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"Teenagers Mental health Cross-cultural studies."
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Unmet need for mental health care among adolescents in Asia and Europe
The unmet need for mental health care is a global concern. There is a lack of cross-cultural studies examining adolescent help-seeking behavior from both formal and informal sources, including both high-and lower-income countries. This study investigates mental health help-seeking behavior in eight Asian and European countries. Data from 13,184 adolescents aged 13–15 (51% girls) was analysed using mixed-effects logistic regression with school-wise random intercepts to compare countries and genders. Although a significant proportion of adolescents considered getting or sought informal help, formal help-seeking remained exceptionally low, especially in middle-income countries (< 1%), while it ranged from 2 to 7% in high-income countries. Among adolescents with high emotional and behavioral problems (scoring above the 90th percentile on the Strengths and Difficulties Questionnaire), 1–2% of those in middle-income countries and 6–25% of those in high-income countries sought formal help. Girls generally seek more help than boys. The study shows the most adolescents do not receive formal help for mental health problems. The unmet need gap is enormous, especially in lower-income countries. Informal sources of support, including relatives, peers, and teachers, play a crucial role, especially in lower-income countries.
Journal Article
Examining effects of mother and father warmth and control on child externalizing and internalizing problems from age 8 to 13 in nine countries
This study used data from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and United States; N = 1,315) to investigate bidirectional associations between parental warmth and control, and child externalizing and internalizing behaviors. In addition, the extent to which these associations held across mothers and fathers and across cultures with differing normative levels of parent warmth and control were examined. Mothers, fathers, and children completed measures when children were ages 8 to 13. Multiple-group autoregressive cross-lagged structural equation models revealed that evocative child-driven effects of externalizing and internalizing behavior on warmth and control are ubiquitous across development, cultures, mothers, and fathers. Results also reveal that parenting effects on child externalizing and internalizing behaviors, though rarer than child effects, extend into adolescence when examined separately in mothers and fathers. Father-based parent effects were more frequent than mother effects. Most parent- and child-driven effects appear to emerge consistently across cultures. The rare culture-specific parenting effects suggested that occasionally the effects of parenting behaviors that run counter to cultural norms may be delayed in rendering their protective effect against deleterious child outcomes.
Journal Article
Predicting Adolescent Mental Health Outcomes Across Cultures: A Machine Learning Approach
Adolescent mental health problems are rising rapidly around the world. To combat this rise, clinicians and policymakers need to know which risk factors matter most in predicting poor adolescent mental health. Theory-driven research has identified numerous risk factors that predict adolescent mental health problems but has difficulty distilling and replicating these findings. Data-driven machine learning methods can distill risk factors and replicate findings but have difficulty interpreting findings because these methods are atheoretical. This study demonstrates how data- and theory-driven methods can be integrated to identify the most important preadolescent risk factors in predicting adolescent mental health. Machine learning models examined which of 79 variables assessed at age 10 were the most important predictors of adolescent mental health at ages 13 and 17. These models were examined in a sample of 1176 families with adolescents from nine nations. Machine learning models accurately classified 78% of adolescents who were above-median in age 13 internalizing behavior, 77.3% who were above-median in age 13 externalizing behavior, 73.2% who were above-median in age 17 externalizing behavior, and 60.6% who were above-median in age 17 internalizing behavior. Age 10 measures of youth externalizing and internalizing behavior were the most important predictors of age 13 and 17 externalizing/internalizing behavior, followed by family context variables, parenting behaviors, individual child characteristics, and finally neighborhood and cultural variables. The combination of theoretical and machine-learning models strengthens both approaches and accurately predicts which adolescents demonstrate above average mental health difficulties in approximately 7 of 10 adolescents 3–7 years after the data used in machine learning models were collected.
Journal Article
Moderating effect of cultural differences on the association between social media use and mental health outcomes in adolescents: A cross-cultural comparison study
The influence of social media on the mental health of adolescents has been controversial and the findings in the literature are inconclusive. Although prior studies have identified several factors that may cause or trigger the proposed relationship, little is known about the culture-related factors as an underlying mechanism that could explain the complexity of this association. This study addressed this gap by examining the associations between the two domains of social media (i.e., time spent on weekdays and weekends) and two mental health outcomes (anxiety and depression) in adolescents via the moderating effect of horizontal-vertical individualism and collectivism. 299 secondary school students (Mage = 15.21 years; 61% girls) from Türkiye (N = 176), Ireland (N = 70), and England (N = 53) completed self-report surveys. Spending more than four hours on weekdays and weekends was positively associated with anxiety and depression whereas spending more than two hours on social media during weekends was positively associated with anxiety in the entire sample. Horizontal and vertical individualism moderated the association between time spent on social media and depression in the entire sample. The study’s strengths and limitations, along with the implications of the findings for future research, are thoroughly discussed.
Journal Article
Cross-national aspects of cyberbullying victimization among 14–17-year-old adolescents across seven European countries
Background
The increasing use of the Internet and social network sites (SNS) has created a new domain of socio-emotional development for adolescents. The aim of this cross-sectional study was to explore cybervictimization across seven European countries, in relation to socio-demographic, Internet use and psychosocial variables.
Methods
A cross-sectional school-based study was conducted in the participating countries: Germany, Greece, Iceland the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test and Achenbach’s Youth Self-Report.
Results
The highest rate of cyber victimization was found in Romania (37.3%) and the lowest in Spain (13.3%). Multiple logistic regression analyses gave differing results between countries. In Romania, Poland and Germany cyberbullying victimization was associated with SNS use, whereas Internet use was associated with increased odds of cybervictimization only in Romania. Cybervictimization was associated with greater internalizing behavior problems in all countries analysed, and with externalizing problems in all except Romania.
Conclusions
Cyberbullying victimization is an on-going problem, which is subject to country-specific socio-demographic factors and diverse patterns of current Internet use and its development. Preventive measures should emphasize the integration of Internet communication technology education in educational contexts, and focus on the consistent association between cybervictimization and internalizing and externalizing difficulties.
Journal Article
The Association Between Parental Rearing Dimensions and Adolescent Psychopathology: A Cross-Cultural Study
Research on parental rearing dimensions faced ethnocentric criticism for mainly focusing on adolescents in Western industrialized countries. Over the past decade, the phenomenon of anxious parenting, so called “helicopter parenting”, gained attention in popular media as well as scholarly publications in addition to support and psychological control. Whether these parenting dimensions, which were associated with different health outcomes in adolescents, were only occurring in the Western world or are visible cross-culturally, has not been sufficiently studied. Therefore, it is unclear whether these links exist also for adolescents from other parts of the world. Additionally, the involvement of fathers in child rearing continues to be neglected in adolescent psychopathology research. The current cross-cultural study tested the association of maternal and paternal rearing dimensions with youth internalizing and externalizing psychopathology in a sample of 2415 adolescents (56% female, 15.33 years, SD = 0.61) from eight countries (Argentina, France, Germany, Greece, Pakistan, Peru, Poland, and Turkey). Hierarchical regression models showed that internalizing symptomatology was associated with mothers’ support, psychological control, and anxious rearing as well as fathers’ psychological control up and above predictors like country and mother’s level of education. For predicting externalizing symptomatology, mother’s anxious rearing, mother’s psychological control, and father’s support as well as father’s psychological control were significant up and above adolescents’ gender, standard of living, and country. To conclude, across countries, anxious rearing and psychological control experienced from both parents were substantially linked with adolescent mental health.
Journal Article
Internalizing and Externalizing Behaviors: A Cross-Cultural Study in Colombian and Mexican Adolescents with Eating Disorders
In Colombia and Mexico, an increase in emotional, behavioral, and eating problems in adolescents has been documented after the pandemic. The objective was to characterize the relationship between internalizing and externalizing behaviors in adolescents with eating disorders in Colombia and Mexico according to the adolescents’ self-report and the parents’ report. In Colombia, 17 adolescents between 12 and 18 years old (M = 15.4; SD = 1.8) and one of their parents (n = 17); in Mexico, 8 adolescents between 12 and 17 years old (M = 14.6; SD = 1.6) and one of their parents (n = 8) were evaluated. The parents completed the Child Behavior Checklist (CBCL), and the adolescents completed the self-report (YSR) and the EAT-26. The analyses showed a statistically significant correlation between eating problems and anxiety/depression of the YSR (r = 0.39; p = 0.031). Statistically significant differences (p < 0.05) were found in the CBCL scores for externalizing problems, somatic complaints, and rule-breaking behavior; all scores were higher in the Colombian sample. The findings provided partial support for differences between adolescents with eating disorders and parental reports. A higher percentage of clinical levels was reported by adolescents compared to their parents, except for the anxious/depressive and aggressive behavior subscales.
Journal Article
Measurement invariance and comparison of the mobile phone dependence questionnaire (MPDQ) across mainland Chinese and Hong Kong adolescents
Background
Mobile phone dependence (MPD) is a serious public health concern in schools. To advance cross-cultural understanding of MPD, this study examined factor structure, measurement invariance, and latent mean differences of the mobile phone dependence questionnaire (MPDQ) across mainland Chinese and Hong Kong adolescents.
Methods
The present cross-sectional study included a total of 918 middle school students (588 boys and 310 girls;
M
age
= 13.58,
SD
= 1.46), comprising 367 adolescents from two Shenzhen schools and 551 adolescents from three Hong Kong schools. Confirmatory factor analysis, measurement invariance test, latent mean comparisons, and multidimensional item response theory analysis were employed for data analyses.
Results
The three-factor structure of the MPDQ, proposed by previous research conducted in Hong Kong adolescents, was also supported in mainland Chinese adolescents. Configural, partial metric, and partial scalar cross-cultural measurement invariance were all achieved. Mainland Chinese adolescents reported higher scores on all MPD factors than their Hong Kong counterparts.
Conclusions
The findings highlight the cross-cultural similarities and differences of MPD among adolescents in mainland China and Hong Kong. The MPDQ is culturally sensitive to measure MPD in both regions, while certain items may need further cultural adaptation. Moreover, Hong Kong adolescents demonstrated more disordered thoughts and behaviors associated with MPD than mainland Chinese adolescents. Implications for using the MPDQ for assessing and understanding the MPD from diverse cultural backgrounds are discussed.
Clinical trial number
Not applicable.
Journal Article
Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Positive Body Image among Adolescents Scale (PBIAS) into Spanish and Catalan
The Positive Body Image among Adolescents Scale (PBIAS) explores the factors that bolster and interfere with developing and maintaining a positive body image during adolescence. The aim of this study was to translate, adapt, and validate the PBIAS into Spanish and Catalan. A cross-sectional study was conducted for the instrument’s translation, cross-cultural adaptation, and psychometric validation. A process of translation, back-translation, expert consultation, and piloting was followed. The reliability and statistical validity were evaluated. The Cronbach’s alpha was 0.95 in both the Spanish and Catalan versions. Pearson’s correlation coefficients were statistically significant (r > 0.087) for all items analyzed. The resulting values of the Spanish and Catalan versions indicate a good level of concordance (p < 0.001) with the original questionnaire, the comparative fit index being 0.914 and 0.913, the Tucker–Lewis index being 0.893 and 0.892, the root mean square error of approximation being 1.31 and 1.28, and the standardized root mean square residual being 0.051 and 0.060, respectively. The instrument presents a good level of internal consistency, a high level of reliability, and statistical validity compared to the original instrument. The PBIAS in Spanish and Catalan can be a useful assessment instrument for educators and health professionals in the context of adolescent mental health literacy. This work contributes to the Sustainable Development Goals (Goal 3) of the United Nations 2030 Agenda.
Journal Article