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Cross-country comparisons of trends in adolescent psychosomatic symptoms: a Rasch analysis of HBSC data from four Nordic countries
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).ORCID iD: 0000-0002-2986-2128
Univ Southern Denmark, Natl Inst Publ Hlth, DK-1353 Copenhagen K, Denmark.
University Bergen Norway.
Univ Jyvaskyla, Finland.
2019 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, article id 27Article in journal (Refereed) Published
Abstract [en]

BackgroundTo analyse the psychometric properties of the HBSC Symptom Checklist (HBSC-SCL) on psychosomatic symptoms with a focus on the operating characteristics of the items, and on the impacts of measurement distortions on the comparisons of person measures across time and between countries.MethodsData were collected in 1993/94, 1997/98, 2001/02, 2005/06, 2008/09, 2013/14 in Denmark, Finland, Norway and Sweden as part of the Health Behaviour in School-aged Children (HBSC) study. Data comprised 116,531 students 11, 13 and 15years old. Rasch analysis was conducted of the HBSC-SCL consisting of eight items with a focus on Differential Item Functioning (DIF) and item threshold ordering. The impacts of DIF and threshold disordering on trend analyses were analysed in a subsample consisting of 15years old students.ResultsOne item shows evidence of severe DIF and the categorisation of some items does not seem to work as intended. Analyses of changes based on proportions of psychosomatic symptoms show that bad item functioning affects some comparisons between countries across time: A four percentage point difference between 15years old girls in Finland and Sweden concerning the rate of increase of psychosomatic symptoms from 1994 to 2014 disappears when the problems with DIF and disordered item thresholds are taken into account. Although the proportions of students with psychosomatic symptoms are clearly higher 2014 than 1994 in all four countries the shape of most trends is nonlinear.ConclusionsSome of the cross-country comparisons were distorted because of DIF and problems related to disordering of the item thresholds. The comparisons among girls between Finland and Sweden were affected by the problems pertaining to the original measure of psychosomatic symptoms, while the trend patterns among boys were not much affected. In addition to confirming increasing rates of adolescent mental health problems in the Nordic countries, the substantive analyses in the current study show that Finland is joining Sweden in having the sharpest increase among older adolescents, in particular among girls.To improve the functioning of the scale the DIF item could be removed or replaced and response categories collapsed in post hoc analyses.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 17, article id 27
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology) Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:kau:diva-71394DOI: 10.1186/s12955-019-1097-xISI: 000458513000002PubMedID: 30728023OAI: oai:DiVA.org:kau-71394DiVA, id: diva2:1292522
Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-03-14Bibliographically approved

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Hagquist, Curt

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