Clusters of Contemporary Risk and Their Relationship to Mental Well-Being Among 15-Year-Old Adolescents Across 37 Countries

Sophie D. Walsh, Tal Sela, Margaretha De Looze, Wendy Craig, Alina Cosma, Yossi Harel-Fisch, Meyran Boniel-Nissim, Marta Malinowska-Cieślik, Alessio Vieno, Michal Molcho, Kwok Ng, William Pickett

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33 Scopus citations

Abstract

Purpose: Adolescents' mental well-being has become a growing public health concern. Adolescents' daily lives and their engagement in risks have changed dramatically in the course of the 21st century, leading to a need to update traditional models of risk to include new exposures and behaviors. To date, studies have examined the relationship between (mainly traditional) risk behaviors and adolescent mental well-being or looked at risk factors that jeopardize mental well-being such as lack of social support but have not combined them together to highlight the most significant risks for adolescent mental well-being today. The present study included new and traditional risk behaviors and risk factors, robustly derived an empirically based model of clusters of risk, and examined the relative association of these clusters to adolescent mental well-being. Methods: Data from the 2017–2018 Health Behaviours in School-aged Children study were used. The sample included 32,884 adolescents (51.7% girls) aged 15 years from 37 countries and regions. The principal component analysis was used to determine the existence of clusters of risk, using 21 items related to adolescent mental well-being that included both risk behaviors (e.g., substance use) and risk factors (e.g., peer support). Analysis was conducted in both a randomly split training and test set and in gender separate models. Mixed-effects logistic regressions examined the association between clusters of risk and mental well-being indices (low life satisfaction and psychosomatic complaints). Results: Seven clusters of risk were identified: substance use and early sex, low social support, insufficient nutrition, bullying, sugary foods and drinks, physical health risk, and problematic social media use (SMU). Low social support and SMU were the strongest predictors of low life satisfaction (odds ratios = 2.167 and 1.330, respectively) and psychosomatic complaints (odds ratio = 1.687 and 1.386, respectively). Few gender differences in predictors were found. Exposure to bullying was somewhat more associated with psychosomatic complaints for girls, whereas physical health risk was associated with reduced relative odds of low life satisfaction among boys. Split-sample validation and out-of-sample prediction confirmed the robustness of the results. Conclusions: The results highlight the importance of contemporary clusters of risk, such as low social support and SMU in the mental well-being of young people and the need to focus on these as targets for prevention. We propose that future studies should use composite risk measures that take into account both risk behaviors and risk factors to explain adolescents' mental well-being.

Original languageEnglish
Pages (from-to)S40-S49
JournalJournal of Adolescent Health
Volume66
Issue number6
DOIs
StatePublished - Jun 2020

Bibliographical note

Publisher Copyright:
© 2020

Funding

The Israeli HBSC research team is funded by grants from the ministries of health, education and public security. The Canadian HBSC research team is funded by the Public Health Agency of Canada (contract 6D016-123071/001/SS) and an operating grant from the Canadian Institutes of Health Research (PJT 162237); The Irish HBSC research team is supported by the Irish Department of Health. Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peer-reviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder. Health Behaviour in School-aged Children is an international study carried out in collaboration with WHO/EURO. The International Coordinator was Jo Inchley (University of Glasgow) for the 2017/2018 survey. The Data Bank Manager was Professor Oddrun Samdal (University of Bergen). The 2017/2018 survey included in this study was conducted by the following principal investigators in the 37 countries: Albania (Gentiana Qirjako), Armenia (Sergey G. Sargsyan), Austria (Rosemarie Felder-Puig), Flemish Belgium (Bart De Clercq), French Belgium (Katia Castetbon), Canada (William Pickett and Wendy Craig), Croatia (Ivana Pavic Simetin), Czech Republic (Michal Kalman), Denmark (Mette Rasmussen), England (Fiona Broks and Ellen Klemera), Estonia (Leila Oja and Katrin Aasvee), Finland (Jorma Tynj?l?), France (Emmanuelle Godeau), Georgia (Lela Shengelia), Germany (Matthias Richter), Greece (Anna Kokkevi), Hungary (?gnes N?meth), Iceland (Arsaell M. Arnarsson), Ireland (Saoirse Nic Gabhainn), Italy (Franco Cavallo), Kazakhstan (Shynar Abdrakhmanova and Valikhan Akhmetov), Lithuania (Kastytis Smigelskas), Luxembourg (Helmut Willems), Malta (Charmaine Gauci), the Netherlands (Gonneke Stevens and Saskia van Dorsselaer), Poland (Joanna Mazur and Agnieszka Ma?kowska-Szkutnik), Portugal (Margarida Gaspar de Matos), Republic of Moldova (Galina Lesco), Romania (Adriana Baban), Russian Federation (Anna Matochkina), Scotland (Jo Inchley), Slovenia (Helena Jericek), Spain (Carmen Moreno), Sweden (Petra Lofstedt and Lilly Augustine), Switzerland (Marina Delgrande-Jordan and Herv? Kuendig), Ukraine (Olga Balakireva), and Wales (Chris Roberts). Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peer-reviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder.

FundersFunder number
EURO
Fiona Broks and Ellen Klemera
French Belgium
Gonneke Stevens and Saskia van Dorsselaer
HBSC
Irish Department of Health
Margarida Gaspar de Matos
Shynar Abdrakhmanova and Valikhan Akhmetov
World Health Organization European Office
World Health Organization
Public Health Agency of Canada6D016-123071/001/SS
Canadian Institutes of Health ResearchPJT 162237
University of Glasgow
Council on grants of the President of the Russian Federation

    Keywords

    • Adolescence
    • Bullying
    • Clusters of contemporary risk
    • Eating
    • Mental well-being
    • Physical health
    • Social media use
    • Social support
    • Substance use

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