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Social stressors and their association with psychosomatic problems among adolescents: Implications for school social work
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0003-3982-5969
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to investigate associations between family-, school- and individual-related social stressors and adolescents’ psychosomatic problems, and which factors might moderate these associations. A cross-sectional study design was employed to collect data and 3764 Swedish adolescents (girls 51.8%), aged between13 and 15 years completed a questionnaire. Multinomial logistic regression was used to analyse associations between social stressors and self-reported psychosomatic problems. Rasch analysis was used to psychometrically evaluate measurements in the studies (II-IV) and as a main method of analysis in study I to evaluate the psychometric properties of the Swedish version of the General Self-Efficacy Scale. School-related stressors that showed significant associations with adolescents’ psychosomatic problems were schoolwork pressure, students’ perceptions of school staff’s bullying interventions and bullying victimization. Family-related stressors that showed significant associations with adolescents’ psychosomatic problems were family residency, parental unemployment and parents’ academic achievement expectations. Factors related to the individual that showed significant associations with psychosomatic problems were having a disability, lower degree of self-efficacy and adolescents’ own academic achievement expectations. Sex moderated the association between self-efficacy and psychosomatic problems. Conclusions are that school social workers should focus on strengthening students’ self-efficacy and target schoolwork pressure and academic achievement expectations. Special attention needs to be paid to girls and adolescents living with a single parent or no parents. Further conclusions are that social support from school staff is important in relation to students’ self-reported psychosomatic problems, irrespective of students’ bullying victimization. The General Self-Efficacy Scale is a valid and reliable measure to use among adolescents.

Abstract [sv]

Bakgrund och syfte: Sociala påfrestningar i och utanför skolan kan leda till psykisk ohälsa och öka sociala ojämlikheter. Att eliminera eller mildra sociala påfrestningar kan bidra till att minska framtida sociala- och hälsorelaterade problem. För att kunna förebygga hälsoproblem och främja välmående bland ungdomar behöver skolsocialt arbete vägledas av kunskap om samspel mellan sociala förhållanden och risk- och skyddsfaktorer i, liksom utanför skolan. Det övergripande syftet med denna avhandling var att undersöka associationer mellan sociala påfrestningar relaterade till familjen, skolan och individen och ungdomars psykosomatiska besvär samt undersöka vilka faktorer som kan tänkas påverka styrkan mellan dessa associationer. 

 

Metod: För att samla in data till de fyra studierna som inkluderas i denna avhandling användes en tvärsnittsdesign. Data samlades in i på skolor 2009 och 2010 med hjälp av enkäter bland 3764 ungdomar (51.8% flickor). Ungdomarna var mellan 13 och 15 år och gick i årkurs 7 till 9 i den kommunala grundskolan i Karlstad kommun, Sverige. Multinomial logistisk regression användes för att analysera associationer mellan sociala påfrestningar relaterade till familjen, skolan och individen och självrapporterade psykosomatiska besvär. Rasch-analys användes för att psykometriskt utvärdera mått som använts i studierna (II-IV) och som huvudanalysmetod i studie I för att bedöma de psykometriska egenskaperna för den svenska versionen av General Self-Efficacy Scale (GSES). 

 

Resultat: Skolrelaterade påfrestningar som visade signifikanta associationer till ungdomars självrapporterade psykosomatiska besvär var press från skolarbete (II), elevers uppfattning om skolpersonalens arbete mot mobbning (III) och utsatthet för mobbning (III). Familjerelaterade påfrestningar som visade signifikanta associationer till ungdomars självrapporterade psykosomatiska besvär var boendesituation (II & III), föräldrars arbetslöshet (II & III), samt föräldrars krav på skolprestationer (IV). Faktorer relaterade till individen som visade signifikanta associationer till psykosomatiska besvär var att ha en funktionsnedsättning och/eller långvarig sjukdom, lägre grad av tilltro till sin egen förmåga samt ungdomars egna krav på skolprestationer (IV).

Resultaten från avhandlingen visade följande: 1) tilltro till sin egen förmåga påverkade inte associationerna mellan någon av de skol- eller familjerelaterade påfrestningarna och psykosomatiska besvär (II). 2) Kön påverkade styrkan i associationen mellan tilltro till den egna förmågan och psykosomatiska besvär (II). 3) Associationen mellan elevers uppfattning av skolpersonalens arbete mot mobbning i skolan och elevernas psykosomatiska besvär påverkades inte av olika typer av mobbning som en elev varit utsatt för, kontrollerat för kön, ålder, boendesituation, föräldrars arbetslöshet och brist på vänskap (III). 4) Associationen påverkades heller inte av huruvida man är flicka eller pojke, ålder, boendesituation eller föräldrars arbetslöshet, kontrollerat för brist på vänskap och utsatthet för mobbning (III). 5) Associationen mellan funktionsnedsättning och psykosomatiska besvär påverkades inte av föräldrars krav på skolprestationer, ungdomens egna krav på skolprestationer eller tilltro till sin egen förmåga (IV). 

Slutsatser: Skolkuratorer bör fokusera på att stärka elevers tilltro till sin egen förmåga samt arbeta med aspekter så som elevers press relaterat till skolarbetet samt krav på bra skolprestationer. Dessutom behövs ett särskilt fokus på flickor då de tillhör en riskgrupp i vissa avseenden samt på ungdomar som bor med en ensamstående förälder eller de som bor utan sina föräldrar. Fler slutsatser är att socialt stöd från vuxna i skolan är viktigt i relation till ungdomars psykosomatiska besvär, oavsett om eleven är utsatt för mobbning eller ej. Därför behöver skolkuratorn kontinuerligt arbeta mot mobbning, både med elever och också lärare samt på organisatorisk nivå. Eftersom sociala, psykologiska och somatiska besvär är benägna att hänga samman är det viktigt att skolkuratorn och skolsköterskan har ett nära samarbete för att förebygga hälsoproblem och främja välmående. Detta samarbete underlättas av ett skolklimat och en skolkultur som stödjer skolpersonalens möjligheter till att arbeta hälsofrämjande. Bristen på interaktionseffekter mellan variablerna som inkluderades i de olika studierna tyder på att variablerna är stabila och att deras inverkan på psykosomatiska besvär inte är lätt att påverka. 

Abstract [en]

Social stress occurring at and outside school can result in mental health problems and increase social inequalities. Reducing or mitigating social stressors may reduce future social and health problems. In order to prevent health problems and to promote well-being among adolescents, school social work needs to be guided by knowledge about the interplay between social conditions and risk and protective factors at school, as well as outside school. The overall aim of this thesis was to investigate associations between family-, school- and individual-related social stressors and adolescents’ psychosomatic problems, and which factors might moderate these associations. Conclusions based on the results are that school social workers should focus on strengthening students’ self-efficacy and target schoolwork pressure and academic achievement expectations. Special attention needs to be paid to girls and adolescents living with a single parent or no parents. Further conclusions are that social support from school staff is important in relation to students’ self-reported psychosomatic problems, irrespective of students’ bullying victimization. Furthermore, the Swedish version of the General Self-Efficacy Scale is a valid and reliable measure to use among adolescents.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2021. , p. 158
Series
Karlstad University Studies, ISSN 1403-8099 ; 2021:32
Keywords [en]
Social stressors, adolescents, psychosomatic problems, school social work, parental unemployment, family residency, schoolwork pressure, academic achievement expectation, bullying, bullying victimization, bullying intervention, self-efficacy, disability, long-term illness
Keywords [sv]
Sociala påfrestningar, ungdomar, psykosomatiska besvär, skolsocialt arbete, föräldrars arbetslöshet, boendesituation, press i skolan, krav på skolprestationer, mobbning, utsatthet för mobbning, interventioner mot mobbning, tilltro till sin egen förmåga, funktionsnedsättning, långvarig sjukdom
National Category
Social Work
Research subject
Social Work
Identifiers
URN: urn:nbn:se:kau:diva-86327ISBN: 978-91-7867-238-7 (print)ISBN: 978-91-7867-249-3 (electronic)OAI: oai:DiVA.org:kau-86327DiVA, id: diva2:1610491
Public defence
2021-12-17, Agardhsalen, 11D 257, Universitetsgatan 2, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Funder
Landstinget i VärmlandAvailable from: 2021-11-26 Created: 2021-11-11 Last updated: 2021-11-26Bibliographically approved
List of papers
1. The Psychometric Properties of the Swedish Version of the General Self-Efficacy Scale: A Rasch Analysis Based on Adolescent Data
Open this publication in new window or tab >>The Psychometric Properties of the Swedish Version of the General Self-Efficacy Scale: A Rasch Analysis Based on Adolescent Data
2018 (English)In: Current Psychology, ISSN 1046-1310, E-ISSN 1936-4733, Vol. 37, no 4, p. 703-715Article in journal (Refereed) Published
Abstract [en]

Self-efficacy describes people’s belief in their own ability to perform the behaviors required to produce a desired outcome. The purpose of this study was to examine the psychometric properties of the Swedish version of the General Self-Efficacy Scale (GSES) with an adolescent sample, using Rasch analysis. The scale was examined with a focus on invariant functioning along the latent trait as well as across sample groups. The data were collected 2009 and 2010 among 3764 students aged between 13 and 15 years, in the 7th to 9th grade, in compulsory schools in the municipality of Karlstad, Sweden. The item fit was acceptable, the categorization of the items worked well and the scale worked invariantly between years of investigations. Although the GSES worked well as a whole, there was some evidence of misfit indicating room for improvements. The targeting may be improved by adding more questions of medium difficulty. Also, further attention needs to be paid to the dimensionality of the GSES as well as to whether the psychometric properties of GSES are affected by using more recent data.

Place, publisher, year, edition, pages
Berlin: Springer, 2018
Keywords
Self-efficacy, Adolescents, Rasch analysis, Psychometric, Sweden, General Self-Efficacy Scale
National Category
Psychology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-47803 (URN)10.1007/s12144-016-9551-y (DOI)000448692200001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-1736
Available from: 2017-02-01 Created: 2017-02-01 Last updated: 2021-11-11Bibliographically approved
2. The association of self-reported schoolwork pressure, family factors and self-efficacy with psychosomatic problems
Open this publication in new window or tab >>The association of self-reported schoolwork pressure, family factors and self-efficacy with psychosomatic problems
2021 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, no 4, p. 603-616Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to investigate the associations between self-reported schoolwork pressure and family factors with psychosomatic problems, and to investigate possible moderators of these associations. We examined self-efficacy as a personal resource that may be directly associated with psychosomatic problems, as well as serve as a moderator between stress exposure and psychosomatic problems. Furthermore, we examined sex as a possible moderator. The data were collected in 2010 among 2,004 pupils, aged between 13 and 15 years, in all schools in the municipality of Karlstad, Sweden. Multinomial logistic regression analysis showed that self-efficacy did not moderate the relationships between any of the school- and family-related factors and psychosomatic problems. However, self-efficacy had a direct effect on psychosomatic problems. Based on the results from the study, we concluded that health promoting and preventive work by the school health team should focus on strengthening pupils' self-efficacy and target schoolwork pressure. Special attention needs to be given to girls and adolescents living with a single parent or no parents.

Place, publisher, year, edition, pages
Routledge, 2021
Keywords
Psychosomatic problems, schoolwork pressure, family-related stress, self-efficacy, school social work
National Category
Social Work
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-77250 (URN)10.1080/13691457.2020.1722944 (DOI)000513980500001 ()
Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2021-11-11Bibliographically approved
3. Students’ Perception of Anti-Bullying Intervention in School and its Association with Students’ Psychosomatic Problems: An Ecological Approach
Open this publication in new window or tab >>Students’ Perception of Anti-Bullying Intervention in School and its Association with Students’ Psychosomatic Problems: An Ecological Approach
(English)Manuscript (preprint) (Other (popular science, discussion, etc.))
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:kau:diva-87092 (URN)
Available from: 2021-11-11 Created: 2021-11-11 Last updated: 2022-04-04Bibliographically approved
4. The association between disability, school achievement expectations, self-efficacy and psychosomatic problems among Swedish adolescents attending compulsory regular school
Open this publication in new window or tab >>The association between disability, school achievement expectations, self-efficacy and psychosomatic problems among Swedish adolescents attending compulsory regular school
2023 (English)In: Children & society, ISSN 0951-0605, E-ISSN 1099-0860, Vol. 37, no 4, p. 1294-1313Article in journal (Refereed) Published
Abstract [en]

The purpose was to investigate the association between disability, and psychosomatic problems among adolescents at compulsory regular school also taking into account parental and student achievement expectations and student self-efficacy. We analysed cross-sectional questionnaire data collected in 2010, from 2004 Swedish adolescents. The results showed that the degree of psychosomatic problems and self-efficacy varied with regard to whether the adolescent reported having a disability or not. The distribution of parents’ and adolescents’ own achievement expectations did not differ significantly with regard to having a disability. Neither achievement expectations nor self-efficacy did moderate the association between disability and psychosomatic problems.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
achievement expectations, adolescents, disability, psychosomatic problems, self-efficacy
National Category
Social Work Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Work
Identifiers
urn:nbn:se:kau:diva-87093 (URN)10.1111/chso.12685 (DOI)000914910100001 ()2-s2.0-85147022297 (Scopus ID)
Funder
Landstinget i VärmlandForte, Swedish Research Council for Health, Working Life and Welfare, 2012–1736
Note

This paper was included as a manuscript in thesis 'Social stressors and their association with psychosomatic problems among adolescents: Implications for school social work' 2021:32

Available from: 2021-11-11 Created: 2021-11-11 Last updated: 2023-12-11Bibliographically approved

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