The international Family Affluence Scale (FAS): Charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities

Mental Health Disparities Between Both-, Other- and Same-Sex Attracted Adolescents: The Role of Bullying Victimization, Gender and Age

Research shows that both-sex attracted adults have poorer mental health than other- and same-sex attracted adults, but evidence regarding whether similar disparities exist among adolescents remains limited. To investigate this, the current study examines differences in life satisfaction and emotional problems between both-, other- and same-sex attracted adolescents. It also studies whether bullying victimization can explain these differences and whether the associations vary by gender and age. Cross-sectional data from the nationally-representative Dutch Health Behavior in School-aged Children (HBSC) study conducted in 2017 and 2021 were analyzed, including 11,683 adolescents (Mage = 14.7, SD = 1.60; 49.7% girls). Both-sex attracted adolescents (n = 507, 4.3%) report lower life satisfaction and more emotional problems than their other- (n = 10,930, 93.6%) and same-sex attracted peers (n = 246, 2.1%). Bullying victimization partially explains the mental health disparities between both- and other-sex attracted adolescents, yet does not account for differences between both- and same-sex attracted peers. The links between romantic attraction and mental health outcomes were similar across gender and age, but differences existed concerning bullying victimization. The results suggest that both-sex attracted adolescents are a unique group that deserves special attention in the literature on mental health disparities.

An examination of sociodemographic and clinical factors influencing help-seeking attitudes and behaviors among adolescents with mental health problems

This study investigated sociodemographic and clinical factors influencing help-seeking attitudes and behavior among adolescents with mental health problems. As part of the ProHEAD ("Promoting Help-seeking using E-technology for ADolescents") consortium a school-based, online assessment of sociodemographic information, psychopathology, risk-taking and self-harming behavior, help-seeking attitudes and behavior, and barriers to help-seeking was conducted in adolescents aged ≥ 12 years recruited from randomly selected schools in five regions of Germany. Linear regression analyses with the LMG formula were performed to explore predictors of help-seeking attitudes and behavior and assess their relative importance. Nine thousand five hundred and nine participants (95.5%) completed the online assessment (mean age: 15.1 years, 58.6% female). In total, 1606 participants (16.9%) showed relevant mental health problems (e.g., depressive and eating disorder symptoms, alcohol problems, and thoughts of self-harming behavior). Among them, 895 (55.7%) reported having sought help (lifetime), with higher rates for informal (n = 842, 52.4%) compared to professional (n = 380, 23.7%) sources. High help-seeking propensity emerged as the most important factor contributing to professional help-seeking, followed by elevated levels of psychopathology and perceived barriers, with sociodemographic factors being less impactful. Psychopathological severity also outweighed sociodemographic factors in predicting negative help-seeking attitudes. These findings indicate that attitudes towards seeking professional help, perceived barriers, and psychopathology severity critically influence limited adolescent help-seeking behavior. This emphasizes the need for initiatives that promote help-seeking, reduce negative attitudes, and address structural barriers in adolescent mental health care.

Acute effect of aerobic exercise on inhibitory control and task-related heart rate variability in preadolescent children

OBJECTIVES

To investigate whether a single session of aerobic exercise improves inhibitory control in preadolescent children and whether this effect is mediated by changes in parasympathetic activity.

DESIGN

In this experimental study, an intervention and control group were pair-matched by age, sex and moderate-to-vigorous physical activity.

METHOD

114 participants either completed a 20 min moderately-intense exercise bout on a cycling ergometer or watched a 20 min video. Prior to and after these conditions, a computer-based Stroop task was administered. During the cognitive task, heart rate variability (HRV) was measured using electrocardiography.

RESULTS

Path-analyses did not support an association between group and posttest accuracy on the Stroop task, while controlling for pretest scores. However, the intervention group had lower time-domain based HRV at posttest. The examination of mediation models revealed a moderation by sex, as the relation of lower time-domain based HRV with higher accuracy on both congruent and incongruent trials of the Stroop task was observed in girls only.

CONCLUSION

A single aerobic exercise session does not necessarily improve inhibitory control in preadolescent children. However, the manipulation of the autonomic state towards a parasympathetic withdrawal has the potential to alter inhibitory control in girls in particular.

Family affluence and bullying victimisation affect life satisfaction in large-bodied adolescents: Evidence from 37 high-income countries

BACKGROUND

Adolescents with large body sizes often experience bullying which likely affects their overall well-being. Yet, there is limited research on how bullying victimisation affects overall life satisfaction among this cohort of adolescents, and how family affluence moderates this relationship.

OBJECTIVE

This study investigates the moderation effects of family affluence in the association between bullying victimisation and life satisfaction among adolescents with large bodies.

SETTING AND PARTICIPANTS

This research involved 16,240 adolescents with large bodies based on the World Health Organization's Body Mass Index Chart/Classification for ages 13 to 15 years from 37 high-income countries in Europe and North America.

DESIGN

The study used data from the Health Behaviour in School-aged Children (HBSC) survey, a cross-national study of adolescent health and well-being. Hypotheses were assessed through mixed effects binary logit models with random intercepts, accounting for data clustering and variations across regions.

RESULTS

After controlling for covariates, both cyberbullying (AOR = 1.72; 95 % CI = 1.48-2.00) and traditional bullying (AOR = 1.74, 95 % CI: 1.53-1.99) were significantly associated with lower life satisfaction compared with no bullying experience among participants. Family affluence partly moderated these associations, wherein the highest level of affluence reduced the effects of cyberbullying (AOR = 1.57, 95 % CI: 1.09-2.27) and traditional bullying (AOR = 1.41, 95 % CI: 1.02-1.96) on life satisfaction compared to lower levels.

CONCLUSION

Both traditional and cyberbullying significantly reduced life satisfaction among adolescents with large body sizes. However, higher family affluence moderates (reduces) these negative effects, suggesting a protective role of socioeconomic status. These findings highlight the need for targeted interventions to support bullied adolescents, particularly those with large bodies and from lower socioeconomic backgrounds.

Social Inequalities in Adolescents' Psychological and Somatic Complaints: Cross-National Trends Between 2002 and 2022 and the Role of Societal Changes

Objectives

Cross-national differences in long-term trends in social inequalities in adolescents' mental health remain poorly understood, as does the impact of societal changes. We tested (1) whether the association between family socioeconomic status and psychological and somatic complaints changed between 2002 and 2022, (2) the extent to which these trends varied across countries, and (3) whether changes in income inequality, schoolwork pressure, and internet activity within countries were related to these trends.

Methods

Using data from 903,344 adolescents across 32 countries from the Health Behaviour in School-aged Children (HBSC) study between 2002 and 2022, we employed multilevel models to investigate the research questions.

Results

We observed a nonlinear increase in psychological and somatic complaints over time. On average, social inequalities in both outcomes remained stable across countries, although the trends varied from one country to another. Only income inequality explained the differences between countries in these trends. In countries where income inequality increased over time, social inequalities in psychological complaints became smaller.

Conclusion

Our study highlights ongoing global disparities in adolescents' mental health problems, urging for more effective health policies.

Adolescent reports of subjective socioeconomic status: An adequate alternative to parent-reported objective and subjective socioeconomic status?

Socioeconomic status (SES) is associated with well-being outcomes across studies; however, there is wide variation in its measurement, particularly in adolescence. One key difference in measures of SES concerns whether participants relay objective information-for example, years of education, household income-or subjective perceptions of socioeconomic status, either with or without reference to others or society. Although parents are often considered the best source of SES information-especially objective SES-within families, interviewing parents within the context of adolescent research is costly, time-consuming, and not always feasible. Given the importance of SES for outcomes in adolescence and cumulative effects over the lifespan, we used data from adolescents (N = 702) and parents (Ns = 664-730) to examine whether adolescent reports of SES serve as reasonable proxies for parent reports of both objective and subjective SES, as well as administrative data assessing family SES and neighborhood SES. Consistent with our hypotheses, adolescents' reports of subjective SES were moderately correlated with parent reports and administrative data tapping family SES. Moreover, adolescents' reports of subjective SES predicted adolescent-reported measures of well-being, including mental health, physical health, school performance, problem behavior, and alcohol use to the same degree as or better than parent reports of both subjective and objective SES and administrative data. These findings suggest that adolescent reports of subjective SES-using two different, easily understood measures-can stand in as reasonable alternatives to parent-reported SES and administrative data.

Prevalence of daily family meals among children and adolescents from 43 countries

Prevalence studies about family meals, including large and representative samples of children and adolescents on this topic, are scarce. Therefore, the aim of this study was twofold: first, to determine the prevalence of daily family meals in large and representative samples of school-going children and adolescents from 43 countries, and second, to identify the sex, age, socioeconomic status (SES), family structure, immigrant status and parental labour market status inequalities associated with this prevalence. Using data from the 2017/2018 wave of the Health Behaviour in School-aged Children study, a total of 179,991 participants from 43 countries were involved in this cross-sectional study. Family meals were assessed by the following question: 'How often do you and your family usually have meals together?'. Participants had five different response options: 'every day', 'most days', 'about once a week', 'less often', and 'never'. The meta package was utilized for conducting a meta-analysis of single proportions, specifically applying the metaprop function. The analysis involved pooling the data using a random-effects model and presenting the outcomes through a forest plot generated using the inverse variance method. Moreover, we applied generalized linear mixed models to explore the relationships between the studied sociodemographic factors as fixed effects, country as a random effect and the status of daily family meals as an outcome. Overall, the prevalence of daily family meals was 49.12% (95% confidence interval [CI]: 45.00-53.25). A greater probability of having daily family meals was identified for children aged 10-12 years (61.55%; 95% CI: 57.44%-65.49%), boys (61.55%, 95% CI: 57.44%-65.49%), participants with high SES (64.66%, 95% CI: 60.65%-68.48%), participants with both parents at home (65.05%, 95% CI: 61.16%-68.74%) and those with both unemployed parents (61.55%, 95% CI: 57.44%-65.49%). In the present study, which included large representative samples of school-going children and adolescents from 43 countries, more than half of the participants did not have daily family meals.

The effect of social media use on adolescents' subjective well-being: Longitudinal evidence from Switzerland

BACKGROUND AND RELEVANCE

Problematic social media use and low subjective well-being in adolescents coincide. However, the causal evidence on the effect of (problematic) social media use on subjective well-being is inconclusive. The analysis by Orben et al. (2022: Nature Communications 13: 1649) demonstrates that the effect is moderated by age and gender, giving rise to 'developmental windows of sensitivity to social media'. In this study, we provide an update of the development of adolescents' subjective well-being and problematic social media use in Switzerland. Furthermore, we investigate, whether 'developmental windows of sensitivity to social media' apply to Switzerland.

DATA AND METHODS

For the description of trends, we use data from the survey Health Behaviour in School-aged Children (HBSC; N = 59'662, 2002-2022, age: 11-15). We identify the effect of problematic social media use on subjective well-being using HBSC trend data from 2018 to 2022 applying multiple OLS regression. To identify the causal effect of social media use on subjective well-being we exploit panel/cohort data of adolescents from the study Transitions from Education to Employment (TREE; N = 19'809, 2016-2022, age: 15-22) applying panel regression models.

RESULTS

We demonstrate that decreases in subjective well-being coincide with increases in problematic social media use. Causal inference shows that the effect of social media use on subjective well-being only applies to females with low or middle parental educational background until the age of 18 years.

DISCUSSION AND CONCLUSION

Our study enhances the findings of Orben et al. (2022). It reaffirms the importance of health interventions targeted at vulnerable groups.

The association between teacher distress and student mental health outcomes: a cross-sectional study using data from the school mental health survey

BACKGROUND

Few studies have examined the inter-relationships between teacher and student mental health. We aimed to examine associations between teacher distress and student mental health difficulties and if student perceptions of school safety moderate these associations.

METHOD

Data from 23,568 students in grades 6-12 and 1,478 teachers from 268 schools participating in the School Mental Health Surveys in Ontario, Canada, were used. Three-level (student, classroom, school) multivariable linear regression models were fit to examine associations between teacher distress and student internalizing and externalizing symptoms by elementary (grades 6-8) and secondary (grades 9-12) school. Statistical interactions were used to evaluate effect modification.

RESULTS

Small but statistically significant, positive associations were found between teacher distress and internalizing (b = 0.02; 95% CI [0.01, 0.04], p < 0.05) and externalizing symptoms (b = 0.03; 95% CI [0.01, 0.05], p < 0.001) among elementary students only. Student perceptions of school safety moderated the association between teacher distress and externalizing symptoms among elementary students, whereby the positive association was magnified among students reporting lower school safety.

CONCLUSIONS

Findings from this study highlight the importance of concurrently addressing the mental health needs of educators and students. School safety represents a modifiable target for prevention and intervention efforts in schools that could serve to promote student mental health and mitigate potential risk factors in schools.

Patterns and trajectories of inequality in physical activity from childhood to adolescence in Kazakhstan

Objective

Sociodemographic differences in physical activity (PA) levels during the transition from childhood to adolescence, particularly in Central Asian countries, is lacking. In this study, we examine individual, family and environmental sociodemographic variables associated with PA among children and young adolescents in Kazakhstan.

Study design

Secondary data analyses of two nationally representative cross-sectional studies administered by parents of children (aged 7-9 y) and by self-report surveys (adolescents aged, 11-15 y) .

Methods

The 2020 Childhood Obesity Surveillance Initiative (COSI) and 2018 Health Behaviour in School-aged Children (HSBC) studies were used. Predictors of daily PA by individual (gender, grade, weight status), family (family composition, family employment, family wealth), and environment (school location) factors were analysed through binary logistic regressions after adjusting for screen time.

Results

Among both children and adolescents, males were more physically active than females. Daily PA among children was positively associated with high family employment (OR = 1.23, CI = 1.03-1.48) or living in an urban location (OR = 0.58, CI = 0.49-0.70). Daily PA was associated with low family wealth, two-parent families (OR = 1.25 CI = 1.08-1.44) or living in a rural location (OR = 1.18 CI = 1.04-1.34) among adolescents.

Conclusion

In Kazakhstan, the trajectory of children's and adolescent's PA levels, differed according to individual, family and environmental characteristics , suggesting a need for age-specific, targeted interventions to promote PA, appropriate policies that promote programs in schools, communities, and development of infrastructure for physically active lifestyles.

Psychometric properties and normative data of the Latvian and Russian language versions of the strengths and difficulties questionnaire (SDQ) in the Latvian general adolescent population

OBJECTIVES

Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores.

MATERIALS AND METHODS

This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents.

RESULTS

Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5-0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants.

CONCLUSIONS

This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations.