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Life circumstances and adolescent mental health: Perceptions, associations and a gender analysis
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0003-2996-3348
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite a well-documented gender pattern of adolescent mental health, public health research investigating possible influencing factors from a gender-theoretical approach is scarce. This study aimed to explore what factors and circumstances are related to adolescent mental health and to apply a gender analysis to the findings in order to improve the understanding of the relationships between life circumstances and the gendered patterning of mental health among young people.

 

The study population was 16-19-year-old Swedish students and data was collected by means of focus groups (N=29) and self-administered questionnaires (N=1,663, 78.3% response rate) in school settings. Mental health problems were defined in a broad sense including the adolescents’ own understandings, perceived stress, psychological distress and deliberate self-harm.

 

The mental health problems of perceived stress, psychological distress and deliberate self-harm were twice as common among girls as boys. The findings suggest that adolescent mental health is associated with the life circumstances of social relationships, demands and responsibility taking and experiences of violence and harassment.  Supportive relationships with friends, family and teachers were found to be of importance to positive mental health, whereas poor social relationships, loneliness and lack of influence were associated with mental health problems.  Perceived demands and responsibility taking regarding school work, relationships, future plans, appearance and financial issues were strongly related to mental health problems, particularly among girls regardless of social class. The results indicate that physical violence, sexual assault, bullying and sexual harassment are severe risk factors for mental health problems in young people. Boys and girls experienced different types of violence, and the victim-perpetrator relationships of physical violence differed. These diverging experiences appeared to influence the associations with mental health problems in boys and girls.

 

A gender analysis provides the tools to gain knowledge about the ways that boys’ and girls’ lives are shaped by gender relations and constructions at different levels in society and how these life circumstances represent risk- or protective factors for mental health. For example, unequal power structures and the ways girls are expected to ‘do’ femininity likely influence their life circumstances in ways that place them at greater risk of mental health problems. Hegemonic constructions of masculinity and advantaged positions likely contribute to life circumstances that are positive for mental health but are also implying risk factors for poor mental health among boys, e.g., violence. It is also important to recognise how the intertwined cultural and structural aspects of gender and social class influence the lives and mental health of boys and girls. In conclusion, gendered and class-related mechanisms at the different levels in society influence the distribution of risk factors unevenly among boys and girls, which could be a possible explanation for the gender differences in reports of perceived stress, psychological distress and deliberate self-harm.

 

The likelihood of gender and socioeconomic differences in mental health problems should be taken into account in prevention and health promotion strategies at all levels in society. A greater awareness about gender relations and the gendered social circumstances under which young people live is required. The school environment is an important arena with respect to prevention and health promotion. There is also a need for a joint action against violence and harassment at all levels in society. Implications do not only concern young people; social policy and legislation should focus on reducing gender and class inequalities in general.

Abstract [sv]

Sammanfattning

Svensk titel: Livsvillkor och ungdomars psykiska hälsa: uppfattningar, associationer och en genusanalys.

 

Trots ett väldokumenterat genusmönster i ungdomars psykiska hälsa finns det en kunskapslucka i den folkhälsovetenskapliga forskningen avseende genusteoretiska analyser av sambanden mellan ungas livsvillkor och psykisk hälsa. Föreliggande studie syftade till att undersöka vilka faktorer och omständigheter som är relaterade till psykiska problem, samt att analysera fynden ur ett genusperspektiv för att fördjupa förståelsen av relationerna mellan ungas livsvillkor och genusmönster i psykiska hälsa.

 

Studiepopulationen var gymnasielever i åldern 16-19 år. Studien genomfördes i skolmiljö och data insamlades genom fokusgrupper (N=29) och en enkätstudie (N=1,663, 78.3% svarsfrekvens). En bred definition av psykisk ohälsa tillämpades vilken representerades av ungdomarnas egen förståelse, samt de psykiska problemen upplevd stress, psykiska besvär samt självskadebeteende.

 

Resultaten visade att stress, psykiska besvär och självskadebeteende var dubbelt så vanligt bland flickor som bland pojkar. Psykiska problem var relaterade till livsvillkoren sociala relationer, krav och ansvarstagande samt utsatthet för våld och trakasserier. Stödjande relationer med vänner, familj och lärare var av stor betydelse för psykisk hälsa medan dåliga relationer, ensamhet och brist på inflytande var relaterat till psykiska problem. Psykiska problem var starkt kopplade till erfarenheter av höga krav och ansvarstagande avseende skolarbete, relationer, framtidsplaner, utseende och ekonomi, i synnerhet bland flickor oavsett socioekonomisk bakgrund. Resultaten indikerar att olika former av våld och trakasserier är allvarliga riskfaktorer för psykiska problem och att flickors och pojkars skiljda erfarenheter av olika former av våld samt relationen till förövaren, kan vara relaterade till skillnader i psykiska problem.

 

Genusanalysen av resultaten föreslår att flickors livsvillkor påverkas av ojämlika maktstrukturer och konstruktioner av femininitet och att dessa livsvillkor bidrar till en ökad risk för psykisk ohälsa bland flickor. Livsvillkor kopplade till manlig överordning och hegemoniska konstruktioner av maskulinitet influerar sannolikt pojkars psykiska hälsa positivt. Dessa villkor kan dock också innebära risk faktorer för psykiska problem, t.ex. i fråga om våld. Studien uppmärksammar även hur kulturella och strukturella aspekter av både genus och social klass kan påverka livsvillkor och psykisk hälsa för pojkar och flickor. Studiens slutsats är att genusifierade och klassrelaterade mekanismer på olika nivåer i samhället bidrar till en skev fördelning av riskfaktorer för psykiska problem vilket kan vara en möjlig förklaring till skillnaderna mellan pojkar och flickor i fråga om upplevd stress, psykiska besvär och självskadebeteende.

 

Genus- och socioekonomiska skillnader i psykiska problem bör tas i beaktande i preventivt och hälsofrämjande arbete på alla nivåer i samhället. Detsamma gäller för en ökad medvetenhet om hur ungas livsvillkor är relaterade till psykisk hälsa och hur dessa villkor är genus- och klassrelaterade. Studien uppmärksammar skolan som en viktig arena för preventivt och hälsofrämjande arbete samt att gemensamma insatser krävs på olika arenor för att motverka våld och trakasserier. Implikationer av studien omfattar även generella samhällspolitiska insatser för minskad ojämlikhet.

Nyckelord: Stress; psykiska besvär; självskadebeteende; gymnasieelever; maskulinitet; femininitet; sociala determinanter; sociala relationer; krav; ansvarstagande; våld och trakasserier; skola.

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University , 2010. , p. 96
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 93
Keyword [en]
Stress; Psychological distress; Deliberate self-harm; Students; masculinity, femininity; social determinants; social relationships; demands; responsibility taking; violence and harassment; school.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:miun:diva-11982ISBN: 978-91-86073-89-3 (print)OAI: oai:DiVA.org:miun-11982DiVA, id: diva2:351985
Public defence
2010-12-17, M108, Campus Sundsvall, Sundsvall, 10:30 (Swedish)
Opponent
Supervisors
Note
Forskarutbildningsämne: Hälsovetenskap. Available from: 2010-10-20 Created: 2010-09-17 Last updated: 2010-11-29Bibliographically approved
List of papers
1. Understanding adolescent mental health: the influence of social processes, doing gender and gendered power relations
Open this publication in new window or tab >>Understanding adolescent mental health: the influence of social processes, doing gender and gendered power relations
2009 (English)In: Sociology of Health and Illness, ISSN 0141-9889, E-ISSN 1467-9566, Vol. 31, no 7, p. 962-978Article in journal (Refereed) Published
Abstract [en]

Despite a well-documented gender pattern in adolescent mental health, research investigating possible explanatory factors from a gender-theoretical approach is scarce. This paper reports a grounded theory study based on 29 focus groups. The aim was to explore 16- to 19-year-old students' perceptions of what is significant for mental health, and to apply a gender analysis to the findings in order to advance understanding of the gender pattern in adolescent mental health. Significant factors were identified in three social processes categories, including both positive and negative aspects: (1) social interactions, (2) performance and (3) responsibility. Girls more often experienced negative aspects of these processes, placing them at greater risk for mental health problems. Boys' more positive mental health appeared to be associated with their low degree of responsibility-taking and beneficial positions relative to girls. Negotiating cultural norms of femininity and masculinity seemed to be more strenuous for girls, which could place them at a disadvantage with regard to mental health. Social factors and processes (particularly responsibility), gendered power relations and constructions of masculinities and femininities should be acknowledged as important for adolescent mental health.

 

 

Keyword
femininity, masculinity, focus groups, mental health, gender
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-7850 (URN)10.1111/j.1467-9566.2009.01170.x (DOI)000271043700002 ()19659740 (PubMedID)2-s2.0-70350493082 (Scopus ID)
Available from: 2010-09-17 Created: 2008-12-22 Last updated: 2017-12-14Bibliographically approved
2. Seventeen and Stressed – Do Gender and Class Matter?
Open this publication in new window or tab >>Seventeen and Stressed – Do Gender and Class Matter?
2012 (English)In: Health Sociology Review, ISSN 1446-1242, E-ISSN 1839-3551, Vol. 21, no 1, p. 82-98Article in journal (Refereed) Published
Abstract [en]

Despite increasing concerns about stress levels in adolescents, knowledge is scarce about what boys and girls from different social backgrounds find stressful. This cross-sectional study explored gender and class patterning of perceived stress and reported stressors in a sample of 1,663 17-year-old Swedish students. The students, especially girls, were highly stressed. No class difference (indicated by educational programme) was found. Performance-related stressors (e.g. school work) and stress due to pressure on looks was mainly patterned by gender (girls), whilst relational stressors were patterned by class (vocational programme students). There was a complex gender and class patterning of stress due to school work and lack of money. The interplay of gender and class inequalities should be acknowledged in identifying determinants of stress in young people. Challenging normative ideals and implementing policies aiming at reducing gender and class inequalities are central components for stress-reducing interventions in, for example, schools.

Keyword
perceived stress; stressors; femininity; masculinity; social class; intersectionality; adolescents; school
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-10738 (URN)10.5172/hesr.2012.21.1.82 (DOI)000303029600008 ()2-s2.0-84863193787 (Scopus ID)
Available from: 2009-12-18 Created: 2009-12-18 Last updated: 2017-12-12Bibliographically approved
3. Experiences of violence among adolescents: gender patterns in types, perpetrators and associated psychological distress
Open this publication in new window or tab >>Experiences of violence among adolescents: gender patterns in types, perpetrators and associated psychological distress
2011 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 56, no 4, p. 419-427Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore the psychological distress associations of experiences of several types of violence and the victim-perpetrator relationship of physical violence, a gender analysis was applied. Methods: Data were derived from a cross-sectional questionnaire study among 17-year-old upper secondary school students (N = 1,663). Variables in focus were: self-reported psychological distress, experiences of physical violence, sexual assault, bullying and sexual harassment. Logistic regressions were used to examine associations. Results: Experiences of physical violence, sexual assault, bullying and sexual harassment were associated with psychological distress in boys and girls. The perpetrators of physical violence were predominately males. Whether the perpetrator was unknown or known to the victim seem to be linked to psychological distress. Victimisation by a boyfriend was strongly related to psychological distress among girls. Conclusions: Experiences of several types of violence should be highlighted as factors associated with mental health problems in adolescents. The victim-perpetrator relationships of violence are gendered and likely influence the psychological distress association. Gendered hierarchies and norms likely influence the extent to which adolescents experience violence and how they respond to it in terms of psychological distress.

Keyword
Victimisation; young people; mental health; gender differences; public health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-10737 (URN)10.1007/s00038-011-0258-4 (DOI)000293187600008 ()21544531 (PubMedID)2-s2.0-80755138426 (Scopus ID)
Available from: 2009-12-18 Created: 2009-12-18 Last updated: 2017-12-12Bibliographically approved
4. Deliberate self-harm and associated factors in 17-year-old Swedish students
Open this publication in new window or tab >>Deliberate self-harm and associated factors in 17-year-old Swedish students
2011 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 1, p. 17-25Article in journal (Refereed) Published
Abstract [en]

Background: Deliberate self-harm (DSH) in young people is an important public health issue. To prevent DSH, more knowledge is needed about its prevalence and associated contextual factors in community samples of adolescents. Aims: To determine the prevalence of deliberate self-harm in 17-year-old Swedish students and to explore the association of demographic variables, psychological distress, experiences of violence, and school-related factors with DSH. Methods: Data were derived from a cross-sectional study in which 17-year-old students completed questionnaires during school hours (n=1,663; 78.3%). The variables used in this analysis are as follows: deliberate self-harm, demographic variables, psychological distress, experiences of violence, and school-related factors. Data were analysed using chi-squared statistics and logistic regression. Results: The lifetime prevalence of DSH was 17%, and it was more common among girls (23.3%) than boys (10.5%). There were considerable socioeconomic differences in reports of DSH. Psychological distress was strongly associated with DSH in both boys and girls, as were experiences of bullying, sexual harassment, physical violence and sexual assault. Social support, safety and academic factors in school were related to reports of DSH in both girls and boys. There were some gender differences with respect to which factors were associated with DSH. Conclusions: Deliberate self-harm is common and more frequently reported by girls than boys. Psychological distress, experiences of different types of violence, and school-related factors (academic, social and safety-related), should be considered risk factors for DSH in young people. Findings can be applied to health-promotion policy and interventions in various contexts, for example schools.

Keyword
Adolescents, community survey, deliberate self-harm, mental health, non-suicidal self-injury, risk factors, school
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-11980 (URN)10.1177/1403494810382941 (DOI)000286610700004 ()2-s2.0-79952267123 (Scopus ID)
Available from: 2010-09-17 Created: 2010-09-16 Last updated: 2017-12-12Bibliographically approved

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