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Cheah YK, Kee CC, Lim KK, Cheong YL. Demographic, lifestyle, social, and psychological factors associated with worry-related sleep problems among school-going adolescents in Timor-Leste. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12468. [PMID: 38654575 DOI: 10.1111/jcap.12468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Adolescent sleep problems are a worldwide public health issue. The present study examines factors associated with worry-related sleep problems among school-going adolescents. The country of interest is Timor-Leste, a low-income country, where studies pertaining to adolescent sleep problems are lacking. DESIGN AND MEASURES Data were analysed from the Global School-Based Student Health Survey Timor-Leste (n = 3455). An ordered probit model was used to assess the effects of demographic, lifestyle, social, and psychological factors on different levels of worry-related sleep problems (i.e., no, mild and severe sleep problems). RESULTS School-going adolescents were more likely to face mild or severe worry-related sleep problems if they were older, passive smokers, alcohol drinkers and moderately active. School-going adolescents who sometimes or always went hungry were more likely to experience worry-related sleep problems than those who did not. Involvement in physical fights, being bullied, and loneliness were positively associated with the probability of having modest or severe worry-related sleep problems. CONCLUSION Age, exposure to second-hand smoke, alcohol consumption, physical activity, going hungry, physical fights, being bullied and loneliness are the important determining factors of adolescent worry-related sleep problems. Policymakers should pay special attention to these factors when formulating intervention measures.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Kuang Kuay Lim
- Centre for Occupational Health Research, Institute for Public Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Yoon Ling Cheong
- Special Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Malaysia
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Mahmood S, Siraji MA, Naher R, Arató N, Kaló Z. Psychometric validation of revised Olweus Bully/Victim Questionnaire (OBVQ-R) among adolescents in Bangladesh. Asian J Psychiatr 2023; 83:103514. [PMID: 36906995 DOI: 10.1016/j.ajp.2023.103514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND The assessment of bullying-related attributes is vital in developing anti-bullying intervention and prevention programs. The revised Olweus Bully/Victim Questionnaire (OBVQ-R) is one tool that has been widely used for this purpose. Thus, as we noticed a rising interest in research on bullying and there is a scarcity of proper psychometric tools to assess bullying-related attributes in Bangladesh, our study aimed to translate the OBVQ-R and test the psychometric properties of the Bangla version of this questionnaire on a large Bangladeshi adolescent sample. METHOD In Bangladesh, we collected data from grade 8-10 students (N = 567, 309 females, 258 males, AgeMean±SD=15.12 ± 0.81). The participants completed Bangla OBVQ-R, Beck Youth Inventory (BYI), and Children's Revised Impact of Events Scale-13 (CRIES-13). RESULTS The item response theory (IRT) analysis discarded five items and retained 15 items (Victimization=8, Perpetration=7). Both subscales had items with high discrimination (Victimization: 3.14 ± 0.67; Perpetration: 3.40 ± 1.04). Confirmatory factor analysis supported a correlated two-factor model (CFI=0.99; TLI=0.99). Both subscales (Victimization and Perpetration) and the 15-item full scale exhibited satisfactory reliability (>0.80). In line with our predictions, both subscales demonstrated significant positive correlations with BYI and CRIES-13, indicating satisfactory concurrent validity. CONCLUSION The results of the psychometric analyses supported the reliability and validity of the 15-item Bangla-version OBVQ-R to assess bullying involvement. Hence, this new, adapted measurement can facilitate further bullying research in Bangladesh and, thus, the development of prevention and intervention programs.
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Affiliation(s)
- Sabrina Mahmood
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE EötvösLoránd University, Budapest, Hungary; Department of Educational and Counselling Psychology, University of Dhaka, Bangladesh
| | - Mushfiqul Anwar Siraji
- Monash University, Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Malaysia; Intelligent Lighting Lab, Monash University, Malaysia
| | - Roufun Naher
- Department of Educational and Counselling Psychology, University of Dhaka, Bangladesh
| | - Nikolett Arató
- Institute of Psychology, ELTE EötvösLoránd University, Budapest, Hungary
| | - Zsuzsa Kaló
- Institute of Psychology, ELTE EötvösLoránd University, Budapest, Hungary.
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Bao W, Qian Y, Fei W, Tian S, Geng Y, Wang S, Pan CW, Zhao CH, Zhang T. Bullying victimization and suicide attempts among adolescents in 41 low- and middle-income countries: Roles of sleep deprivation and body mass. Front Public Health 2023; 11:1064731. [PMID: 36908401 PMCID: PMC9992427 DOI: 10.3389/fpubh.2023.1064731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
Background Suicide is the fourth leading cause of death for adolescents, and globally, over 75% of completed suicides occur in low- and middle-income countries (LMICs). Bullying has been proven to be closely related to suicide attempts. However, further understanding of the mechanisms underlying the relationship between bullying and adolescents' suicide attempts is urgently needed. Methods We used data from the Global School-based Student Health Survey (GSHS) (2010-2017) from 41 LMICs or regions. This study was based on questions assessing bullying victimization, suicide attempts, sleep deprivation, and body mass. Chi-square tests were used to explore the correlations among the main variables. The mediating role of sleep deprivation and the moderating role of body mass index (BMI) were analyzed using PROCESS. Results The results showed a positive association between bullying victimization and suicide attempts. Sleep deprivation partially mediated the relationship between the frequency of being bullied and suicide attempts. In addition, sleep deprivation played a full or partial mediating role in the relationship between different types of bullying and suicide attempts. BMI moderated the relationships between the frequency of being bullied and suicide attempts, between being made fun of about one's body and sleep deprivation, and between sleep deprivation and suicide attempts. Conclusion Being bullied has a positive effect on suicide attempts, which is mediated by sleep deprivation and moderated by body mass. The results of this study are consistent with the stress-diathesis model of suicide, suggesting that being bullied is one of the stressors of suicide in adolescents, while sleep deprivation and body mass are susceptibility diatheses of suicide. The results are conducive to identifying adolescents at a high risk of suicide, suggesting that there is a need to pay more attention to bullied adolescents, especially their sleep quality and body mass, and design effective intervention measures to improve the current situation of adolescent suicide in LMICs.
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Affiliation(s)
- Wenxin Bao
- School of Public Health, Medical College of Soochow University, Suzhou, China.,Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Qian
- School of Public Health, Medical College of Soochow University, Suzhou, China.,Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Wenjing Fei
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Shun Tian
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yiran Geng
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Shaishai Wang
- School of Public Health, Medical College of Soochow University, Suzhou, China.,Infectious Disease Control Division, Xiangcheng District Center for Disease Control and Prevention, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chun-Hua Zhao
- Department of General Medicine, Big Data Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, China
| | - Tianyang Zhang
- School of Public Health, Medical College of Soochow University, Suzhou, China
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Kearns JC, Kittel JA, Schlagbaum P, Pigeon WR, Glenn CR. Worry-related sleep problems and suicidal thoughts and behaviors among adolescents in 88 low-, middle-, and high-income countries: an examination of individual- and country-level factors. Eur Child Adolesc Psychiatry 2022; 31:1995-2011. [PMID: 34213638 DOI: 10.1007/s00787-021-01838-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/25/2021] [Indexed: 01/26/2023]
Abstract
A strong association between sleep problems and suicidal thoughts and behaviors (STBs) has been demonstrated in high-income countries. The sleep-STB relationship, however, is minimally understood among youth in low and middle-incomes countries. There also is a limited understanding of how individual- (i.e., age, sex) and country-level (i.e., economic inequality, economic quality) factors may moderate the magnitude of the sleep-STB association among youth. Data were analyzed from the cross-national Global School-based Health Survey 2003-2017, which assessed a range of health behaviors among school-enrolled adolescents aged 11-18 years from 88 low-, lower-middle, upper-middle, and high-income countries. Multilevel models were used to examine the influence of individual- and country-level factors on the association between past-year worry-related sleep problems and past-year suicide ideation, suicide plans, and suicide attempts. Worry-related sleep problems were significantly associated with suicide ideation, plans, and attempts. Adolescent sex, country economic quality (income group designation), and country economic inequality moderated the sleep-STB association, but age did not. The sleep-STB relationship was stronger for males and across macroeconomic indices, the relationship was generally strongest among upper-middle income countries (economic quality) and countries with a big income gap (economic inequality). When examining how individual-level factors differentially affected the sleep-STB relationship within economic quality (income group designation), the effects were driven by older adolescents in high-income countries for suicide ideation and suicide plans. Study findings suggest an important role for global macroeconomic factors, for males, and older adolescents in high-income countries in the sleep-STB relationship. Future directions include expanding worldwide coverage of countries, assessing a wider range of sleep problems, and longitudinal work to understand potential mechanisms in the sleep-STB relationship.
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Affiliation(s)
- Jaclyn C Kearns
- Department of Psychology, University of Rochester, 180 Meliora Hall, Box 270266, Rochester, NY, 14627, USA.
| | - Julie A Kittel
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Paige Schlagbaum
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Wilfred R Pigeon
- VA Center for Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, NY, USA.,Sleep and Neurophysiology Research Lab, University of Rochester Medical Center Rochester, Rochester, NY, USA
| | - Catherine R Glenn
- Department of Psychology, Old Dominion University, Norfolk, VA, USA.,Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
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Dreher A, Yusuf R, Ashraf H, Ahmed SAKS, Strümpell C, Loerbroks A. Social stressors and social resources at work and their association with self-reported health complaints among ready-made garment workers in Bangladesh: a cross-sectional study. BMC Public Health 2022; 22:1793. [PMID: 36131265 PMCID: PMC9492303 DOI: 10.1186/s12889-022-14173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bangladesh is one of the world's largest garment exporters. Physical working conditions of garment workers are precarious and known to largely affect their health. Research on garment workers' psychosocial working conditions, however, is scarce. We aimed to quantify psychosocial working conditions of garment workers and possible associations with workers' health. METHODS We conducted a cross-sectional survey among 1,118 ready-made garment (RMG) workers in labor colonies in Dhaka, Bangladesh, in February 2021. Descriptive analyses were performed to characterize social stressors (e.g., being bullied at work, poor leadership) and social resources at work (e.g., receiving support at work, vertical trust between management and employees, beneficial leadership) and workers' health (self-reported overall health and 10 specific health complaints). To examine links of social stressors and social resources with self-reported health outcomes we ran multivariable Poisson regression models yielding prevalence ratios (PR) and 95% confidence intervals (CI). RESULTS We found low to moderate levels of workplace bullying and high levels of poor leadership (i.e., supervisors not caring about workers' problems). We also found high levels of social support, vertical trust and beneficial leadership (i.e., supervisors taking decisions free of bias). Garment workers frequently suffered from health complaints, first and foremost headache (68.3%), cold (55.3%), and back pain (50.7%). Health outcomes were poorer among workers who reported to be bullied at work versus not bullied (e.g., PR 1.55 [95% CI 1.32-1.92] for poor self-reported health when bullied by colleagues) and health was better among those reporting to feel supported versus unsupported (e.g., PR 0.61 [0.52-0.71] for poor self-reported health when supported by supervisor). Perceived vertical trust between workers and management was weakly associated with better health. Leadership behavior did not display a consistent pattern. CONCLUSIONS Our findings suggest that working conditions of RMG workers are rather good (e.g., characterized by low levels of bullying and high levels of support, vertical trust and beneficial leadership). The majority of workers reported good or very good health, although health complaints were frequently mentioned, first and foremost headache, cold, and back pain. Associations between psychosocial working conditions and health indicate worse working conditions being associated with poorer health.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rita Yusuf
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Plot #16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka, 1229, Bangladesh
| | - Hasan Ashraf
- Department of Anthropology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Syed A K Shifat Ahmed
- International Center for Biotechnology and Health (ICBH), Center for Health Population and Development (CHPD), Independent University, Plot #16, Block B, Aftabuddin Ahmed Road, Bashundhara R/A, Dhaka, 1229, Bangladesh
| | - Christian Strümpell
- Institute of Social and Cultural Anthropology, University of Hamburg, Edmund-Siemers-Allee 1, West, 20146, Hamburg, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
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Srinivasan SP, Arumugam C, Rangeela E, Raghavan V, Padmavati R. Bullying among children and adolescents in the SAARC countries: A scoping review. Heliyon 2022; 8:e09781. [PMID: 35815144 PMCID: PMC9257344 DOI: 10.1016/j.heliyon.2022.e09781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/02/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Bullying is defined as repetitive and intentional aggression by an individual or group towards other individuals that happens in a power differential between the individuals being bullied and the bullies. There is increasing recognition of how bullying occurs among children and adolescents and its long-term effects. There is a dearth of research on bullying from the Lower- and Middle-Income Countries (LMIC). This scoping review focused on the research from the South Asian Association for Regional Cooperation (SAARC) nations that share a common history, similar demographics, and socio-cultural background. Methodology Various databases were searched using specific search terms and articles reviewed from the past 5 years. Results Of 194 articles identified, 53 met the criteria for inclusion in the review. There is a wide variation in the number of studies done across the SAARC nations. The prevalence of bullying victimization ranged from 4.1% to 95% and from 16 to 85% for perpetration. Only 3 interventions conducted in India and Pakistan showed some efficacy of play, the teaching of skills and multicomponent interventions to deal with bullying, each made culturally relevant. Discussion This review highlights the lacunae in the research conducted on bullying in the Indian sub-continent. It also highlights the need for contextually appropriate definitions, long term effects on the health and well-being of bullying, and socially appropriate interventions to address bullying.
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Geographical variations in the association between bullying victimization and sleep loss among adolescents: a population-based study of 91 countries. Sleep Med 2021; 90:1-8. [PMID: 35051736 DOI: 10.1016/j.sleep.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 11/09/2021] [Accepted: 12/24/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine geographical variations in the association between bullying victimization and sleep loss over worry among adolescents. METHODS We used data from the Global School-based Student Health Survey conducted between 2003 and 2017 in 91 countries across the globe. Sleep loss was categorised as: none/minimum (reported never or rarely sleep loss), moderate (reported sometimes), and severe (reported most of the time or always). We obtained country-specific estimates from multiple multinomial logistic regression analyses and pooled estimates from meta-analyses. RESULTS Of 282,036 adolescents 13-17 years of age, 28.1% (male: 25.4%, female: 31.0%) and 8.4% (male: 7.3%, female: 9.5%) of adolescents reported moderate and severe sleep loss respectively. Adolescents who frequently experienced bullying (≥3 per 30 days) reported higher prevalence of severe sleep loss. Meta-analyses showed that increased frequency of bullying victimization is associated with increased odds of sleep loss, with adolescents who experienced bullying for ≥3 days in the past 30 days were 1.65 and 2.65 times more likely than adolescents without being bullied to experience respectively moderate (OR 1.65, 95% CI: 1.59-1.72) and severe (OR 2.65, 95% CI: 2.52-2.79) sleep loss. Irrespective of sex, the association between bullying victimization and sleep loss was significant in all regions, income groups, and in all but a few countries. CONCLUSIONS Increased frequency of bullying victimization is positively associated with increased sleep loss among adolescents. Appropriate policies and programmes to stop bullying at school could help downgrade the risk of sleep loss among adolescents.
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Dos Santos AT, Soares FC, Lima RA, Dos Santos SJ, Silva CRDM, Bezerra J, de Barros MVG. Violence and psychosocial stress: A 10-year time trend analysis. J Affect Disord 2021; 295:116-122. [PMID: 34419779 DOI: 10.1016/j.jad.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
AIM The aim of this study was to analyze the temporal trend of psychosocial stress and its association between exposure to violence in adolescents. METHODS This is a cross-sectional study of temporal trends based on three school-based and statewide surveys with regular intervals of five years. The target population consisted of high school students from public schools. A total of 4,207 adolescents were evaluated in 2006, 6,264 in 2011, and 6,002 in 2016. The psychosocial stress indicator was the dependent study variable and was analyzed according to questions: a) Feeling of loneliness; b) Feeling of sadness; c) Difficulty sleeping due to worry; d) Number of close friends; e) Suicide ideation. Exposure variables were exposure to physical violence, involvement in fights and bullying. Logistic and linear regressions were used to verify the temporal trend of psychosocial stress, and to analyze the association between exposure of violence and psychosocial stress. RESULTS Regardless of gender, the psychosocial stress score increasing trend between 2006 and 2016. The girls showed a variation in the feeling of loneliness from 18.7% to 22.8%, and suicide ideation increased from 10.4% to 14.2% between 2006 and 2016. All types of violence were associated with greater psychosocial stress for both boys and girls. CONCLUSION Adolescents had a higher prevalence of feelings of loneliness, difficulty sleeping due to worry and suicide ideation during the period from 2006 to 2016, regardless of gender. Exposure to violence is associated with psychosocial stress in both genders, however, the strongest associations occurred in girls.
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Affiliation(s)
| | - Fernanda Cunha Soares
- Research Group on Lifestyles and Health, University of Pernambuco, Recife, Brazil; Department of Dental Medicine, Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, Stockholm, Sweden.
| | - Rodrigo Antunes Lima
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | | | - Jorge Bezerra
- Research Group on Lifestyles and Health, University of Pernambuco, Recife, Brazil
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Pengpid S, Peltzer K. Prevalence of anxiety-induced sleep disturbance and associated factors among a national sample of in-school adolescents in Benin. JOURNAL OF PSYCHOLOGY IN AFRICA 2020. [DOI: 10.1080/14330237.2020.1842395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
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Pengpid S, Peltzer K. Prevalence of Worry-Induced Sleep Disturbance and Associated Factors among a National Sample of In-School Adolescents in Lebanon. Behav Sci (Basel) 2020; 10:bs10100148. [PMID: 32992487 PMCID: PMC7600147 DOI: 10.3390/bs10100148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 01/11/2023] Open
Abstract
Persistent worry can cause significant distress among adolescents. The goal of this study was to estimate the prevalence and correlates of worry-induced sleep disturbance (WISD) among adolescent school children in Lebanon. Cross-sectional, nationally representative data were analysed from 5849 adolescents (15 years median age) that took part in the "2017 Lebanon Global School-Based Student Health Survey (GSHS)". The results indicate that the prevalence of WISD was 14.7%, 9.6% among males and 17.2% among females. In adjusted logistic regression analysis, loneliness, older age, female sex, having no close friends, infrequent bullying victimization, parents disrespected privacy, current tobacco use, ever cannabis use, high leisure-time sedentary behaviour and having sustained multiple serious injuries (past year) were associated with WISD. In addition, in unadjusted analysis, mostly or always feeling hungry (or low economic status), school truancy, having been physically attacked, frequently being in physical fights (past year), low peer support, parental emotional neglect, parents never checking homework, ever drunk and frequent soft drink intake were positively, and infrequent fast food intake was negatively, associated with WISD. One in seven students reported WISD and several associated factors were identified, which can aid intervention strategies. Multi-level interventions are needed targeting psychosocial distress, social-environmental factors and health risk behaviours to prevent WISD in this adolescent school population.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand;
- Department of Research Administration and Development, University of Limpopo, Sovenga 0727, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Correspondence:
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