The overarching concept of salutogenesis in the context of health care

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Self-esteem and mental health in adolescents – level and stability during a school year

Aim: Adolescence represent an important period for positive mental health development. The aim of the present paper was to investigate gender differences as well as the level, stability and predictive role of mental health (symptoms of depression/anxiety and mental well-being) and self-esteem in adolescents during a school year. Methods: The study sample consisted of a cohort of 351 students aged 15–21 years in Mid-Norway. In a survey administrated at the beginning and end of the 2016/2017 school year, mental well-being was assessed with Warwick-Edinburgh Mental Well-Being Scale, depression/anxiety with Hopkins Symptom Checklist and self-esteem with the Rosenberg Self-Esteem Scale. Two models were tested for prediction; self-esteem on mental health (vulnerability model) and mental health on self-esteem (scar model). Results: Girls reported significantly higher depression/anxiety than boys and showed a slightly significant increase in depression/anxiety, stress and self-esteem during the two assessments. Boys scored significantly higher on mental well-being and self-esteem and reported stable mental health during the school year. Selfesteem significantly predicted depression/anxiety and mental well-being. Mental well-being and depression/ anxiety also significantly predicted self-esteem. Conclusion: The results suggest that self-esteem and mental health are reciprocally associated. The results underline the gender differences in overall mental health in adolescents and thus the potential importance of acknowledging gender when working on universal strategies for positive mental health development

Stress and health in adolescents:The role of potential protective factors

Adolescence is a developmental period characterized by multiple changes in virtually every aspect of an individual’s life, calling for new psychological adaptations. Exposure to different stressors caused by these changes represents a central and normal part of the process of growth and development during adolescence. However, experience of cumulative and simultaneous negative stressors remains central as a potential threat to the well-being and healthy development during adolescence. Meanwhile, when faced with identical stressors, the stress process and the health outcomes of stress vary individually; the outcome depends on the role of different vulnerabilities and protective factors, in the individual as well as in the environment. The present thesis comprises an investigation of the role and nature of adolescent stressors and the association between stress and different health outcomes (emotional states, selfesteem and subjective health complaints). Gender and age differences on stress and the health outcome variables are also assessed. The thesis further considers the role of three potential protective factors with importance for stress and coping processes, as well as for health and well-being during adolescence; leisure time physical activity, self-esteem and sense of coherence (SOC). The factor structure and psychometric properties of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N), a questionnaire assessing stressors common in adolescence, are also investigated. The thesis is based on three cross-sectional samples of Norwegian adolescents 13-18 years, attending public elementary and secondary schools in rural and urban areas in the two counties of the middle part of Norway The findings support a reliable and valid nine-factor structure of the ASQ-N. Moreover, girls seem to report higher levels of stress, more emotional symptoms and subjective health complaints than boys, especially in the age group 15-16 years. Conversely boys score higher on self-esteem. Both total sum stress and domain specific stress, especially in interpersonal contexts, is related to more emotional problems, lower self-esteem and more subjective health complaints in both boys and girls. The thesis has also revealed the positive role of leisure time physical activity, sense of coherence and self-esteem, controlled for experience of stress, in association with adolescents’ health outcomes. Methodological, theoretical and practical implications of the results are discussed.Ungdomstiden er en utviklingsperiode i livet der den unge må tilpasse seg mange ulike forandringer, både fysiske, psykiske og sosiale. Å utsettes for ulike stressorer, forårsaket av disse store endringene, utgjør en sentral og normal del av vekst og utvikling hos ungdom. Imidlertid representerer opplevelse av mange negative og samtidige stressorer en potensiell trussel mot ungdoms helse og velvære. Når ungdom utsettes for samme type stressor, vil stressprosessen og utfallet av stresspåvirkningen for de unges helse, gi individuelle variasjoner. Resultatet av stressprosessen og stresspåvirkningen på helse vil være avhengig av ulike sårbarhets- og beskyttende faktorer, både i individet og i omgivelsene. Ph.d. avhandlingen omfatter en undersøkelse av hvilken rolle og betydning stressorer har i ungdoms hverdagsliv; hvordan stress er relatert til ungdoms psykiske helse, selvfølelse, og subjektive helseplager. Kjønns- og aldersforskjeller på stress og de ulike helsevariablene er også undersøkt. Avhandlingen vurderer betydningen av tre faktorer med potensiell betydning for prosesser knyttet til stress, mestring og helse hos ungdom; fysisk aktivitet i fritiden, selvfølelse og opplevelse av sammenheng. Ph.d. avhandlingen omfatter videre en undersøkelse av faktorstrukturen og de psykometriske egenskapene til den norske versjonen av The Adolescent Stress Questionnaire (ASQ-N), et spørreskjema som måler vanlig forekommende stressorer i ungdoms hverdagsliv. Avhandlingen baserer seg på tre tverrsnittsutvalg av ungdom i alderen 13-18 år og inkluderer ungdomsskoler og videregående skoler fra lands- og by områder i Trøndelag. Resultatene av valideringen av ASQ-N støtter en faktorstruktur bestående av ni pålitelige og gyldige stressdimensjoner. Jenter, spesielt i 15-16 årsalderen, rapporterer høyere stressnivå, så  vel som mer emosjonelle og subjektive helseplager sammenlignet med gutter. Gutter derimot rapporterer i alle aldersklasser høyere grad av selvfølelse. Høyere skåre både på total sum stress og områdespesifikt stress, spesielt i mellommenneskelig kontekst, er funnet å være relatert til mer emosjonelle problemer, mer subjektive helseplager og lavere selvfølelse både hos gutter og jenter. Avhandlingen har videre avdekket at fysisk aktivitet, opplevelse av sammenheng og høy grad av selvfølelse har positiv betydning for ungdoms helse, kontrollert for opplevelse av stress. Metodologiske, teoretiske og praktiske implikasjoner av funnene er diskuter

Sense of Coherence in Association with Stress Experience and Health in Adolescents

This study investigated the associations between sex, age, socio-economic status, stress, sense of coherence (SOC), and health (mental wellbeing, depressive symptoms, self-rated health, and subjective health complaints) in Norwegian adolescents aged 13–19 years. Furthermore, the study investigated the potential protective or compensatory role from SOC on the association between stress and health. Methods: The study was based on a cross-sectional sample of 1233 adolescents. Data were analyzed with descriptive, comparative, and multiple linear regression analyses. Results: Girls reported significantly higher scores on depressive symptoms and subjective health complaints than boys. Stress was significantly and positively associated with depressive symptoms. SOC associated significantly with all outcome variables; and especially with mental wellbeing and depressive symptoms. Significant interaction effects of sex in combination with stress and SOC were found in association with depression and mental wellbeing. Associations were strongest for girls. Conclusion: The findings provided support for the significant role of SOC as a coping resource, especially in relation to adolescents’ mental health; weaker associations were found with subjective health complains and self-rated health. The findings also mainly supported a compensatory role of SOC on the association between stress and health during adolescence.publishedVersio

Self-esteem and mental health in adolescents - level and stability during a school year.

Aim: Adolescence represent an important period for positive mental health development. The aim of the present paper was to investigate gender differences as well as the level, stability and predictive role of mental health (symptoms of depression/anxiety and mental well-being) and self-esteem in adolescents during a school year. Methods: The study sample consisted of a cohort of 351 students aged 15–21 years in Mid-Norway. In a survey administrated at the beginning and end of the 2016/2017 school year, mental well-being was assessed with Warwick-Edinburgh Mental Well-Being Scale, depression/anxiety with Hopkins Symptom Checklist and self-esteem with the Rosenberg Self-Esteem Scale. Two models were tested for prediction; self-esteem on mental health (vulnerability model) and mental health on self-esteem (scar model). Results: Girls reported significantly higher depression/anxiety than boys and showed a slightly significant increase in depression/anxiety, stress and self-esteem during the two assessments. Boys scored significantly higher on mental well-being and self-esteem and reported stable mental health during the school year. Selfesteem significantly predicted depression/anxiety and mental well-being. Mental well-being and depression/ anxiety also significantly predicted self-esteem. Conclusion: The results suggest that self-esteem and mental health are reciprocally associated. The results underline the gender differences in overall mental health in adolescents and thus the potential importance of acknowledging gender when working on universal strategies for positive mental health development

Sense of Coherence in Association with Stress Experience and Health in Adolescents

This study investigated the associations between sex, age, socio-economic status, stress, sense of coherence (SOC), and health (mental wellbeing, depressive symptoms, self-rated health, and subjective health complaints) in Norwegian adolescents aged 13–19 years. Furthermore, the study investigated the potential protective or compensatory role from SOC on the association between stress and health. Methods: The study was based on a cross-sectional sample of 1233 adolescents. Data were analyzed with descriptive, comparative, and multiple linear regression analyses. Results: Girls reported significantly higher scores on depressive symptoms and subjective health complaints than boys. Stress was significantly and positively associated with depressive symptoms. SOC associated significantly with all outcome variables; and especially with mental wellbeing and depressive symptoms. Significant interaction effects of sex in combination with stress and SOC were found in association with depression and mental wellbeing. Associations were strongest for girls. Conclusion: The findings provided support for the significant role of SOC as a coping resource, especially in relation to adolescents’ mental health; weaker associations were found with subjective health complains and self-rated health. The findings also mainly supported a compensatory role of SOC on the association between stress and health during adolescence

Sense of Coherence in Association with Stress Experience and Health in Adolescents

This study investigated the associations between sex, age, socio-economic status, stress, sense of coherence (SOC), and health (mental wellbeing, depressive symptoms, self-rated health, and subjective health complaints) in Norwegian adolescents aged 13–19 years. Furthermore, the study investigated the potential protective or compensatory role from SOC on the association between stress and health. Methods: The study was based on a cross-sectional sample of 1233 adolescents. Data were analyzed with descriptive, comparative, and multiple linear regression analyses. Results: Girls reported significantly higher scores on depressive symptoms and subjective health complaints than boys. Stress was significantly and positively associated with depressive symptoms. SOC associated significantly with all outcome variables; and especially with mental wellbeing and depressive symptoms. Significant interaction effects of sex in combination with stress and SOC were found in association with depression and mental wellbeing. Associations were strongest for girls. Conclusion: The findings provided support for the significant role of SOC as a coping resource, especially in relation to adolescents’ mental health; weaker associations were found with subjective health complains and self-rated health. The findings also mainly supported a compensatory role of SOC on the association between stress and health during adolescence

Satisfaction with life scale in adolescents: evaluation of factor structure and gender invariance in a Norwegian sample

In spite of the significance of life satisfaction (LS) for adolescent health and well-being, the past decades have yielded limited progress in investigating the psychometric properties of a well-used inventory measuring LS, The satisfaction with Life Scale (SWLS) in adolescents. The present study aimed at investigating the factor structure, gender invariance, and convergent validity of the Norwegian version of the five-item SWLS in adolescents 13–18 years. The study was based on a cross-sectional sample of 1,073 adolescents from rural areas in Mid-Norway, and the data were analysed using confirmatory factor analysis (CFA) and multi-group analyses in AMOS. Results from the CFA supported a single-factor structure with correlated residual variances between items 4 and 5. The results from the multi-group analyses indicated configural and metric invariance of SWLS between genders, as indicated by invariant factor structure and factor loadings. The SWLS also showed high reliability and correlated in expected directions with measures of emotional symptoms and self-esteem, supporting the convergent validity of the instrument. The psychometric properties of the SWLS need to be further evaluated in adolescents; however the present results indicate that the SWLS is a questionnaire appropriate for assessing LS in a population of Norwegian adolescents

Life satisfaction in association with self-efficacy and stressor experience in adolescents – self-efficacy as a potential moderator

Aim This paper reports associations among socio‐demographic variables, stressor experience, self‐efficacy and life satisfaction among Norwegian adolescents aged 15–21 years and the potential moderating role of self‐efficacy on the association between stressor experience and life satisfaction. Methods The cross‐sectional school‐based survey study involved 1816 upper‐secondary school students from Mid‐Norway. Data were analysed with independent samples t test, Pearson's product moment correlation and multiple linear regression analysis. Results Bivariate results showed that boys scored higher than girls on life satisfaction and self‐efficacy, whereas girls scored higher than boys on all stressor domains. Multiple linear regression analysis showed that life satisfaction declined weakly with age, whereas stronger family economy and having parents who work full‐time associated with higher life satisfaction. Stress with teacher interaction, peer pressure, home life, school attendance, school–leisure conflict and school performance were all negatively associated with life satisfaction, whereas self‐efficacy associated positively and strongly with life satisfaction. Self‐efficacy moderated the association between both interpersonal and school‐related stressors and life satisfaction. Conclusion The results provide support for the unique role of stressor experience and self‐efficacy in association with adolescents' life satisfaction as well as self‐efficacy as a stress moderator in relation to life satisfaction