Identifying family correlates of adolescents’ subjective health complaints: evidence from a Greek cross-sectional study

Distinct aspects of family life have been suggested to influence adolescent psychosomatic health. The aim of the present study was to investigate family factors associated with adolescents’ Subjective Health Complaints (SHC)

The role of perceived well-being in the family, school and peer context in adolescents’ subjective health complaints: Evidence from a Greek cross-sectional study

Background During adolescence children are usually confronted with an expanding social arena. Apart from families, schools and neighbourhoods, peers, classmates, teachers, and other adult figures gain increasing importance for adolescent socio-emotional adjustment. The aim of the present study was to investigate the extent to which Greek adolescents’ perceived well-being in three main social contexts (family, school and peers) predicted self-reported Subjective Health Complaints. Methods Questionnaires were administered to a Greek nation-wide, random, school-based sample of children aged 12–18 years in 2003. Data from 1.087 adolescents were analyzed. A hierarchical regression model with Subjective Health Complaints as the outcome variable was employed in order to i) control for the effects of previously well-established demographic factors (sex, age and subjective economic status) and ii) to identify the unique proportion of variance attributed to each context. Bivariate correlations and multicollinearity were also explored. Results As hypothesized, adolescents’ perceived well-being in each of the three social contexts appeared to hold unique proportions of variance in self-reported Subjective Health Complaints, after controlling for the effects of sex, age and subjective economic status. In addition, our final model confirmed that the explained variance in SHC was accumulated from each social context studied. The regression models were statistically significant and explained a total of approximately 24% of the variance in Subjective Health Complaints. Conclusions Our study delineated the unique and cumulative contributions of adolescents’ perceived well-being in the family, school and peer setting in the explanation of Subjective Health Complaints. Apart from families, schools, teachers and peers appear to have a salient role in adolescent psychosomatic adjustment. A thorough understanding of the relationship between adolescents’ Subjective Health Complaints and perceived well-being in their social contexts could not only lead to more effective tailored initiatives, but also to promote a multi- and inter-disciplinary culture in adolescent psychosomatic health

Identifying the sociodemographic determinants of subjective health complaints in a cross-sectional study of Greek adolescents

Background: Experience of common health symptoms without a clear physical or psychological cause, such as headache or dizziness, is often reported in adolescence. The present study attempted to investigate associations of self-reported subjective health complaints (SHC) with a number of sociodemographic factors of Greek adolescents. Methods: Questionnaires were administered to a Greek nationwide random school-based sample of adolescents aged 11 to 18 years and their parents in 2003. Data from 922 adolescent-parent pairs were analyzed (response rate = 63%). Adolescents’ reported subjective health complaints were assessed for their association with a number of sociodemographic factors: age, sex, type of area of residence according to level of urbanization, immigration background, parental education and employment status, family socioeconomic status and perceived quality of financial resources (PQFR). Multiple linear regression analysis was used to assess the association of the aforementioned factors with subjective health complaints as the dependent variable. Results: Most sociodemographic variables, apart from area of residence and immigration background, were independently associated with subjective health complaints in the univariate analyses. The multiple linear regression analysis, however, limited the factors that could predict adolescents’ subjective health complaints to four (age, sex, Family Affluence Scale score and perceived quality of financial resources). Some considerations regarding parental employment status and immigration background are highlighted. Conclusions: Our study highlights the sociodemographic components of subjective health complaints in the Greek adolescent population. The need to include adolescent-specific measures when collecting information on adolescents’ social background is underlined. Identifying vulnerable adolescent populations could lead to effective health promoting and preventive interventions

Subjective health complaints in adolescent students in Greece and their associated factors

Subjective health complaints (SHC) is a general term that describes a variety of common healthsymptoms experienced by the individual without pathological signs or where the pathologicalfindings are disproportionate to the illness experience. The main aim of the present thesis wasto explore the relationships among SHC and a number of individual, family and social factors. Asecondary aim was to assess the psychometric properties of the Greek version of the HBSCSCLinstrument, which was used for SHC assessment.The study was conducted within the framework of the KIDSCREEN study. Self-reportedquestionnaires were administered to a Greek, nationwide, random, school-based sample ofpupils aged 12-18 years old and their parents. A total of 1194 completed questionnaires werereturned. Bivariate analyses and multiple linear and logistic regression models were performedin order to investigate the associations of SHC with a number of socio-demographic, individual,family and social factors. The assessment of the HBSC-SCL psychometric properties involved:a) a confirmatory factor analysis (CFA) in order to test its construct validity, b) internalconsistency reliability by calculating the Cronbach α coefficient, c) gender and age effects, d)convergent validity by investigating the correlation of HBSC-SCL with the KIDSCREEN-52 ande) discriminant validity by exploring associations with health-related factors (chronic diseases,excess weight).The psychometric assessment of the HBSC-SCL showed that a) a model of two significantlycorrelated factors (somatic and psychological) fitted the data reasonably well and b) acceptablepsychometric properties, except from discriminant validity which should be re-assessed by usingnon self-reported data. In investigating the associations among SHC and a number of sociodemographic,individual, family and social life-related factors, the most robust associations wereshown for gender, age, family affluence, perceived quality of financial resources, Health RelatedQuality of Life, emotional/behavioural difficulties, smoking, binge drinking, perceived parentalmental health, parent-adolescent relationship, parent’s solicitous response to child’s symptoms,as well as adolescent’s perception regarding his/her wellbeing and functioning in the family,school and peer milieu.The present thesis encourages the use of the HBSC-SCL in large scale community studies, asa useful mental health screening instrument. However, further research is needed to assess itsdiscriminant validity. The major conclusion highlights the need of a multi- and inter-disciplinaryapproach to adolescent psychosomatic health and adjustment, since a variety of individual andsocial factors were significantly associated with self-reported SHC. Unraveling the complexitiesof adolescent psychosomatic ill-health could be a useful tool in designing age-appropriate,community and clinical interventions aiming to promote adolescent psychosomatic health andadjustment.Τα Παράπονα Υποκειμενικής Υγείας (ΠΥΥ) αναφέρονται σε κοινά συμπτώματα σωματικής ή/καιψυχολογικής φύσης για τα οποία δεν υπάρχει ακριβής ή επαρκής αιτιολογία και διάγνωση.Βασικός στόχος της παρούσας διατριβής ήταν η διερεύνηση των παραγόντων από το ατομικό,οικογενειακό και κοινωνικό πλαίσιο λειτουργίας του εφήβου ως προς τις σχέσεις τους με ταΠΥΥ. Επιμέρους στόχο αποτέλεσε η εκτίμηση των ψυχομετρικών ιδιοτήτων της ελληνικήςέκδοσης της κλίμακας HBSC-SCL που χρησιμοποιήθηκε για τη μέτρηση των ΠΥΥ.Η έρευνα πραγματοποιήθηκε στο πλαίσιο του προγράμματος KIDSCREEN και αφορούσε στησυμπλήρωση ερωτηματολογίων αυτοαναφοράς από ένα τυχαίο, πολυπληθές δείγμα μαθητώνηλικίας 12-18 ετών και των γονιών τους από όλη την Ελλάδα. Επιστράφησαν συνολικά 1194 ερωτηματολόγια. Διμεταβλητές αναλύσεις και μοντέλα πολλαπλής γραμμικής και λογιστικήςπαλινδρόμησης χρησιμοποιήθηκαν για την διερεύνηση των σχέσεων των ΠΥΥ των εφήβων μεέναν αριθμό κοινωνικοδημογραφικών, ατομικών, οικογενειακών και κοινωνικών παραγόντων. Οψυχομετρικός έλεγχος της κλίμακας μέτρησης των ΠΥΥ συμπεριέλαβε την επιβεβαιωτικήπαραγοντική ανάλυση για τον έλεγχο της εγκυρότητας εννοιολογικής κατασκευής, τηναξιοπιστία εσωτερικής συνοχής μέσω υπολογισμού του συντελεστή Cronbach α, τις επιδράσειςτου φύλου και της ηλικίας και την συντρέχουσα και διακριτική της εγκυρότητα μέσω διερεύνησηςτων σχέσεων της κλίμακας με το ερωτηματολόγιο για την ΠΖσΥ KIDSCREEN-52 για τη μενπρώτη και με εργαλεία εκτίμησης της ύπαρξης χρόνιας ασθένειας και υπερβολικού βάρους γιατην δεύτερη.Ο ψυχομετρικός έλεγχος της ελληνική εκδοχής της κλίμακας HBSC-SCL έδειξε την ύπαρξη δύουποκείμενων, σημαντικά αλληλοσυσχετιζόμενων διαστάσεων (σωματική – ψυχολογική). Ηκλίμακα εμφάνισε ικανοποιητικές ψυχομετρικές ιδιότητες σε όλες τις υπό εξέταση παραμέτρους,εκτός της διακριτικής εγκυρότητας, εύρημα που χρήζει επιβεβαίωσης μέσω της χρήσης μηαυτοαναφορικών δεδομένων. Αναφορικά με τις σχέσεις των ΠΥΥ με αριθμόκοινωνικοδημογραφικών, ατομικών, οικογενειακών και κοινωνικών παραγόντων, οι ισχυρότερεςσχέσεις σημειώθηκαν για το φύλο, την ηλικία, την οικογενειακή οικονομική ευημερία, τηνυποκειμενική αντίληψη του εφήβου για την ποιότητα των διαθέσιμων οικονομικών του πόρων,την Ποιότητα Ζωής που σχετίζεται με την Υγεία, τις συναισθηματικές/συμπεριφορικές δυσκολίες,το κάπνισμα και την περιστασιακά υπερβολική χρήση αλκοόλ, την υποκειμενικά αντιληπτήψυχική κατάσταση του γονέα, τις σχέσεις γονέα-εφήβου, την ανησυχία του γονέα αναφορικά μετα συμπτώματα του εφήβου, καθώς και την υποκειμενικά αντιληπτή ευεξία και λειτουργικότητατου εφήβου στο πλαίσιο της οικογένειας, του σχολείου και των ομηλίκων.Η παρούσα διατριβή προσέφερε ενθαρρυντικά αποτελέσματα για τη συνέχιση της χρήσης τηςκλίμακας HBSC-SCL ως ένα εύχρηστο εργαλείο διαλογής ψυχικής υγείας για μελέτες μεγάληςκλίμακας. Βασικό συμπέρασμα συνιστά η αναγκαιότητα διεπιστημονικής προσέγγισης τηςψυχοσωματικής υγείας και προσαρμογής κατά την εφηβική περίοδο, καθώς τααυτοαναφερόμενα ΠΥΥ εμφάνισαν σημαντικές συσχετίσεις με παράγοντες που αφορούν τόσοστον ίδιο τον έφηβο όσο και στο κοινωνικό του πλαίσιο. Η αναγνώριση και διευκρίνηση τηςπολυπλοκότητας της εφηβικής ψυχοσωματικής υγείας–ασθένειας θα μπορούσε να εμπλουτίσειτον σχεδιασμό ηλικιακά κατάλληλων, κοινοτικών και κλινικών παρεμβάσεων για την προαγωγήτης ψυχοσωματικής υγείας και προσαρμογής του εφήβου

Selected family characteristics are associated with adolescents' subjective health complaints

AimThis national study of schoolchildren in Greece investigated the association between adolescents’ subjective health complaints (SHC) and a number of family characteristics. MethodsQuestionnaires were completed by a random, school-based sample of children from 12 to 18 years of age, and one of their parents (76.6% mothers), in 2003. Data from 1041 adolescent-parent pairs were analysed. Multiple linear regression analysis was used to assess the associations between the adolescent’s SHC and the following characteristics: parent’s marital status, parent’s physical and mental health status, parent’s worries about their child’s SHC, the parent-child relationship, family cohesion, family socio-economic status and the adolescent’s sex and age. ResultsThe analysis showed that the adolescents’ SHC were independently and significantly correlated with poor parental subjective mental health status, poor quality parent-child relationships and parental worry. There were also associations between levels of SHC and female and older adolescents. ConclusionCertain family features can be seen as potential contributing factors to SHC in adolescence and should therefore constitute complementary targets for prevention and treatment planning

Effectiveness of a school-based intervention for enhancing adolescents’ positive attitudes towards people with mental illness

High school students are a common target group in initiatives addressing discriminatory attitudes towards people with mental illness. However, these initiatives are rarely evaluated and documented. The aim of our paper is to evaluate the effectiveness of a school-based educational intervention for improving adolescents’ attitudes and reducing the desire for social distance from people with mental illness living in their community. A total of 161 students aged 16-18 years old were questioned at baseline assessment and 86 of them received a three-workshop educational intervention while 75 students comprised the control group. A follow-up assessment 1 month post intervention evaluated its impact. Attitudes and the social distance were assessed through the Community Attitudes towards the Mentally Ill scale and a 10-statement questionnaire based on the Self-report Inventory of Fear and Behavioural Intentions, respectively. Data from 140 subjects were analyzed. All attitude dimensions and half of the measured social distance statements were significantly improved in the intervention group at follow up assessment compared to controls. However, the statements measuring more intimate types of social relationships did not change significantly post intervention. In conclusion, short educational interventions can be effective to some extent in reducing discriminatory attitudes towards people with mental illness. However, effective interventions to address deeply held negative stereotypes will require further research

Adolescents' multiple, recurrent subjective health complaints: investigating associations with emotional/behavioural difficulties in a cross-sectional, school-based study

Background: Adolescence has been documented as the peak age of onset for mental health perturbations, clinical disorders and unsubstantiated health complaints. The present study attempted to investigate associations between multiple, recurrent subjective health complaints (SHC) with emotional/behavioural difficulties, as measured by the Strengths and Difficulties Questionnaire scale (SDQ), among Greek adolescents. Methods: Questionnaires were administered in a large, nation-wide, random, school-based sample of Greek adolescents, aged 12-18 years. Data from 1170 participants were analyzed. Adolescents with multiple, recurrent SHC were compared in terms of their emotional/behavioural difficulties to their peers with lower levels of health complaints. SDQ scales were separately investigated for their associations with multiple, recurrent SHC, after adjustment for gender, age and socioeconomic status (ses). Further analysis included multiple logistic regression models with multiple, recurrent SHC as the dependent variable and gender, age, ses and SDQ Total difficulties score as independent factors. Potential gender and age interactions were also explored. Results: Almost half of the study participants reported multiple, recurrent SHC. Adolescents with multiple, recurrent SHC had higher scores on all SDQ scales, except from the Prosocial behavior scale, compared to their peers with lower levels of health complaints. Emotional Symptoms, Conduct Problems, Hyperactivity/Inattention and Peer Problems were associated with greater likelihood of having multiple, recurrent SHC, after adjustment for gender, age and ses. The multiple logistic regression models revealed that older adolescents and girls, as well as those with increased Total difficulties score had an increased risk for multiple, recurrent SHC reporting. No significant interaction between SDQ scales and gender or age was found. Conclusions: Our study highlights the magnitude of psychological burden among adolescents experiencing multiple, recurrent SHC. Professionals in school and clinical settings should be cautious for impaired emotional/behavioural functioning when assessing adolescents with multiple, recurrent SHC, so as early identification of at-risk individuals and timely, appropriate referrals are facilitated

Identifying the sociodemographic determinants of subjective health complaints in a cross-sectional study of Greek adolescents

Background: Experience of common health symptoms without a clear physical or psychological cause, such as headache or dizziness, is often reported in adolescence. The present study attempted to investigate associations of self-reported subjective health complaints (SHC) with a number of sociodemographic factors of Greek adolescents. Methods: Questionnaires were administered to a Greek nationwide random school-based sample of adolescents aged 12 to 18 years and their parents in 2003. Data from 922 adolescent-parent pairs were analyzed (response rate = 63%). Adolescents’ reported subjective health complaints were assessed for their association with a number of sociodemographic factors: age, sex, type of area of residence according to level of urbanization, immigration background, parental education and employment status, family socioeconomic status and perceived quality of financial resources (PQFR). Multiple linear regression analysis was used to assess the association of the aforementioned factors with subjective health complaints as the dependent variable. Results: Most sociodemographic variables, apart from area of residence and immigration background, were independently associated with subjective health complaints in the univariate analyses. The multiple linear regression analysis, however, limited the factors that could predict adolescents’ subjective health complaints to four (age, sex, Family Affluence Scale score and perceived quality of financial resources). Some considerations regarding parental employment status and immigration background are highlighted. Conclusions: Our study highlights the sociodemographic components of subjective health complaints in the Greek adolescent population. The need to include adolescent-specific measures when collecting information on adolescents’ social background is underlined. Identifying vulnerable adolescent populations could lead to effective health promoting and preventive interventions