Item response theory and differential test functioning analysis of the HBSC-Symptom-Checklist across 46 countries.

BACKGROUND: The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries. METHODS: Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined. RESULTS: Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low. CONCLUSION: HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.

School experiences in relation to emotional and conduct problems in adolescence: a 3-year follow up study.

BACKGROUND: Mental health in adolescents has become a major public health issue. This study examined school experiences in relation to mental health (emotional problems and conduct problems) from early to middle adolescence. METHODS: This longitudinal 3-year follow up study used data from the Swedish Study of Health in School Children in Umeå. Analyses were conducted in 1379 participants that were attending grade six in 2003 or 2006 (age 12 years). KIDSCREEN-52 was used to assess school experiences and the Strengths and Difficulties Questionnaire for emotional and conduct problems. Statistical analyses included repeated measures ANOVA and multiple linear regressions. RESULTS: Positive school experiences decreased while emotional and conduct problem scores increased from grades six to nine. Positive school experiences were negatively associated with emotional and conduct problem scores and contributed to the explanation of mental health scores in middle adolescence after controlling for background factors. When baseline mental health problem scores were taken into account the association with early school experiences disappeared (except for conduct problems in boys). However, incorporating concurrent school experiences in the analysis increased the levels of explanation for emotional and conduct problem scores further. CONCLUSIONS: The results of this study confirm that school experiences are linked to emotional and conduct problems. That link may be stronger for conduct problems. In addition, the association of school experiences in early adolescence with later mental health may be overridden by concurrent school experiences in middle adolescence.

Prevalence of emergency contraceptive pill use among Spanish adolescent girls and their family and psychological profiles.

BACKGROUND: Adolescent girls' family context and psychological characteristics play important roles in their sexual behavior, including the use of the emergency contraceptive pill (ECP). This study aims to (1) determine the prevalence of ECP use among girls who have had sexual intercourse and (2) comparatively analyze their family and psychological profiles according to whether they have used ECPs. METHODS: The sample of 1735 Spanish girls aged 15 to 18 came from a representative sample of the 2014 edition of the Health Behaviour in School-aged Children (HBSC) study. Of this sample, 398 girls had sexual intercourse and reported their ECP use. Data collection for the HBSC study was performed through an online questionnaire to which adolescents responded anonymously in school. Data analyses were descriptive and bivariate and were performed with the statistical program IBM SPSS Statistics 23. RESULTS: The results demonstrated that 30.65% of girls who had sexual intercourse used ECPs. Noticeable differences in paternal knowledge and communication with the father were observed between girls who used the ECP at least once and those who did not use it. In contrast, differences between girls who used the ECP once and those who used it twice or more were pronounced with regard to parental knowledge, communication with parents, maternal affection, life satisfaction, sense of coherence and depression. CONCLUSIONS: This work demonstrates a high prevalence of ECP use and a more positive family and psychological profile for girls who used ECP once compared with those who used it twice or more.

The utility of salutogenesis for guiding health promotion: the case for young people's well-being.

Twenty years have passed since the publication of the seminal paper 'The salutogenic model as a theory to guide health promotion' (Health Promot Int 1996;11:11-18.), in which Antonovsky proposed salutogenesis and its central construct sense of coherence as a way of boosting the theoretical basis for health promotion activities. Since then there has been a notable amount of conceptual and empirical work carried out to further explore its significance. The aim of this paper is to critically assess the current theoretical status of salutogenesis and its utility to advance effective health promotion practice for young people. The assessment was carried out in the context of contemporary international policy agendas on well-being. An analytic framework was developed using the previous literature on the definition and function of theory. This organizing framework comprised four criteria: description, explanation, prediction and measurability. The paper concludes with a perspective on the status of salutogenesis as a theory and how it can be further developed. Specifically, the critical assessment highlighted that salutogenesis has been subjected to considerable empirical testing over the last few decades resulting in convincing evidence of the relevance and subsequent advancement of the idea. However, less emphasis seems to have been placed on a systematic process of testing and iteration to develop its theoretical basis. The paper identifies a number of aspects that should be developed to support the progression of salutogenesis to the next level. A research-practice cycle approach is proposed that can facilitate that important next step.

Emotional and Psychosocial Factors Associated With Drunkenness and the Use of Tobacco and Cannabis in Adolescence: Independent or Interactive Effects?

BACKGROUND: Although previous research has examined emotional and psychosocial factors associated with substance use, there is a paucity of studies examining both at the same time, and insufficient attention has been paid to how these factors may interact. OBJECTIVES: The aim of this study was to simultaneously examine the contributions from emotional (emotional control and depression) and psychosocial (peers' conventional behavior, peers' substance use and parent-child relationships) factors to drunkenness and the use of tobacco and cannabis in adolescence. METHODS: Sample consisted of 1,752 adolescents aged 15 to 16 years who had participated in the 2014 edition of the WHO Health Behaviour in School-aged Children survey in Spain. Data were collected by means of anonymous online questionnaires, and hierarchical multiple regression models (with sex and age as controls and including interactions among the examined predictors) were used for statistical analysis. RESULTS: Emotional and psychosocial factors showed significant interactive effects on substance use. Emotional control, which tended to buffer the effects of potential risk factors, and peers' substance use were consistent predictors of substance use. In contrast, the role of other factors depended on the substance under study, with depression and peers' conventional behavior being part of interactive terms for tobacco use and cannabis use only, and the quality of parent-child relationships being absent from the final model on cannabis use. Conclusions/Importance: Exploring interactions and potential substance-specific effects is fundamental to reach a better understanding of how emotional and psychosocial factors work in concert relative to substance use in adolescence.

Understanding the joint effects of family and other developmental contexts on the sense of coherence (SOC): a person-focused analysis using the Classification Tree.

Using a person-focused approach, the present study sought to identify meaningful constellations of contextual factors that led to predominantly high and low levels of sense of coherence (SOC). Specifically, the contributions of the quality of parent-child relationships, teacher and classmate support, models of behaviour in the peer group, and neighbourhood assets were examined in a representative sample of Spanish adolescents aged 13 to 18 that had taken part in the 2010 edition of the study Health Behaviour in School-aged Children. The quality of parent-child relationships emerged as the main predictor of SOC for the whole sample, but the remaining factors also made significant contributions, which underlines the importance of the simultaneous analysis of the main contexts in adolescents' lives. Additionally, the identified constellations usually included compensatory effects, so no factor should be considered to be completely determining. Interestingly, the role of support at school was different depending on contextual profiles.

Neighbourhood perceptions and sense of coherence in adolescence.

The neighbourhood has traditionally been neglected in studies about adolescents' sense of coherence (SOC). The current study represents the first attempt to analyse the associations between neighbourhood assets, neighbourhood risks, and SOC during adolescence. The sample consisted of 7,580 Spanish adolescents aged 13-18 who were selected for the 2009/10 edition of the Health Behaviour in School-aged Children (HBSC) survey in Spain. The adolescents completed self-report questionnaires that included the SOC-29 scale and separate HBSC scales measuring neighbourhood risks and assets. The results showed that neighbourhood risks were negatively associated with the adolescents' SOC. In contrast, neighbourhood assets, especially relationships with significant adults, were positively associated with the adolescents' SOC. Assets explained 6.5% of the variability in SOC scores after controlling for risks, suggesting that assets may play a significant role, even in neighbourhoods where risks are present. We discuss implications and future research directions.

Sense of coherence and substance use in Spanish adolescents. Does the effect of SOC depend on patterns of substance use in their peer group?

The aims of this work were to analyse the relationships between sense of coherence (SOC) and substance use among Spanish adolescents and to examine the potential moderator effect of the patterns of substance use in the peer group. Sample consisted of 5475 Spanish adolescents aged 15 to 18 from the 2010 edition of the Health Behaviour in School-aged Children (HBSC) study. Statistical analysis included cluster analysis to identify groups of adolescents according to their peer group's patterns of substance use and logistic regression with SOC and peers' pattern of consumption as predictors of current tobacco use, current alcohol use, life-time drunkenness and current drunkenness. The results showed that a strong SOC seemed to reduce the adolescents' likelihood of involving in tobacco use and drunkenness, but it was not associated with being a current drinker. In addition, the protective effect of SOC was moderated by peers' patterns of substance use. Specifically, SOC had a significant protective influence in adolescents whose peer group showed either a nonconsumption pattern or a pattern of frequent alcohol use and occasional drunkenness; but the protective effect of SOC disappeared if peers showed a pattern of consumption that included illegal drugs. In conclusion, SOC tends to act as a protective personal variable with respect to substance use during adolescence, but the influence exerted by the peer group seems to moderate the aforementioned protective effect of SOC.

Stress of school performance among secondary students: The role of classroom goal structures and teacher support.

With concern growing about the increasing levels of school stress among secondary school students, examining its associations with students' perceptions of important elements in classroom climate can offer valuable scientific information. However, there is minimal research about the role of perceived classroom goal structures and teacher support in school stress. In addition, most research on classroom goal structure has not made a distinction between performance-approach structures and performance-avoidance structures, which may have different effects on school stress. The aim of the present study was to examine the role of classroom goal structures and teacher support in students' stress linked to school performance. We also examined the potential moderating effect of teacher support in the association between classroom goal structures and stress. Our sample consisted of 4768 secondary school students aged 11-17 years (Mage = 13.74; 47.9% boys) from 54 schools in Andalusia, Spain. Consistent with the study's aims, hierarchical multilevel multiple regression was used to examine the relationships between mastery goal structure, performance-approach goal structure, performance-avoidance goal structure, and teacher support on our stress of school performance outcome. After controlling for gender, age, and previous academic achievement, performance-avoidance goal structure was significantly associated with higher levels of stress of school performance (p < .01). Furthermore, perceived classroom goals and teacher support tended to work together, with the role of performance-approach goal structure being dependent on the levels of mastery goal structure and teacher support (p < .05). Practical implications from these findings and future research directions are discussed.

Analysis of the importance of family in the development of sense of coherence during adolescence.

AIMS: The aim of this work was to study the influence of several family dimensions on sense of coherence (SOC) in adolescence, controlling the possible effects from the demographic variables, gender and age. METHODS: The sample consisted of 7580 adolescents between the ages of 13 and 18, who had taken part in the 2010 edition of the WHO Health Behaviour in School-aged Children study in Spain. RESULTS: The results showed that there were no significant gender differences in SOC levels. However, age had a significant influence on SOC. Higher levels of SOC were found in adolescents aged 13 and 14 compared to older participants. Family variables explained 18% of SOC variability, with affection, easy communication with parents, and parental knowledge as the most outstanding variables. In addition, positive relationships between parents and family affluence had a significant role in explaining SOC levels. CONCLUSIONS: The results suggest that the family context plays an important role in providing meaningful experiences for the development of a strong SOC in adolescence.

Bullying, cyberbullying, and adoption: What is the role of student-teacher connectedness?

Bullying and cyberbullying have rarely been studied among the adoptive population, although the few studies available show adopted students frequently experience these phenomena. To address this research gap, this article examined potential differences in bullying and cyberbullying between domestic adoptees, intercountry adoptees, and nonadopted students, paying separate attention to frequent and occasional victimization and perpetration experiences. In addition, the aims of the article include analyzing student-teacher connectedness in these groups and exploring its potential protective role for the aforementioned bullying and cyberbullying experiences. The sample consists of 541 adopted adolescents (67.1% intercountry adoptees and 32.9% domestic adoptees) and 582 nonadopted adolescents aged 11-18 years who had participated in the 2017/2018 edition of the Health Behaviour in School-aged Children (HBSC) study in Spain. Results show that the likelihood of involvement in bullying and cyberbullying (either victimization or perpetration) was lower for the nonadopted group, whereas domestic adoptees were significantly more likely to report these experiences. Furthermore, student-teacher connectedness was lower among domestic adoptees compared to their nonadopted peers. Finally, teacher connectedness was consistently associated with a lower likelihood of frequent bullying and cyberbullying victimization, and of both occasional and frequent cyberbullying perpetration. Overall, our findings are consistent with an increased risk of bullying and cyberbullying among domestic adoptees and a predominantly consistent protective role of student-teacher connectedness, although differences depending on the specific kind of experience deserve further examination in future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

School Satisfaction and School Pressure in the WHO European Region and North America: An Analysis of Time Trends (2002-2018) and Patterns of Co-occurrence in 32 Countries.

PURPOSE: The purpose of the study was to examine the trends between 2002 and 2018 in school pressure and school satisfaction among 15-year-old students, across countries and by gender, in the WHO European region and North America, and explore whether there are variations between countries and by gender in the co-occurrence of school pressure and school satisfaction. METHODS: Data from the 32 countries that participated in the Health Behaviour in School-aged Children study (HBSC) study between 2002 and 2018 were used. Statistical analyses included t-tests, binary logistic regression analyses, and chi-square tests, as required by each of the study aims. RESULTS: School satisfaction tended to increase over the period 2002-2018 among boys, whereas school pressure increased among girls. Also, gender differences tended to dissipate in school satisfaction and generally increase in school pressure. The co-occurrence of school satisfaction and school pressure in 2017/2018 shows that the majority of students are found in the "not pressured-not highly satisfied" and "pressured-not highly satisfied" groups. There were more boys in the former group and more girls in the latter group. CONCLUSION: Few students in the 32 countries belonged to the "not pressured-highly satisfied" group, which from a public health perspective may be seen as the most desirable group. The increases in school pressure in girls from 2002 to 2018 and their overrepresentation in the pressured groups require further attention.

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; meanage = 13.54; standard deviationage = 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.

Trend Analysis of Bullying Victimization Prevalence in Spanish Adolescent Youth at School.

BACKGROUND: We analyze trends in bullying victimization prevalence in a representative sample of Spanish adolescent schoolchildren in 2006, 2010, and 2014. METHODS: We distinguish between reported bullying, which is assessed via the global question in the Revised Bully/Victim Questionnaire by Olweus, and observed bullying, which is a measure developed from the answers that the adolescents gave to specific items that refer to different types of bullying that have been codified as physical, verbal, and relational bullying. RESULTS: For 2006 and 2010/2014, the results show stability in the assessment of reported bullying and an increase in observed bullying, analyzed both globally and within the 3 categories: physical, verbal, and relational. CONCLUSIONS: A valid, reliable, and accurate measure to detect cases of bullying is necessary, as is the importance of continuing efforts devoted to raising awareness and the prevention of this phenomenon.

Characterization of Vulnerable and Resilient Spanish Adolescents in Their Developmental Contexts.

Research on resilience and vulnerability can offer very valuable information for optimizing design and assessment of interventions and policies aimed at fostering adolescent health. This paper used the adversity level associated with family functioning and the positive adaptation level, as measured by means of a global health score, to distinguish four groups within a representative sample of Spanish adolescents aged 13-16 years: maladaptive, resilient, competent and vulnerable. The aforementioned groups were compared in a number of demographic, school context, peer context, lifestyles, psychological and socioeconomic variables, which can facilitate or inhibit positive adaptation in each context. In addition, the degree to which each factor tended to associate with resilience and vulnerability was examined. The majority of the factors operated by increasing the likelihood of good adaptation in resilient adolescents and diminishing it in vulnerable ones. Overall, more similarities than differences were found in the factors contributing to explaining resilience or vulnerability. However, results also revealed some differential aspects: psychological variables showed a larger explicative capacity in vulnerable adolescents, whereas factors related to school and peer contexts, especially the second, showed a stronger association with resilience. In addition, perceived family wealth, satisfaction with friendships and breakfast frequency only made a significant contribution to the explanation of resilience. The current study provides a highly useful characterization of resilience and vulnerability phenomena in adolescence.

Bullying victimization prevalence and its effects on psychosomatic complaints: can sense of coherence make a difference?

BACKGROUND: The aim of this study was to examine the prevalence of bullying victimization and its impact on physical and psychological complaints in a representative sample of adolescents and to explore the role of sense of coherence (SOC) in victimization prevalence and consequences. METHODS: A representative sample of Spanish adolescents (N = 7580, mean age = 15.41) was selected as part of the Health Behaviour in School-aged Children study. Bullying victimization, physical and psychological symptoms, and SOC were measured, and comparisons were made between strong- and weak-SOC adolescents regarding their likelihood of being a victim of bullying and the negative effects of bullying victimization on their health. RESULTS: Weak-SOC adolescents were significantly more likely to suffer from bullying victimization regardless of type (nonphysical vs physical and nonphysical) or means (traditional vs cyberbullying). In addition, bullying victimization showed significant increasing effects on weak-SOC adolescents' physical and psychological symptoms whereas in strong-SOC adolescents it was not significantly associated with increases in physical complaints and its effects on psychological complaints seemed to be weaker. CONCLUSIONS: Weak-SOC adolescents seem to be at higher risk of becoming bullying victims and victimization experiences appear to have increased negative effects on them when compared to strong-SOC students.

Sense of coherence and biopsychosocial health in Spanish adolescents.

The aim of this study was to analyse the effect of the SOC on the main components of biopsychosocial health separately, thereby contributing to a better understanding of the relationship between the SOC and health in adolescence. The sample consisted of 7,580 Spanish adolescents aged 13 to 18 who had participated in the 2009/10 edition of the WHO international survey Health Behaviour in School-aged Children. Using multivariate analysis of variance, the effects of the SOC and demographic variables (including interaction effects between them) on different health components were analysed. A higher SOC was associated with better self-rated health, lower frequency of somatic and psychological complaints and higher quality of life and life satisfaction. Thus, results support the association between SOC and positive health outcomes, especially for the psychological components of health. In addition, the effect of SOC on the various health components was homogeneous among all of the adolescents, regardless of gender and age.

Developmental contexts and sense of coherence in adolescence: a systematic review.

The salutogenic model has led to revolutionary changes in the study of health. In recent years, a large amount of research has been carried out on the relationship between sense of coherence and health, but relatively little is known about sense of coherence in adolescence. This study is a systematic review of the studies that looked at sense of coherence in adolescent samples. Valuable information is provided regarding the characteristics of the samples, the reliability of the sense of coherence scale versions, the influence of demographic variables and how family, school, peers and neighbourhood impact sense of coherence development. Furthermore, future directions for the study of sense of coherence in adolescence are provided.

Sense of coherence and biopsychosocial health in Spanish adolescents

The aim of this study was to analyse the effect of the SOC on the main components of biopsychosocial health separately, thereby contributing to a better understanding of the relationship between the SOC and health in adolescence. The sample consisted of 7,580 Spanish adolescents aged 13 to 18 who had participated in the 2009/10 edition of the WHO international survey Health Behaviour in School-aged Children. Using multivariate analysis of variance, the effects of the SOC and demographic variables (including interaction effects between them) on different health components were analysed. A higher SOC was associated with better self-rated health, lower frequency of somatic and psychological complaints and higher quality of life and life satisfaction. Thus, results support the association between SOC and positive health outcomes, especially for the psychological components of health. In addition, the effect of SOC on the various health components was homogeneous among all of the adolescents, regardless of gender and age (AU)

No disponible

Sentido de coherencia y consumo de sustancias en adolescentes españoles. ¿Depende el efecto del SOC de los patrones de consumo de sustancias del grupo de iguales? / Sense of coherence and substance use in Spanish adolescents. Does the effect of SOC depend on patterns of substance use in their peer group?

Los objetivos de este trabajo fueron analizar las relaciones entre el sentido de coherencia (SOC) y el consumo de sustancias en los adolescentes españoles y el potencial efecto moderador de los patrones de consumo de sustancias en el grupo de iguales en dicha relación. La muestra constaba de 5475 adolescentes españoles de 15 a 18 años, participantes en la edición 2010 del estudio Health Behaviour in School-aged Children (HBSC). Los análisis estadísticos consistieron en análisis de cluster, para identificar grupos de adolescentes según los patrones de consumo de sustancias en su grupo de iguales, y regresión logística, con el SOC y los patrones de consumo en el grupo de iguales como predictores del consumo actual de tabaco y alcohol, episodios de embriaguez alguna vez en la vida y en la actualidad. Los resultados mostraron que un fuerte SOC parecía reducir la probabilidad de consumo de tabaco y episodios de embriaguez, pero no se asoció con el consumo actual de alcohol. Además, el efecto protector del SOC estaba moderado por los patrones de consumo del grupo de iguales. En concreto, el SOC tuvo un efecto protector significativo en los adolescentes cuyo grupo de iguales mostraba un patrón de no consumo o de frecuente consumo de alcohol y episodios de embriaguez ocasionales, pero el efecto del SOC desapareció si el patrón de consumo de los iguales incluía drogas ilegales. En conclusión, el SOC tiende a actuar como un factor protector individual respecto al consumo de sustancias durante la adolescencia, pero la influencia del grupo de iguales parece moderar dicho efecto protector del SOC (AU)

The aims of this work were to analyse the relationships between sense of coherence (SOC) and substance use among Spanish adolescents and to examine the potential moderator effect of the patterns of substance use in the peer group. Sample consisted of 5475 Spanish adolescents aged 15 to 18 from the 2010 edition of the Health Behaviour in School-aged Children (HBSC) study. Statistical analysis included cluster analysis to identify groups of adolescents according to their peer group’s patterns of substance use and logistic regression with SOC and peers’ pattern of consumption as predictors of current tobacco use, current alcohol use, life-time drunkenness and current drunkenness. The results showed that a strong SOC seemed to reduce the adolescents’ likelihood of involving in tobacco use and drunkenness, but it was not associated with being a current drinker. In addition, the protective effect of SOC was moderated by peers’ patterns of substance use. Specifically, SOC had a significant protective influence in adolescents whose peer group showed either a non consumption pattern or a pattern of frequent alcohol use and occasional drunkenness; but the protective effect of SOC disappeared if peers showed a pattern of consumption that included illegal drugs. In conclusion, SOC tends to act as a protective personal variable with respect to substance use during adolescence, but the influence exerted by the peer group seems to moderate the aforementioned protective effect of SOC (AU)