Gender differences in subjective health complaints in adolescence: The roles of self-esteem, stress from schoolwork and body dissatisfaction

Psychological correlates of body dissatisfaction in Swiss youth over a one-year study-period

Introduction

It is well known that young individuals often report pronounced negative perceptions and attitudes towards their own body or intense fear of being not muscular enough. There is much less data available, however, on the role of psychological mechanisms on these perceptions and attitudes, such as emotion regulation difficulties, correlates of alexithymia, and appearance-related rejection sensitivity.

Methods

We therefore set out to assess associations between these psychological mechanisms, and body image as well as muscle dysmorphic symptoms. Our sample was recruited as part of a larger-scale study aiming at assessing correlates of mental health (with a focus on eating disorder symptoms) in German speaking Switzerland. The first wave (T1), starting in April 2021, included 605 participants (80% female, 19.6 ± 2.5 years) who completed the online-questionnaire and were reassessed in a second wave (T2), one year later.

Results

Results indicated that at both waves, emotion regulation difficulties [DERS-SF] and appearance-based rejection sensitivity [ARS-D] were both positively cross-sectionally associated with body dissatisfaction [BSQ-8C] and muscle dysmorphic symptoms [MDDI] at the first assessment time-point and one year later at follow-up assessment. Moreover, alexithymia [TAS-20] was positively cross-sectionally associated with muscle dysmorphic symptoms at both waves. We further observed high absolute and relative level stabilities for all variables involved across the one-year study period.

Discussion/Conclusion

Even though the effects for some associations were rather small, our findings underline the relevance of such mechanisms in the development of body dissatisfaction and to a lesser extent of muscle dysmorphia symptoms over the period of one year. Additional research is necessary to replicate these findings in other youth samples.

Parenting Practices and Psychosomatic Complaints Among Swedish Adolescents

Objectives: Parent-adolescent relationships play a crucial role in youth development. This study examines the associations between parenting practices (parental support, knowledge, and rule-setting) and psychosomatic complaints across middle and late adolescence. Methods: The study utilised data from a Swedish national cohort (n = 3,678). Participants completed self-report questionnaires in 2017 (∼15-16 years) and again in 2019 (∼17-18 years). Results: Parental support exhibited the strongest and most consistent inverse cross-sectional associations with psychosomatic complaints during both middle and late adolescence. Furthermore, increases in parental support and parental knowledge were associated with decreases in adolescent psychosomatic complaints. However, parental support and knowledge at age 15-16 were not prospectively associated with psychosomatic complaints at age 17-18. Conclusion: These findings underscore the importance of ongoing parental engagement, particularly in terms of providing constant support, throughout middle and late adolescence.

Prospective associations between psychosomatic complaints in adolescence and depression and anxiety symptoms in young adulthood: A Swedish national cohort study

Background

Psychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood.

Methods

A Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779).

Results

The frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls.

Conclusions

Psychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.

Time trends in associations between neighbourhood and school characteristics and mental health problems among Dutch adolescents

We investigated trends in associations between physical and social neighbourhood and school characteristics and adolescent mental health problems between 2005 and 2017. Nationally representative, repeated cross-sectional data collected in the Netherlands among primary (N = 5,871) and secondary school students (N = 20,778) were analysed through cross-classified multilevel models. Hardly any evidence was found for over-time changes in associations between neighbourhood and school characteristics and adolescent mental health problems. Findings showed that for both groups of students, only social characteristics within the two contexts were associated with adolescent mental health problems. For secondary school students, school effects were larger than neighbourhood effects, while the opposite was true for primary school students. Specifically, primary school students residing in more socially fragmented or lower socioeconomic status (SES) neighbourhoods, and lower SES schools, reported more conduct problems and peer relationship problems. For secondary school students, only the SES of the neighbourhood and the school was associated with all four aspects of mental health problems. Remarkably, the direction of the associations between neighbourhood/ school SES and adolescent mental health problems varied across the different mental health outcomes. More research is warranted to replicate our findings.

Differences between problematic internet and smartphone use and their psychological risk factors in boys and girls: a network analysis

BACKGROUND

Problematic internet and smartphone use are significant health challenges for contemporary adolescents. However, their mutual relationship is unclear because studies investigating these phenomena are scarce. The present study aimed to investigate the psychological risks and protective factors associated with problematic internet and smartphone use.

METHOD

A representative sample of Slovak adolescents (N = 4070, M_age = 14.38, SD_age = 0.77, 50.5% girls) from the Health Behavior in School-aged Children project was analyzed using network analysis separately for boys and girls.

RESULTS

The results showed weak (for boys) and moderate (for girls) associations between problematic internet use and problematic smartphone use. Risk factors showed stronger associations with problematic internet use than problematic smartphone use, with the exception of fear of missing out, which was strongly associated with problematic smartphone use. The central nodes were externalizing problems for boys and internalizing problems, externalizing problems, and resilience for girls.

CONCLUSION

The study concluded that while problematic internet use and problematic smartphone use are somewhat related, they differ at the psychological level. In addition, the phenomena are rather different between boys and girls.

Negative attitudes of healthy older adults toward unhealthy older adults: Focus on the subjective health

Negative attitudes toward older adults, especially those with declining physical function and/or advanced dementia (i.e., unhealthy older adults), are serious. It is important to identify psychological factors associated with such negative attitudes toward unhealthy older adults. In this study, we focused on subjective health (subjective perception of one's own health status). We tested the hypothesis that healthy older adults with lower subjective health have more negative attitudes toward unhealthy older adults. We also examined whether this association is still pronounced after controlling for the participants' physical health status and demographics. In this study, an online survey was conducted among Japanese older adults who were not certified as needing long-term care (N = 1,082, aged 65-88). To control for the participants' physical health status, we focus on frailty. We conducted a factor analysis and multiple regression analysis on negative attitudes toward unhealthy older adults. As a result, healthy older participants with lower subjective health perceived unhealthy older adults negatively, and this association was still pronounced even after controlling for the participants' frailty score and demographics. Based on our findings, it is suggested that increasing the subjective health of older adults may help them view each other more positively. Therefore, it is important to devise gerontological and psychological interventions to improve older adults' subjective health. This study has limitations, such as the fact that we conducted only an online survey. Previous studies on how older adults perceive the social group of older adults are scarce, and further studies are expected.

Psychosocial School Conditions and Mental Wellbeing Among Mid-adolescents: Findings From the 2017/18 Swedish HBSC Study

Objectives: To investigate mid-adolescent boys' and girls' experiences of school demands, teacher support, and classmate support, and explore the associations of these factors with mental wellbeing. Methods: Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15-16 years). School demands, teacher support, and classmate support were measured by indices based on three items each. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Linear regression analyses were performed. Results: Higher demands were associated with lower mental wellbeing. Conversely, mental wellbeing increased with greater teacher support and classmate support. Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental wellbeing was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental wellbeing increased and revealed an inverse association between school demands and mental wellbeing. Conclusion: The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance wellbeing among students.

Factors associated with self-rated health in primary care in the South-Western health zone of Malawi

Background

Self-rated health (SRH) is a single-item measure of current health, which is often used in community surveys and has been associated with various objective health outcomes. The prevalence and factors associated with SRH in Sub-Saharan Africa remain largely unknown. This study sought to investigate: (1) the prevalence of poor SRH, (2) possible associations between SRH, and socio-demographic and clinical parameters, and (3) associations between SRH and the patients’ assessment of the quality of primary care.

Methods

A cross-sectional study was conducted in 12 primary care facilities in Blantyre, Neno, and Thyolo districts of Malawi among 962 participants who sought care in these facilities. An interviewer-administered questionnaire containing the Malawian primary care assessment tool, and questions on socio-demographic characteristics and self-rated health was used for data collection. Descriptive statistics were used to determine the distribution of variables of interest and binary logistic regression was used to determine factors associated with poor SRH.

Results

Poor SRH was associated with female sex, increasing age, decreasing education, frequent health care attendance, and with reported disability. Patients content with the service provided and who reported higher scores of relational continuity from their health care providers reported better SRH as compared with others.

Conclusion

This study reports findings from a context where SRH is scarcely examined. The prevalence of poor SRH in Malawi is in line with findings from clinical populations in other countries. The associations between poor SRH and socio-demographic factors are also known from other populations. SRH might be improved by emphasizing continuity of care in primary care services.

Association of single child family with subjective health complaints in children and adolescents

The number of single-child families has been increasing across developing countries during the last decades. We aimed to examine the association between being a single child (SC) and subjective health complaints (SHCs) in Iranian children and adolescents. This study was conducted as a part of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V). This national survey included a total of 14,400 students 7-18 years and their parents from rural and urban areas in 30 provinces of Iran. Data on demographic characteristics, lifestyle variables, and SHCs were measured using the questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS). Multivariate logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for the association of being an SC with SHCs. Data on 14,151 participants were available for this study, of whom 7.7% (1092) were SCs. The most frequent SHCs were irritability (37.1%, 95%CI: 36.3-37.9%), feeling nervous 32.5%, 95% CI: (31.7-33.3%), and headache 24.3%, 95%CI: (23.6-25.0% ). In the multivariate model, being an SC significantly increased the odds of dizziness [adjusted OR (95% CI): 1.37(1.08-1.72)] and backache complaint [1.22(1.01-1.47)]. The association of being an SC with other SHCs (feeling low, irritability, feeling nervous, difficulty in getting to sleep, headache, stomachache) was not statistically significant (p value > 0.05). Our results suggest that being an SC may be associated with higher odds of dizziness and backache complaints.

Adolescents' Experience of Stress: A Focus Group Interview Study with 16-19-Year-Old Students during the COVID-19 Pandemic

The purpose was to investigate stress among adolescents (16-19 years old) during the coronavirus disease 2019 (COVID-19) pandemic. Focus group (n = 9) interviews with students at upper secondary schools (16-19 years old, n = 41) were conducted in southern Sweden during the COVID-19 pandemic in 2021. The interviews were analyzed by qualitative content analysis. The analysis revealed five categories of experience of stress: (1) School-related stress, (2) Stress in relationships and leisure, (3) How stress manifests itself, (4) Stress can increase performance, and (5) Experiences of counteracting stress. The adolescents in the study experienced stress linked to school and relationships, partly due to the COVID-19 pandemic. Distance education during the COVID-19 pandemic increased stress levels. The adolescents stated that high stress levels were experienced negatively and impaired their ability to perform, while moderate stress could contribute to achieving goals and improving performance. School nurses and other health professionals who meet with adolescents are important to support adolescents experiencing stress.

Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study

Background

Lifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents.

Methods

This was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities.

Results

The 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain.

Conclusions

A screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.

Factors associated with self-rated health in primary care in the South-Western health zone of Malawi

BACKGROUND

Self-rated health (SRH) is a single-item measure of current health, which is often used in community surveys and has been associated with various objective health outcomes. The prevalence and factors associated with SRH in Sub-Saharan Africa remain largely unknown. This study sought to investigate: (1) the prevalence of poor SRH, (2) possible associations between SRH, and socio-demographic and clinical parameters, and (3) associations between SRH and the patients' assessment of the quality of primary care.

METHODS

A cross-sectional study was conducted in 12 primary care facilities in Blantyre, Neno, and Thyolo districts of Malawi among 962 participants who sought care in these facilities. An interviewer-administered questionnaire containing the Malawian primary care assessment tool, and questions on socio-demographic characteristics and self-rated health was used for data collection. Descriptive statistics were used to determine the distribution of variables of interest and binary logistic regression was used to determine factors associated with poor SRH.

RESULTS

Poor SRH was associated with female sex, increasing age, decreasing education, frequent health care attendance, and with reported disability. Patients content with the service provided and who reported higher scores of relational continuity from their health care providers reported better SRH as compared with others.

CONCLUSION

This study reports findings from a context where SRH is scarcely examined. The prevalence of poor SRH in Malawi is in line with findings from clinical populations in other countries. The associations between poor SRH and socio-demographic factors are also known from other populations. SRH might be improved by emphasizing continuity of care in primary care services.

Social Media Use and Body Dissatisfaction in Adolescents: The Moderating Role of Thin- and Muscular-Ideal Internalisation

Internalisation of appearance ideals moderates the relationship between exposure to media images and body dissatisfaction. To date, the role of thin- and muscular-ideal internalisation in the context of social media remains under explored, particularly for boys. As such, we aimed to explore how social media use (Instagram and Snapchat) was related to body dissatisfaction, and whether thin- and muscular-ideal internalisation would moderate this relationship in a sample of 1153 adolescent boys and girls (55.42% males; M_age = 13.71, SD = 1.14). As hypothesised, social media use, and thin- and muscular ideal internalisation were positively correlated with body dissatisfaction in both genders. In moderation analyses, thin-ideal internalisation emerged as the only variable that had a significant effect on body dissatisfaction in both genders. Additionally, the influence of social media use on body dissatisfaction was moderated by muscular-ideal internalisation in boys, whereby for boys with high muscular-ideal internalisation, greater social media use was associated with greater body dissatisfaction. The two-way (muscular x thin-ideal internalisation) and three-way interaction (social media use x thin-ideal internalisation x muscular-ideal internalisation) effects on body dissatisfaction were non-significant. These findings emphasise the importance of considering the sociocultural environment (i.e., new media influences) as frameworks for understanding body dissatisfaction and suggest targeting of internalisation of appearance ideals in body dissatisfaction prevention programs.

Youth Perceptions of Sport-Confidence

ABSTRACT

Zuk, EF, Maksymiw, K, Evanovich, J, McGarry, JE, Root, HJ, and Distefano, LJ. Youth perceptions in sport-confidence. J Strength Cond Res XX(X): 000-000, 2021-Sport-confidence is an important construct that is often missed during physical activity interventions in youth. Male and female children might display differences in sport-confidence that influences their activity levels. The purpose of this study is to assess any association between sport-confidence and gender in elementary school and middle-school children. All 286 children {(boys [ES: n = 71, age = 8±1 years; MS: n = 63, 11±1 years]; girls [ES: n = 67, 7±1 years; MS: n = 85, 11±1 years])} completed the Physical Literacy Assessment for Youth-Self Questionnaire. Separate chi-square tests of the association were used to evaluate the association between gender and sport-confidence among elementary (grades K-4) and middle-school (grades 5-8) children because of varying injury and participation rates for these groups, for each relevant question with a significance set at p ≤ 0.05. For elementary school children, there were no significant associations between genders and sport-confidence (p > 0.05). In middle-school children, there were significant associations detected for learning new skills (ϕ = 0.12; p = 0.031), perception of skill (ϕ = 0.12; p = 0.054), confidence in activity (ϕ = 0.17; p = 0.035), and being the best in the class (ϕ = 0.15; p = 0.048) between genders and sport-confidence. For all results, boys displayed more sport-confidence than girls. Education for key stakeholders about the importance of including sport-confidence in physical activity interventions is integral in promoting life-long activity, specifically in middle-school girls.

Psychological Distress, Somatic Complaints, and Their Relation to Negative Psychosocial Factors in a Sample of Swedish High School Students

Background: Adolescence is a period in life characterized by major neurobiological, physiological, and psychological changes. Those changes may give rise to worsened mental health and an increased prevalence of somatic complaints combined with a negative psychosocial environment. Rapid changes in society, which may also affect young people in several ways, call for a renewed screening of today's adolescents' mental and somatic well-being. Aim: The present study's primary aim was to measure the level of self-rated psychological distress and the prevalence of somatic complaints in a sample of Swedish high school students. As a secondary aim, it identifies gender-specific patterns and examines mental and somatic health in relation to negative psychosocial factors (such as parental alcohol use problems or the experience of physical or psychological abuse). Method: Two hundred and eighty-seven Swedish high school students completed a survey including the Brief Symptom Inventory (BSI) and a questionnaire about the presence of defined somatic complaints. In order to examine the relationship between negative psychosocial factors and mental and somatic health, three groups were formed: those reporting (i) parental substance use problems, (ii) previous experience of abuse, (iii) none of these problems. Results: The majority of the Swedish high-school students (>80%) reported no or only a few problems with psychological distress and no or only one somatic complaint. Female students disclosed a significantly higher psychological distress level captured by each BSI domain. The number of somatic complaints was similarly distributed between the genders. The students rarely reported parental substance use problems, but almost 40% of the male and 50% of the female students indicated the experience of physical and/or psychological abuse. Such negative psychosocial circumstances were related to an increased level of anxiety in the male and an increased general level of psychological distress in female students. Conclusions: The study confirmed female students' higher psychological distress level. Gender differences in the type of somatic complaints, but not in the number were detected. The experience of physical and/or psychological abuse was found to significantly worsen psychological distress in students of both genders.

Factors Predicting Physical Activity and Sports Participation in Adolescence

Physical activity is important for children's health and wellbeing, yet participation declines across teenage years. It is important to understand the mechanisms that could support adolescents to maintain physical activity participation. The aim of this study was firstly to examine change in sports and nonsports activities over two years during adolescence. Secondly, we explored possible predictors of physical activity and sports participation after two years. Method. A longitudinal cohort study was conducted between 2011 and 2013. Our data were collected from 1225 Norwegian adolescents who were followed over a two-year period, from 6th to 8th grade (11 to 13 years) and from 8th to 10th grade (13 to 15 years). We examined the relations between physical activity and predictors such as peer support, parent support, socioeconomic status (SES), attitude towards physical education, active transportation to school, self-rated health, body image, and change of nonsports activities. We used linear regression analyses and binary logistic regression to explore possible predictors of physical activity and sports participation after two years. Results. We found a significant reduction in sports participation during early adolescence, most pronounced, from 8th to 10th grade (from 13 to 15 years). Factors which predicted physical activity after two years were a positive attitude towards physical education, perceived support from parents, if the student travelled to school in an active way (by walk or bicycle) and also how the student rated his/her own health. The last three factors also predicted improvements of physical activity during the two years. Possible predictors of persisting or starting doing sports were increasing levels of self-rated health, increasing socioeconomic status, whereas increasing engagement in nonsports activities predicted reduced participation in sports. Conclusion. Health promotive efforts aiming at increasing active school transportation, parental support, and subjective health seem important for maintenance of physical activity and sports participation during adolescence. Attitudes may improve by adapting physical education to individual needs and interests and can function as an additional promotive factor.

Longitudinal analysis of subjective well-being in preadolescents: The role of emotional intelligence, self-esteem and perceived stress

Subjective wellbeing has been conceptualized as a person's cognitive and affective evaluation of their life. In this line, life satisfaction and somatic complaints may be outstanding indicators of well-being. The aim of this longitudinal study was to analyze the combined contribution of trait emotional intelligence, self-esteem and perceived stress to well-being. Participants were 381 pupils aged 12-16 years (56.1% female). Hierarchical regression models and a fuzzy-set qualitative comparative analysis (QCA) were conducted. Trait emotional intelligence, self-esteem and low perceived stress were related in the expected direction to life satisfaction and somatic complaints. Findings support a specific pathway to improve wellbeing in preadolescents.

Cross-National Time Trends in Adolescent Mental Well-Being From 2002 to 2018 and the Explanatory Role of Schoolwork Pressure

PURPOSE

Previous research has shown inconsistent time trends in adolescent mental well-being, but potential underlying mechanisms for such trends are yet to be examined. This study investigates cross-national time trends in adolescent mental well-being (psychosomatic health complaints and life satisfaction) in mainly European countries and the extent to which time trends in schoolwork pressure explain these trends.

METHODS

Data from 915,054 adolescents from 36 countries (50.8% girls; mean_age = 13.54; standard deviation_age = 1.63) across five Health Behaviour in School-aged Children surveys (2002, 2006, 2010, 2014, and 2018) were included in the analyses. Hierarchical multilevel models estimated cross-national trends in adolescent mental well-being and schoolwork pressure. We also tested whether schoolwork pressure could explain these trends in mental well-being.

RESULTS

A small linear increase over time in psychosomatic complaints and schoolwork pressure was found. No change in life satisfaction emerged. Furthermore, there was large cross-country variation in the prevalence of, and trends over time in, adolescent mental well-being and schoolwork pressure. Overall, declines in well-being and increases in schoolwork pressure were apparent in the higher income countries. Across countries, the small increase in schoolwork pressure over time partly explained the decline in psychosomatic health complaints.

CONCLUSIONS

Our findings do not provide evidence for substantial declines in mental well-being among adolescents. Yet, the small declines in mental well-being and increases in schoolwork pressure appear to be quite consistent across high-income countries. This calls for the attention of public health professionals and policy-makers. Country differences in trends in both adolescent mental well-being outcomes and schoolwork pressure were considerable, which requires caution regarding the cross-national generalization of national trends.

School Ethos and Recurring Sickness Absence: A Multilevel Study of Ninth-Grade Students in Stockholm

School absence has been identified as a severe problem in Sweden, both at the individual level and for society as a whole. Despite the multitude and complexity of reasons behind school absence, health-related problems are likely to be one important determinant. This indicates that knowledge about factors that may contribute to preventing health-related absence among students is relevant. The aim was to investigate whether a higher level of teacher-reported school ethos was associated with less recurring sickness absence among students. Data from four cross-sectional surveys performed in 2014 and 2016 were combined. The Stockholm School Survey was carried out among 9482 ninth-grade students (ages 15-16 years) in 150 school units, and the Stockholm Teacher Survey was performed among 2090 teachers in the same units. School ethos was operationalised by an index of 12 teacher-reported items that was aggregated to the school-level. Recurring student sickness absence was captured by self-reports and defined as absence on >10 occasions during the current school year. Two-level logistic regressions were performed. The results show that about 9.5% of the students reported recurring sickness absence. Students attending schools with higher levels of teacher-rated school ethos were less likely to reporting recurring sickness absence than those attending schools with lower levels of ethos, even when adjusting for potential confounders (OR 0.79, 95% CI 0.65-0.97). In conclusion, recurring sickness absence was less common among students attending schools with higher levels of teacher-rated ethos. The findings suggest that schools may contribute to promoting student health.

Divorce and conversational difficulties with parents: Impact on adolescent health and self-esteem

Background: Divorce experience (DE) may cause health and self-conceptual problems, but these consequences might also be caused by conflicts and lack of conversational confidence (CC) with one or both parents. We investigated how DE impacted CC and how DE and CC impacted health complaints and self-esteem in a two-year longitudinal cohort study. Methods: The study was performed between 2011 and 2013 among 1225 students in junior high school (aged 11 and 13 years in 2011). We used binary logistic analyses to account for how DE impacted CC, and linear regression analyses to examine how DE and CC impacted on subjective health and self-esteem in 2013. Results: The study revealed that former and recent DEs impacted CC with fathers only. The impact was most evident for the more severe forms of conversational difficulties. DE in itself predicted only self-esteem, and CC with parents mediated this association. CC with both mothers and fathers had strong temporal causal associations with the outcomes two years later. Only CC with fathers impacted changes of the health complaints and self-esteem in full-model residual change analyses. Conclusions: The study proves a sex-specific effect on loss of CC between fathers and children after divorce. The impairment of CC has predictive repercussions on the health and self-conception of adolescents in their middle teenage years. From a public-health perspective, preserving the relation and the confidence between children and their fathers after divorce seems an important task.

Somatic health and its association with negative psychosocial factors in a sample of Moroccan adolescents

Background:

Adolescence is a distinct developmental phase characterized by multiple physical and psychological changes and by an increased vulnerability to somatic and mental health problems. These risk and vulnerability factors are part of a complex biopsychosocial matrix, encompassing multiple factors, such as inherited biological determinants and psychological, societal, and cultural influences, which affect an adolescent’s overall wellbeing. In Morocco, similar to other developing countries, adolescents (young people aged from 15 to 19 years) constitute a substantial proportion of the population (almost 9%). However, studies about adolescents’ health in developing countries are scarce. In this study, we describe adolescents’ somatic health in a sample of high school students from the city of Tetouan, Morocco, and investigate how negative psychosocial factors, such as parental alcohol use problems and/or the experience of abuse, may influence them.

Methods:

The study sample included 655 adolescents (315 boys and 340 girls, M = 16.64 years, range = 15–18 years) from conviniently selected classes of four high schools in the city of Tetouan in Morocco. The students responded to a survey that assessed the prevalence of somatic complaints/disorders. They also indicated whether they had ever experienced physical and/or psychological abuse and whether they had parents with alcohol use problems.

Results:

More than half of the adolescents suffered from headaches and one-third had substantial problems with diarrhea or constipation. Both problems were more common in female students. The third most frequent somatic problem, affecting one in four in both genders, was allergy. Almost one-third of Moroccan adolescents (significantly more boys than girls; p = 0.004) reported no somatic complaints. In adolescents who reported parental alcohol use problems and/or experience of physical and/or psychological abuse, the prevalence of several somatic complaints (epilepsy, migraine, headache, diarrhea/constipation, gluten intolerance, allergy, and skin or thyroid disease) increased highly significantly compared to the adolescents who reported no such psychosocial environmental factors.

Conclusion:

The results suggest that only 3 in 10 urban-living Moroccan adolescents are free of somatic complaints, while the majority suffer from some somatic problems, most often headaches and diarrhea/constipation. The association of certain negative psychosocial factors with adolescents’ somatic health suggests the need of a holistic approach to the treatment of affected adolescents.

Health problems during childhood and school achievement: Exploring associations between hospitalization exposures, gender, timing, and compulsory school grades

Aims

To investigate while accounting for health at birth 1) associations between health problems during childhood, measured as hospitalizations, and school achievement in the final year of compulsory school, measured as overall grade points and eligibility for upper secondary education, 2) if and how gender moderates the association between health problems and school achievement, 3) if and how the timing of a health problem during childhood is associated with later school achievement.

Methods

Analyzes were performed on a population-based cohort (n = 115 196) born in 1990 in Sweden (51.3% boys, 48.7% girls) using data from several national registries. Multiple linear regression and logistic regression were used to analyze associations between study variables.

Results

Overall grade points and eligibility for continuation to upper secondary school were lower for individuals exposed to hospitalizations. Only the association between hospitalizations and overall grade points was moderated by gender and only for ages 13–16 years. Exposure close to actual grading had worst outcomes.

Conclusions

Health problems, measured through hospitalizations, was significantly associated with lower school achievements among Swedish children. Girls exposed to health problems requiring hospitalizations had relatively poorer school achievements as compared to boys. Health problems requiring hospitalization during junior high school had the greatest negative association with final achievement at compulsory school.