1
|
Stromájer GP, Csima M, Iváncsik R, Varga B, Takács K, Stromájer-Rácz T. Stress and Anxiety among High School Adolescents: Correlations between Physiological and Psychological Indicators in a Longitudinal Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1548. [PMID: 37761509 PMCID: PMC10529881 DOI: 10.3390/children10091548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. OBJECTIVE Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of psychological tests measuring anxiety with the cortisol levels obtained from biological sampling. METHOD In our longitudinal follow-up study, we involved 125 individuals in May 2019. Validated measurement tools were used during questionnaire data collection, including the State-Trait Anxiety Inventory, Clear Communication Scale, Multiple Social Perceived Support Scale, and related HBSC questions. As objective data, we collected hair samples for cortisol level measurement. RESULTS At the end of the school year, the anxiety levels measured by psychological tests were significantly higher (p = 0.001) compared to the anxiety levels at the beginning of the next school year. Anxiety levels were higher among girls and were influenced by the type of school and parental expectations. Both state anxiety and trait anxiety showed a strong correlation with psychosomatic symptoms (p < 0.001) and anxiety arising from school expectations (p < 0.05). The changes in cortisol levels did not follow the changes in psychological tests. Cortisol level increased (p = 0.01) in the second sample.
Collapse
Affiliation(s)
- Gábor Pál Stromájer
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Melinda Csima
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Réka Iváncsik
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (M.C.); (R.I.)
| | - Bernadett Varga
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Krisztina Takács
- Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary; (G.P.S.); (B.V.); (K.T.)
| | - Tímea Stromájer-Rácz
- Institute of Diagnostic, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
| |
Collapse
|
2
|
Grande AJ, Hoffmann MS, Evans-Lacko S, Ziebold C, de Miranda CT, Mcdaid D, Tomasi C, Ribeiro WS. Efficacy of school-based interventions for mental health problems in children and adolescents in low and middle-income countries: A systematic review and meta-analysis. Front Psychiatry 2023; 13:1012257. [PMID: 36684024 PMCID: PMC9852982 DOI: 10.3389/fpsyt.2022.1012257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Background Implementation of interventions to treat child and adolescent mental health problems in schools could help fill the mental health care gap in low- and middle-income countries (LMICs). Most of the evidence available come from systematic reviews on mental health prevention and promotion, and there is less evidence on treatment strategies that can be effectively delivered in schools. The aim of this review was to identify what school-based interventions have been tested to treat children and adolescents in LMICs, and how effective they are. Methods We conducted a systematic review including seven electronic databases. The search was carried out in October 2022. We included randomised or non-randomised studies that evaluated school-based interventions for children or adolescents aged 6-18 years living in LMICs and who had, or were at risk of developing, one or more mental health problems. Results We found 39 studies with 43 different pairwise comparisons, treatment for attention-deficit and hyperactivity (ADHD), anxiety, depression, and posttraumatic stress disorder (PTSD), Conduct disorder (CD). Pooled SMD were statistically significant and showed that, overall, interventions were superior to comparators for PTSD (SMD = 0.61; 95% CI = 0.37-0.86), not statistically significant for anxiety (SMD = 0.11; 95% CI = -0.13 to 0.36), ADHD (SMD = 0.36; 95% CI = -0.15 to 0.87), and for depression (SMD = 0.80; 95% CI = -0.47 to 2.07). For CD the sample size was very small, so the results are imprecise. Conclusion A significant effect was found if we add up all interventions compared to control, suggesting that, overall, interventions delivered in the school environment are effective in reducing mental health problems among children and adolescents. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=129376], identifier [CRD42019129376].
Collapse
Affiliation(s)
- Antonio Jose Grande
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul, Campo Grande, Brazil
| | - Mauricio Scopel Hoffmann
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
- Department of Neuropsychiatry, Universidade Federal de Santa Maria, Santa Maria, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - David Mcdaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Cristiane Tomasi
- Department of Public Health, Universidade do Extremo Sul Catarinense, Criciúma, Brazil
| | - Wagner Silva Ribeiro
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| |
Collapse
|
3
|
Dapari R, Bashaabidin MSM, Hassan MR, Dom NC, Rahim SSSA, Wan Mahiyuddin WR. Health Education Module Based on Information-Motivation-Behavioural Skills (IMB) for Reducing Depression, Anxiety, and Stress among Adolescents in Boarding Schools: A Clustered Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215362. [PMID: 36430081 PMCID: PMC9692668 DOI: 10.3390/ijerph192215362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 05/27/2023]
Abstract
Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri Sembilan, Malaysia. A single-blinded cluster randomised control trial (RCT) was conducted among students with abnormal DASS-21 scores. They were divided into an intervention group (three schools, 62 participants) and a control group (three schools, 57 participants). Participants in the intervention group received IMB-based health education, while participants in the control group underwent the standard care session. To determine the effectiveness of the intervention, the Generalised Linear Mixed Model (GLMM) analysis was conducted. A total of 119 students participated in this study, and no loss to follow-up was reported. Both intervention and control groups showed significantly reduced DAS scores (p < 0.005). However, the reduction of these scores was greater in the intervention group. The GLMM analysis revealed that the intervention was effective in reducing depression (ß = -2.400, t = -3.102, SE = 0.7735, p = 0.002, 95% CI = -3.921, -0.878), anxiety (ß = -2.129, t = -2.824, SE = 0.7541, p = 0.005, 95% CI = -3.612, -0.646), and stress (ß = -1.335, t = -2.457, SE = 0.536, p = 0.015, 95% CI = -2.045, -0.266) among adolescents. The IMB-based health education module was effective in reducing DAS among adolescents in boarding schools.
Collapse
Affiliation(s)
- Rahmat Dapari
- Department of Community Health, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Mohd Rohaizat Hassan
- Department of Community Health, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Nazri Che Dom
- Faculty of Health Sciences, Universiti Teknologi MARA, Bandar Puncak Alam 42300, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Institute for Medical Research, National Institute of Health, Ministry of Health, Shah Alam 40170, Malaysia
| |
Collapse
|
4
|
Yu T, Xu J, Jiang Y, Hua H, Zhou Y, Guo X. School educational models and child mental health among K-12 students: a scoping review. Child Adolesc Psychiatry Ment Health 2022; 16:32. [PMID: 35477408 PMCID: PMC9047301 DOI: 10.1186/s13034-022-00469-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The promotion of mental health among children and adolescents is a public health imperative worldwide, and schools have been proposed as the primary and targeted settings for mental health promotion for students in grades K-12. This review sought to provide a comprehensive understanding of key factors involved in models of school education contributing to student mental health development, interrelationships among these factors and the cross-cultural differences across nations and societies. METHODS This scoping review followed the framework of Arksey and O'Malley and holistically reviewed the current evidence on the potential impacts of school-related factors or school-based interventions on student mental health in recent 5 years based on the PubMed, Web of Science, Embase and PsycExtra databases. RESULTS/FINDINGS After screening 558 full-texts, this review contained a total of 197 original articles on school education and student mental health. Based on the five key factors (including curriculum, homework and tests, physical activities, interpersonal relationships and after-school activities) identified in student mental development according to thematic analyses, a multi-component school educational model integrating academic, social and physical factors was proposed so as to conceptualize the five school-based dimensions for K-12 students to promote student mental health development. CONCLUSIONS The lessons learned from previous studies indicate that developing multi-component school strategies to promote student mental health remains a major challenge. This review may help establish appropriate school educational models and call for a greater emphasis on advancement of student mental health in the K-12 school context among different nations or societies.
Collapse
Affiliation(s)
- Ting Yu
- grid.16821.3c0000 0004 0368 8293The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030 China
| | - Jian Xu
- The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030, China.
| | - Yining Jiang
- grid.16821.3c0000 0004 0368 8293The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030 China
| | - Hui Hua
- grid.16821.3c0000 0004 0368 8293The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030 China
| | - Yulai Zhou
- grid.16821.3c0000 0004 0368 8293The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030 China
| | - Xiangrong Guo
- grid.16821.3c0000 0004 0368 8293The International Peace Maternity & Child Health Hospital, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai Jiao Tong University School of Medicine, No. 910 Hengshan Road, Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293MOE-Shanghai Key Laboratory of Children’s Environmental Health, Department of Child and Adolescent Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092 China
| |
Collapse
|
5
|
Bulimwengu AS, Cartmel J. The tween years: A systematic literature review for services for children aged 10-13 years. Heliyon 2022; 8:e08822. [PMID: 35128107 PMCID: PMC8810366 DOI: 10.1016/j.heliyon.2022.e08822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/21/2021] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
|
6
|
School-based depression and anxiety prevention programs: An updated systematic review and meta-analysis. Clin Psychol Rev 2021; 89:102079. [PMID: 34571372 DOI: 10.1016/j.cpr.2021.102079] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022]
Abstract
Depression and anxiety are often first experienced during childhood and adolescence, and interest in the prevention of these disorders is growing. The focus of this review was to assess the effectiveness of psychological prevention programs delivered in schools, and to provide an update to our previous review from five years ago (Werner-Seidler, Perry, Calear, Newby, & Christensen, 2017). Three electronic databases were systematically searched for published articles of randomised controlled trials (RCTs) evaluating the efficacy of school-based prevention programs until October 2020. There were 130 articles that met inclusion criteria, representing 118 unique trials and 45,924 participants. Small between-group effect sizes for depression (g = 0.21) and anxiety (g = 0.18) were detected immediately post-intervention. Subgroup analyses suggested that targeted prevention programs (for young people with risk factors or symptoms) were associated with significantly greater effect sizes relative to universal programs for depression, which was confirmed by meta-regression. There was also some evidence that external providers conferred some benefit over school-staff delivered programs. Overall, study quality was moderate and no association between risk of bias and effect size was detected. School-delivered psychological prevention programs have small effects in reducing symptoms of depression and anxiety. Refinement of these programs, and knowledge about how they can be sustainably delivered in schools beyond the trial period is now needed for population-level preventive effects. Systematic Review Registration Number: PROPSERO - CRD42020188323.
Collapse
|