Top

International Journal of Public Health

Published in:

01-05-2016 | Original Article

Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren?

Authors: Charlotte Meilstrup, Lau Caspar Thygesen, Line Nielsen, Vibeke Koushede, Donna Cross, Bjørn Evald Holstein

Published in: International Journal of Public Health | Issue 4/2016

Abstract

Objectives

Emotional symptoms are widespread among adolescents with the highest prevalence among lower socioeconomic groups. Less is known about why and how to reduce this inequality but personal control, e.g., self-efficacy may be crucial. This study examines whether self-efficacy is a mediator in the association between occupational social class (OSC) and emotional symptoms.

Methods

Data stem from the cross-sectional Health Behavior in School-aged Children-Methodology Development Survey 2012 (HBSC-MDS) conducted among 11–15-year old schoolchildren in two Danish municipalities. Participation rate was 76.8 % of 5165 enrolled schoolchildren, n = 3969.

Results

Low OSC is associated with higher odds of daily emotional symptoms and low selfefficacy. Schoolchildren with low self-efficacy have higher odds for daily emotional symptoms. We find a strong and statistically significant direct effect between low OSC and daily emotional symptoms (OR = 1.55, 95 % CI: 1.33; 1.84) and a borderline statistically significant indirect effect of self-efficacy [OR = 1.17 (0.99; 1.38)].

Conclusions

Socioeconomic inequality in emotional symptoms exists. This inequality is partly explained by socioeconomic inequality in self-efficacy. Promotion of personal competences like self-efficacy may reduce emotional symptoms among all socioeconomic groups, thereby reducing socioeconomic inequalities in emotional symptoms.

Amone-P’Olak K, Burger H, Ormel J, Huisman M, Verhulst FC, Oldehinkel AJ (2009) Socioeconomic position and mental health problems in pre- and early adolescents: the TRAILS study. Soc Psychiatry Epidemiol 44:231–238CrossRef

Bandura A (1997) Self-efficacy: the exercise of control. Worth Publishers, UK

Bandura A (2006) Adolescent development from an agentic perspective. In: Pajares F, Urdan T (eds) Self-efficacy beliefs of adolescents. Information age publishing, Greenwich

Barry MM (2009) Addressing the determinants of positive mental health: concepts, evidence and practice. Int J Ment Health Promot 11:4–17CrossRef

Barry MM, Clarke AM, Jenkins R, Patel V (2013) A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC Public Health 13:835–853CrossRefPubMedPubMedCentral

Boardman JD, Robert SA (2000) Neighborhood socioeconomic status and perceptions of self-efficacy. Soc Perspect 43:117–136CrossRef

Bøe T, Øverland S, Lundervold AJ, Hysing M (2012) Socioeconomic status and children’s mental health: results from the Bergen Child Study. Soc Psychiatry Epidemiol 47:1557–1566CrossRef

Christensen U, Krølner R, Nilsson CJ, Lyngbye PW, Hougaard CO, Nygaard E, Thielen K, Holstein BE, Avlund K, Lund R (2014) Addressing social inequality in aging by the Danish occupational social class measurement. J Aging Health 26:106–127CrossRefPubMed

Cole SR, Hérnan MA (2002) Fallibility in estimating direct effects. Int J Epidemiol 31:163–165CrossRefPubMed

Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, Samdal O, Smith ORF, Barnekow V (2012). Social determinants of health and well-being among young people. In: Health behaviour in school-aged children (HBSC) study: international report from the 2009/2010 survey. WHO Regional Office for Europe, Copenhagen

Damsgaard MT, Holstein BE, Koushede V, Madsen KR, Meilstrup C, Nelausen MK, Nielsen L, Rayce SB (2014) Close relations to parents and emotional symptoms among adolescents: beyond socio–economic impact? Int J Public Health 59:721–726CrossRefPubMed

Due P, Krølner R, Rasmussen M, Andersen A, Trab Damsgaard M, Graham H, Holstein BE (2011) Pathways and mechanisms in adolescence contribute to adult health inequalities. Scand J Public Health 39:62–78CrossRefPubMed

Haugland S, Wold B (2001) Subjective health complaints in adolescence-reliability and validity of survey methods. J Adolesc 24:611–624CrossRefPubMed

Jané-Llopis E, Anderson P, Stewart-Brown S, Weare K, Wahlbeck K, McDaid D, Cooper C (2011) Reducing the silent burden of impaired mental health. J Health Commun 16:59–74CrossRefPubMed

Jerusalem M, Hessling JK (2009) Mental health promotion in schools by strengthening self-efficacy. Health education 129:329–341

Jiang J, Vanderweele TJ (2015) When is the difference method conservative for assessing mediation? Am J Epidemiol 182:105–108CrossRefPubMed

Kaufman JS, MacLehose RF, Kaufman S (2004) A further critique of the analytic strategy of adjusting for covariates to identify biologic mediation. Epidemiol Perspect Innov 1:4CrossRefPubMedPubMedCentral

Keyfitz L, Lumley MN, Hennig KH (2013) The role of positive schema’s in child psychopathology and resilience. Cogn Ther Res 37:97–108CrossRef

Lange T, Vansteelandt S, Bekaert M (2012) A Simple unified approach for estimating natural direct and indirect effects. Am J Epidemiol 176:190–195CrossRefPubMed

Lien N, Friestad C, Klepp KI (2001) Adolescents’ proxy reports of parents’ socioeconomic status: how valid are they? J Epidemiol Community Health 55:731–737CrossRefPubMedPubMedCentral

Marmot MG (2004) The status syndrome: how social standing affects our health and longevity. Owl Books, New York

Mazur J, Malkowska-Szkutnik A, Tabak I (2014) Changes in family socio-economic status as predictors of self-efficacy in 13-year-old Polish adolescents. Int J Public Health 59:107–115CrossRefPubMed

Moor I, Richter M, Ravens-Sieberer U, Ottova-Jordan V, Elgar FJ, Pförtner T (2015) Trends in social inequalities in adolescent health complaints from 1994 to 2001 in Europe, North America and Israel: the HBSC study. Eur J Pub Health 25:57–60CrossRef

Muris P (2002) Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Pers Individ Differ 32:337–348CrossRef

Nielsen L, Meilstrup C, Nelausen MK, Koushede V, Holstein BE (2015) Promotion of social and emotional competence—experiences from a mental health intervention applying a whole school approach. Health Education 115:339–356CrossRef

Nordahl H, Krølner R, Páll G, Currie C, Andersen A (2011) Measurement of ethnic background in cross-national school surveys: agreement between students’ and parents’ responses. J Adolesc Health 49:272–277CrossRefPubMed

Patel V, Flisher AJ, Hetrick S, McGorry P (2007) Mental health of young people: a global public-health challenge. Lancet 369:1302–1313CrossRefPubMed

Pearl J (2009) Causality: models, reasoning, and inference. Cambridge University Press, New YorkCrossRef

Petersen MA, Groenvold M, Bjorner JB, Aaronsen N, Conroy T, Cull A, Fayers P, Hjermstad M, Sprangers M, Sullivan M (2003) Use of differential item functioning analysis to assess the equivalence of translations of a questionnaire. Qual Life Res 12:373–385CrossRefPubMed

Petersen ML, Sinisi SE, van der Laan MJ (2006) Estimation of direct causal effects. Epidemiology 17:276–284CrossRefPubMed

Ravens-Sieberer U, Erhart M, Torsheim T, Hetland J, Freeman Danielson M, Thomas C, The HBSC Positive Health Group (2008) An international scoring system for self-reported health complaints in adolescents. Eur J Public Health 18:294–299CrossRefPubMed

Reiss F (2013) Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 90:24–31CrossRefPubMed

Schwarzer R (1992) Self-efficacy. Thought control of actions, Routledge

Schwarzer R, Jerusalem M (1995) Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M (eds) Measures in health psychology: a user’s portfolio. Causal and control beliefs. NFERNELSON, Windsor, UK, pp 35–37

Stansfeld SA, Clark C, Rodgers B, Caldwell T (2008) Childhood and adulthood socio-economic position and midlife depressive and anxiety disorders. Br J Psychiatry 192:152–153CrossRefPubMed

Steca P, Abela JRZ, Monzani D, Greco A, Hazel NA, Hankin BL (2014) Cognitive vulnerability to depressive symptoms in children: the protective role of self-efficacy beliefs in a multi-wave longitudinal study. J Abnorm Child Psychol 42:137–148CrossRefPubMedPubMedCentral

Tahmassian K, Moghadam NJ (2011) Relationship between self-efficacy and symptoms of anxiety, depression, worry and social avoidance in a normal sample of students. Iran J Psychiatry Behav Sci 5:91–97PubMedPubMedCentral

Vereecken C, Vandegehuchte A (2003) Measurement of parental occupation: agreement between parents and their children. Arch Public Health 61:141–149

Weare K, Nind M (2011) Mental health promotion in schools: what does the evidence say? Health Promot Int 26:i29–i69CrossRefPubMed

Wells J, Barlow J, Stewart-Brown S (2003) A systematic review of universal approaches to mental health promotion in schools. Health Educ 103:197–220CrossRef

Title: Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren?
Authors: Charlotte Meilstrup
Lau Caspar Thygesen
Line Nielsen
Vibeke Koushede
Donna Cross
Bjørn Evald Holstein
Publication date: 01-05-2016
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue 4/2016
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-016-0790-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren?

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2016

The dynamic interdependence between family support and depressive symptoms among adolescents in Ghana

Weight development from age 13 to 30 years and adolescent socioeconomic status: The Norwegian Longitudinal Health Behaviour study

Breast cancer diagnosis, patterns of care and burden of disease in Queensland, Australia (1998–2004): does being Indigenous make a difference?

Decreased smoking initiation among male youths in China: an urban–rural comparison

If I tweet will you cite? The effect of social media exposure of articles on downloads and citations

Molecular and genomic sciences in health: apply the established rules of evidence