Academic Stress and Adolescents Mental Health: A Multilevel Structural Equation Modeling (MSEM) Study in Northwest of Iran

Background: We aimed to determine the relation of different sources of academic stress and adolescents´ mental health through mediator variables on the student and school levels.Study design: A cross-sectional study. Methods: Overall, 1724 students aged 12-19 yr were selected from 53 high schools in Qazvin City, northwest instead of central Iran through stratified cluster sampling. The sources of academic stress include family conditions, education system, future concerns, academic competitions, interaction with teachers, school disciplines, peer pressure, parental involvement, and financial problems. Academic self-efficacy and self-concept were the mediator constructs. The students and schools´ information were considered on levels 1 and 2, respectively. A Multilevel Structural Equation Modeling (MSEM) analysis was done. Results: High value of academic stress was associated with reduction of mental health. On the student level, the academic stress caused by the families 0.31 (95% CI: 0.28, 0.34), peers 0.29 (95% CI: 0.27, 0.32), and the education system 0.21 (95% CI: 0.18, 0.24) had the highest impact on the adolescentsˊ mental health, respectively. There was a direct and indirect relation between academic stress and mental health through the self-concept. On the school level, only familyconditions stress had a relation with mental health (P=0.015, b=1.08). Academic self-efficacy showed no significant relation in the model. Conclusion: The stress from the family is the most important source of stress associated with adolescent mental health. Self-concept unlike academic self-efficacy had an important mediating role in the relation between different sources of academic stress and adolescents' mental health. Keywords: Academic stress , Mental health , Self-concept, Adolescents ,Ira

Sources of academic stress among Iranian adolescents: a multilevel study from Qazvin City, Iran

Background: Academic stress can cause mental and physical problems and affect adolescents’ healthy development. This study aimed to estimate academic stress and explore its sources at the individual- and school levels among school-going adolescents in the city of Qazvin, Iran. Results: This cross-sectional study used a stratified cluster sampling to recruit 1724 students aged 12–19 years from 53 schools in Qazvin City. Data were collected using a validated self-administered questionnaire. The mean academic stress score was 45.7 (95% CI 45.2, 46.3). The stress level was statistically higher among older 47.5 (95% CI 46.7, 48.3) than younger 44.1 (95% CI 43.4, 44.9) adolescents. The main academic stressors included: future uncertainty 69.7 (95% CI 68.8, 70.7), academic competition 58.5 (95% CI 57.3, 59.6), and interaction with teachers 56.1 (95% CI 55.3, 56.9). Gender, educational period, school type, family socioeconomic status, and father’s education were associated with academic stress. Conclusions: We conducted a multilevel study using a random sample of male and female students in the city of Qazvin, Iran. Results indicated moderate levels of stress among Iranian adolescents. The academic stress was associated with several individual and school-level variables. Students and their families and teachers need education on stress prevention methods and coping mechanisms. Future research should focus on developing and testing multilevel policies and interventions to improve students’ mental health and academic performance. Keywords: Academic stress, Adolescence, Students, Multilevel analysis, Ira

Sources of academic stress among Iranian adolescents: a multilevel study from Qazvin City, Iran

Background: Academic stress can cause mental and physical problems and affect adolescents’ healthy development. This study aimed to estimate academic stress and explore its sources at the individual- and school levels among school-going adolescents in the city of Qazvin, Iran. Results: This cross-sectional study used a stratified cluster sampling to recruit 1724 students aged 12–19 years from 53 schools in Qazvin City. Data were collected using a validated self-administered questionnaire. The mean academic stress score was 45.7 (95% CI 45.2, 46.3). The stress level was statistically higher among older 47.5 (95% CI 46.7, 48.3) than younger 44.1 (95% CI 43.4, 44.9) adolescents. The main academic stressors included: future uncertainty 69.7 (95% CI 68.8, 70.7), academic competition 58.5 (95% CI 57.3, 59.6), and interaction with teachers 56.1 (95% CI 55.3, 56.9). Gender, educational period, school type, family socioeconomic status, and father’s education were associated with academic stress. Conclusions: We conducted a multilevel study using a random sample of male and female students in the city of Qazvin, Iran. Results indicated moderate levels of stress among Iranian adolescents. The academic stress was associated with several individual and school-level variables. Students and their families and teachers need education on stress prevention methods and coping mechanisms. Future research should focus on developing and testing multilevel policies and interventions to improve students’ mental health and academic performance. Keywords: Academic stress, Adolescence, Students, Multilevel analysis, Ira

تبیین رفتار شاهدان قلدری در مدارس بر اساس عدم درگیری اخلاقی و حساسیت اخلاقی با نقش واسطه‌ای هویت اخلاقی

Background and Aim: Bullying is a behavioral phenomenon that has attracted the attention of many teachers and educators in different parts of the world in recent years. The purpose of this study is to explain the Bystander behavior in schools based on Moral Disengagement and moral sensitivity with the mediating role of moral identity. The target population was male and female high school students in Lorestan province in the 1397-98 academic year. Materials and Methods: This is a cross-sectional study kind of correlation. The sample of the present study included 617 students who were selected by cluster sampling. Participants responded to the scales of Mechanisms of Moral Disengagement, Ethical Sensitivity, participant's role (and Self-Importance of Moral Identity. Data analysis was performed using structural equation modeling as well as path analysis by AMOS 24 software. Findings: The results showed that conceptual model of research has a desirable and acceptable fit with the research data. Findings from the structural equation model show that moral disengagement and moral sensitivity are related to the bystander behavior in bullying. In other words, those with high moral disengagement and low moral sensitivity they behave more harmful. The results of the analysis also show that moral identity has a mediating role in the relationship between bystander behaviors in schools and moral disengagement and moral sensitivity. Ethical Considerations: In this study, principles related to ethical considerations such as confidentiality of the respondents' identity, satisfaction of the participants in the research and the right to leave the research was taken into consideration. Conclusion: The results show that moral disengagement and moral sensitivity are related to the type of students' reaction as a witness during bullying and this reaction can be different according to characteristics such as moral identity.   Cite this article as: Souri H, Kadivar P, Keramati H, Hassanabadi HR. Explaining the Bystander behavior of Bullying in Schools Based on Moral Disengagement and Moral Sensitivity with the Mediating Role of Moral Identity. Med Ethics J 2021; 15(46): e5.زمینه و هدف: قلدری پدیده رفتاری است که در سال‌های اخیر توجه بسیاری از معلمین (مربیان) و سیاستگذاران در نقاط مختلف جهان را به خود جلب کرده است. هدف پژوهش حاضر تبیین رفتار شاهدان قلدری در مدارس بر اساس عدم درگیری اخلاقی و حساسیت اخلاقی با نقش واسطه‌ای هویت اخلاقی است. مواد و روش‌ها: این پژوهش مقطعی از نوع توصیفی ـ همبستگی است. جامعه مورد نظر دانش‌آموزان پسر و دختر متوسطه دوم استان لرستان در سال تحصیلی 98-1397 بود. نمونه پژوهش حاضر شامل 617 دانش‌آموز که به روش نمونه‌گیری خوشه‌ای انتخاب شدند. شرکت‌کنندگان به مقیاس‌های مکانیسم‌های عدم درگیری اخلاقی (Bandura و همکاران)، حساسیت اخلاقی (Narvaez & Endicott)، نقش شرکت‌کنندگان (رفتار شاهدان) (Salmivalli و همکاران) و اهمیت برای خویشتن هویت اخلاقی (Aquino & Reed) پاسخ دادند. تجزیه و تحلیل داده‌ها با استفاده از مدل معادلات ساختاری و همچنین تحلیل مسیر به وسیله نرم‌افزار AMOS 24انجام گرفت. یافته‌ها: نتایج نشان داد که مدل مفهومی پژوهش با داده‌های پژوهش برازش مطلوب و قابل قبولی دارد. یافته‌های حاصل از مدل معادلات ساختاری نشان می‌دهد که عدم درگیری اخلاقی و حساسیت اخلاقی با رفتار شاهدان در قلدری رابطه دارد. به عبارتی دیگر کسانی که عدم درگیری اخلاقی بالا و حساسیت اخلاقی پایین دارند، به صورت زیان‌آورتری رفتار می‌کنند. همچنین نتایج تحلیل نشان می‌دهد که هویت اخلاقی در ارتباط بین رفتارهای شاهدان قلدری در مدارس و عدم درگیری اخلاقی و حساسیت اخلاقی نقش واسطه‌ای دارند. ملاحظات اخلاقی: در این مطالعه اصول مرتبط با ملاحظات اخلاقی از جمله محرمانه‌ماندن هویت پرسش‌شوندگان، رضایت آگاهانه شركت‌كنندگان در پژوهش و اختیار خروج از روند تحقیق رعایت گردید. نتیجه‌گیری: نتایج پژوهش حاضر نشان می‌دهد که عدم درگیری اخلاقی و حساسیت اخلاقی با نوع واکنش دانش‌آموزان به عنوان شاهد در هنگام قلدری رابطه دارد و این واکنش با توجه به ویژگی‌هایی مانند هویت اخلاقی می‌تواند متفاوت باشد

Academic stress from the viewpoint of Iranian adolescents: A qualitative study

BACKGROUND: Academic stress is one of the major affecting factors on adolescent health. This study investigates adolescents' view about the sources of academic stress, with which their identification could be used for the reduction of adolescent academic stress. MATERIALS AND METHODS: This qualitative study was conducted with Directional Content Analysis methodology. Semi-structured interview methods were used for data collection. Participants were students aged 12–18 years old. Purposeful sampling with Opportunistic Maximum Variation Method was performed in terms of type of schools, socioeconomic classes, and gender of students. A total of 43 interviews and were conducted by two interviewers. RESULTS: A total of 173 codes, 11 subcategories, and 5 categories were extracted as academic stressors. The categories included family factors (32 codes); peers (18 codes); teachers, school supervisors, and educational system (72 codes); homework and test scores (32 codes); and educational assistance classes (19 codes). CONCLUSION: This study showed that students have different sources of academic stress. Awareness of their source of stress can help parents and teachers to revise their treat about students' function and policymaker to provide better planning and management for students

The role of mental health, academic stress, academic achievement, and physical activity on self-rated health among adolescents in Iran: A multilevel analysis

BACKGROUND: Health promotion of adolescents requires appropriate evidences of its determinants. The aim of this study was to investigate predictors of self-rated health (SRH) among adolescents in Qazvin, Iran. MATERIALS AND METHODS: In this descriptive cross-sectional study, with a multistage sampling method, we recruited 1740 adolescents aged 12–19 years from 53 schools in Qazvin, Iran (2018). We used the Strengths and Diffculties Questionnaire and Adolescents’ Academic Stress Questionnaire for data collection. The analysis was conducted using a multilevel logistic regression model. Gender, educational period, and socioeconomic status were considered as confounders. RESULTS: Almost 21% of the adolescents reported their SRH suboptimal. Suboptimal SRH was higher in girls and older adolescents. Mental health disorders and academic stress had a positive association with SRH. However, this association was negative for academic achievement and physical activity. The interaction between mental health disorders and academic stress with SRH had a signifcant association in a crud regression model. CONCLUSION: Mental health, academic stress, academic achievement, and physical activity were important predictors for SRH. Interventions that focus on promoting mental health,academic stress, academic achievement, and physical activity such as physical activity for 1 h and each day for 3 days per week can improve SRH in adolescents. Hence, policymakers should pay more attention to this issue in health promotion programs of adolescents. Keywords: Academic achievement, academic stress, adolescents, Iran, mental health, physical activity, selfrated healt

Academic Stress and Adolescents Mental Health: A Multilevel Structural Equation Modeling (MSEM) Study in Northwest of Iran

Background: We aimed to determine the relation of different sources of academic stress and adolescents´ mental health through mediator variables on the student and school levels.Study design: A cross-sectional study. Methods: Overall, 1724 students aged 12-19 yr were selected from 53 high schools in Qazvin City, northwest instead of central Iran through stratified cluster sampling. The sources of academic stress include family conditions, education system, future concerns, academic competitions, interaction with teachers, school disciplines, peer pressure, parental involvement, and financial problems. Academic self-efficacy and self-concept were the mediator constructs. The students and schools´ information were considered on levels 1 and 2, respectively. A Multilevel Structural Equation Modeling (MSEM) analysis was done. Results: High value of academic stress was associated with reduction of mental health. On the student level, the academic stress caused by the families 0.31 (95% CI: 0.28, 0.34), peers 0.29 (95% CI: 0.27, 0.32), and the education system 0.21 (95% CI: 0.18, 0.24) had the highest impact on the adolescentsˊ mental health, respectively. There was a direct and indirect relation between academic stress and mental health through the self-concept. On the school level, only familyconditions stress had a relation with mental health (P=0.015, b=1.08). Academic self-efficacy showed no significant relation in the model. Conclusion: The stress from the family is the most important source of stress associated with adolescent mental health. Self-concept unlike academic self-efficacy had an important mediating role in the relation between different sources of academic stress and adolescents' mental health. Keywords: Academic stress , Mental health , Self-concept, Adolescents ,Ira

Mental Health Problems and the Associated Family and School Factors in Adolescents: A Multilevel Analysis

Objective: Mental health is one of the most important issues in adolescents' life. Adolescents' health is highly important, because of their role in the future. This study was conducted using multilevel analysis to investigate the risk factors at student and school levels. Method: This was a cross sectional study for which 1740 students and 53 schools were selected between February and March 2018 in Qazvin, Iran. Multistage stratified cluster sampling was used for data collection. Mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Emotional symptom, conduct problem, hyperactivity, peer relationship problem, and prosocial behavior were the subscales. This study used multilevel analysis to determine the association between each of the questionnaire scales and students and schools variables. Results: The prevalence of the mental health problems was 16.2%. Conduct problem was more prevalent than others (21.1%). Overall, the score of mental health problems was significantly lower in boys' schools, in adolescents with physical activity, and in families with high socioeconomic status. Hyperactivity and emotional symptoms were significantly higher in girls' schools. While prosocial behavior and peer relationship problems were significantly higher in boys' schools. The association between variables and the scales of mental health problems was different. Conclusion: Results indicated desirable physical activity and socioeconomic status are effective components in the adolescents' mental health, and, mostly girls' schools were more vulnerable than boys' schools. Therefore, the educational authorities and health policymakers should consider this diversity to design interventional programs and pay more attention to the high-risk adolescents in different schools. Copyright © 2021 Tehran University of Medical Sciences. Author keywords Adolescents; Iran; Mental Health; Multilevel Analysis; SDQ; Student