Contributing Factors in Adolescents’ Mental Well-Being—The Role of Socioeconomic Status, Social Support, and Health Behavior

Latent classes of adolescent health behaviour, social covariates and mental wellbeing: a longitudinal birth cohort study

BACKGROUND

Adolescent mental wellbeing has been declining in the United Kingdom for over a decade. Expansion of services to support the mental wellbeing of young people is a public health priority and a core component of the National Health Service's Long-Term Plan. In this paper, we leverage secondary analysis of a very large longitudinal dataset (#BeeWell) to generate insights regarding different patterns of health behaviour, their covariates, and consequences for mental wellbeing one year later.

METHODS

A Latent Class Analysis was conducted using data on physical activity, sleep, and eating habits collected in 2021 from 18,478 Year 8 pupils from Greater Manchester (United Kingdom) to (1) identify distinct latent classes of adolescent health behaviour; (2) establish factors likely to be associated with latent class membership; and (3) determine whether latent class membership contributes to variance in self-reported mental wellbeing one year later.

RESULTS

A three-class solution was identified as an excellent fit to the data, discriminating between: the Wellness Weary (n = 2,717; 15%); the Balanced Bunch (n = 7,377; 40%); and the Green and Dream Team (n = 8,384; 45%). Several factors significantly influenced class membership. Most notably, socio-economic disadvantage and social media use were linked with less favourable health behaviour patterns, whilst cisgender heterosexual girls were likely to endorse healthier patterns. After adjusting for covariates, the Green and Dream Team reported significantly greater mental wellbeing than the Balanced Bunch one year later. However, there was no difference between the Balanced Bunch and the Wellness Weary, signalling that health behaviours may support mental wellbeing, but only among the healthiest young people.

CONCLUSIONS

Beyond advancements in fundamental understanding, our findings yield significant translation opportunities through their use and application in health, education, and allied professional settings designed to support young people.

Social determinants of health and their relation to suboptimal health status in the context of 3PM: a latent profile analysis

Background

Suboptimal health is identified as a reversible phase occurring before chronic diseases manifest, emphasizing the significance of early detection and intervention in predictive, preventive, and personalized medicine (PPPM/3PM). While the biological and genetic factors associated with suboptimal health have received considerable attention, the influence of social determinants of health (SDH) remains relatively understudied. By comprehensively understanding the SDH influencing suboptimal health, healthcare providers can tailor interventions to address individual needs, improving health outcomes and facilitating the transition to optimal well-being. This study aimed to identify distinct profiles within SDH indicators and examine their association with suboptimal health status.

Method

This cross-sectional study was conducted from June 16 to September 23, 2023, in five regions of China. Various SDH indicators, such as family health, economic status, eHealth literacy, mental disorder, social support, health behavior, and sleep quality, were examined in this study. Latent profile analysis was employed to identify distinct profiles based on these SDH indicators. Logistic regression analysis by profile was used to investigate the association between these profiles and suboptimal health status.

Results

The analysis included 4918 individuals. Latent profile analysis revealed three distinct profiles (prevalence): the Adversely Burdened Vulnerability Group (37.6%), the Adversity-Driven Struggle Group (11.7%), and the Advantaged Resilience Group (50.7%). These profiles exhibited significant differences in suboptimal health status (p < 0.001). The Adversely Burdened Vulnerability Group had the highest risk of suboptimal health, followed by the Adversity-Driven Struggle Group, while the Advantaged Resilience Group had the lowest risk.

Conclusions and relevance

Distinct profiles based on SDH indicators are associated with suboptimal health status. Healthcare providers should integrate SDH assessment into routine clinical practice to customize interventions and address specific needs. This study reveals that the group with the highest risk of suboptimal health stands out as the youngest among all the groups, underscoring the critical importance of early intervention and targeted prevention strategies within the framework of 3PM. Tailored interventions for the Adversely Burdened Vulnerability Group should focus on economic opportunities, healthcare access, healthy food options, and social support. Leveraging their higher eHealth literacy and resourcefulness, interventions empower the Adversity-Driven Struggle Group. By addressing healthcare utilization, substance use, and social support, targeted interventions effectively reduce suboptimal health risks and improve well-being in vulnerable populations.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13167-024-00365-5.

Machine Learning-Based Prediction of Mental Well-Being Using Health Behavior Data from University Students

BACKGROUND

Since the onset of the COVID-19 pandemic in early 2020, the importance of timely and effective assessment of mental well-being has increased dramatically. Machine learning (ML) algorithms and artificial intelligence (AI) techniques can be harnessed for early detection, prognostication and prediction of negative psychological well-being states.

METHODS

We used data from a large, multi-site cross-sectional survey consisting of 17 universities in Southeast Asia. This research work models mental well-being and reports on the performance of various machine learning algorithms, including generalized linear models, k-nearest neighbor, naïve Bayes, neural networks, random forest, recursive partitioning, bagging, and boosting.

RESULTS

Random Forest and adaptive boosting algorithms achieved the highest accuracy for identifying negative mental well-being traits. The top five most salient features associated with predicting poor mental well-being include the number of sports activities per week, body mass index, grade point average (GPA), sedentary hours, and age.

CONCLUSIONS

Based on the reported results, several specific recommendations and suggested future work are discussed. These findings may be useful to provide cost-effective support and modernize mental well-being assessment and monitoring at the individual and university level.

Mental health of people with limited access to health services: a retrospective study of patients attending a humanitarian clinic network in Germany in 2021

BACKGROUND

Germany has a statutory health insurance system. However, a substantial part of the population still suffers from limited access to regular health services. While humanitarian organizations are partially filling this gap, people with limited access show a high prevalence of mental disorders. This study investigates the prevalence, and social determinants of mental disorders in patients attending the clinics of a humanitarian health network in three major cities in Germany, as well as perceived barriers to healthcare access in this population.

METHODS

We performed a descriptive, retrospective study of individuals attending the outpatient clinics of the humanitarian organization Ärzte der Welt, in Berlin, Hamburg and Munich, in 2021. Medico-administrative data was collected using a digital questionnaire at first presentation to the clinics. We report the prevalence of both perceived altered mental health and diagnosed mental disorders, as well as the perceived barriers to healthcare access in this population. We performed a logistic regression analysis to identify the socio-demographic factors associated with mental disorders.

RESULTS

Our study population consisted of 1,071 first presenters to the clinics in 2021. The median age at presentation was 32 years and 57.2% of the population were male. 81.8% experienced a form of homelessness, 40% originated from non-EU countries and only 12.4% had regular statutory health insurance. 101 (9.4%) patients had a diagnosed mental disorder. In addition, 128 (11.9%) patients reported feeling depressed, 99 (9.2%) reported a lack of interest in daily activities, and 134 (12.5%) lacked emotional support in situations of need on most days. The most reported barrier to accessing health services was high health expenses, reported by 61.3% of patients.In the bivariate logistic regression analysis age, insurance status and region of origin were significantly associated with mental disorders. In the multivariable analysis, only age groups 20-39 and 40-59 years remained significant.

CONCLUSIONS

People with limited access to regular health services have a high need for mental health services. As a chronic condition, this is even more difficult to manage outside of regular services, where humanitarian clinics are only filling the gap in serving basic health needs.

The association between dietary inflammatory index, dietary antioxidant index, and mental health in adolescent girls: an analytical study

BACKGROUND

Diet is considered as one of the modifiable factors that appears to exert a vital role in psychological status. In this way, we designed this study to examine the association between dietary inflammatory index (DII), dietary antioxidant index (DAI), and mental health in female adolescents.

METHODS

This cross-sectional study included 364 female adolescents selected from high schools in the five regions of Tabriz, Iran. A 3-day food record was used to extract the dietary data and calculate DII/DAI scores. DII and DAI were estimated to assess the odds of depression, anxiety, and stress based on the Depression Anxiety Stress Scales-21. Adjusted relationships of the DII and DAI with depression, anxiety, and stress were determined using multiple regression after adjusting for age, energy intake, BMI, family income and mother and father education. Overweight was defined as body mass index (BMI)-for-age >  + 1 z-score relative to world health organization standards.

RESULTS

Depression, anxiety, and stress were observed in 21.4%, 26.6%, and 25.7% of subjects, respectively. The percentage of overweight among adolescents was 19.4%. The association between DII and score of mental health profile was positive among subjects in the third tertile of DII compared to subjects in the first tertile. However, this association was not statistically significant after adjusting for confounding variables. Moreover, there was a significant inverse association between DAI and depression and anxiety; and a statistically insignificant association between DAI and stress after adjusting for confounders.

CONCLUSIONS

Our results highlighted the importance of a healthy and anti-inflammatory diet on mental health in female adolescents. Therefore, modifying unhealthy dietary habits are likely to be effective in the management of psychosocial disorders.

The relationship between perceptions of school climate and internet gaming disorder of teenage students: A moderated mediation model

Background

In recent years, teenage students' internet gaming disorder has raised widespread concern in the society. The current study aims to explore how perceptions of school climate, maladaptive cognition, and belief in a just world impact teenage students' internet gaming disorder and seek the suitable intervention to prevent teenage students' internet gaming disorder tendency.

Methods

A total of 1,164 teenage students (age: 19.62 ± 3.14 years) were evaluated using the Perceived School Climate Scale (PSCS), Maladaptive Cognition Scale (MCS), Belief in a Just World Scale (BJWS), and Internet Gaming Disorder Scale (IGDS).

Results

(1) Perceptions of school climate could predict teenage students' internet gaming disorder [β = -0.15, p < 0.001, 95% CI = (-0.20, -0.11)]. (2) Teenage students' maladaptive cognition exerts a partial mediating effect between their perceptions of school climate and internet gaming disorder [ab = -0.13, boot SE = 0.01, 95% CI = (-0.16, -0.11)]. (3) The direct effect of perceptions of school climate on internet gaming disorder [β = -0.07, p < 0.01, 95% CI = (-0.11, -0.02)], the first half of the mediation model "perceptions of school climate → maladaptive cognition" [β = -0.08, p < 0.01, 95% CI = (-0.12, -0.03)], and the second half of the mediation model "maladaptive cognition → internet gaming disorder" [β = 0.10, p < 0.001, 95% CI = (0.06, 0.14)] are all moderated reciprocally by teenage students' belief in a just world.

Conclusion

Schools should create a good climate and shape belief in a just world to reduce the maladaptive cognition of teenagers, to effectively prevent teenage students' internet gaming disorder tendency.

Depressive Symptoms and Their Associated Factors in Vocational-Technical School Students during the COVID-19 Pandemic

The objectives of this study were to compare the prevalence of depressive symptoms, behavioral habits, and QoL in students from two vocational-technical schools, and to determine the association of depressive symptoms with behavioral habits and quality of life (QoL) in these students during the COVID-19 pandemic. A cross-sectional survey was conducted with students attending the institution of the Brazilian Federal Network of Professional, Scientific and Technological Education. The students answered a questionnaire on sociodemographic variables, situations related to the COVID-19 pandemic, behavioral habits, QoL, and depressive symptoms. The outcome variable was the presence of depressive symptoms, assessed using the Children's Depression Inventory (CDI). Poisson regression analysis with robust variance was performed. A total of 343 students participated in this study (women, 55.7%; mean age of 16.1 ± 0.93 years). The prevalence of depressive symptoms among students was 43.4% (95% confidence interval [CI]: 38.0-49.0), and these symptoms were significantly associated with being female (prevalence ratio [PR] 1.72; 95% CI: 1.31-2.27); being in the 10th grade (PR: 1.80; 95% CI: 1.18-2.76) and 9th grade (PR 2.08; 95% CI: 1.37-3.18); social isolation (PR: 2.04; 95% CI: 1.00-4.14); hunger due to a lack of food at home (PR: 1.78; 95% CI: 1.33-2.39); low physical activity levels (PR: 1.68; 95% CI: 1.09-2.59); and moderate (PR: 2.87, 95% CI: 1.68-4.89) and low QoL (PR: 5.66; 95% CI: 3.48-9.19). The results emphasize the importance of interventions aimed mainly at female students and those in the initial years of high school, in addition to the importance of physical activity, food safety, and QoL to improve the mental health of students.

A School Intervention's Impact on Adolescents' Health-Related Knowledge and Behavior

Background

Many factors can influence health behavior during adolescence, and the lifestyle of adolescents is associated with health behavior during adulthood. Therefore, their behavior can determine not only present, but also later health status.

Objective

We aimed to develop an intervention program to improve high school students' health behavior and to evaluate its effectiveness.

Methods

We performed our study at a secondary school in a rural town in East Hungary between 2016 and 2020. Sessions about healthy lifestyles were organized regularly for the intervention group to improve students' knowledge, to help them acquire the right skills and attitudes, and to shape their behavior accordingly. Data collection was carried out via self-administered, anonymous questionnaires (n = 192; boys = 49.5%; girls = 50.5%; age range: 14-16). To determine the intervention-specific effect, we took into account the differences between baseline and post-intervention status, and between the intervention and control groups using individual follow-up data. We used generalized estimating equations to assess the effectiveness of our health promotion program.

Results

Our health promotion program had a positive effect on the students' health-related knowledge and health behavior in the case of unhealthy eating, moderate to vigorous physical activity, and alcohol consumption.

Conclusion

Our findings suggest that school health promotion can be effective in knowledge transfer and lifestyle modification. To achieve a more positive impact on health behavior, preventive actions must use a complex approach during implementation.

Parental Perceptions of Child and Adolescent Mental Health During the COVID-19 Pandemic in Argentina

Background

As a result of the COVID-19 pandemic, governments have implemented preventive measures towards reducing infections. These conditions can affect the mental health of children and adolescents; however, this has not yet been fully explored.

Objective

The aim of the study was to analyze changes in symptomatology and positive emotions in Argentine children and adolescents since the onset of isolation, based on parent/caregiver report. We analyzed differences based on gender, age, socioeconomic status (SS) and containment measure (and their interactions); their associations with symptomatology and positive affect of parents/caregivers; and the moderating effects of sociodemographic factors on these associations.

Method

A total of 1205 caregivers responded to a survey regarding the mental health of children and adolescents under their care. They also completed a set of anxiety, depression, and affect measures about themselves.

Results

A considerable proportion of parents/caregivers perceived changes in their children’s and adolescents’ mental health compared to before the pandemic. Increased levels of anxiety-depression, aggression-irritability, impulsivity-inattention, and dependence-withdrawal were reported, as well as alterations in sleeping and eating habits, and a reduction in positive affect. Differences were observed according to their age and containment measure. Finally, we found correlations between parents/caregivers’ symptomatology and that reported about their children or adolescents. Gender, age and SS moderated some of these relationships.

Conclusions

Continued monitoring of child and adolescent mental health is a fundamental necessity. We recommend the implementation of early intervention strategies to prevent the escalation of serious mental health problems, particularly in those groups that have been most adversely affected since the onset of the pandemic.

Perceived Social Support for a Sustainable Adolescence: A Theoretical Model of Its Sources and Types

Despite the growing interest in perceived social support as a means of achieving sustainable psychological development and well-being in the various contexts of the adolescent, its definition and composition remain unclear. The aim of this study is to test both the hierarchical order and the types and sources of a theoretical model of the social support perceived by adolescents. The model is based on the theories of Tardy and Lin, as well as on the findings of recent studies on the construct. Three theoretical models are compared using the structural equations method. The participants were 1081 randomly selected secondary school students (aged 12–18 years) from the north of Spain, who completed the APIK Perceived Social Support Questionnaire. The model positing that perceived social support comprises a hierarchical first level formed by sources of support (family, friends and teachers) and a lower second level derived from the first one, formed by types of support (emotional, material and informational), proved to be the first-choice solution. The results establish a solid theoretical base for both future studies on perceived social support during adolescence and possible educational interventions designed to improve social support for teenagers.