The association between stress, self-esteem and depressive symptoms in adolescents

The association between academic pressure and adolescent mental health problems: A systematic review

BACKGROUND

Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised.

METHODS

We conducted the first systematic review of the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adolescents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was prospectively registered with PROSPERO (CRD42021232702).

RESULTS

We included 52 studies. Most studies assessed mixed anxiety and depressive symptoms (n = 20) or depressive symptoms (n = 19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome.

LIMITATIONS

Most studies were cross-sectional (n = 39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences.

CONCLUSIONS

We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school- and policy-based interventions.

FUNDING

UCL Health of the Public; Wellcome Institutional Strategic Support Fund.

Understanding Perceived Stress in Adolescent Inflammatory Bowel Disease

Background

Inflammatory bowel disease (IBD) is a chronic and debilitating illness associated with psychosocial comorbidities. Adolescents are vulnerable to the additive stress of managing IBD and navigating developmental milestones. Psychosocial factors, such as catastrophizing, illness stigma, illness uncertainty, and illness-related shame, often contribute to perceived stress in chronic illnesses. However, the combination of these variables on perceived stress in adolescents with IBD has not been examined.

Methods

Participants completed a cross-sectional online self-report survey. Model 4 of PROCESS Macro in SPSS was used to test the parallel mediation model of the relationship between disease severity and perceived stress using catastrophizing, stigma, uncertainty, and shame as mediators using 10,000 bootstrap samples. T-tests were run to assess systematic differences in the dependent variable between subjects.

Results

One hundred and thirty-one adolescents (Mage = 18.95 years; 100 females) completed the survey. Females had higher stress scores than males (P =0.002), and there were no difference in stress between younger and older participants (P = 0.085), location (P = 0.484), or IBD type (P = 0.515). The total effect of disease stress on perceived stress operating through the mediators was significant, b = 0.168, SE = 0.028, 95% CI [0.112, 0.224]. Helplessness catastrophizing, illness uncertainty, and illness-related shame, but not illness stigma, were equally strong, positive mediators.

Conclusions

The present results suggest that helplessness catastrophizing, illness uncertainty, and illness-related shame are central elements to target in stress interventions for adolescents with IBD.

Association between loneliness, self-esteem and outcome of life satisfaction in Norwegian adolescents aged 15-21

AIMS

Adolescence is an important developmental stage for understanding the role of perceived loneliness and self-esteem on life satisfaction. This study investigated the association between loneliness, self-esteem and the outcome of life satisfaction, as well as potential interaction effects in association with life satisfaction, in a sample of Norwegian adolescents.

METHODS

The study was based on a cross-sectional sample of 1816 adolescents aged 15-21 years. Data were collected in September 2016. The participants reported scores on the five-item Satisfaction with Life Scale, the 10-item Rosenberg Self-Esteem Scale and one item assessing loneliness. Control variables included sex, age, perceived family economy, parents' education, place of birth and perceived bullying. The data were analysed with descriptive and multiple linear regression analysis.

RESULTS

A significant negative and moderately strong association was found between loneliness and life satisfaction, where the association was stronger for girls than for boys. Self-esteem showed a significant positive and strong association with life satisfaction; however, no significant interaction effect was found.

CONCLUSIONS

The findings show the significant role of both loneliness and self-esteem in association with adolescents' perception of life satisfaction. The findings support promoting self-esteem, belongingness and social integration in all daily life contexts for adolescents to support their life satisfaction.

An examination of the moderating role of growth mindset in the relation between social stress and externalizing behaviors among adolescents

INTRODUCTION

Experiencing elevated stress increases the risk of further difficulties in mental health, including externalizing behaviors in adolescents. There is a need for understanding the factors that help adolescents mitigate social stress to prevent problematic externalizing behaviors. Growth mindset has been found to be a promising protective factor in adolescent development including mental health. This study aimed to examine the potential buffering role of growth mindset of thoughts-emotion-and-behaviors in the context of two types of social stress (i.e., family and peer) to reduce externalizing behaviors among adolescents.

METHODS

The sample is composed of 399 adolescents (age range 14-18 years, M = 16.22, SD = 1.21; 56.4% female, 42.3% male, 1.3% gender-nonconforming or variant) from a large, urban, diverse high school in the United States. Adolescent self-reports were administered at one time.

RESULTS

Moderation analyses revealed that growth mindset of thoughts, emotion, and behaviors moderate the association between family stress and externalizing behaviors. The magnitude of this association weakened as the level of growth mindset increased, supporting the buffering effect of the moderator. Neither the moderation effect of growth mindset nor the main effects of peer stress and growth mindset were significant in predicting externalizing behaviors.

CONCLUSION

Taken together, the findings suggested that growth mindset has protective effects in reducing externalizing behaviors when adolescents experience family stress. Future directions and implications are discussed.

Social Adaptation in Context: The Differential Role of Religiosity and Self-Esteem in Vulnerable vs. Non-vulnerable Populations - A Registered Report Study

There is evidence that religiosity and self-esteem are positively related, while self-esteem and religiosity in turn predict successful social adaptation. Moreover, self-esteem has been shown to be directly related to social adaptation in vulnerable contexts. In this registered report study, we tested the hypothesis that religiosity has a positive influence on social adaptation for people living in vulnerable contexts and that self-esteem is a mediator of this relationship. Evidence from this study indicates that neither there is any effect of religiosity on social adaptation nor on self-esteem, independent of whether people live in vulnerable contexts or not.

Secondhand Smoking and Depressive Symptoms Among In-School Adolescents

INTRODUCTION

Smoking has been linked with depressive symptoms in adolescents, but data on secondhand smoking and depressive symptoms in low- and middle-income countries are scarce. Thus, this study analyzes the association between secondhand smoking and depressive symptoms among in-school adolescents from 22 low- and middle-income countries.

METHODS

Data from the 2003-2008 Global School-Based Student Health Survey were analyzed in June 2019. Data on past-week exposure to secondhand smoke and past-year depressive symptoms were collected. The association between secondhand smoke and depressive symptoms was studied using multivariable logistic regressions and meta-analyses.

RESULTS

The sample consisted of 37,505 adolescents aged 12-15 years who never smoked. The prevalence of depressive symptoms increased from 23.0% in adolescents with no secondhand smoking to 28.9% in those with secondhand smoking every day in the past week. After adjusting for sex, age, food insecurity, and country, there was a dose-response relationship between secondhand smoking and depressive symptoms in the overall sample (0 days: reference; 1-2 days: OR=1.06, 95% CI=0.95, 1.18; 3-6 days: OR=1.38, 95% CI=1.20, 1.58; 7 days: OR=1.63, 95% CI=1.44, 1.86). The country-wise analysis showed that secondhand smoking on at least 3 days (versus <3 days) in the past week was associated with a 1.48-fold increase in the odds of depressive symptoms (95% CI=1.39, 1.59), with a low level of between-country heterogeneity (I²=4.2%).

CONCLUSIONS

There was a positive association between secondhand smoking and depressive symptoms among in-school adolescents from low- and middle-income countries. Further research should investigate causality and assess whether prevention of exposure to secondhand smoke can have a positive effect on the mental well-being of adolescents.

Exploring the Influence of Self-Efficacy, School Context and Self-Esteem on Job Burnout of Iranian Muslim Teachers: A Path Model Approach

This study tested the influence of self-efficacy, school context and self-esteem on job burnout of Iranian Muslim teachers. Job burnout was taken to be composed of three components: emotional exhaustion, depersonalization and personal accomplishment. A sample of 212 secondary school teachers completed a packet of scales that measure self-efficacy, school context, self-esteem and job burnout. The relationships between the variables were examined via path analysis. Path analysis showed self-efficacy to have a significant direct negative effect on depersonalization (β = - 0.25, p < 0.01) and reduced personal accomplishment (β = - 0.31, p < 0.01). School context had a significant direct effect on emotional exhaustion (β = - 0.36, p < 0.01), depersonalization (β = - 0.23, p < 0.01) and reduced personal accomplishment (β = - 0.17, p < 0.01). Self-esteem had a significant direct effect on emotional exhaustion (β = - 0.36, p < 0.01), depersonalization (β = - 0.15, p < 0.01) and reduced personal accomplishment (β = - 0.26, p < 0.01). The proposed model explained 47% of total variance of "emotional exhaustion," 28% of "depersonalization" and 54% of "reduced personal accomplishment."

Temperament and Sense of Coherence: Emotional Intelligence as a Mediator

Sense of coherence (SOC) reflects an individual’s capacity and available resources to deal with stressful situations. For some time now studies have revealed that people differ in their experience of SOC; yet, very little is known about how and through which mechanisms a high level of SOC is formed. In order to increase our understanding about the paths to a high SOC in the stage of adulthood, we focused on exploring the role both of temperament, as it has been confirmed as a potential component in the development of more complex traits that emerge later in life, and of emotional intelligence (EI) as it has been found to increase SOC. The sample consisted of 173 participants between 18 and 49. We used the Temperament Evaluation of Memphis, Pisa and San Diego Autoquestionnaire (TEMPS-A), Orientation to Life Questionnaire (OLQ), and Emotional Intelligence Questionnaire (INTE). Results showed a negative correlation between the depressive, cyclothymic, irritable, and anxious dimensions of temperament and SOC, and EI. There was also a positive correlation between hyperthymic temperament and SOC, and EI. EI correlated positively with a general sense of coherence and its three dimensions. The PROCESS macro for SPSS showed that emotional intelligence mediates the relationship between depressive, cyclothymic, hyperthymic, irritable and anxious temperament, comprehensibility, manageability, meaningfulness, and global orientation to life. On the basis of the obtained outcomes, it can be stated that emotional intelligence mediates the relationship between dimensions of temperament and dimensions of SOC.

Effects of self-esteem and stress on self-assessed health: a Swiss study from adolescence to early adulthood

PURPOSE

A large literature shows important effects of self-esteem and stress on mental and physical health in young adulthood. Negative life events are one type of stressor associated with poor health, but it is less clear whether more neutral stressors are also associated with poor health. This study contributes to the existing literature by investigating the association between different types of stressful life events, self-esteem, and health during the transition from adolescence to early adulthood in Switzerland.

METHODS

We draw on the "Transitions from Education to Employment" (TREE) panel study, a nationally representative longitudinal survey of a cohort of Swiss young adults, using logistic regression analysis. The study includes eight waves over a 10-year period, from 2001, average age 16, to 2010, average age 26. Our dependent variable is a dichotomized health self-assessment, and key independent variables include self-esteem and three measures of cumulative significant life events (SLEs): total cumulative SLEs, cumulative negative SLEs, and cumulative neutral SLEs.

RESULTS

Self-esteem had a significant positive impact on health, whereas cumulative SLEs had a significant negative impact. Negative SLEs had a larger negative impact than total SLEs, and neutral SLEs had a smaller impact. Considered individually, negative SLEs were more likely to have a significant negative impact on health.

CONCLUSIONS

In addition to their known influence on mental health, stress and self-esteem are important factors influencing individuals' general health, even in adolescence and young adulthood. While all types of stressors have a negative impact on health, the negative stressors seem to have more prominent effects than neutral stressors.

Latent profiles of stress and their relationships with depression and problematic Internet use among college freshmen

As noted in previously published literature, college students frequently experience academic stress, financial stress, and the stresses caused by intimate, peer, and parent-adolescent relationships. The present study uses latent profile analysis to identify stress profiles based on the aforementioned five stressors among 430 college freshmen. Thereafter, we compare the levels of depression and problematic Internet use (PIU) among the different profile groups and investigate whether background variables could predict each latent stress group. Three latent groups were labelled as follows: Ordinary (n = 257, 59.77%); all moderate-high (n = 98, 22.79%); and college-life moderate-high (n = 75, 17.44%). Compared with the ordinary group, the all moderate-high and college-life moderate-high groups displayed significantly higher levels of depression. Moreover, the all moderate-high group had a severer level of PIU than the college-life moderate-high and ordinary groups. Interestingly, males and students who were dating were more likely to fall under the all moderate-high group than the college-life moderate-high group; but students who were more concerned with their academic performance were more likely to fall under the college-life moderate-high group than the all moderate-high group. These findings have important implications for college educators and school counsellors with regard to developing appropriate interventions as required.

Jovens Insatisfeitos com a Imagem Corporal: Estresse, Autoestima e Problemas Alimentares

Resumo Jovens correm riscos para transtornos alimentares. Este estudo verificou as relações entre imagem corporal (IC), estresse percebido, autoestima, comportamento alimentar e Índice de Massa Corporal (IMC) em 238 adolescentes e jovens (14-20 anos; 62,2% meninas), respondendo ao Eating Atittudes Test, Escala de Estresse Percebido, Silhouette Matching Task e Inventário de Autoestima, medindo-se peso e altura (IMC). Meninas apresentaram riscos para distúrbios alimentares, maior preocupação com IC, mais estresse e menor autoestima; meninos desejam ser mais musculosos. Pela análise de redes, comportamento alimentar e IMC não se associaram, divergindo de outros estudos. Houve relações positivas entre IC e IMC e, entre fator dieta e fator bulimia; foram negativas as relações entre autoestima e estresse, e entre IC e sexo. Foram identificadas relações que podem subsidiar intervenções preventivas e centradas em variáveis, como a preocupação em emagrecer, estresse e autoestima em meninas, e o desejo de aumentar a massa corporal nos meninos.

Does perceived stress moderate the association between depressive symptoms and socioemotional and behavioural strengths and difficulties in adolescence?

More and more students report high level of perceived stress during childhood and adolescence, which is associated with socioemotional and behavioural strengths and difficulties. This study aims-based on the cognitive vulnerability-transactional stress theory-to examine perceived stress in early adolescence as a potential moderator in the association between depressive symptoms and socioemotional and behavioural strengths and difficulties from early to middle adolescence. Results of latent moderated structural equations with questionnaire data from a longitudinal study with 1,088 German students (Time 1: M_age  = 13.70, SD = 0.53; Time 2: N = 845, M_age  = 15.32, SD = 0.49) indicate that perceived stress functions as a moderator in the above-mentioned association and dominates the interaction if perceived strongly.

The direct and indirect effect of loneliness on the development of adolescent alcohol use in the United Kingdom

Alcohol use among adolescents in the United Kingdom (UK) remains relatively high compared to those in other European countries. The present study sought to examine both the direct and indirect effect of loneliness on drinking behavior. Participants were school children (mean age 13.5 years at Time 1) participating in a Randomized Controlled Trial in the UK, who completed a battery of questionnaires examining alcohol-use indicators, loneliness, self-efficacy and sensation seeking at Time 1 and at +12 months. Loneliness at Time 1 had a substantive, though largely indirect (i.e., via self-efficacy and sensation seeking covariates), impact on alcohol-related harm at +12 months. Furthermore, Loneliness interacted with gender in the prediction of context of alcohol use, where being female and experiencing loneliness put an individual at a greater risk of unsupervised drinking. Females experiencing loneliness were also 2.9 times as likely to have had a drink in the past 30 days, and around 2.5 times as likely to have ever consumed a full drink, when compared to their male peers. The current results indicate that loneliness is an important but complex factor in adolescent drinking. There are important implications for the development of interventions to prevent underage drinking, not least that it is not appropriate to consider all underage drinkers as socially marginalised. However, for those that are, the self-medication hypothesis is potentially relevant through emotional self-efficacy.

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Data were gathered on loneliness, self-efficacy, sensation seeking and alcohol use.

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Loneliness at Time 1 had an indirect impact on alcohol-related harm at + 12 months.

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Loneliness interacted with gender in the prediction of context of alcohol use.

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Being female and experiencing loneliness put an individual at a greater risk of unsupervised drinking.

Trends in Psychological Symptoms among Canadian Adolescents from 2002 to 2014: Gender and Socioeconomic Differences

OBJECTIVE

To describe trends in psychological health symptoms in Canadian youth from 2002 to 2014 and examine gender and socioeconomic differences in these trends.

METHOD

We used data from the Canadian Health Behaviour in School-aged Children (HBSC) study. We assessed psychological symptoms from a validated symptom checklist and calculated a symptom score (range, 0-16). We stratified our analyses by gender and affluence tertile based on an index of material assets. We then plotted trends in symptom score and calculated the probability of experiencing specific symptoms over time.

RESULTS

Between 2002 and 2014, psychological symptom score increased by 1.01 (95% confidence interval [CI], 0.73 to 1.41), 1.08 (95% CI, 0.79 to 1.37), and 0.84 (95% CI, 0.55 to 1.13) points in girls in the low-, middle-, and high-affluence tertiles, respectively. In boys, psychological symptoms decreased by -0.39 (95% CI, -0.66 to -0.12) and -0.12 (95% CI, -0.43 to 0.19) points in the high- and middle-affluence tertiles, respectively, and increased by 0.30 (95% CI, -0.04 to 0.63) points in the low-affluence tertile. The probability of feeling anxious and having sleep problems at least once a week notably increased in girls from all affluence groups, while the probability of feeling depressed and irritable decreased among boys from the high-affluence tertile.

CONCLUSION

Psychological symptoms increased in Canadian adolescent girls across all affluence groups while they remained stable in boys from low and middle affluence and decreased in boys from high affluence. Specific psychological symptoms followed distinct trends. Further research is needed to uncover the mechanisms driving these trends.