'Every day I worry about something': A qualitative exploration of children's experiences of stress and coping

Sources of Stress and Coping Strategies Among Urban African American Adolescents: A Qualitative Study of Child and Caregiver Perspectives

Early adolescence is a critical point for intervention to protect against negative consequences of stress on the developing brain. This study aimed to gather perspectives on stress from adolescents and their caregivers living in under-resourced Baltimore City neighborhoods. Nine African American adolescents and their caregivers (n = 18 total) participated in qualitative interviews exploring neighborhood environments, sources of stress, and coping behaviors. Neighborhood social cohesion was described as a strength of participants' communities, despite concerns about neighborhood safety. Caregivers were highly aware of their child's stressors and coping behaviors. School-related pressure was a prevalent source of stress emphasized by adolescents, along with social stress due to disrupted routines during the COVID-19 pandemic. Adolescents described frequent use of electronics to cope with stress, as well as self-care and relaxation techniques. Themes identified from these data can be used to inform future adolescent stress-reduction interventions and stress-prevention efforts in this priority population.

Associations between chronic stress and hair cortisol in children: A systematic review and meta-analysis

OBJECTIVES

This review systematically examined the associations between chronic stress and hair cortisol concentration (HCC) in children, and the potential modification effects of type, measurement period and scales of chronic stress, child age and sex, hair length and HCC measurement method, characteristics of study site, and congruence between time periods measured for chronic stress and HCC.

METHODS

Pubmed, Wed of Science, and APA PsycINFO were systematically searched for articles examining the association between chronic stress and HCC.

RESULTS

Thirteen studies from five countries with 1,455 participants were included in the systematic review and nine studies were included in the meta-analysis. Meta-analysis revealed that chronic stress was associated with HCC (pooled-r = 0.09, 95 % CI: 0.03, 0.16). Stratified analyses revealed that type, measurement time and scales of chronic stress, hair length and measurement method of HCC, and the congruence between time periods measured for chronic stress and HCC modified such correlations. The positive correlations between chronic stress and HCC were significant for studies measuring chronic stress as stressful life events, assessing chronic stress within the past six months, extracting HCC from 1 cm, 3 cm, or 6 cm of hair, measuring HCC by LC-MS/MS, or having congruence between time periods measured for chronic stress and HCC. The potential modifying effects of sex and country developmental status could not be concluded due to the limited number of studies included.

CONCLUSIONS

Chronic stress was positively correlated with HCC, varying by characteristics and measurements of chronic stress and HCC. HCC could be a biomarker for chronic stress among children.

Chinese school adolescents' stress experience and coping strategies: a qualitative study

BACKGROUND

Stress in adolescence is associated with adverse mental health outcomes. Coping resources have been proved by literature to have buffering effects on the impact of stress on mental health. It is imperative to understand the stress and coping strategies of adolescents. However, to date, there has been a scarce of qualitative examination of stress and coping strategies in adolescents in a Chinese population.

OBJECTIVES

This study aimed to understand the stress experience and coping strategies of high school students in China.

METHODS

This study adopted a qualitative design involving three focus group interviews. A purposive sampling method was used to recruit high school students who were enrolled in grades 10 to 11, and their teachers, at a Chinese high school which resulted in 20 students and 9 teacher participants. Data were analysed using inductive thematic analysis.

RESULTS

A total of 4 themes were identified: (i) sources of stress; (ii) impacts of stress (iii) coping strategies used by students; and (iv) recommendations for stress management programs. Students experienced excessive stress in their daily lives. The primary source of stress came from high expectations for academic achievement. Other sources of stress were peer relationships and family issues. The stress had negative impacts on students' emotions, sleep, study, and mental wellbeing. The students demonstrated various coping strategies, with the most common being avoidant coping. Students and teachers agreed that the coping strategies were not effective in reducing stress in the long run and that more coping skills training was needed.

CONCLUSIONS

This study is the first to assess the perceptions of Chinese high school students and their teachers regarding adolescent stress experiences and coping strategies. Chinese high school students experienced significant stress in their daily lives and demonstrated unhelpful coping strategies. Participants demonstrated consensus that they did not have the skills to cope. There is a demonstrated need for interventions that focus on increasing coping skills in this population.

The Perceived Stress Scale for Kids (PeSSKi): Initial development of a brief measure for children aged 7-11 years

Perceived stress, a known risk factor for poor health, has been extensively assessed in adult populations. Yet an equivalent assessment tool for measurement of global perceived stress in children is lacking. This study aimed to develop and provide initial validation of a scale to measure perceived stress in children aged 7-11 years. Using a two-phase design, we conducted semi-structured interviews with thirteen child-parent dyads for development of items. In a sample of 123 children (age range 7-11 years, Mage = 9 years 7 months, 54.5% male) we administered the resulting Perceived Stress Scale for Kids (PeSSKi). Exploratory factor analysis of the 10-item PeSSKi yielded support for both a one-factor and a two-factor solution (negative, positive item wording). The PeSSKi was associated positively with the Penn-State Worry Questionnaire for Children (r = 0.748, p < 0.001) and negatively with the Students' Life Satisfaction Scale (r = 0.381, p < 0.001) indicating strong convergent/divergent validity respectively. Girls showed higher scores on the PeSSKi than boys with no effects observed by age. Initial psychometrics suggest the PeSSKi provides a robust scale for assessment of perceived stress in children. Further validation is needed across different child populations, over time and with physical measures of stress and health outcomes.

The effect of life events, resilience, self-esteem, and coping styles on aggressive behavior among left-behind adolescents: Structural equation modeling

INTRODUCTION

Without parental support, left-behind adolescents are more likely than their peers to experience negative emotions and demonstrate aggressive behavior in the same frustrating situation. However, research on this subject has been sparse. To fill this gap and identify potential targets for intervention, this study sought to examine the relationships among factors influencing left-behind adolescents' aggressive behavior.

METHODS

A total of 751 left-behind adolescents were enrolled in a cross-sectional survey, with data collected using the Adolescent Self-Rating Life Events Checklist, Resilience Scale for Chinese Adolescents, Rosenberg Self-Esteem Scale, Coping Style Questionnaire, and Buss-Warren Aggression Questionnaire. The structural equation model was used for data analysis.

RESULTS

The results showed that left-behind adolescents reported higher levels of aggression. Further, the factors found to have a direct or indirect effect on aggressive behavior included life events, resilience, self-esteem, positive coping, negative coping, and household income. The results of confirmatory factor analysis indicated goodness of fit. In the face of negative life events, left-behind adolescents with high resilience, self-esteem, and positive coping were less likely to exhibit aggressive behavior (P < 0.05).

DISCUSSION

Left-behind adolescents can reduce their aggressive behavior by assuaging the adverse effects of life events via increased resilience and self-esteem as well as the adoption of positive coping strategies.

Women's Experiences of Symptoms of Suspected or Confirmed COVID-19 Illness During the Pandemic

OBJECTIVE

To explore experiences of symptoms of suspected or confirmed COVID-19 illness among women using the CovidWatcher mobile citizen science app.

DESIGN

Convergent parallel mixed-methods design.

PARTICIPANTS

Twenty-eight self-identified women consented for follow-up after using CovidWatcher. Participants' ages ranged from 18 to 83 years old.

METHODS

We collected data via semistructured, virtual interviews and surveys: the COVID-19 Exposure and Family Impact Survey and Patient-Reported Outcomes Measurement Information System measures. We used directed content analysis to develop codes, categories, themes, and subthemes from the qualitative data and summarized survey data with descriptive statistics.

RESULTS

We derived five themes related to symptom experiences: (a) Physical Symptoms, (b) Mental Health Symptoms, (c) Symptom Intensity, (d) Symptom Burden, and (e) Symptom Trajectories. Subthemes reflected more nuanced experiences of suspected or confirmed COVID-19 disease. For those without COVID-19, anxiety and mental health symptoms were still present. Of those who attested to one of the PROMIS-measured symptoms, all but one had at least mild severity in one of their reported symptoms.

CONCLUSION

This study demonstrates the cross-cutting impact of the COVID-19 pandemic on individuals who identify as women. Future research and clinical practice guidelines should focus on alleviating physical and mental health symptoms related to the ongoing pandemic, regardless of COVID-19 diagnosis. Furthermore, clinicians should consider how patients can use symptom reconciliation apps and tracking systems.

Definitions, theories, and measurement of stress in children

PROBLEM

Stress in children remains a complex concept to examine due to the inherent subjectivity and lack of specific manifestations, as well as the multiple ways stress can be defined and measured in children. Because stress is multifactorial,is experienced daily by children, and undergirds adolescent health and early mental illness, it is crucial to have a clear understanding of stress and the effects of stress in children from infancy through age twelve years.

ELIGIBILITY CRITERIA

To be included in this review, literature must pertain to and highlight theories, definitions/classifications, and measurements of stress in children from infancy to 12 years of age.

SAMPLE

The most pertinent articles identified through database searches (PubMed, Scopus, PsycINFO, CINAHL, Google Scholar), gray literature sources (e.g., child health websites), and reference lists of identified articles were included in this narrative overview.

RESULTS

The results of this review are organized by themes and include: classifications and definitions of stress, stress-related theories, and tools to measure stress in children.

CONCLUSIONS

Research addressing stressors and stress in children is limited, and there is wide variation in how researchers define and classify stress in children. Existing measures of stress in children younger than 12 address physiological, psychological, and observational components, but may be inconsistent and threaten validity of otherwise well-designed and well-executed studies.

IMPLICATIONS

Improving the understanding and accurate measurement of stress in children enables researchers and clinicians to curtail undesirable health outcomes.

The prevalent anxiety disorders among elementary students in Bandung, Indonesia

Background

Anxiety constitutes one of the most prevalent childhood mental health problems. It affects social functions, academic functions and increases the risk of mental health problems at the next stage of development among elementary school children. Besides, psychopathologic disorders in teenagers appear in form of emotional symptoms. Early anxiety screening is important for elementary students as anxiety disorders incur huge financial treatment costs, meanwhile, related data are needed to provide early and adequate interventions. This study is expected to be the basis for developing mental health programs at the elementary school level. Furthermore, aims to identify types of anxiety disorders among grade 4 and 5 students at the elementary level.

Design and Methods

The study was conducted using a quantitative method with a descriptive design. Meanwhile, the Screen for Child Anxiety Related Disorders (SCARED) model consisting of 41 questions was used, while the instrument's Reliability and Validity was 0.81 and 0.67 respectively. A total of 135 students from the private elementary schools participated in this study.

Results

Among the 135 elementary students aged 10 to 11, 48.9% were males while 51.1% were females, 79.3% had anxiety consisting of generalized anxiety 40%, panic disorder 48.1%, separation anxiety 40%, social anxiety 65.9%, while 28.9% experienced school avoidance.

Conclusions

Based on the results, health workers, teachers and parents need to work together to manage anxiety in elementary students. In addition, nurses as health workers at community primary health need to work together with counselling and guidance teachers to provide preventive and promotive interventions through the school's mental health services.

A Focus Group Interview Study of the Experience of Stress amongst School-Aged Children in Sweden

The study explored experiences of stress in children aged 10–12. An inductive qualitative design was used. Ten focus group interviews were conducted with Swedish schoolchildren (n = 42) aged 10–12. The interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. The study identified one theme—“Body and mind react”—and three subthemes: (1) Friendships matters, (2) Parental stress affect, and (3) Trying to do my best. Stress often occurred in the children’s everyday environment. The children had experienced how stress could be expressed both physically and mentally, inside and outside school. The children also had the experience of seeing people in their environment being stressed, which could create feelings that affected the children. The experience of the children was also that stress can sometimes be good. Stress related to peers, family, school, and society was commonly experienced by children aged 10–12. Both positive and negative stress was reported.