ABSTRACT
Background: Academic stress is part of a student's life. Chronic stress may result in mental health problems, affecting the adolescent's well-being in adulthood. However, not all types of stress result in a negative effect. Therefore, understanding how adolescents adapt to academic stress can lay the groundwork for preventive interventions. The Response to Stress Questionnaire (RSQ) for academic problems centred on a multidimensional model of responses to stress. However, it has not been tested among Malaysians. Thus, this study aimed to validate the questionnaire among Malaysians. Methods: The questionnaire was translated into the Malay language using forward and backward translation. Data were collected via self-administered questionnaires at a secondary school in Kuching. A validity test was conducted using face and content validation by subject matter experts, and construct validation was performed using exploratory factor analysis (EFA). A reliability test was conducted by checking Cronbach's alpha. Results: Results showed that the questionnaire has good validity and reliability. The EFA resulted in only three dimensions of responses to stress among Malaysian adolescents in contrast to the five dimensions in the original RSQ for academic problems. The Cronbach's alpha showed good reliability of the questionnaire. Conclusion: The questionnaire measuring responses to stress was valid and reliable in assessing the responses of adolescents to academic stress.
ABSTRACT
BACKGROUND: The trend of depression is rising worldwide. There are limited studies on depression in adolescents. The aim of this study was to estimate the prevalence of and identify the factors associated with depressive symptoms in adolescents in Kuching, Malaysia, and to analyze the relationship between depressive symptoms and suicidal ideation. METHODS: A cross-sectional study was conducted in 320 students from urban and rural secondary schools. The participants were randomly selected via multi-stage sampling. They completed the Malay versions of the Children's Depression Inventory (CDI) and Beck Scale for Suicide Ideation (BSS). RESULTS: The prevalence of depressive symptoms was 26.2%. On binary logistic regression analysis, variables with significant association with depressive symptoms were race (P = 0.028), type of class (P < 0.001), mother's education level (P = 0.036), type of housing (P = 0.036), parents' marital status (P = 0.012), alcohol intake (P = 0.005), stealing (P < 0.001) and history of disciplinary record (P = 0.005). Variables that remained significant on multivariable logistic regression were type of class (P = 0.004), parents' marital status (P = 0.017) and stealing (P < 0.001). Students from the Arts stream (OR, 2.43) with parents who were separated, divorced or widowed (OR, 3.13) and who had experience of stealing (OR, 3.27) were predicted to be at risk of developing depressive symptoms. There was a significant correlation between total CDI score and total BSS score (P < 0.001). CONCLUSIONS: The prevalence of depressive symptoms in adolescents was high. Depressive symptoms are significantly correlated with suicidal ideation. Greater collaboration between the education and health agencies is essential for mental health promotion in schools and early detection of depression, especially in at-risk adolescents.