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Sense of coherence predicts adolescent mental health
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). The Research School of Health and Welfare, Jönköping University, Sweden. (Kvinna, barn, ungdom och familj (WomFam), Woman, Child, Youth and Family)ORCID iD: 0000-0002-0183-896X
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). University of Turku, Department of Public Health, Finland. (Individ och samhälle VIDSOC, Individual and Society)ORCID iD: 0000-0001-6648-603X
School of Health and Welfare, Department of Natural Sciences and Biomedicine, Centre for Oral Health, Jönköping University, Sweden / Department of Health Sciences, Karlstad University, Sweden.
Department of General Practice, University of Turku and Turku University Hospital, Finland.
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2020 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 274, p. 1206-1210Article in journal (Refereed) Published
Abstract [en]

Background: Strong sense of coherence (SOC) has been shown to predict good mental health among adults whereas its predictive value in adolescence is unclear. This life-course oriented prospective study explores whether SOC predicts mental health in a three-year follow-up. Methods: The data is part of the ongoing ‘Finnish Family Competence Study’ launched in 1986 in southwestern Finland (baseline n = 1287). The outcome variable was adolescent's mental health at 18 years of age, measured on the Development and Well-Being Assessment (DAWBA) scale. The main predictor was Antonovsky's SOC score (1987) measured at the age of 15. A total of 498 adolescents were included in the present analyses. Poisson regression was used by univariate and multivariable models using the parents’ age and socioeconomic status and adolescents’ gender as covariates. Results: Multivariable analysis showed that a one-unit increase in SOC decreased the relative risk of a DAWBA-based diagnosis by 4 % (RR [95% CI] 0.96 [0.94–0.98], p < 0.001). Limitations: Typical of very long follow-up, as in our study of nearly two decades, a substantial proportion of the original population-based cohort was lost to follow-up weakening the representability of our cohort. Conclusions: Sense of coherence is a useful and clinically sensitive tool to predict mental health in adolescence. The easily administered, coping-oriented SOC questionnaire is an appropriate instrument in screening for adolescents who would benefit from supportive measures to strengthen their mental well-being. 

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 274, p. 1206-1210
Keywords [en]
Adolescents, Development and well-being assessment scale, Follow-up study, Mental health, Sense of coherence
National Category
Nursing Public Health, Global Health and Social Medicine
Research subject
Individual and Society VIDSOC; Woman, Child and Family (WomFam)
Identifiers
URN: urn:nbn:se:his:diva-18558DOI: 10.1016/j.jad.2020.04.023ISI: 000546346900016PubMedID: 32663952Scopus ID: 2-s2.0-85085972252OAI: oai:DiVA.org:his-18558DiVA, id: diva2:1443709
Available from: 2020-06-18 Created: 2020-06-18 Last updated: 2025-09-29Bibliographically approved
In thesis
1. Predictors of mental health in adolescents - with a salutogenic perspective
Open this publication in new window or tab >>Predictors of mental health in adolescents - with a salutogenic perspective
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mental health in adolescence is an increasing public health concern. Over half of all mental disorders debut by 14 years of age and remain largely untreated up to adulthood, which underlines the importance of early detection. Mental health is a complex concept that consists of both mental well-being and mental ill-health (including mental health problems and mental disorders). However, the development of mental health during the transition period from childhood to adulthood is dependent on the coping strategies used to meet everyday stressors. Therefore, the framework is salutogenic, looking at the world from a resource perspective to promote mental well-being. However, finding predictors also include identifying risk factors of mental ill-health.

The overall aim of the thesis was to investigate predictors of mental health in adolescents from a longitudinal perspective. The Finnish Family Competence (FFC) study was used with adolescents at 15 years of age and their parents, with a follow-up at 18 years of age. Also, Swedish data material was used, The Longitudinal Research on Development In Adolescence (LoRDIA) with adolescents at 12-13 years and a follow-up at 17 years. In sub-studies I, II, and III the outcome was a probable mental health diagnosis determined by a standardised Development and Well-being Assessment (DAWBA) interview. In sub-study IV the outcome was perceived mental health status (MHS).

The results showed that a strong sense of coherence was associated with a decreased risk for subsequent mental disorders (sub-study I) and that self-esteem was negatively associated with future mental well-being (sub[1]study IV). Further, low levels of mental health problems reported by the adolescents (sub-study II) or by their parents (sub-study III) were related to a decreased risk for subsequent mental disorders. There was a gender aspect that affected the results and which showed girls as having more internal mental health problems or mental disorders. Other factors indicating an increased risk of mental ill-health were parental low age at childbirth and socioeconomic factors such as the mother’s low educational level, father’s blue-collar profession, and a poor economic situation in the family.

The results from this thesis underline the importance of having a salutogenic approach when dealing with mental health in adolescence to identify coping resources for stressors in Antonovsky’s ‘River of Life’. The school might be an arena for creating interventions with a resource perspective for strengthening a sense of coherence and self-esteem, and for alleviating perceived mental health problems.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2022. p. 114
Series
Dissertation series, ISSN 1654-3602 ; 121
Keywords
adolescents, DAWBA, mental health, predictors, resources, salutogenesis
National Category
Public Health, Global Health and Social Medicine Psychiatry Medical and Health Sciences Pediatrics
Research subject
Family-Centred Health
Identifiers
urn:nbn:se:his:diva-21888 (URN)978-91-88669-20-9 (ISBN)
Public defence
2022-11-04, G110, Högskolan i Skövde, Skövde, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2022-10-12 Created: 2022-09-30 Last updated: 2025-09-29Bibliographically approved

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Carlén, KristinaSuominen, Sakari

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