Impact of parent-adolescent bonding on school bullying and mental health in Vietnamese cultural setting: evidence from the global school-based health survey

Does parent-child connectedness influence substance use among Bhutanese adolescents: evidence from a national survey?

BACKGROUND

Adolescent substance use is recognized as a global health crisis that threatens adolescents' physical and mental health worldwide. Alcohol is the most available one; WHO findings suggest that more than 155 million adolescents, representing over a quarter of the adolescent population aged between 11 and 15, use alcohol-based drinks worldwide. Since adolescents are the future of the world, protecting them from substance use is of paramount importance.

OBJECTIVES

This study aimed to explore the prevalence of adolescent substance use (alcohol, marijuana, and tobacco) among Bhutanese adolescents and examine the association with parent-child connectedness as a protective factor while controlling sociodemographic, socio-emotional distress, and other contextual factors.

METHODS

A total of 7576 school-going adolescents' data from the 2016 Global School-based Student Health Survey (GSHS) Bhutan dataset were used in this study. To analyze the relationship between predictor and outcome variables, both univariate and multivariate binary logistic regression models were constructed utilizing the "complex samples" tool of SPSS 25. A significance level of p ≤ 0.05 was used for the analyses.

RESULTS

An estimated 30.7% of the Bhutanese school-going adolescents used tobacco, 25.8% consumed alcohol, and 12.7% used marijuana. Parent-child connectedness: (i) child's homework supervision and (ii) child's free time supervision by parents significantly lower the odds of using tobacco and alcohol consumption, while parents understanding child's problem showed no significant association with substance use among the respondents. However, no significant association was found between parent-child connectedness and marijuana use. Besides parental connectedness, anxiety, bullying, passive smoking, school truancy, being involved in fights, or being attacked were also significantly associated with adolescents' substance use.

CONCLUSION

Parental connectedness has been found to be an important factor that can lead to a substantive reduction in substance use among the adolescents of Bhutan. However, the lesson is pertinent for any global initiatives aiming to prevent the harmful use of substances among global adolescents.

How do Differences in Adolescent and Caregiver Reports of Adolescent Adverse Childhood Experiences Relate to Adolescent Depression?

Objective

To compare adolescent and caregiver reports of adolescent adverse childhood experiences (ACEs) and their relationship with current adolescent depression and to analyze the relationship between ACEs and depression.

Methods

We recruited 46 adolescent-caregiver dyads from a large, inner-city medical center's adolescent medicine clinic. Adolescents and caregivers completed the Center for Youth Wellness ACE questionnaire, encompassing traditional ACEs (eg, abuse, neglect, household dysfunction) and nontraditional ACEs (eg, foster care, parental death, exposure to community violence). Adolescents also completed the Patient Health Questionnaire-9A (PHQ-9A) depression screening tool.

Results

Among adolescents, 14 (30%) reported no traditional ACEs, 11 (24%) reported 1, and 21 (46%) reported more than 1. Regarding nontraditional ACEs, 16 (35%) reported none, 11 (24%) reported 1, and 19 (41%) reported more than 1. Caregiver reports consistently indicated lower ACEs compared with adolescent self-reports (P < .005). For the PHQ-9A scores, 26 (57%) of adolescents showed no or minimal depression, 14 (30%) mild, and 6 (13%) moderate depression. A moderate positive correlation emerged between PHQ-9A scores and self-reported traditional ACEs (rs = 0.5, P < .001) and nontraditional ACEs (rs = 0.49, P < .001). In addition, a positive correlation was observed between the absolute differences in adolescent and caregiver reports of traditional ACEs and PHQ-9A scores (n = 46, ρ = 0.51, P < .001).

Conclusions

As the differences in ACE reports between adolescents and caregivers increased, there was a corresponding increase in adolescent depression scores. It is essential to incorporate comprehensive ACE screening and encourage open communication between adolescents and caregivers, which may improve mental health outcomes.

Traditional, cyberbullying, and suicidal behaviors in Argentinian adolescents: the protective role of school, parental, and peer connectedness

Introduction

Bullying, both in person and online, is a significant risk factor for a range of negative outcomes including suicidal behaviors among adolescents and it is crucial to explore the protective effects of parental, school, and peer connectedness on suicidal behaviors among victims.

Methods

This study is a secondary analysis of the Argentina Global School-based Student Health Survey (GSHS 2018). Logistic regression analysis, adjusting for age and sex, determines the likelihood of suicidal thoughts and attempts among bullying victims. To explore the modifying effect of school, parental, and peer connectedness on the association between bullying and suicide behaviors, the interaction term was included. Sampling design and weights were applied in all analyses in STATA 17.

Results

The study included 56,783 students in grades 8-12, with over half being female. Adolescents aged 14-15 exhibited the highest prevalence of bullying, cyberbullying, suicidal thoughts, and attempts, with females displaying a higher prevalence in all measured categories. The study found that adolescents who reported being bullied or cyberbullied demonstrated a significantly higher likelihood of experiencing suicidal thoughts and attempting suicide. Furthermore, protective factors such as school, parental, and peer connectedness were found to play a critical role in mitigating the adverse impacts of bullying and cyberbullying on suicidal thoughts and attempts.

Conclusion

The findings underscore the critical prevalence of both bullying and cyberbullying among school-going Argentinian adolescents and their profound association with suicidal behaviors. The study emphasizes the importance of supportive family environments and peer and school connectedness in mitigating the negative effects of bullying and cyberbullying on mental health and suicide risk among adolescents.

Parental involvement affects parent-adolescents brain-to-brain synchrony when experiencing different emotions together: An EEG-based hyperscanning study

Parental involvement (PI) is a broad and multifaceted construct, which refers to the parental demonstration of interest in their child, caring, and warmth (Davis et al., 2021). Parental involvement affects parent-adolescent's relationship and communication. However, there was little research to examine the underlying neural mechanism. The present study aimed to explore how parental involvement is associated with the brain-to-brain synchronous activation between parent-adolescent dyads when sharing emotional experience together by using the electroencephalograph (EEG) hyperscanning. EEG was recorded simultaneously in a sample of 26 parent-adolescent dyads (Mparents'age=43.312, SD=5.468; Madolescents' age=12.077, SD=1.412) when completing the picture processing task. Phase locking values (PLVs) in beta band and gamma band were used to compare the differences in the parent-adolescent dyads' induced brain-to-brain synchrony between the high parental involvement group (HPI) and the low parental involvement group (LPI). Results showed that greater beta brain-to-brain synchrony was observed in the HPIs than in the LPIs when experiencing positive emotions together in the central region. However, there was no significant difference between the HPIs and the LPIs in the negative and neutral condition. Moreover, greater gamma brain-to-brain synchrony was observed when viewing negative emotional stimuli together than viewing positive emotional stimuli together in the LPIs in the central region. However, there was no significant difference between different emotional conditions in the HPIs. Findings of the present study provide neuroscientific evidence that parental involvement may strengthen parent-adolescent's emotional interaction and communication.

Predicting Risk of Bullying Victimization among Primary and Secondary School Students: Based on a Machine Learning Model

School bullying among primary and secondary school students has received increasing attention, and identifying relevant factors is a crucial way to reduce the risk of bullying victimization. Machine learning methods can help researchers predict and identify individual risk behaviors. Through a machine learning approach (i.e., the gradient boosting decision tree model, GBDT), the present longitudinal study aims to systematically examine individual, family, and school environment factors that can predict the risk of bullying victimization among primary and secondary school students a year later. A total of 2767 participants (2065 secondary school students, 702 primary school students, 55.20% female students, mean age at T1 was 12.22) completed measures of 24 predictors at the first wave, including individual factors (e.g., self-control, gender, grade), family factors (family cohesion, parental control, parenting style), peer factor (peer relationship), and school factors (teacher-student relationship, learning capacity). A year later (i.e., T2), they completed the Olweus Bullying Questionnaire. The GBDT model predicted whether primary and secondary school students would be exposed to school bullying after one year by training a series of base learners and outputting the importance ranking of predictors. The GBDT model performed well. The GBDT model yielded the top 6 predictors: teacher-student relationship, peer relationship, family cohesion, negative affect, anxiety, and denying parenting style. The protective factors (i.e., teacher-student relationship, peer relationship, and family cohesion) and risk factors (i.e., negative affect, anxiety, and denying parenting style) associated with the risk of bullying victimization a year later among primary and secondary school students are identified by using a machine learning approach. The GBDT model can be used as a tool to predict the future risk of bullying victimization for children and adolescents and to help improve the effectiveness of school bullying interventions.

The association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents

The purpose of this study is to investigate the association between psychosocial factors, protective factors, and its associated triggers with psychological distress among Bolivian adolescents. This cross-sectional study was conducted by investigating the 2018 Bolivia global school-based student health survey (GSHS). The total number of students who participated in this survey was 7931, and the final sample was 7377. The mean age of the participants was 15.3 years (SD = 1.4). Psychological distress was assessed with a 2-item screener (loneliness and worry induced sleep disturbance). In all 22.3% of participants reported experiencing psychological distress, with 18.1% among adolescent males and 26.2% among adolescent females. In adjusted logistic regression analysis (AOR, 95% CI), there are two significant directions of association. One is the negative association, such as parental involvement as a protective factor. School adolescents who had more parental involvement were less likely to experience psychological distress. Parents understand problems or worries (0.64, 0.54-0.75, p < .001) and parents disregard privacy (0.69, 0.58-0.82, p < .001). On the other hand, many psycho-social factors are significantly positively associated with psychological distress. School adolescents who experience more psychosocial factors are more likely to experience psychological distress. Physical assault in the previous year (1.83, 1.59-2.11, p < .001), being bullied at school (1.27, 1.07-1.52, p < .01), being bullied outside of school (1.36, 1.15-1.61, p < .001), and being cyberbullied (1.60, 1.37-1.88, p < .001), were all significantly associated with psychological distress. Healthy relationships in a family, and interventions to reduce violence and bullying, should be encouraged and promoted.

Mental health and its determinants among adolescents living in families with separated or divorced parents in an urban area of Vietnam

BACKGROUND

We assessed the prevalence of stress, anxiety, and depression among adolescents living in families with separated or divorced parents in Hue City, Vietnam and identified factors associated with these conditions.

METHODS

This cross-sectional study enrolled 309 adolescents, aged 12 to 17 years, living in families with separated or divorced parents in Hue City, Vietnam. The depression anxiety stress scale-21 (DASS-21) was used to measure stress, anxiety, and depression. Predictors of overall and individual mental health problems were identified using ordered and binary logistic regression, respectively.

RESULTS

The DASS-21 scale revealed a 49.2% prevalence of stress, while anxiety and depression had s prevalence rates of 61.5%. Among participants, 42.4% experienced all 3 mental health issues. Several factors were identified as significant predictors of mental health problems, including poor to average economic status (adjusted odds ratio [aOR], 2.00; 95% confidence interval [CI], 1.21-3.31; p=0.007); being in high school (aOR, 5.02; 95% CI, 2.93-8.60; p<0.001); maternal occupation of teacher, healthcare professional, or official (aOR, 2.39; 95% CI, 1.13-5.03; p=0.022); longer duration of family separation or divorce (aOR, 1.24; 95% CI, 1.05-1.45; p=0.009); living with one's mother (aOR, 1.69; 95% CI, 1.03-2.76; p=0.04); alcohol consumption (aOR, 1.70; 95% CI, 0.99-2.92; p=0.050); and being bullied (aOR, 5.33; 95% CI, 1.10-25.69; p=0.037). Most of these factors were associated with stress, anxiety, and depression. Additionally, smoking was associated with stress.

CONCLUSION

Adolescents with separated or divorced parents were at increased risk of stress, anxiety, and depression. The findings of this study provide important implications for prevention programs.

Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study

Objective

Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences.

Method

This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire.

Results

2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%).

Conclusions

High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.

Associations of psychological factors, parental involvement, and adverse health behaviors with bullying among tunisian middle school students

BACKGROUND

Bullying is a serious problem that significantly affect adolescent well-being and health, needing the attention of teachers, school administrators, parents and public health professionals. In this study, we aimed at estimating the prevalence of bullying, from the perspective of victims in middle school students in the region of Monastir Tunisia, as well as analyzing its association with individual and family context variables.

METHODS

This is a cross-sectional study conducted in December 2017 and January 2018 among a sample of students from two middle schools in the region of Monastir (Tunisia), using the Global School-based Student Health Survey (GSHS) self-answered questionnaire. We defined bullying victimization as being bullied in at least one day in the previous 30 days. Binary logistic regression model was used to identify factors associated with being bullied.

RESULTS

Out of 802 students included in this study, nearly half (43.4%) reported having been bullied in the past month with CI _95%: 38.9-48.2. Gender did not interact with this behavior: (44.5%; CI _95%: 38.1-51.7) in boys versus (43.4% ; CI _95%: 37.2-50.2) in girls. Univariate analysis indicated significant differences regarding some individual factors such as physical fight, cigarette smoking, feeling lonely and being worried, in terms of prevalence of being bully victims. There were no significant differences in parental factors between the two groups (being bullied or not). Multivariate analysis showed the following factors as independently associated with bullying: being involved in physical fight (OR = 2.4; CI_95%:1.77-3.25), feeling lonely (OR = 3.38; CI_95% :2.04-5.57) and being worried (OR = 2.23; CI _95%:1.44-3.43).

CONCLUSION

Bullying victimization was common among school-going adolescents and was linked with physical fight and psychosocial distress. This study highlights the need for school-based violence prevention programs to address this problem among the students.

Prevalences of Parental and Peer Support and Their Independent Associations With Mental Distress and Unhealthy Behaviours in 53 Countries

Objective: Parental and peer support are both associated with mental distress and unhealthy behaviour indices in adolescents.

Methods: We used the Global School-Based Student Health Survey data (n = 192,633) from 53 countries and calculated the weighted prevalence of individual and combined parental and peer support. Multiple logistic regression analysis was used to estimate the adjusted associations between combined parental and peer support with mental distress and unhealthy behaviours.

Results: The prevalence figures for having all four categories of parental support and two peer-support were 9.7% and 38.4%, respectively. Compared with no parental support, adolescents with all four parental support negatively associated with all five mental distress and eight unhealthy behaviours factors, and the ORs ranged from 0.19 to 0.75. Additionally, adolescents with two peer support were negative association with all mental distress and four health risk behaviours, and positively associated with a sedentary lifestyle.

Conclusion: Parental and peer support were lacking in some countries, while greater parental and peer support were negative associated with mental distress and most unhealthy behaviours in adolescents, and the relationships were independent.

How Does Parent-Adolescent Conflict and Deviant Peer Affiliation Affect Cyberbullying: Examining the Roles of Moral Disengagement and Gender

Purpose

With the widespread use of the Internet and mobile phone, cyberbullying has become a new type of bullying among adolescents. It is of great practical significance to explore the relevant factors affecting cyberbullying for prevention and intervention of adolescents’ cyberbullying. However, few studies have considered the effect of both the family and social factors on cyberbullying. Therefore, the current study examines whether the parent-adolescent conflict as a family factor and deviant peer affiliation as a social factor have an effect on adolescents’ cyberbullying, as well as the role of moral disengagement and gender.

Methods

A total of 777 middle school students (females = 336; mean age = 13.57; SD = 0.98) were surveyed by using the Parent-child Relationship Questionnaire, Deviant Peer Affiliation Questionnaire, Moral Disengagement Questionnaire and Cyber Bullying Behavior Questionnaire. SPSS21.0 was used to conduct descriptive statistics, Pearson correlation analysis and T-test, PROCESS were used to conduct significance test of moderated mediation effect on the data.

Results

Parent-adolescent conflict does not directly predict cyberbullying. Moral disengagement played a complete mediating role between parent-adolescent conflict and cyberbullying, and gender played a moderating role between moral disengagement and cyberbullying. Deviant peer affiliation directly predict cyberbullying. Moral disengagement played a partially mediating role between parent-adolescent conflict and cyberbullying, and gender played a moderating role between moral disengagement and cyberbullying.

Conclusion

Attention should be paid to the effect of moral disengagement on cyberbullying in family and social factors, as well as the role of gender.

Back and neck pain: A comparison between acute and chronic pain-related Temporomandibular Disorders

Background

Temporomandibular disorders (TMDs) are common and cause persistent pain. Comorbidities are associated with TMDs and can affect the effectiveness of their treatments. The literature is lacking enough evidence on the difference between acute and chronic pain, particularly in TMDs. Investigating this difference could highlight potential risk factors for the transition from acute to chronic pain-related TMDs.

Aim

To compare the likelihood of back and neck pain (BP, NP) between acute and chronic pain-related TMDs (AP-TMD, CP-TMD) as defined by pain duration and pain-related disability.‎.

Methods

Participants with AP-TMDs (≤3 months) and CP-TMDs (>3 months) were recruited according to the diagnostic criteria and research diagnostic criteria of TMD. BP and NP were assessed using a self-reported checklist. CP-TMDs defined by disability (chronic disability) and depression and anxiety symptoms were assessed using validated instruments. Logistic regression analyses were employed.

Results

This study enrolled 487 adults with AP-TMD (n = 118) and CP-TMD (n = 369). Relative to AP-TMD, participants with CP-TMD had twice the odds of reporting NP (odds ratio [OR] = 2.17‎, 95% CI 1.27-3.71) but not BP ‎‎(OR = 0.96, 95% CI 0.57-1.64). Participants with chronic disability were twice as likely to report NP ‎(OR = 1.95‎, 95% CI 1.20-3.17‎) but not BP (OR = 1.13, 95% CI 0.69-1.82)‎ compared to those without. All analyses were adjusted for age, sex, and anxiety and depression symptoms.

Conclusions

Within the limitations of this study, results suggest that central dysregulation or trigeminocervical convergence mechanisms are implicated in the process of pain-related TMD chronification and highlight the relevance of considering disability when defining CP-TMDs.

Global Variation in Hand Hygiene Practices Among Adolescents: The Role of Family and School-Level Factors

While appropriate hand hygiene practices (HHP) are protective against infections, the paucity of evidence on global estimates and determinants of HHP in adolescents limits effective design and planning of intervention to improve HHP in young people. We examined the prevalence and correlates of HHP in adolescents. We used nationally representative data from the Global School-based Student Health Survey (2003–2017) from 92 countries. HHP were categorized as “appropriate”, “inappropriate” and “lacking” based on the information about “hand washing before eating”, “hand washing after using the toilet”, and “hand washing with soap”. Multinomial logistic regression analyses were used to assess the role of socio-demographic, health, lifestyle, school, and family-related variables in HHP. Among 354,422 adolescents (13–17 years), only 30.3% were found to practice appropriate hand hygiene. Multivariable models suggest that sedentary behavior (adjusted relative risk ratio (ARRR) 1.41, 95% CI 1.31–1.51)), and bullying victimization (ARRR 1.20, 95% CI 1.10–1.30) promoted inappropriate HHP. In contrast, parental supervision (ARRR 0.55, 95% CI 0.50–0.59) and parental bonding (ARRR 0.81, 95% CI 0.75–0.87) were protective against inappropriate HHP. From a policy perspective, hand hygiene promotion policies and programs should focus on both school (bullying, exercise) and family-level factors (parental supervision and parental bonding) factors.

Bullying and ART Nonadherence Among South African ALHIV: Effects, Risks, and Protective Factors

BACKGROUND

Identifying risk and protective factors for adolescent antiretroviral therapy (ART) adherence is a public health priority, given high HIV-related mortality in this population. An area that merits further investigation is the relationship between bullying victimization, mental health problems, and ART nonadherence among adolescents living with HIV (ALHIV). However, no known studies assess effects of bullying on adolescent nonadherence or risk and protective factors that could moderate this relationship.

SETTING

This study investigates (1) the direct longitudinal relationship between bullying exposure and ART nonadherence, and the indirect relationship via psychological distress, and (2) potential risk and modifiable protective factors moderating these pathways, among vertically and horizontally infected ALHIV who initiated treatment across 53 public health care facilities in a South African health district.

METHODS

Survey data were collected at 2 time points, between 2014 and 2017, with 1046 ALHIV (94% retention). Various mediation and moderated mediation models were run as part of a staged analysis approach.

RESULTS

A significant longitudinal relationship was found between bullying victimization and nonadherence, operating indirectly through psychological distress [B = 0.07; 95% confidence interval (CI): (0.03 to 0.13)]. Moderation analyses indicated that older adolescents exposed to bullying are more at risk of nonadherence [B = 0.52; 95% CI: (0.07 to 0.97) P < 0.05], and parental monitoring is a potential protective factor buffering indirect effects of bullying on nonadherence [B = -0.22; 95% CI: (-0.42 to -0.02) P < 0.05].

CONCLUSIONS

These findings underscore the importance of interventions that address bullying and psychological distress, and strengthen parental monitoring, particularly among older ALHIV.

Psychological distress and parental involvement among adolescents in 67 low-income and middle-income countries: A population-based study

BACKGROUND

Adolescents with mental illnesses account for a significant proportion of young people globally. Mental illness is a major public health problem because of its harmful effects on adolescents' development. There is a need to better understand the prevalence and protective factors regarding adolescents' psychological distress to inform policies for effective prevention.

METHODS

We used data from the Global School-based Student Health Surveys between 2009 and 2017. The data were collected through anonymous self-report questionnaires. This report is based on four questions assessing psychological distress and three questions assessing parental involvement. We calculated the pooled overall and regional estimates by random-effects meta-analysis. Logistic regression models were used to analyse the association between psychological distress and parental involvement. The association between adolescents' psychological distress and a country's purchasing power parity (PPP) was examined by linear regression analysis.

RESULTS

We included 167,484 young adolescents (boys, 47.3%; girls, 52.7%) in low-income and middle-income countries. The overall prevalence rates of psychological distress (loneliness, insomnia due to anxiety, suicidal ideation, and no close friends) were 10.7%, 9.1%, 13.6%, and 6.4%, respectively. A high level of parental involvement was associated with good mental health. The relationships of PPP with loneliness and insomnia due to anxiety were positive, but the relationships of PPP with the other two aspects were negative.

LIMITATIONS

The cross-sectional data do not infer causality between psychological distress and parental involvement.

CONCLUSIONS

This study indicated that high levels of parental involvement were significantly associated with a decreased likelihood of psychological distress. In addition, PPP was also related to psychological distress. Specifically, PPP was significantly associated with a decreased likelihood of not having close friends.

Role of School Health Officers in Mental Health Care for Secondary School Students in Can Tho City, Vietnam

The objectives of the study were to explore the experiences of school health officers in identifying and managing mental health problems of secondary school students and to gather recommendations from the school officers for improving the effectiveness of mental health care in secondary schools in Can Tho City, Vietnam. We conducted a qualitative study based on in-depth interviews using a semi-structured guideline with 15 school health officers at 15 secondary schools in Can Tho City, Vietnam. Data were analyzed using content-driven analysis to identify recurring themes. The school health officers reported that stress, depression, suicidal ideation, and sexual orientation issues were the most commonly encountered mental health problems among their students. The officers worked with a limited range of interventions for helping these students, such as giving non-narcotic analgesics or advising students to take a short break at school or to go home. Most of them felt that their training was insufficient to deal with mental health problems in an optimal way. They recommended further training to improve their knowledge and skills in recognizing and managing mental health problems in students. They also considered a university-sponsored mental health website a good source of information on mental health care for students. School health officers reported that they did not feel well equipped to manage mental health problems because of insufficient training, lack confidence, and absence of an appropriate network for advice and referral. Updated policies and programs are needed for initial training and refresher courses, which will strengthen the role of school health officers as first line support for secondary school students with mental health problems.

Global variation in the prevalence of suicidal ideation, anxiety and their correlates among adolescents: A population based study of 82 countries

BACKGROUND

Suicidal ideation and anxiety are common among adolescents although their prevalence has predominantly been studied in high income countries. This study estimated the population prevalence of suicidal ideation and anxiety and their correlates with peer support, parent-adolescent relationship, peer victimization, conflict, isolation and loneliness across a range of low-income, lower-middle-income, upper-middle-income countries and high-income countries (LMIC-HICs).

METHODS

Data were drawn from the Global School-based Student Health Survey (GSHS) of adolescents aged 12-17 years between 2003 and 2015 in 82 LM-HICs from the six World Health Organization (WHO) regions. For those countries with repeated time point data in this study, we used data from the most recent survey. We estimated weighted prevalence of suicidal ideation and anxiety by country, region and at a global level with the following questions:-"Did you ever seriously consider attempting suicide during the past 12 months?" and "During the past 12 months, how often have you been so worried about something that you could not sleep at night?". We used multiple binary logistic regression to estimate the adjusted association between adolescent age, sex, socioeconomic status, peer support, parent-adolescent relationship, peer victimization, conflict, isolation and loneliness with suicidal ideation and anxiety.

FINDINGS

The sample comprised of 275,057 adolescents aged 12-17 years (mean age was 14.6 (SD 1.18) years of whom 51.8% were females). The overall 12 months pooled prevalence of suicidal ideation and anxiety were 14.0% (95% CI 10.0-17.0%) and 9.0% (7.0-12.0%) respectively. The highest pooled prevalence of suicidal ideation was observed in the Africa Region (21.0%; 20.0-21.0%) and the lowest was in the Asia region (8.0%, 8.0-9.0%). For anxiety, the highest pooled prevalence was observed in Eastern Mediterranean Region (17.0%, 16.0-17.0%) the lowest was in the European Region (4.0%, 4.0-5.0%). Being female, older age, having a lower socioeconomic status and having no close friends were associated with a greater risk of suicidal ideation and anxiety. A higher levels of parental control was positively associated with a greater likelihood of experiencing suicidal ideation (OR: 1.65, 1.45-1.87) and anxiety (1.53, 1.30-1.80). Parental understanding and monitoring were negatively associated with mental health problems. Similarly, the odds of experiencing suicidal ideation and anxiety were higher among adolescents who had been experiencing peer conflict (1.36, 1.24-1.50; 1.54, 1.40-1.70), peer victimization (1.26, 1.15-1.38; 1.13, 1.02-1.26), peer isolation (1.69, 1.53-1.86; 1.76, 1.61-1.92) and reported loneliness (2.56, 2.33-2.82; 5.63, 5.21-6.08).

INTERPRETATIONS

Suicidal ideation and anxiety are prevalent among adolescents although there is significant global variation. Parental and peer supports are protective factors against suicidal ideation and anxiety. Peer based interventions to enhance social connectedness and parent skills training to improve parent-child relationships may reduce suicidal ideation and anxiety. Research to inform the factors that influence country and regional level differences in adolescent mental health problems may inform preventative strategies.

FUNDING

None.

Mental health among Vietnamese urban late adolescents: The association of parenting styles

The aim of this study was to explore the correlation between parental styles and mental problems among Vietnamese high school students. In total, 16.4 percent of 757 eligible participants reported mental difficulties. Findings showed that being female and in grade 12 were risk factors to mental problems while living in Hue city was likely as a protective factor. The father’s warmth reduced the risk of having mental problems among adolescents, while an overprotective mother increased the risk. There was no correlation between authoritarianism of both mother and father and mental difficulties. These results suggest that a parenting program for parents might reduce the risk of mental problems among Vietnamese youth.

Global variation in the prevalence of bullying victimisation amongst adolescents: Role of peer and parental supports

BACKGROUND

Bullying victimisation is a global public health problem that has been predominantly studied in high income countries. This study aimed to estimate the population level prevalence of bullying victimisation and its association with peer and parental supports amongst adolescents across low and middle income to high income countries (LMIC-HICs).

METHODS

Data were drawn from the Global School-based Student Health Survey of school children aged 12-17 years, between 2003 and 2015, in 83 LMIC-HICs in the six World Health Organization (WHO) regions. We estimated the weighted prevalence of bullying victimisation at country, region and global level. We used multiple binary logistic regression models to estimate the adjusted association of age, gender, socioeconomic status, and parental support and peer support, and country level variables (GDP and government expenditure on education) with adolescent bullying victimisation.

FINDINGS

Of the 317,869 adolescents studied, 151,036 (48%) were males, and 166,833 (52%) females. The pooled prevalence of bullying victimisation on one or more days in the past 30 days amongst adolescents aged 12-17 years was 30·5% (95% CI: 30·2-31·0%). The highest prevalence was observed in the Eastern Mediterranean Region (45·1%, 44·3-46·0%) and African region (43·5%, 43·0-44·3%), and the lowest in Europe (8·4%, 8·0-9·0%). Bullying victimisation was associated with male gender (OR: 1·21; 1·11-1·32), below average socio-economic status (OR: 1·47, 1·35-1·61), and younger age (OR: 1·11, 1·0-1·24). Higher levels of peer support (0·51, 0·46-0·57), higher levels of parental support (e.g., understanding children's problems (OR: 0·85, 0·77-0·95), and knowing the importance of free time spent with children (OR: 0·77, 0·70-0·85)), were significantly associated with a reduced risk of bullying victimisation.

INTERPRETATIONS

Bullying victimisation is prevalent amongst adolescents globally, particularly in the Eastern Mediterranean and African regions. Parental and peer supports are protective factors against bullying victimisation. A reduction in bullying victimisation may be facilitated by family and peer based interventions aimed at increasing social connectedness of adolescents.