School-based Stress Management Training for Adolescents: Longitudinal Results from an Experimental Study

We need better ways to help students avoid the harms of stress: Results of a meta-analysis on the effectiveness of school-based stress management interventions

The level of psychological stress in children and adolescents has increased rapidly over the past decade. The aim of the present meta-analysis was to evaluate the effectiveness of school-based intervention programs targeting stress management and coping/resilience in school-aged children. The present study used more rigorous selection criteria than previous meta-analyses by only including randomized controlled trials to increase the validity of the meta-analysis. Fifty-five studies were selected for the analysis, including 66 comparisons in the case of stress and 47 comparisons in the case of coping/resilience outcomes. A meta-regression with robust variance estimation was used. Effects were calculated as the standardized mean difference (Hedges' g) between the intervention and control conditions at posttest. The results highlighted important methodological issues and the influence of outliers. Without outliers, the results indicated a small significant overall effect on stress (g = -0.15, p < .01) and coping/resilience (g = 0.14, p = .01). When outliers were included, the effect sizes markedly increased in both cases (gstress = -0.26, p = .022; gcoping/resilience = 0.30, p = .009). Stress management interventions were more effective if they were delivered by mental health professionals or researchers than by teachers. Coping/resilience interventions were more effective in older age groups, in selective samples, and if they included cognitive behavioral therapy. An explanation of the results and a detailed discussion of the limitations of the study and its implications for practice are considered.

Breathing life into social emotional learning programs: A Bio-Psycho-Social approach to risk reduction and positive youth development

INTRODUCTION

Over one-third of US adolescents engage in health risk and problem behaviors. Additionally, significant percentages of problem-free youth aren't flourishing. Left unaddressed, the lifetime mental/physical health and financial burdens may be substantial. Social-Emotional Learning (SEL) and Positive Youth Development (PYD) programs have proliferated to address the drivers of adaptive versus risk behaviors. Research suggests SEL/PYD program outcomes can be improved by adding techniques that physiologically induce calmness, yet few studies exist.

METHODS

This randomized controlled trial of 79 urban eighth-graders examined a standardized bio-psycho-social program, SKY Schools, which incorporates a physiologically calming component: controlled yogic breathing.

RESULTS

Repeated-measures ANOVAs demonstrated that compared to controls, SKY graduates exhibited significant improvements in emotion regulation, planning and concentration, and distractibility. After 3 months, significant improvements were evidenced in emotion regulation, planning and concentration, identity formation, and aggressive normative beliefs.

CONCLUSION

SEL/PYD programs may benefit by incorporating biologically-calming techniques to enhance well-being and prevent risk/problem behaviors.

Indicated Stress Prevention Addressing Adolescents with High Stress Levels Based on Principles of Acceptance and Commitment Therapy: A Randomized Controlled Trial

INTRODUCTION

Stress affects many adolescents and is associated with physical and mental health symptoms that can have a negative impact on normative development. However, there are very few evidence-based, specific treatment approaches. The aim of the study was to investigate an eight-session group intervention using components of Acceptance and Commitment Therapy (ACT) enriched with elements of CBT (psychoeducation, problem solving) and art therapy, compared to a waitlist control (WLC) group, regarding its efficacy in reducing stress and associated symptoms.

METHODS

We conducted a randomized controlled trial in eight cohorts. Eligible participants were 13-18 years old with elevated stress levels. Via block-randomization (n = 70), participants were allocated to receive ACT (n = 38) or WLC (n = 32) and subsequent ACT. We used a multimodal assessment (self-reports, interviews, ecological momentary assessment, physiological markers) before treatment (T1), after the training of the ACT group (T2) and after subsequent training in the WLC group (T3). Primary outcome was perceived stress at T2 assessed with the Perceived Stress Scale. The trial was preregistered at the German Clinical Trials Register (ID: DRKS00012778).

RESULTS

Results showed significantly lower levels of perceived stress in the ACT group at T2, illustrating superiority of ACT compared to WLC with a medium to large effect size (d = 0.77). Furthermore, the training was effective in the reduction of symptoms of school burnout and physical symptoms associated with stress.

CONCLUSION

Indicated prevention, especially when based on the principles of ACT and CBT, seems efficient in significantly decreasing stress in adolescents with increased stress.

Coping styles mediate the association between psychological inflexibility and psychological functioning during the COVID-19 pandemic: A crucial role of meaning-centered coping

People's psychological response to the COVID-19 pandemic is significantly affected by their psychological inflexibility. One possible mechanism explaining the association between psychological inflexibility and psychological functioning concerns coping styles. While avoidance and approach coping styles were previously found to mediate this association, the mediating role of meaning-centered coping has not yet been explored. However, meaning-centered coping it is likely to be crucial in circumstances as uncertain as those at the onset of the COVID -19 pandemic. This study explored the mediating role of the three coping styles in the relationship of psychological inflexibility with ill-being and well-being. Slovenian adults (N = 1365) aged 18-81 years provided self-reports on the Acceptance and Action Questionnaire, the Depression Anxiety Stress Scale, the PERMA Profiler, the Brief COPE Inventory, and the Meaning-Centered Coping Scale. In the context of the highly stressful beginning of the pandemic, psychological inflexibility contributed to higher ill-being and lower well-being directly and through increased use of avoidance coping, decreased use of meaning-centered coping, and, to a lesser extent, decreased use of approach coping. Avoidance coping predicted higher levels of ill-being, suggesting a maladaptive effect of this coping strategy. Approach coping positively but weakly predicted well-being, indicating a diminished value of this coping style in low-controllable circumstances of the pandemic. Finally, meaning-centered coping appeared to be the most beneficial in such circumstances, as it was associated with both lower levels of ill-being and higher levels of well-being. This finding suggests that meaning-centered coping should be studied as a stand-alone strategy, rather than as a combination of specific approach coping strategies. Consistent with previous research, this study demonstrates the importance of psychological inflexibility in effectively adapting to and actively coping with aversive situations. Furthermore, the results suggest that seeking or making meaning is vital, at least in a context characterized by low levels of control and high levels of uncertainty.

Moderators of pre-post changes in school-based mental health promotion: Psychological stress symptom decrease for adolescents with mental health problems, knowledge increase for all

Background

School-based mental health promotion aims to strengthen mental health and reduce stress. Results on the effectiveness of such programs are heterogeneous. This study realized a school-based mental health promotion program (StresSOS) for all students and aimed to identify moderators (mental health status, gender, grade level) of pre- to post-changes in stress symptoms and knowledge.

Methods

Participants were N = 510 adolescents (from 29 classes; 46.7% female) aged 12-18 years (M = 13.88, SD = 1.00; grade levels 7-10). They were without mental health problems (65.9%), at risk for mental health problems (21.6%), or with mental health problems (12.5%) and participated in a 90 min per week face-to-face training with 8 sessions in class at school. Demographic variables, mental health status, stress symptoms, and knowledge about stress and mental health were collected at baseline. Program acceptance, stress symptoms, and knowledge were collected post-intervention. Multilevel mixed effects models were conducted with the fixed effects time (within factor), mental health status, gender, and grade level (between factors). Random effects for students within classes were included.

Results

In the pre-post comparison, mental health status moderated the changes on psychological stress symptoms (p < 0.05). In adolescents with mental health problems the largest reduction in stress symptoms was observed between pre- and post-assessment. Gender and grade level were less relevant. For all adolescents knowledge gains were revealed (p < 0.001). Program acceptance was moderated by mental health status and grade level (p < 0.01). Mentally healthy adolescents and within the group of adolescents at-risk or with mental health problems, especially younger students (7th/8th grade), rated program acceptance higher.

Conclusion

Psychological stress symptoms decreased among adolescents with mental health problems and not among adolescents at risk for or without mental health problems. Mental health-related knowledge increased for all adolescents. The results add to knowledge on school-based mental health intervention research and practice. Its implications for different prevention strategies (universal, selective or a combination of both) are discussed.

Effectiveness of school-based brief cognitive behavioral therapy with mindfulness in improving the mental health of adolescents in a Japanese school setting: A preliminary study

Background

Emotional regulation is important for adolescents’ adaptive development. Preventive interventions for anxiety and depression are necessary for reducing the development of disorders later in life, and emotional regulation is a potentially relevant factor.

Objective

We investigated the effects of a mindfulness-based psychological education and prevention program [the Mindfulness and Awareness Program (MAP)] on the mental health of junior high school students in Japan.

Methods

Our MAP primarily focused on mindfulness meditation to improve emotional regulation, thereby reducing depression and anxiety. The MAP comprised eight sessions (20 min each) administered by a school counselor in a school setting. All participants (N = 349) were 12–13-year-old adolescents from nine classes in two Japanese schools. The program was provided to the intervention group, wherein students were educated on emotional expression, emotional cognition, and emotional regulation. The control group received regular school counseling services.

Results

Compared with the control group, the intervention group showed significant improvement in emotional regulation and a decrease in depression and generalized anxiety. The effect was greater at the follow-up assessment than at the immediate post-intervention assessment, and greater in female students.

Conclusion

Our mental health prevention program exhibited efficacy in reducing depression and anxiety and enhancing emotional regulation in early adolescence. Further, it appeared to be more effective for female adolescents.

Reducing behavioral health symptoms by addressing minority stressors in LGBTQ adolescents: a randomized controlled trial of Proud & Empowered

Background

Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no interventions have been tested through an RCT to address these concerns.

Methods

We report on an RCT of an intervention—Proud & Empowered—with four high schools. Measures assess the intervention’s impact on mental health symptoms.

Results

Compared to the control, participants in the treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health outcomes compared to those in the control condition.

Conclusions

Results suggest that Proud & Empowered help reduce mental health symptoms and exposure to minority stressors and build coping strategies.

Trial Registration

The intervention was registered on clinicaltrials.gov on August 1, 2019 under Trial #NCT04041414.

Perceived stress, eating behavior, and overweight and obesity among urban adolescents

Background

WHO estimated 20% of adolescents (10–19 years) have mental health problems. We examined the prevalence and associated risk predictors of overweight/obesity and perceived stress using eating behaviors and physical activity among school-and-college-going urban adolescents in Bangladesh.

Methods

A cross-sectional study with a multistage sampling technique was employed to select 4609 adolescent students, aged 13–19 years, from all eight Bangladesh divisions during January–June 2019. Data were collected using a self-administered questionnaire containing Turconi Physical Activity Questionnaire (PAQ), Adolescent Stress Questionnaire (ASQ), Dutch Eating Behavior Questionnaire (DEBQ), and Anthropometric measurements. Logistic regression and different association measures assessed relationships among adolescent characteristics.

Results

The major 61.5% of adolescents were in moderate-to-extremely-severe levels of stress, 28.2% were overweight/obese, only 2.7% had a very active lifestyle, and 30.5% had a sedentary lifestyle. Perceived stress was positively and significantly correlated with eating behaviors and body mass index, whereas physical activity was significantly associated with the prevalence of overweight/obesity and high stress. The prevalence of overweight/obesity (53.8%) and high stress (52.5%) was higher in males. Adolescents’ obesity was 2.212 times more likely who had a sedentary lifestyle (95% CI 1.377–3.552), 1.13 times more likely for those who had experienced stress due to school/leisure conflict (95% CI 1.051–1.222), and 1.634 times more likely for those who were tempted by restrained eating behavior (95% CI 1.495–1.786).

Conclusion

Stress on secondary school-and-college-going students needs to be recognized, and strategies need to be developed to improve adolescents’ mental health.

Implementation trial of a cognitive behavioural therapy programme for reducing student stress in the final year of secondary school

The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence-based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence-based cognitive-behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE-AIM framework at pre-intervention, post-intervention, and three-month follow-up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students.

Effects of Motivation-Based Academic Group Psychotherapy on Psychological and Physiological Academic Stress Responses among Korean Middle School Students

This study investigated the effects of motivation-based academic group psychotherapy on psychological and physiological academic stress responses. Indicators of academic stress were the psychological measures of academic burnout and physiological measures of salivary cortisol. The intervention group was expected to show higher salivary cortisol levels initially and that both measures of academic burnout and salivary cortisol would decrease post-intervention. After the first measurement, the intervention group received group psychotherapy, and the comparison group received no treatment. Means, standard deviations, and correlation coefficients were calculated and general linear modeling was conducted. No initial between-group difference was detected in salivary cortisol. Post-intervention, signs of academic burnout decreased in the intervention group, mostly for cynicism. However, salivary cortisol increased in both groups. Accordingly, possible mechanisms and implications are discussed.

Can Schools Reduce Adolescent Psychological Stress? A Multilevel Meta-Analysis of the Effectiveness of School-Based Intervention Programs

Increased levels of psychological stress during adolescence have been associated with a decline in academic performance, school dropout and increased risk of mental health problems. Intervening during this developmental period may prevent these problems. The school environment seems particularly suitable for interventions and over the past decade, various school-based stress reduction programs have been developed. The present study aims to evaluate the results of (quasi-)experimental studies on the effectiveness of school-based intervention programs targeting adolescent psychological stress and to investigate moderators of effectiveness. A three-level random effects meta-analytic model was conducted. The search resulted in the inclusion of k = 54 studies, reporting on analyses in 61 independent samples, yielding 123 effect sizes (N = 16,475 individuals). The results indicated a moderate overall effect on psychological stress. Yet, significant effects were only found in selected student samples. School-based intervention programs targeting selected adolescents have the potential to reduce psychological stress. Recommendations for practice, policy and future research are discussed.

Stressful Life Events and Negative Emotions on Delinquency Among Korean Youth: An Empirical Test of General Strain Theory Assessing Longitudinal Mediation Analysis

The current study examines the extent to which the argument of Agnew's general strain theory extends to a sample of South Korean youth to be able to explain the hypothesized direct and indirect/mediated effects of negative emotions derived from various negative life experiences of strain on delinquent behaviors. These experiences can include bullying victimization, parental abuse, poor friend quality, and poor physical functioning. Data for this study were compiled from the Korean Welfare Panel Study (KOWEPS), which is a longitudinal study among 7,027 Korean households surveyed from 2006 through 2012. This study utilizes the longitudinal mediation models for temporal precedence. Results reveal that adolescents with poor-quality friends during the previous year are more likely to engage in later delinquency, and adolescents who experience bullying victimization, child abuse, and poor friendship quality during the previous year are more likely to later feel negative emotions. Furthermore, early feelings of negative emotions are significantly related to later delinquent behaviors and partially mediate the link between poor friend quality and later delinquent behaviors. Finally, bullying victimization, child abuse, and poor friend quality generated negative emotions, which led to a greater likelihood of delinquent behavior later.

Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis

AIM

To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness.

DESIGN

This study is designed as a non-randomized controlled trial with a two-arm structure.

METHODS

Adolescents of 12-16-year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school-based intervention. The control group only followed the school-based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile.

RESULTS

The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ² _p  = 0.03, p = .03), positive life perspective (ƞ² _p  = 0.04, p = .01), and global lifestyle (ƞ² _p  = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05).

CONCLUSIONS

Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add-on to standard interdisciplinary interventions.

IMPACT

Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision-making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.

Does Stress Mediate the Association Between Emotional Intelligence and Life Satisfaction During Adolescence?

BACKGROUND

Based on Mayer and Salovey's model of emotional intelligence, this study examined whether perceived stress mediates the interplay of emotional intelligence and life satisfaction for girls and boys during early and middle adolescence.

METHODS

Using multigroup structural equation modeling with questionnaire data from a sample of Spanish adolescent students (N = 800; M_Age T1 = 14.02, M_Age T2 = 15.00, SD = 1.21) in 2 waves (T1 = March 2015; T2 = December 2015).

RESULTS

Results of multigroup structural equation modeling indicated no group differences between boys and girls in early adolescence (7th and 8th grade) and middle adolescence (9th and 10th grade), as stress function as mediator between emotional intelligence and life satisfaction for all groups. However, latent mean comparison indicated that girls not only perceive and understand emotions better than boys, but they also perceive higher amounts of stress at an older age.

CONCLUSION

Results indicate the potential risk of perceived stress that might drop the protective effect of emotional intelligence on life satisfaction. These findings have implications for future research and educational practice considering combined prevention programs for adolescent's health and well-being.

Longitudinal Trajectories of Family Functioning Among Recent Immigrant Adolescents and Parents: Links With Adolescent and Parent Cultural Stress, Emotional Well-Being, and Behavioral Health

This study examined longitudinal effects of adolescent and parent cultural stress on adolescent and parent emotional well-being and health behaviors via trajectories of adolescent and parent family functioning. Recent immigrant Latino adolescents (Mage  = 14.51) and parents (Mage  = 41.09; N = 302) completed measures of these constructs. Latent growth modeling indicated that adolescent and parent family functioning remained stable over time. Early levels of family functioning predicted adolescent and parent outcomes. Baseline adolescent cultural stress predicted lower positive adolescent and parent family functioning. Latent class growth analyses produced a two-class solution for family functioning. Adolescents and parents in the low family functioning class reported low family functioning over time. Adolescents and parents in the high family functioning class experienced increases in family functioning.

School-based mental health promotion in children and adolescents with StresSOS using online or face-to-face interventions: study protocol for a randomized controlled trial within the ProHEAD Consortium

BACKGROUND

Schools are an ideal setting in which to promote health. However, empirical data on the effectiveness of school-based mental health promotion programs are rare, and research on universal Internet-based prevention in schools is almost non-existent. Following the life skills approach, stress management training is an important component of health promotion. Mental health literacy is also associated with mental health status, and it facilitates formal help-seeking by children and adolescents (C&A). The main objectives of this study are (1) the development and evaluation of an Internet-based version of a universal school-based health promotion program called StresSOS and (2) demonstrating non-inferiority of the online setting compared to the face-to-face setting. StresSOS aims to improve stress management and mental health literacy in C&A.

METHODS/DESIGN

A school-based sample of 15,000 C&A (grades 6-13 and older than 12 years) will be recruited in five regions of Germany within the ProHEAD Consortium. Those with a screening result at baseline indicating no mental health problems will be invited to participate in a randomized controlled trial comparing StresSOS online to an active online control condition (Study A). In addition, 420 adolescents recruited as a separate school-based sample will participate in the StresSOS face-to-face intervention. Participants in both intervention groups (online or face-to-face) will receive the same eight treatment modules to allow for the comparison of both methods of delivery (Study B). The primary outcome is the number of C&A with symptoms of mental health problems at a 12 months follow-up. Secondary outcomes are related to stress/coping (i.e., knowledge, symptoms of stress, coping resources), mental health literacy (knowledge and attitudes toward mental disorders and help-seeking), program usage patterns, cost-effectiveness, and acceptability of the intervention.

DISCUSSION

This study represents the first adequately powered non-inferiority trial in the area of school-based mental health promotion. If online StresSOS proves efficacious and non-inferior to face-to-face delivery, this offers great potential for health promotion in youths, both in and outside the school environment.

TRIAL REGISTRATION

German Clinical Trials Register, DRKS00014693 . Registered on 14 May 2018.

Building Resilience: The Conceptual Basis and Research Evidence for Resilience Training Programs

The relationship between adverse experiences and later development has been explored by many researchers, leading to the conceptualization of resilience as a factor explaining the normal or optimal development of some individuals exposed to adversity. Today many different interventions exist aiming to improve the ability of individuals to respond to adversity. In this narrative literature review, we evaluate the literature surrounding resilience and resilience training, discussing the quality of the evidence supporting resilience training, theoretical and practical differences between types of training, and the impact of resilience and psychological training on outcome measures across a variety of settings. The results of our review show that the quality of the literature is mixed, resilience training is not well differentiated from other forms of training, and that the impact of psychological training on later functioning depends heavily on the type of outcome measured and the setting of the training. Further research must be conducted prior to the implementation of resilience training programs in order to assure their efficacy and effectiveness in proposed contexts.

[Cluster-randomized, controlled evaluation of stress management training for high school students]

Cluster-randomized, controlled evaluation of stress management training for high school students Abstract.

OBJECTIVE

One fifth of German adolescents show elevated levels of mental health problems. The development of mental health problems is often closely related to experiences of stress. Hence, fostering competences in coping with stress offers an approach for counteracting the development of psychological problems. The aim of the present study is to test a stress management training of 3 x 90 minutes in a German high school, 11^th grade.

METHOD

A cluster-randomized, controlled design was used. The primary outcome was stress. Secondary outcome criteria were knowledge about stress, coping behaviour, emotional and behavioural problems as well as health-related quality of life. Students from twenty-one courses from four schools participated in the study.

RESULTS

The sample comprised 286 students (58.25 % girls; mean age 16.58 ± 0.65). Changes in stress levels from pre- to post-evaluation did not differ significantly between intervention and control group. With regard to secondary criteria, apart from a significant increase in knowledge no further effects were observed. An exploratory moderation analysis hints at a positive association between baseline levels of stress and effectiveness of the training.

CONCLUSIONS

The results question whether the universal application of a brief cognitive behavioural intervention is appropriate to prevent stress in this population. Future research should, inter alia, investigate the potential of indicated prevention regarding stress.

Stressverarbeitungsfragebogen für Kinder und Jugendliche (SVF-KJ)

Zusammenfassung. Der Stressverarbeitungsfragebogen für Kinder und Jugendliche (SVF-KJ) erhebt die soziale und schulische Stressverarbeitung über 9 Subtests und 36 Items. Der Gültigkeitsbereich wurde in der aktuellen Version von 2016 auf die Altersspanne von 8 bis 16 Jahre erweitert. Ferner wurden 4 Items geringfügig angepasst und aktuelle Normen wurden erhoben. Die Normwerte und psychometrischen Gütekriterien wurden bei N = 1 087 Kindern und Jugendlichen ermittelt. Befunde von konfirmatorischen Faktorenanalysen bestätigten die Zuordnung der Items zu den Subtests, die sich in früheren exploratorischen Faktorenanalysen ergeben hatten. Korrelationsanalysen sprechen für eine hinreichend divergente Validität gegenüber dem Konstrukt „Emotionsregulation“. Schließlich wurde an einer Teilstichprobe von N = 374 deutschen Kindern und Jugendlichen die interne Konstruktvalidität bekräftigt, indem erwartungskonforme Geschlechts- und Altersunterschiede nachgewiesen wurden. Insgesamt unterstützen die weiteren Analysen, dass der SVF-KJ die Stressverarbeitungsdispositionen im Kindes- und Jugendalter valide erfasst.

Using a Modified Theory of Planned Behavior to Examine Adolescents' Workplace Safety and Health Knowledge, Perceptions, and Behavioral Intention: A Structural Equation Modeling Approach

Work, a defining feature of adolescence in the United States, has many benefits. Work also has risks, as adolescents experience a higher rate of serious job-related injuries compared to adults. Talking Safety, a free curriculum from the National Institute for Occupational Safety and Health, is one tool educators may adopt to provide teens with essential workplace safety and health education. Adolescents (N = 2503; female, 50.1%; Hispanic, 50.0%) in a large urban school district received Talking Safety from their eighth-grade science teachers. This study used a modified theory of planned behavior (which included a knowledge construct), to examine students' pre- and post-intervention scores on workplace safety and health knowledge, attitude, self-efficacy, and behavioral intention to enact job safety skills. The results from confirmatory factor analyses indicate three unique dimensions reflecting the theory, with a separate knowledge factor. Reliability estimates are ω ≥ .83. The findings from the structural equation models demonstrate that all paths, except pre- to posttest behavioral intention, are statistically significant. Self-efficacy is the largest contributor to the total effect of these associations. As hypothesized, knowledge has indirect effects on behavioral intention. Hispanic students scored lower at posttest on all but the behavioral intention measure, possibly suggesting the need for tailored materials to reach some teens. Overall the findings support the use of a modified theory of planned behavior to evaluate the effectiveness of a foundational workplace safety and health curriculum. This study may inform future efforts to ensure that safe and healthy work becomes integral to the adolescent experience.

Do universal school-based mental health promotion programmes improve the mental health and emotional wellbeing of young people? A literature review

AIMS AND OBJECTIVES

To examine evidence-using a range of outcomes-for the effectiveness of school-based mental health and emotional well-being programmes.

BACKGROUND

It is estimated that 20% of young people experience mental health difficulties every year. Schools have been identified as an appropriate setting for providing mental health and emotional well-being promotion prompting the need to determine whether current school-based programmes are effective in improving the mental health and emotional well-being of young people.

METHODS

A systematic search was conducted using the health and education databases, which identified 29 studies that measured the effectiveness of school-based universal interventions. Prisma guidelines were used during the literature review process.

RESULTS

Thematic analysis generated three key themes: (i) help seeking and coping; (ii) social and emotional well-being; and (iii) psycho-educational effectiveness.

CONCLUSION

It is concluded that whilst these studies show promising results, there is a need for further robust evaluative studies to guide future practice.

RELEVANCE TO CLINICAL PRACTICE

All available opportunities should be taken to provide mental health promotion interventions to young people in the school environment, with a requirement for educational professionals to be provided the necessary skills and knowledge to ensure that the school setting continues to be a beneficial environment for conducting mental health promotion.

The Effect of Stress Management Training Program on Stress Coping Styles among the Adolescents in Prison in Turkey

This study was performed to determine the effects of a stress management training program that was administered to adolescents in prison. This was a semi-experimental study that used pretests and posttests in controlled groups; it was performed between June 2012 and March 2013 in a closed prison for children and adolescents. The study was completed with the participation of 73 adolescents (36 in the experimental group and 37 in the control group). Adolescent Lifestyle Profile scale and the Stress Coping Styles Scale were used as the data collection tools. The Stress Management Training Program was developed by the researchers and carried out for 2 weeks, a total of 10 sessions of 40 min each. The scales were administered before the program was implemented, immediately after the program and 1 month following the program. Although there were no statistically significant differences between the mean Stress Coping Styles Scale scores of the experimental and control groups before the intervention (p > 0.05), a statistically significant difference was found after the intervention and at re-test (p < 0.05). This study has shown that this training program could be implemented with adolescents in prison, and the program was effective in providing positive behavioural changes in stress management. Copyright © 2016 John Wiley & Sons, Ltd.

Use of Treatment and Counseling Services and Mind-Body Techniques by Students With Emotional and Behavioral Difficulties

BACKGROUND

School-based treatment and counseling services (TCSs) can integrate mind-body techniques (MBTs) to improve children's health, wellness, and academic performance. We aimed to describe the effect of school-based TCS on MBT-use among students experiencing difficulties with concentration, emotions, behaviors, and getting along (DCEBG).

METHODS

National Health Interview Survey data were utilized (N₂₀₀₇  = 1225; N₂₀₁₂  = 1835). Logistic regression examined associations between TCS-type and MBT-use, while propensity score matching controlled for confounders in the prematch sample.

RESULTS

Compared with children without DCEBG, MBT-use was higher among children with DCEBG, but it decreased from 2007 (9.7%) to 2012 (5.1%). Receipt of school-based TCS increased from 2007 (11.3%) to 2012 (33.9%). Receipt of school-only TCS, compared with nonschool-only TCS, was associated with lower MBT-use (OR₂₀₀₇  = 0.20; OR₂₀₁₂  = 0.54). After matching, this difference remained for 2007 (t_prematch  = -2.77; t_postmatch  = -2.00), but not 2012 (t_prematch  = -2.53; t_postmatch  = -0.88). School-only TCS-use increased with family activity limitations; in 2012, it decreased with higher parental education. Mind-body techniques-use was higher in girls and associated with higher parental education and family activity limitations.

CONCLUSIONS

While the relative increase of MBT integration by school-based TCS is commendable and further encouraged, school mental health practitioners should account for the differential effects of family-level factors on TCS-choice and MBT-use.

Treatment integrity in school-wide programs: a review of the literature (1993-2012)

We assessed the reporting of treatment integrity in school-wide prevention programs in K-12 schools. This review was designed to determine (a) the extent to which treatment integrity was reported in school-wide prevention and intervention programs and how the reporting varied by research design, year, and journal; and (b) the procedures (e.g., method, frequency, informant) used to collect treatment integrity data. Results indicated that fewer than half of the studies in the review (n = 36, 45.6 %) measured and reported treatment integrity. Those studies reporting treatment integrity often used multiple methods and informants. Reporting treatment integrity in this body of literature has increased steadily over time.

Ethnic Discrimination, Acculturative Stress, and Family Conflict as Predictors of Depressive Symptoms and Cigarette Smoking Among Latina/o Youth: The Mediating Role of Perceived Stress

Latino youth can experience a range of cultural (i.e., ethnic discrimination and acculturative stress) and familial (i.e. family conflict) risk factors that can contribute to their perceived stress, thereby increasing their risk for depressive symptoms and cigarette smoking. To understand the mechanisms by which ethnic discrimination, acculturative stress and family conflict influence the risk for depressive symptoms and cigarette smoking of youth, the current study investigated the mediating role of perceived stress in these associations. The data came from a longitudinal study of acculturation and substance use with 1919 Latino adolescents (52% female; 84% 14 year-olds; 87% U.S. born). Structural equation modeling indicated that discrimination and family conflict (Time 1) related with higher perceived stress (Time 2), which, in turn, related with more depressive symptoms and smoking (Time 3). The results suggest that perceived stress might be one mechanism by which ethnic discrimination and family conflict contribute to Latino youth symptoms of depression and cigarette smoking. The findings highlight the need for prevention and intervention strategies that help youth manage their general perceived stress and/or focus on stress reduction techniques.

A Randomised Controlled Trial Comparing the Impact of Yoga and Physical Education on the Emotional and Behavioural Functioning of Middle School Children

BACKGROUND

Yoga programs geared for school children have become more widespread, but research regarding its impact on children is lacking. Several studies have reported positive outcomes, though there is a need for more randomised controlled trials.

OBJECTIVES

To determine the effects of yoga on children's emotional and behavioural functioning when compared with physical education (PE) classes.

METHODS

Thirty middle school children were randomised to participate in either a school-based Ashtanga-informed yoga or PE class three times a week for 12 weeks. Emotional (i.e. affect, self-perceptions) and behavioural (i.e. internalising and externalising problems, aggression) functioning were measured pre and post-intervention.

RESULTS

There were no significant changes between groups in self-reported positive affect, global self-worth, aggression indices or parent reports of their children's externalising and internalising problems. However, negative affect increased for those children participating in yoga when compared to the PE program.

CONCLUSIONS

In general, findings suggest that yoga and PE classes do not differentially impact on middle school children's emotional and behavioural functioning. However, children reported experiencing increased negative emotions after receiving yoga while children in the PE group reported a decrease in these feelings. Implications of these results and potential directions for future research on children's yoga are discussed.

Impact of school-based health promotion interventions aimed at different behavioral domains: a systematic review

OBJECTIVE

Given that lifestyleshave similar determinants and that school-based interventions are usually targeted at all the risks that affect adolescents, the objective of this systematic review was to summarize the characteristics and effects of school-based interventions acting on different behavioral domains of adolescent health promotion.

METHODS

The review process was conducted by two independent reviewers who searched PubMed, Scopus, PsycINFO, and ERIC databases for experimental or observational studies with at least two measures of results published from 2007 to 2011, given that the research information available doubles every 5 years. Methodological quality was assessed with a standardized tool.

RESULTS

Information was extracted from 35 studies aiming to prevent risk behaviors and promote healthy nutrition, physical activity, and mental and holistic health. Activities were based on theoretical models and were classified into interactive lessons, peer mediation, environmental changes, parents' and community activities, and tailored messages by computer-assisted training or other resources, usually including multiple components. In some cases, we identified some moderate to large, short- and long-term effects on behavioral and intermediate variable.

CONCLUSIONS

This exhaustive review found that well-implemented interventions can promote adolescent health. These findings are consistent with recent reviews. Implications for practice, public health, and research are discussed.

Evaluation of the mental health benefits of yoga in a secondary school: a preliminary randomized controlled trial

The goal of this study was to evaluate potential mental health benefits of yoga for adolescents in secondary school. Students were randomly assigned to either regular physical education classes or to 11 weeks of yoga sessions based upon the Yoga Ed program over a single semester. Students completed baseline and end-program self-report measures of mood, anxiety, perceived stress, resilience, and other mental health variables. Independent evaluation of individual outcome measures revealed that yoga participants showed statistically significant differences over time relative to controls on measures of anger control and fatigue/inertia. Most outcome measures exhibited a pattern of worsening in the control group over time, whereas changes in the yoga group over time were either minimal or showed slight improvements. These preliminary results suggest that implementation of yoga is acceptable and feasible in a secondary school setting and has the potential of playing a protective or preventive role in maintaining mental health.

Stress reduction through psychoeducation: a meta- analytic review

The aim of this meta-analysis was to evaluate the effectiveness of psychoeducational interventions in reducing stress and to gain more insight in determining features moderating the magnitude of effects. Relevant studies were selected from 1990 to 2010 and were included according to predetermined criteria. For each study, the standardized mean difference was calculated for the outcome measure primarily related to stress. Nineteen studies met the inclusion criteria; for 16 studies, a standardized mean difference could be calculated. The average effect size was .27 (95% confidence interval = [.14, .40]) at posttest and .20 (95% confidence interval = [-.04, .43]) at follow-up. To determine possible moderators of intervention effects, all 19 studies were included. Only interventions that were shorter in duration provided better results. When a model with multiple moderators was considered, a model combining both intervention duration and the number of women in an intervention was significant and accounted for 42% of the variability found in the data set. Specifically, interventions with more women that were shorter in duration obtained better results.

Effekte des Anti-Stress-Trainings in der Grundschule

Grundschulkinder erleben eine Vielzahl schulischer Belastungssituationen, die eine Gefährdung der psychischen Gesundheit darstellen können. Bislang wurde im deutschsprachigen Raum die Entwicklung und Evaluation primärpräventiver schulbasierter Stressbewältigungsprogramme für das Kindesalter eher vernachlässigt. In der vorliegenden Studie wurde eine Version des Anti-Stress-Trainings für Kinder (AST; Hampel & Petermann, 2003 ) adaptiert, die im schulischen Alltag im Klassenverband umgesetzt wurde. Die Effekte des Trainings auf die Stressverarbeitung wurden bei 102 Dritt- und Viertklässlern vor, unmittelbar nach und sechs Wochen nach Abschluss der Intervention anhand eines Kontrollgruppendesigns mit Block-Randomisierung untersucht. Die Kinder der Interventionsgruppe waren unmittelbar und sechs Wochen nach der Intervention in den günstigen Stressverarbeitungsstrategien verbessert. Außerdem waren unmittelbar nach der Intervention die günstigen Stressverarbeitungsstrategien der Interventionsgruppe statistisch und klinisch signifikant besser ausgeprägt als in der unbehandelten Kontrollgruppe. Das AST in der Grundschule erzielt demnach gute Effekte auf die günstige Stressverarbeitung und trägt somit zur Verbesserung der psychischen Gesundheit im Grundschulalter bei.

What makes the everyday life of Swedish adolescent girls less stressful: a qualitative analysis

Stress is a widespread phenomenon in society today, not least among children and adolescents. Stress-related ill-health has increased in this population and affects girls to a greater extent than boys. Against this background, it is important to acquire knowledge about measures that prevent stress, especially in girls. The aim of this study was therefore to illuminate adolescent girls' experiences and reflections about what makes everyday life less stressful. An explorative design, qualitative content analysis, was used. In-depth interviews were conducted with fifteen 17-year-old girls. The analysis comprised both manifest and latent content and revealed the girls' own experiences of and reflections about what makes everyday life less stressful. Three categories, 'Enjoyment and Recovery', 'Trust' and 'Insight and Influence', and nine subcategories emerged. The latent content of these categories is described by the theme 'access to sources of strength'. It is essential that persons in the girls' surroundings are aware of all sources that provide the strength to resist and prevent stress in everyday life. A climate has to be created in all arenas of the girls' everyday life in which they can access these sources of strength. Utilizing the girls' experiences and views about what needs to be done is the first step towards a preventive and promotive mode of working on their own circumstances and wishes. This approach is consistent with the Ottawa Charter for Health Promotion, which emphasizes the importance of involving the target group.