample. AYAs surveyed had high problematic use of cannabis and high internet use. Attention to substance use and addictive behaviors is recommended to ensure optimal care.

[What Causes Future-Related Stress in Immigrant and German Adolescents and how do they Cope with these Stressors?]

What Causes Future-Related Stress in Immigrant and German Adolescents and how do they Cope with these Stressors? In the present study, the stress perception and coping of German and immigrant adolescents with regard to future stress were compared. The 1,789 adolescents (164 immigrated, 1,625 German adolescents) at the age of fifteen completed questionnaires on the assessment of stress and coping with regard to future stress. Immigrated youth show a higher stress burden in the domain future than German adolescents. The fear of becoming unemployed was a major stressor in both groups, and both groups were also very active in tackling future-related problems. However, German youths show an even more active approach to coping with future stress and involve parents or friends more often. Migrant youth have higher levels of the coping style withdrawal, especially in emotion regulation and resignative withdrawal. The ability to reflect on the solution of future-related stressors is quite high in both groups. Worries about the increasing destruction of the environment are more important for German youth, while migrant youth care more about how they should reconcile work and family life later.

"It is like a mind attack": stress and coping among urban school-going adolescents in India

BACKGROUND

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.

METHODS

Focus 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.

RESULTS

Proximal 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.

CONCLUSIONS

The 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.

Perceived stress and reference ranges of hair cortisol in healthy adolescents

Background

Chronic stress during adolescence has usually been evaluated through subjective measures, leaving aside objective measures such as hair cortisol concentrations. Therefore, the aim of this study was to provide reference ranges for hair cortisol concentrations by sex and age and to study the relationship between subjective and objective measures of stress and temporal stability.

Methods

The participants were 170 adolescents aged between 12 and 14 years (mean = 12.78 years; standard deviation = 0.71 years; 52.40% girls) who completed the Perceived Stress Scale 4 and had their hair sampled.

Results

The results revealed hair cortisol concentrations ranging from 0.07 pg/mg to 9.54 pg/mg. Subjective and objective measures of stress were not related, nor was there intraindividual stability of the hair cortisol concentrations. Girls had higher hair cortisol concentrations, and there were no age differences.

Conclusions

This research provides cortisol reference values for adolescents that will allow the early detection of chronic stress. Such detection methods make it possible to prevent problems arising from stress because we can act more quickly and the treatments will be more effective. The study suggests that there is no relationship between perceived and objective stress; while perceived stress remained stable, the levels of hair cortisol were increased at 6 months. Despite the interesting findings of the study, there are some limitations: the sample was not obtained through probabilistic sampling, the age range was narrow, and some demographic, anthropomorphic and clinical factors are missing, which make the generalization of results difficult.

Coping styles in youth exposed to maltreatment: Longitudinal patterns reported by youth in foster care

Coping styles in youth living in foster care with a history of maltreatment were examined to determine the nature and stability of self-reported coping behavior over time. Participants included 542 (time 1), 377 (time 2), and 299 (time 3) youth ages 8-22 years (M=13.28years, SD=3.04). Using the Behavioral Inventory of Strategic Control, a dimensional, continuous measure of coping, across four possible coping styles endorsed in reference to specific potentially stressful situations, the results indicated that direct action coping was the most frequently endorsed or preferred style for more than 50% of the sample at each time point. A number of youth endorsed using more than one coping style, indicating some flexibility in the approach to coping when problems occur. Although most youth endorsed a preferred style, coping style endorsed did vary somewhat over time. The coping style endorsed also varied depending on the type of problem referenced, but no statistically significant differences were noted across situations, including social, academic, general, and foster-specific situations. Effects for age were also examined and the results indicated no significant differences across the age range for type of coping most commonly endorsed. The present study is the first large-scale, longitudinal assessment of coping styles in youth in foster care and the results suggest that coping is not a simple, categorical-only construct and the implications for the endorsement of the direct approach for youth in foster care along with the other findings are discussed.

The Role of Perceived Stress and Self-Efficacy in Young People's Life Satisfaction: A Longitudinal Study

Life satisfaction is an important indicator of successful development. However, adolescents' life satisfaction tends to be relatively unsteady, and environmental influences play a critical role in shaping life satisfaction among adolescents in the transition to young adulthood. Given the paramount importance that education plays in adolescents' lives, adolescents' life satisfaction may vary as a function of school-related stress experience. At the same time, coping resources may help reduce adverse effects of stress on life satisfaction. With this in mind, we examined whether, and to what extent, perceived stress in education and general self-efficacy (a resource that facilitates coping) affect the life satisfaction of adolescents in transition to young adulthood. We distinguished between baseline levels of stress and self-efficacy and within-person change in stress and self-efficacy to determine whether life satisfaction is sensitive to fluctuations in stress and self-efficacy when person-specific levels of stress and self-efficacy are taken into account. Estimating growth curve models on data from a panel study on the life trajectories of compulsory-school leavers (n = 5126, 55.3 % female), we found that baseline levels of stress and self-efficacy, as well as within-person change in stress and self-efficacy, affected adolescents' life satisfaction. Moreover, our results showed that baseline self-efficacy mitigated the negative effect of baseline stress on life satisfaction. These findings improve our understanding of two major psychological determinants of adolescents' life satisfaction and extend our knowledge of life satisfaction trajectories during the transition to young adulthood.

Stress and the adolescent brain: Amygdala-prefrontal cortex circuitry and ventral striatum as developmental targets

Adolescence is a time in development when significant changes occur in affective neurobiology. These changes provide a prolonged period of plasticity to prepare the individual for independence. However, they also render the system highly vulnerable to the effects of environmental stress exposures. Here, we review the human literature on the associations between stress-exposure and developmental changes in amygdala, prefrontal cortex, and ventral striatal dopaminergic systems during the adolescent period. Despite the vast differences in types of adverse exposures presented in his review, these neurobiological systems appear consistently vulnerable to stress experienced during development, providing putative mechanisms to explain why affective processes that emerge during adolescence are particularly sensitive to environmental influences.

Evaluation of coping strategies in established rheumatoid arthritis patients: emergence of concealment in an Asian cohort

AIM

To evaluate coping strategies of Asian RA patients and their associations with health-related quality of life (HRQoL).

METHODS

A cross-sectional sample of patients with established RA was evaluated using measures of coping (Coping in Rheumatoid Arthritis Questionnaire [C-RAQ]; appraisal of coping effectiveness and helplessness), HRQoL (Mental and Physical Components [MCS/PCS] of the Short Form 12v2; Rheumatoid Arthritis Impact of Disease score [RAID]) and clinical/laboratory assessments. Principal component analysis was conducted to identify coping strategies. Multiple linear regression analyses were performed to evaluate the associations between coping strategies and HRQoL outcomes.

RESULTS

The study sample comprised 101 patients, 81% female, 72.3% Chinese, mean age 54.2 ± 12.6 years. Five coping strategies were identified: Active problem solving (E = 5.36), Distancing (E = 2.30), Concealment (E = 1.89), Cognitive reframing (E = 1.55) and Emotional expression (E = 1.26). Concealment was consistently associated with PCS (r_s = -0.23, P = 0.049), MCS (r_s = -0.24, P = 0.04) and RAID (r_s = 0.39, P < 0.001), and was significant in the multivariate model to explain lower disease-specific HRQoL (RAID) even after adjusting for disease activity, coping effectiveness and helplessness (β = 0.20, P = 0.04). Emotional expression was associated with poorer physical HRQoL (PCS), after adjusting for disease severity, body mass index, coping effectiveness, helplessness and Concealment (β = -0.39, P < 0.001). Perceived coping-related helplessness was significant in multivariate correlates for PCS (β = -0.25, P = 0.036), MCS (β = -0.29, P = 0.02) and RAID (β = 0.53, P < 0.001), after adjusting for covariates.

CONCLUSION

Concealment and Emotional expression are associated with lower disease-specific HRQoL and physical HRQoL respectively, with the former coping strategy likely to be culture-specific. Interventions should tailor psychosocial support needs to address not only coping strategies, but patients' perception of their coping.

Handling Demands of Success Among Girls and Boys in Primary School: A Conceptual Model

Stress among adolescents in Western societies is becoming an issue of increasing concern, and the global trend of adolescents' health shows a gradual deterioration that is independent of national differences and increases with age. The aim of this study was to explore the main concern of adolescents and about how they cope with demands in everyday life. Participants were 14-16 years old, and data were collected from three sources. A constructivist grounded theory was used as a method for generating a model of the adolescents' description of how they cope with demands in their everyday lives. The main concern described by participants in this study was to strive to be successful and to succeed in the present and throughout their lives. We conclude that differences between girls and boys, in terms of coping with demands in their everyday lives, are important to consider in the development of health promotion initiatives targeted at adolescents.

Cross-country differences in basal and stress-induced cortisol secretion in older adults

Objective

Several studies have emphasized the association between socioeconomic status (SES) and inadequate response of the biological stress system. However, other factors related to SES are rarely considered, such as cultural values, social norms, organization, language and communication skills, which raises the need to investigate cross-country differences in stress response. Although some studies have shown differences in cortisol levels between immigrants and natives, there is no cross-country evidence regarding cortisol levels in country-native elders. This is particularly important given the high prevalence of stress-related disorders across nations during aging. The current study examined basal diurnal and reactive cortisol levels in healthy older adults living in two different countries.

Methods

Salivary cortisol of 260 older adults from Canada and Brazil were nalyzed. Diurnal cortisol was measured in saliva samples collected at home throughout two working days at awakening, 30 min after waking, 1400 h, 1600 h and before bedtime. Cortisol reactivity was assessed in response to the Trier Social Stress Test (TSST) in both populations.

Results

Our results showed that even under similar health status, psychological and cognitive characteristics, Brazilian elders exhibited higher basal and stress-induced cortisol secretion compared to the Canadian participants.

Conclusion

These findings suggest that country context may modulate cortisol secretion and could impact the population health.

Predictor and Moderator Effects of Ego Resilience and Mindfulness on the Relationship Between Academic Stress and Psychological Well-Being in a Sample of Ghanaian College Students

This study examined the predictor and moderator effects of ego resilience and mindfulness on the relationship between academic stress and psychological well-being in a sample of Ghanaian college students ( N = 431). The results indicated that academic stress was positively associated with both anxiety and depression and that mindfulness and ego resilience were both negatively associated with anxiety and depression. Mindfulness buffered the positive relationship between academic stress and depression but not anxiety. In contrast, ego resilience buffered the positive relationship between academic stress and anxiety but not depression. Implications for the study’s findings are discussed and recommendations for future research are presented.

Monthly variation of United States pediatric headache emergency department visits

OBJECTIVE

The objective of this article is to determine the monthly variation of emergency department (ED) visits for pediatric headache. We hypothesized youth have increased headache-related ED visits in the months associated with school attendance.

METHODS

Using a United States representative sample of ED visits in the National Hospital Ambulatory Medical Care Survey from 1997 to 2009, we estimated number of visits associated with ICD-9 codes related to headache, migraine, status migrainosus, or tension-type headache in 5- to 18-year-olds. Age-stratified multivariate models are presented for month of visit (July as reference).

RESULTS

There was a national estimate of 250,000 ED visits annually related to headache (2.1% of total visits) in 5- to 18-year-olds. In 5- to 11-year-olds, the adjusted rate of headache-related visits was lower in April (OR 0.42, 95% CI 0.20, 0.88). In 12- to 18-year-olds, there were higher rates in January (OR 1.92, 95% CI 1.16, 3.14) and September (OR 1.64, 95% CI 1.06, 2.55).

CONCLUSIONS

In adolescents we found higher ED utilization in January and September, the same months associated with school return from vacation for a majority of children nationally. No significant reduction in the summer suggests that school itself is not the issue, but rather changes in daily lifestyle and transitions.

Coping mit Alltagsstress in verschiedenen Problembereichen

Fragestellung: In der Untersuchung klinisch auffälliger Jugendlicher fehlen bislang Studien zum Coping mit alltäglichen Stressoren im Vergleich zu gesunden Jugendlichen. Methodik: Klinisch auffällige Jugendliche mit verschiedenen Störungen (gemischten Störungen einschließlich Delinquenz, Sucht, Depression) wurden anhand des Coping across Situations Questionnaire ( Seiffge-Krenke, 1995 ) und einer gekürzten Version des Youth Self Report ( Achenbach, 1991 ) mit gesunden Jugendlichen verglichen. Ergebnisse: Die verschiedenen klinischen Gruppen (n = 469) zeigten spezifische Muster hinsichtlich ihres Copings. Die Gruppe der depressiven Jugendlichen zeigten insgesamt sehr geringe Werte im Coping. Die Gruppe aus den Einrichtungen der Suchthilfe hingegen bediente sich vor allem dysfunktionaler Copingstrategien. Die Jugendlichen aus Einrichtungen der Jugendhilfe (gemischte Störungen einschließlich Delinquenz) hatten sowohl in den dysfunktionalen als auch in den funktionalen Copingstrategien höhere Werte als die beiden anderen klinisch auffälligen Gruppen. Die Kontrollgruppe zeigte mehr funktionales und geringeres dysfunktionales Coping. Die klinisch auffälligen Jugendlichen differenzierten in ihrem Copingverhalten nicht in Abhängigkeit von den unterschiedlichen Problembereichen. Es zeigte sich des Weiteren ein geringer Geschlechtseffekt im Coping. Schlussfolgerungen: Klinisch auffällige Jugendliche waren nicht in der Lage adaptiv auf verschiedene Problembereiche zu reagieren, sondern wandten situationsübergreifend dysfunktionale Copingstrategien wie Rückzug und Problemmeidung an.

Growing up is hard: mental disorders in adolescence

BACKGROUND

Puberty brings on many biological, mental, and social changes. In this phase of life, the prevalence of serious mental disorders is about 10%.

METHODS

This review is based on a selective search for publications on the prevalence, causes, risk factors, and effects of mental disorders in adolescence.

RESULTS

Internalizing mental disorders are more common in girls; these include depression, social anxiety, and eating disorders. Their prevalence ranges from 12% to 23%, depending on the particular diagnostic instruments and criteria that are applied. Disruptive disorders, e.g., disorders of social behavior, are more common in boys, with a worldwide prevalence of approximately 5% to 10%. Marked differences between the sexes appear during puberty. The one-year prevalence of self-injurious behavior is about 14% in boys and 25% in girls. The consumption of legal and illegal drugs is one of the risk-seeking behaviors associated with adolescence.

CONCLUSION

In routine check-ups and medical office visits, particular attention should be paid to the possibility of a mental disorder. Special outpatient clinics for adolescents can help more young people avail themselves of the existing preventive and therapeutic measures. Early diagnosis and treatment may prevent mental disorders in adulthood and foster age-appropriate development.

Longitudinal study of daily hassles in adolescents in Arab Muslim immigrant families

This study investigated which daily hassles (i.e., parent, school, peer, neighborhood, and resource) were perceived by Arab Muslim immigrant adolescents as most stressful over a three-year time period and according to child's gender and mother's immigration status (i.e., refugee or non refugee). Data were collected at three time points during adolescence and analyzed using doubly multivariate analysis of covariance with linear and quadratic trends. School and parent hassles were greater than other hassles at every time point. Main effects of time, immigration status, and father's employment, but not child's gender, were statistically significant. School and parent hassles increased while peer and resource hassles decreased over time. Adolescents with refugee mothers reported greater school and neighborhood and fewer parent hassles than those with non refugee mothers. Adolescents with unemployed fathers reported significantly more school and neighborhood hassles. Study findings identify two at risk subgroups: those adolescents with refugee mothers and/or those adolescents with unemployed fathers; and pinpoint problematic daily hassles. Additional research is needed to explore vicarious trauma effects as a potential underlying reason for the pattern of daily hassles noted in adolescents with refugee mothers.

The neurobiological effects of stress on adolescent decision making

Relative to other developmental periods, adolescence is characterized by risky decision making, increased perceived stress and heightened reactivity to acute stress. It is also during this time that individuals undergo significant neurodevelopment in brain regions that process decision making and stress. In this review, we summarize what is currently known about stress during adolescence, how it impacts risky decision-making, and how acute stress may exert neurobiological effects on circuitry that subserves decision-making in the developing brain. We conclude by suggesting future research directions that may help the field gain traction on this important, but relatively understudied, question.