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What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide

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Abstract

Adolescence is a vulnerable period for psychological distress. This study aimed to comprehensively investigate the distribution of major stress-causing factors and their correlates in a large population of adolescents. A computerized self-report questionnaire was completed by 291,110 participating adolescents over a 4-year period using a cross-sectional study design. The questionnaire included items assessing demographic variables, major stressors, severity of perceived stress, and mental health outcomes such as depressed mood, suicidal ideation, and attempts. Among the major stressors, schoolwork/career was the most predominant (54.7%). However, the odds ratios for depressed mood and suicidal ideation were the highest in the stressor of conflict with peers (OR = 1.97 for depressed mood and OR = 2.00 for suicidal ideation), followed by family circumstances (OR = 1.77 and 1.94 for depressed mood and suicidal ideation, respectively). Conversely, schoolwork/career presented significantly lower odds ratios of 0.87 and 0.87 for depressed mood and suicidal ideation, respectively. This study provides important information on psychological distress related to adolescents’ mental health. Although school/career was the most prevalent source of psychological stress, the odds ratios for negative health outcomes of adolescents were higher in interpersonal problems such as conflicts with parents and peers and family circumstances. The present findings might help parents and clinicians understand the psychological distress of adolescents and improve their mental health.

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Abbreviations

KYRBS:

Korean Youth Risk Behavior Web-based Survey

K-CDC:

Korea Centers for Disease Control and Prevention

OECD:

Organization for Economic Co-operation and Development

CES-D:

Center for Epidemiologic Studies Depression Scale

References

  1. Griffin A (2017) Adolescent neurological development and implications for health and well-being in Healthcare. Multidisciplinary Digital Publishing Institute, Basel

    Google Scholar 

  2. Viner RM et al (2012) Adolescence and the social determinants of health. Lancet 379(9826):1641–1652

    PubMed  Google Scholar 

  3. Smetana JG, Campione-Barr N, Metzger A (2006) Adolescent development in interpersonal and societal contexts. Annu Rev Psychol 57:255–284

    PubMed  Google Scholar 

  4. Zarrett N, Eccles J (2006) The passage to adulthood: challenges of late adolescence. New Dir Youth Dev 2006(111):13–28

    Google Scholar 

  5. Merikangas KR et al (2010) Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989

    PubMed  PubMed Central  Google Scholar 

  6. Andersen SL, Teicher MH (2008) Stress, sensitive periods and maturational events in adolescent depression. Trends Neurosci 31(4):183–191

    CAS  PubMed  Google Scholar 

  7. Klomek AB, Sourander A, Gould M (2010) The association of suicide and bullying in childhood to young adulthood: a review of cross-sectional and longitudinal research findings. Can J Psychiatry 55(5):282–288

    Google Scholar 

  8. Marmorstein NR, Iacono WG (2004) Major depression and conduct disorder in youth: associations with parental psychopathology and parent–child conflict. J Child Psychol Psychiatry 45(2):377–386

    PubMed  Google Scholar 

  9. Pilowsky DJ et al (2006) Family discord, parental depression, and psychopathology in offspring: 20-year follow-up. J Am Acad Child Adolesc Psychiatry 45(4):452–460

    PubMed  Google Scholar 

  10. McCarty CA et al (2008) Adolescent school failure predicts later depression among girls. J Adolesc Health 43(2):180–187

    PubMed  PubMed Central  Google Scholar 

  11. McMahon SD et al (2003) Stress and psychopathology in children and adolescents: is there evidence of specificity? J Child Psychol Psychiatry 44(1):107–133

    PubMed  Google Scholar 

  12. Kim Y et al (1076e) Data resource profile: the Korea youth risk behavior web-based survey (KYRBS). Int J Epidemiol 45(4):1076–1076e

    PubMed  Google Scholar 

  13. Ang RP et al (2009) Cross-cultural invariance of the academic expectations stress inventory: adolescent samples from Canada and Singapore. J Adolesc 32(5):1225–1237

    PubMed  Google Scholar 

  14. Crystal DS et al (1994) Psychological maladjustment and academic achievement: a cross-cultural study of Japanese, Chinese, and American high school students. Child Dev 65(3):738–753

    CAS  PubMed  Google Scholar 

  15. Lee M, Larson R (2000) The Korean ‘examination hell’: long hours of studying, distress, and depression. J Youth Adolesc 29(2):249–271

    Google Scholar 

  16. Low NC et al (2012) Common stressful life events and difficulties are associated with mental health symptoms and substance use in young adolescents. BMC Psychiatry 12(1):116

    PubMed  PubMed Central  Google Scholar 

  17. Moksnes UK, Espnes GA (2011) Evaluation of the Norwegian version of the Adolescent Stress Questionnaire (ASQ-N): Factorial validity across samples. Scand J Psychol 52(6):601–608

    PubMed  Google Scholar 

  18. Hollenstein T, Lougheed JP (2013) Beyond storm and stress: typicality, transactions, timing, and temperament to account for adolescent change. Am Psychol 68(6):444

    PubMed  Google Scholar 

  19. Renk K et al (2005) Gender and age differences in the topics of parent-adolescent conflict. Fam J 13(2):139–149

    Google Scholar 

  20. Laursen B, Coy KC, Collins WA (1998) Reconsidering changes in parent-child conflict across adolescence: a meta-analysis. Child Dev 69(3):817–832

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Byrne DG, Davenport S, Mazanov J (2007) Profiles of adolescent stress: the development of the adolescent stress questionnaire (ASQ). J Adolesc 30(3):393–416

    CAS  PubMed  Google Scholar 

  22. Moksnes UK et al (2010) Adolescent stress: evaluation of the factor structure of the adolescent stress questionnaire (ASQ-N). Scand J Psychol 51(3):203–209

    PubMed  Google Scholar 

  23. Yan Y-W et al (2018) The relationship between adolescent academic stress and sleep quality: a multiple mediation model. Soc Behav Personal 46(1):63–77

    Google Scholar 

  24. Lee J et al (2013) Age-related differences in academic burnout of Korean adolescents. Psychol Sch 50(10):1015–1031

    Google Scholar 

  25. Carter JS, Garber J (2011) Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: stress and negative cognitions. J Abnorm Psychol 120(4):779

    PubMed  Google Scholar 

  26. Rudolph KD et al (2000) Toward an interpersonal life-stress model of depression: the developmental context of stress generation. Dev Psychopathol 12(2):215–234

    CAS  PubMed  Google Scholar 

  27. Rudolph KD, Hammen C (1999) Age and gender as determinants of stress exposure, generation, and reactions in youngsters: a transactional perspective. Child Dev 70(3):660–677

    CAS  PubMed  Google Scholar 

  28. Anniko MK et al (2018) Development of a shortened version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents. Scand J Child Adolesc Psychiatry Psychol 6(1):4–15

    Google Scholar 

  29. Liu X, Tein J-Y (2005) Life events, psychopathology, and suicidal behavior in Chinese adolescents. J Affect Disord 86(2–3):195–203

    PubMed  Google Scholar 

  30. Hankin BL et al (1998) Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 107(1):128

    CAS  PubMed  Google Scholar 

  31. Twenge JM, Nolen-Hoeksema S (2002) Age, gender, race, socioeconomic status, and birth cohort difference on the children's depression inventory: a meta-analysis. J Abnorm Psychol 111(4):578

    PubMed  Google Scholar 

  32. Rohde P et al (2009) Major and minor depression in female adolescents: onset, course, symptom presentation, and demographic associations. J Clin Psychol 65(12):1339–1349

    PubMed  PubMed Central  Google Scholar 

  33. Sourander A et al (2006) Early predictors of deliberate self-harm among adolescents: a prospective follow-up study from age 3 to age 15. J Affect Disord 93(1–3):87–96

    PubMed  Google Scholar 

  34. Cash SJ, Bridge JA (2009) Epidemiology of youth suicide and suicidal behavior. Curr Opin Pediatr 21(5):613

    PubMed  PubMed Central  Google Scholar 

  35. Hawton K, Saunders KE, O'Connor RC (2012) Self-harm and suicide in adolescents. Lancet 379(9834):2373–2382

    PubMed  Google Scholar 

  36. Juon HS, Nam JJ, Ensminger ME (1994) Epidemiology of suicidal behavior among Korean adolescents. J Child Psychol Psychiatry 35(4):663–676

    CAS  PubMed  Google Scholar 

  37. OECD (2015) Health at a glance 2015. OECD, Paris

    Google Scholar 

  38. Organisation for Economic Co-operation and Development, OECD child well-being module: CO4.4 teenage suicide (15–19 years old). 2012, Paris: OECD, Social Policy Division, Directorate of Employment, Labour and Social Affairs

  39. Lemstra M et al (2008) A systematic review of depressed mood and anxiety by SES in youth aged 10–15 years. Can J Pub Health 99(2):125–129

    Google Scholar 

  40. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401

    Google Scholar 

  41. Kim M (2008) The prevalence of depression of middle school students in a city, and the effect of depression on the school adjustment. Korean J Couns 9:645–658

    Google Scholar 

  42. Cho SJ et al (2001) Prevalence and correlates of depressive symptoms among the adolescents in an urban area in Korea. J Korean Neuropsychiatr Assoc 40(4):627–639

    Google Scholar 

  43. Cho SJ et al (2002) Prevalence of suicide behaviors (suicidal ideation and suicide attempt) and risk factors of suicide attempts in junior and high school adolescents. J Korean Neuropsychiatr Assoc 41(6):1142–1155

    Google Scholar 

  44. Serafini G et al (2015) Life adversities and suicidal behavior in young individuals: a systematic review. Eur Child Adolesc Psychiatry 24(12):1423–1446

    PubMed  Google Scholar 

Download references

Acknowledgments

The author wish to thank the Ministry of Education, Ministry of Health and Welfare, and Korea Centers for Disease Control and Prevention, which provided the raw data.

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Authors and Affiliations

  1. Department of Psychiatry, College of Medicine, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam-do, 31116, Republic of Korea

    Kyoung Min Kim

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Correspondence to Kyoung Min Kim.

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Kim, K.M. What makes adolescents psychologically distressed? Life events as risk factors for depression and suicide. Eur Child Adolesc Psychiatry 30, 359–367 (2021). https://doi.org/10.1007/s00787-020-01520-9

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  • DOI: https://doi.org/10.1007/s00787-020-01520-9

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