The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data

Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents

BACKGROUND

This study examined how health behavior patterns are associated with anxiety and suicidal behaviors among Korean adolescents.

METHODS

Data were collected from a national cross-sectional sample of adolescents (n = 54,948, 51.5 % boys) in the 2020 Korea Youth Risk Behavior Web-based Survey. Latent class analysis was conducted based on 12 health behaviors (e.g., eating habits, physical activity, and substance use) using the R-based Jamovi 2.3.21 program.

RESULTS

Four classes of health behaviors were identified: Class 1 (boys: 45.4 %, girls: 34.4 %) engaged in healthy behaviors; Class 2 (boys: 31.7 %; girls: 22.3 %) had unhealthy eating habits; Class 3 (boys: 18.0 %; girls: 39.9 %) had the lowest physical activity; and Class 4 (boys: 5.0 %, girls: 3.4 %) engaged in substance use, including smoking, drinking, and problematic smartphone use. Overall, girls had a higher odds ratio (OR) for anxiety and suicidal behaviors than boys did. Among girls, Class 4 had a higher OR for anxiety (OR = 2.78, 95 % confidence interval [CI] = 2.40-3.21), suicidal ideation (OR = 3.99, 95 % CI = 3.46-4.62), suicide plan (OR = 3.32, 95 % CI = 2.66-4.16), and suicide attempts (OR = 5.62, 95 % CI = 4.43-7.12) than Class 1.

LIMITATIONS

This study has a few limitations including the participants' response bias, the use of a self-report survey, and the lack of diagnosis by clinicians.

CONCLUSION

Adolescents engaging in substance abuse (Class 4) were more prone to anxiety symptoms and suicidal behaviors (ideation, plan, and attempts) than those engaged in healthy behaviors (Class 1). We suggest that more attention is needed to develop suicide prevention strategies that consider adolescent substance use patterns such as current smoking, drinking, and problematic smartphone use.

Effects of COVID-19 outbreak on Korean adolescents: Impact of altered economic perception on physical activity, sedentary behavior, and stress levels in an age-, gender-, and BMI-matched study

The current study is to examine the disparities in physical activity (PA), sedentary behavior (SB), and stress levels in Korean adolescents concerning changes in their perception of family economic status (ES) during COVID-19. Among a total of 6144 Korean adolescents aged 12 to 18, the participants were categorized into two groups based on their responses regarding changes in their family ES due to COVID-19: Declined ES (n = 3072) and Non-changed ES (n = 3072), with matching in terms of age, gender, and BMI. All variables were assessed using the 16th year (2020) of the Korean Youth Risk Behavior Survey. Statistical analyses were conducted using the SPSS 26.0 version, employing independent t-tests to examine anthropometrics' differences and multinominal logistic regression to predict the impact of perception of family ES on PA, SB, and stress while comparing the two groups. The significance level was set at α = 0.05. Adolescents in the Declined ES group were 1.2 times more likely to engage in MVPA for less than 420 mins/wk (OR = 1.16, p = 0.039), 1.7 times more likely to meet recommended muscular strength activities (i.e., ≥ 3 days/wk) (OR = 1.70, p < 0.001), 37% less likely to not meet recommended recreational sitting time (i.e., ≥ 840 mins/wk) (OR = 0.63, p < 0.01), and were 2.1 times more likely to experience very severe stress level than the Non-changed ES group (p < 0.001). These results shed light on the importance of promoting mental health care in adolescents, regardless of PA levels, for their well-being during potential future pandemics. Understanding the impact of perceived ES changes on health behaviors can inform targeted interventions and support strategies to improve the mental health outcomes of adolescents during challenging times.