Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Study Design
2.2. Data Availability
2.3. Measurements
2.3.1. Demographic Information
2.3.2. Physical Activity Measure
2.3.3. School Adaptation Measure
2.3.4. Mental Health Problem Measure
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- UNICEF China. Adolescent Mental Health. Available online: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health (accessed on 17 November 2021).
- Zhou, S.J.; Zhang, L.G.; Wang, L.L.; Guo, Z.C.; Wang, J.Q.; Chen, J.C.; Liu, M.; Chen, X.; Chen, J.X. Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19. Eur. Child Adolesc. Psychiatry 2020, 29, 749–758. [Google Scholar] [CrossRef] [PubMed]
- Li, J.; Li, J.; Jia, R.; Wang, Y.; Qian, S.; Xu, Y. Mental health problems and associated school interpersonal relationships among adolescents in China: A cross-sectional study. Child Adolesc. Psychiatry Ment. Health 2020, 14, 12. [Google Scholar] [CrossRef]
- Darling, S.; Dawson, G.; Quach, J.; Smith, R.; Perkins, A.; Connolly, A.; Smith, A.; Moore, C.L.; Ride, J.; Oberklaid, F. Mental health and wellbeing coordinators in primary schools to support student mental health: Protocol for a quasi-experimental cluster study. BMC Public Health 2021, 21, 1467. [Google Scholar] [CrossRef] [PubMed]
- Bøe, T.; Hysing, M.; Askeland, K.G.; Skogen, J.C.; Heradstveit, O. Do Parental Education-Related Inequality Matter in Child and Adolescent Utilization of Mental Health Services: Results from a Norwegian Register Linkage Study. Health Serv. Insights 2021, 14, 11786329211055302. [Google Scholar] [CrossRef] [PubMed]
- Luo, Y.; Cui, Z.; Zou, P.; Wang, K.; Lin, Z.; He, J.; Wang, J. Mental Health Problems and Associated Factors in Chinese High School Students in Henan Province: A Cross-Sectional Study. Int. J. Environ. Res Public Health 2020, 17, 5944. [Google Scholar] [CrossRef] [PubMed]
- Tao, G.; Qiu, J.; Li, B.; Zeng, W.; Xu, J. Longitudinal study of psychological development of single and non-single child: A 10-year follow-up study in Nanjing. Chin. Ment. Health J. 1999, 13, 210–212. [Google Scholar]
- Reiss, F.; Meyrose, A.K.; Otto, C.; Lampert, T.; Klasen, F.; Ravens-Sieberer, U. Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS ONE 2019, 14, e0213700. [Google Scholar] [CrossRef] [Green Version]
- Yi, X.; Liu, Z.; Qiao, W.; Xie, X.; Yi, N.; Dong, X.; Wang, B. Clustering effects of health risk behavior on mental health and physical activity in Chinese adolescents. Health Qual. Life Outcomes 2020, 18, 211. [Google Scholar] [CrossRef]
- Ji, H.; Zheng, C. The influence of physical exercise on college students’ mental health and social adaptability from the cognitive perspective. Work 2021, 69, 651–662. [Google Scholar] [CrossRef]
- Bowe, A.K.; Owens, M.; Codd, M.B.; Lawlor, B.A.; Glynn, R.W. Physical activity and mental health in an Irish population. Ir. J. Med. Sci. 2019, 188, 625–631. [Google Scholar] [CrossRef]
- Pascoe, M.; Bailey, A.P.; Craike, M.; Carter, T.; Patten, R.; Stepto, N.; Parker, A. Physical activity and exercise in youth mental health promotion: A scoping review. BMJ Open Sport Exerc. Med. 2020, 6, e000677. [Google Scholar] [CrossRef] [PubMed]
- Bell, S.L.; Audrey, S.; Gunnell, D.; Cooper, A.; Campbell, R. The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: A cohort study. Int. J. Behav. Nutr. Phys. Act. 2019, 16, 138. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Quesnel-Vallée, A.; Taylor, M. Socioeconomic pathways to depressive symptoms in adulthood: Evidence from the National Longitudinal Survey of Youth 1979. Soc. Sci. Med. 2012, 74, 734–743. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Thomson, K.C.; Guhn, M.; Richardson, C.G.; Shoveller, J.A. Associations between household educational attainment and adolescent positive mental health in Canada. SSM-Popul. Health 2017, 3, 403–410. [Google Scholar] [CrossRef] [PubMed]
- Havas, J.; Bosma, H.; Spreeuwenberg, C.; Feron, F.J. Mental health problems of Dutch adolescents: The association with adolescents’ and their parents’ educational level. Eur. J. Public Health 2010, 20, 258–264. [Google Scholar] [CrossRef] [Green Version]
- Bluth, K.; Park, J.; Lathren, C. Is parents’ education level associated with adolescent self-compassion? Explore 2020, 16, 225–230. [Google Scholar] [CrossRef]
- Long, E.; Zucca, C.; Sweeting, H. School climate, peer relationships, and adolescent mental health: A social ecological perspective. Youth Soc. 2021, 53, 1400–1415. [Google Scholar] [CrossRef]
- Bonell, C.; Parry, W.; Wells, H.; Jamal, F.; Fletcher, A.; Harden, A.; Thomas, J.; Campbell, R.; Petticrew, M.; Murphy, S.; et al. The effects of the school environment on student health: A systematic review of multi-level studies. Health Place 2013, 21, 180–191. [Google Scholar] [CrossRef]
- Houri, D.; Nam, E.W.; Choe, E.H.; Min, L.Z.; Matsumoto, K. The mental health of adolescent school children: A comparison among Japan, Korea, and China. Glob. Health Promot. 2012, 19, 32–41. [Google Scholar] [CrossRef]
- Miller-Lewis, L.R.; Sawyer, A.C.; Searle, A.K.; Mittinty, M.N.; Sawyer, M.G.; Lynch, J.W. Student-teacher relationship trajectories and mental health problems in young children. BMC Psychol. 2014, 2, 27. [Google Scholar] [CrossRef] [Green Version]
- McCarty, C.A.; Mason, W.A.; Kosterman, R.; Hawkins, J.D.; Lengua, L.J.; McCauley, E. Adolescent school failure predicts later depression among girls. J. Adolesc. Health 2008, 43, 180–187. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kang, Y.; Yi, K.; Kim, Y.; Hur, Y. School adaptation and its correlates in Lao adolescents. Child. Youth Serv. Rev. 2021, 120, 105721. [Google Scholar] [CrossRef]
- Sampasa-Kanyinga, H.; Colman, I.; Goldfield, G.S.; Janssen, I.; Wang, J.; Podinic, I.; Tremblay, M.S.; Saunders, T.J.; Sampson, M.; Chaput, J.P. Combinations of physical activity, sedentary time, and sleep duration and their associations with depressive symptoms and other mental health problems in children and adolescents: A systematic review. Int. J. Behav. Nutr. Phys. Act. 2020, 17, 72. [Google Scholar] [CrossRef] [PubMed]
- Alfonso, V.C.; Rentz, E.; Orlovsky, K. Test review: School social behavior scales. J. Psychoeduc. Assess. 2007, 25, 82–92. [Google Scholar] [CrossRef]
- Zhang, S.; Luo, W.; Dong, X.; Chen, W.; Yi, X.; Zhou, W.; Zhang, Y.; Zhao, Y. A Dataset on the Status Quo of Health and Health-Related Behaviors of Chinese Youth: A Longitudinal Large-Scale Survey in the Secondary School Students of Shandong Province. Chin. Med. Sci. J. 2022, 37, 60–66. [Google Scholar] [PubMed]
- Shandong University. Database of Youth Health. Population Health Data Archive. Available online: https://www.ncmi.cn/phda/dataDetails.do?id=CSTR:17970.11.A0031.202107.209.V1.0 (accessed on 20 July 2021).
- Kowalski, K.C.; Crocker PR, E.; Donen, R.M. The Physical Activity Questionnaire for Older Children (PAQ-C) and Adolescents (PAQ-A) Manual; College of Kinesiology, University of Saskatchewan: Saskatoon, SK, Canada, 2004; Volume 87, pp. 1–38. [Google Scholar]
- Adeniyi, A.F.; Okafor, N.C.; Adeniyi, C.Y. Depression and physical activity in a sample of nigerian adolescents: Levels, relationships and predictors. Child Adolesc. Psychiatry Ment. Health 2011, 5, 16. [Google Scholar] [CrossRef] [Green Version]
- Dong, X.; Ding, M.; Chen, W.; Liu, Z.; Yi, X. Relationship between smoking, physical activity, screen time, and quality of life among adolescents. Int. J. Environ. Res. Public Health 2020, 17, 8043. [Google Scholar] [CrossRef]
- Martín-Antón, L.J.; Monjas, M.I.; Garcia Bacete, F.J.; Jiménez-Lagares, I. Problematic social situations for peer-rejected students in the first year of elementary school. Front. Psychol. 2016, 7, 1925. [Google Scholar] [CrossRef] [Green Version]
- Liu, H. Norm of symptom checklist (SCL-90) in Chinese middle school students. Chin. Ment. Health J. 2004, 18, 88–90. [Google Scholar]
- Mei, Q.; Li, C.; Yin, Y.; Wang, Q.; Wang, Q.; Deng, G. The relationship between the psychological stress of adolescents in school and the prevalence of chronic low back pain: A cross-sectional study in China. Child Adolesc Psychiatry Ment Health 2019, 13, 24–34. [Google Scholar] [CrossRef] [Green Version]
- Chen, S.; Li, L. SCL-90 reliability and validity test and Norm re-comparison. Chin. J. Neuropsychiatr. Dis. 2003, 29, 323–327. [Google Scholar]
- Li, F.; Cui, Y.; Li, Y.; Guo, L.; Ke, X.; Liu, J.; Luo, X.; Zheng, Y.; Leckman, J.F. Prevalence of mental disorders in school children and adolescents in China: Diagnostic data from detailed clinical assessments of 17,524 individuals. J. Child. Psychol. Psychiatry 2022, 63, 34–46. [Google Scholar] [CrossRef] [PubMed]
- Ng, P.; Chan, K.F.; Ho, W.C. A study on mental health of secondary school students in three metropolitan cities in China: Hong Kong, Shanghai, and Beijing. Int. J. Adolesc. Med. Health 2008, 20, 53–62. [Google Scholar] [CrossRef] [PubMed]
- Hale, D.R.; Bevilacqua, L.; Viner, R.M. Adolescent health and adult education and employment: A systematic review. Pediatrics 2015, 136, 128–140. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Loades, M.E.; Chatburn, E.; Higson-Sweeney, N.; Reynolds, S.; Shafran, R.; Brigden, A.; Linney, C.; McManus, M.N.; Borwick, C.; Crawley, E. Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J. Am. Acad. Child Adolesc. Psychiatry 2020, 59, 1218–1239. [Google Scholar] [CrossRef]
- Wang, C.; Wang, Q.; Li, X.; Zhang, Y.; Wei, W.; Deng, W.; Guo, W.; He, L.; Tang, W.; Chen, T.; et al. Rural birth/upbringing and childhood adversities are associated with psychotic experiences in university students in China. Schizophr. Res. 2019, 209, 105–112. [Google Scholar] [CrossRef]
- Liu, S.; Zhang, X.; Lu, S.; Gao, H.; Liu, H.; Ma, H. Correlation analysis of mental health status and personality characteristics of only-child students in middle school. China J Health Psychol 2019, 27, 620–622. [Google Scholar]
- Qin, J.; Ding, Y.; Gao, J.; Wu, Y.; Lv, H.; Wu, J. Effects of COVID-19 on mental health and anxiety of adolescents aged 13-16 years: A comparative analysis of longitudinal data from China. Front. Psychiatry 2021, 12, 1243. [Google Scholar] [CrossRef]
- Gadassi Polack, R.; Sened, H.; Aubé, S.; Zhang, A.; Joormann, J.; Kober, H. Connections during crisis: Adolescents’ social dynamics and mental health during COVID-19. Dev. Psychol. 2021, 57, 1633. [Google Scholar] [CrossRef]
- Xiang, M.; Gu, X.; Zhang, X.; Moss, S.; Huang, C.; Nelson, L.P.; Zhang, T. Psychosocial mechanism of adolescents’ depression: A dose-response relation with physical activity. Children 2020, 7, 37. [Google Scholar] [CrossRef]
- Zhang, D.; Cui, Y.; Zhou, Y.; Cai, M.; Liu, H. The Role of School Adaptation and Self-Concept in Influencing Chinese High School Students’ Growth in Math Achievement. Front. Psychol. 2018, 9, 2356. [Google Scholar] [CrossRef] [PubMed]
- Subramani, C.; Kadhiravan, S. Academic stress and mental health among high school students. Indian J. Appl. Res. 2017, 7, 404–406. [Google Scholar]
- Van Zalk, M.H.; Kerr, M.; Branje, S.J.; Stattin, H.; Meeus, W.H. It takes three: Selection, influence, and de-selection processes of depression in adolescent friendship networks. Dev. Psychol. 2010, 46, 927. [Google Scholar] [CrossRef] [PubMed]
- Araban, M.; Montazeri, A.; Stein, L.A.; Karimy, M.; Mehrizi, A.A. Prevalence and factors associated with disruptive behavior among Iranian students during 2015: A cross-sectional study. Ital. J. Pediatr. 2020, 46, 85. [Google Scholar] [CrossRef] [PubMed]
- Liu, J.; Liu, C.X.; Wu, T.; Liu, B.P.; Jia, C.X.; Liu, X. Prolonged mobile phone use is associated with depressive symptoms in Chinese adolescents. J. Affect. Disord. 2019, 259, 128–134. [Google Scholar] [CrossRef] [PubMed]
Demographic Characteristics | Number of Participants, n (%) | SCL-90 Score (Mean ± SD) | t/F | p |
---|---|---|---|---|
Gender | t = −5.19 | <0.001 | ||
Male | 4524 (48.1) | 134.67 ± 53.73 | ||
Female | 4874 (51.9) | 140.38 ± 52.93 | ||
Place of residence | t = −2.44 | 0.02 | ||
Urban | 7205 (76.7) | 136.89 ± 54.03 | ||
Rural | 2193 (23.3) | 140.07 ± 51.15 | ||
Single child household | t = −3.09 | 0.002 | ||
Yes | 2820 (30.0) | 135.03 ± 54.72 | ||
No | 6578 (70.0) | 138.74 ± 52.77 | ||
Intimate friends of the opposite sex a | t = 7.95 | <0.001 | ||
Have | 2230 (23.7) | 147.06 ± 57.66 | ||
No | 6441 (68.5) | 136.07 ± 51.99 | ||
In the top class | F = 6.98 | 0.008 | ||
No | 7612 (81.0) | 136.93 ± 52.76 | ||
Yes | 1786 (19.0) | 140.63 ± 55.91 | ||
Family economic status | F = 108.22 | <0.001 | ||
Poor | 1452 (15.5) | 156.09 ± 65.58 | ||
Middle | 7219 (76.8) | 133.78 ± 49.12 | ||
Good | 727 (7.7) | 139.01 ± 58.98 | ||
Father’s educational level | F = 49.73 | <0.001 | ||
Elementary school and below | 1050 (11.2) | 156.07 ± 66.94 | ||
Junior high school | 3760 (40.0) | 138.59 ± 51.08 | ||
High school | 2736 (29.1) | 135.50 ± 50.94 | ||
University | 1675 (17.8) | 127.20 ± 47.90 | ||
Postgraduate and above | 177 (1.9) | 139.42 ± 66.60 | ||
Mother’s educational level | F = 39.02 | <0.001 | ||
Elementary school and below | 2020 (21.5) | 148.73 ± 58.66 | ||
Junior high school | 3523 (37.5) | 137.58 ± 51.54 | ||
High school | 2368 (25.2) | 134.69 ± 51.87 | ||
University | 1322 (14.1) | 126.37 ± 47.80 | ||
Postgraduate and above | 165 (1.8) | 135.29 ± 63.17 | ||
PA | t = 10.16 | <0.001 | ||
Inactive | 5107 (54.3) | 142.69 ± 55.11 | ||
Active | 4291 (45.7) | 131.60 ± 50.61 | ||
SSBS-Social Competence | F = 411.47 | <0.001 | ||
Low | 1311 (13.9) | 165.81 ± 71.75 | ||
Middle | 3875 (41.2) | 144.34 ± 51.82 | ||
High | 4212 (44.8) | 122.68 ± 42.14 | ||
SSBS-Antisocial Behavior | F = 133.03 | <0.001 | ||
Low | 9211 (98.0) | 136.41 ± 51.66 | ||
Middle | 158 (1.7) | 190.84 ± 78.08 | ||
High | 29 (0.3) | 235.28 ± 135.06 |
Subscale | Mean ± SD | Normal | Mild | Moderate | Severe |
---|---|---|---|---|---|
SCL-90 Score | 137.63 (53.39) | 6863 (73.0) | 1465 (15.6) | 636 (6.8) | 434 (4.6) |
GSI Score | 1.53 (0.59) | 5803 (61.7) | - | - | - |
SOM * | 1.43 (0.58) | 8230 (87.6) | 963 (10.2) | 161 (1.7) | 44 (0.5) |
O-C * | 1.75 (0.69) | 6843 (72.8) | 2078 (22.1) | 397 (4.2) | 80 (0.9) |
I-S * | 1.61 (0.69) | 7448 (79.3) | 1545 (16.4) | 325 (3.5) | 80 (0.9) |
DEP * | 1.56 (0.68) | 7648 (81.4) | 1339 (14.2) | 321 (3.4) | 90 (1.0) |
ANX * | 1.53 (0.66) | 7869 (83.7) | 1196 (12.7) | 254 (2.7) | 79 (0.8) |
HOS * | 1.47 (0.64) | 8161 (86.8) | 952 (10.1) | 209 (2.2) | 76 (0.8) |
PHOB * | 1.44 (0.63) | 8163 (86.9) | 964 (10.3) | 218 (2.3) | 53 (0.6) |
PAR * | 1.48 (0.63) | 8088 (86.1) | 1055 (11.2) | 204 (2.2) | 51 (0.5) |
PSY * | 1.46 (0.59) | 8135 (86.6) | 1034 (11.0) | 187 (2.0) | 42 (0.4) |
Categories | B | S.E | OR (95% CI) | p-Value b |
---|---|---|---|---|
Gender | ||||
Male | 0 a | 1.0 (Referent) | N/A c | |
Female | 0.18 | 0.05 | 1.20 (1.09, 1.33) | <0.001 |
Place of residence | ||||
Urban | 0 a | N/A c | ||
Rural | −0.03 | 0.06 | 0.97 (0.87, 1.10) | 0.652 |
Single child household | ||||
Yes | 0 a | 1.0 (Referent) | N/A c | |
No | 0.11 | 0.06 | 1.12 (1.00,1.25) | 0.062 |
Intimate friends of the opposite sex | ||||
Have | 0 a | 0.03 | 1.0 (Referent) | N/A c |
No | −0.38 | 0.05 | 0.68 (0.61, 0.76) | <0.001 |
In the top class | ||||
No | 0 a | 1.0 (Referent) | N/A c | |
Yes | 0.09 | 0.06 | 1.09 (0.97, 1.23) | 0.166 |
Family economic status | ||||
Poor | 0 a | 1.0 (Referent) | N/A c | |
Middle | −0.48 | 0.07 | 0.62 (0.55, 0.70) | <0.001 |
Good | −0.23 | 0.11 | 0.80 (0.65, 0.99) | 0.038 |
Father’s educational level | ||||
Elementary school and below | 0 a | 1.0 (Referent) | N/A c | |
Junior high school | −0.14 | 0.08 | 0.87 (0.74, 1.02) | 0.077 |
High school | −0.13 | 0.09 | 0.88 (0.74, 1.05) | 0.148 |
University | −0.25 | 0.12 | 0.78 (0.62, 0.98) | 0.033 |
Graduate and above | −0.12 | 0.28 | 0.88 (0.50, 1.53) | 0.658 |
Mother’s educational level | ||||
Elementary school and below | 0 a | 1.0 (Referent) | N/A c | |
Junior high school | −0.08 | 0.07 | 0.92 (0.81, 1.05) | 0.222 |
High school | −0.12 | 0.08 | 0.88 (0.75, 1.04) | 0.131 |
University | −0.20 | 0.12 | 0.82 (0.65, 1.03) | 0.084 |
Graduate and above | −0.28 | 0.28 | 0.75 (0.43, 1.32) | 0.319 |
PA | ||||
Inactive | 0 a | 1.0 (Referent) | N/A c | |
Active | −0.26 | 0.05 | 0.77 (0.70, 0.85) | <0.001 |
SSBS-Social Competence | ||||
Low | 0 a | 1.0 (Referent) | N/A c | |
Middle | −0.56 | 0.07 | 0.57 (0.50, 0.65) | <0.001 |
High | −1.47 | 0.07 | 0.23 (0.20, 0.27) | <0.001 |
SSBS-Antisocial Behavior | ||||
Low | 0 a | 1.0 (Referent) | N/A c | |
Middle | 1.31 | 0.16 | 3.71 (2.72, 5.05) | <0.001 |
High | 1.94 | 0.37 | 6.98 (3.41, 14.32) | <0.001 |
Categories | SOM | O-C | I-S | DEP | ANX | HOS | PHOB | PAR | PSY |
---|---|---|---|---|---|---|---|---|---|
Father’s educational level | |||||||||
Elementary school and below | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Junior high school | 0.79 (0.65, 0.97) * | 0.82 (0.70, 0.96) * | 0.77 (0.65, 0.90) ** | 0.76 (0.64, 0.90) ** | 0.77 (0.64, 0.93) ** | 0.78 (0.64, 0.95) * | 0.80 (0.66, 0.97) * | 0.76 (0.63, 0.92) ** | 0.70 (0.58, 0.86) *** |
High school | 0.83 (0.66, 1.04) | 0.78 (0.66, 0.93) ** | 0.76 (0.63, 0.92) ** | 0.79 (0.65, 0.95) * | 0.81 (0.66, 0.99) * | 0.77 (0.62, 0.97) * | 0.76 (0.61, 0.95) * | 0.75 (0.60, 0.93) ** | 0.70 (0.56, 0.87) ** |
University | 0.77 (0.57, 1.04) | 0.75 (0.60, 0.93) ** | 0.71 (0.56, 0.91) ** | 0.76 (0.59, 0.98) * | 0.71 (0.55, 0.93) * | 0.85 (0.64, 1.13) | 0.75 (0.56, 0.99) * | 0.82 (0.62, 1.09) | 0.74 (0.55, 0.98) * |
Graduate and above | 1.08 (0.59, 1.98) | 0.71(0.42, 1.21) | 0.93 (0.54, 1.59) | 0.77 (0.43, 1.38) | 0.83 (0.46, 1.50) | 0.68 (0.36, 1.28) | 0.75 (0.39, 1.43) | 1.16 (0.64, 2.10) | 0.89 (0.48, 1.67) |
Mother’s educational level | |||||||||
Elementary school and below | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Junior high school | 0.90 (0.76, 1.07) | 0.90 (0.79, 1.02) | 0.87 (0.75, 1.00) * | 0.83 (0.72, 0.96) * | 0.85 (0.73, 0.99) * | 0.86 (0.72, 1.01) | 0.91 (0.77, 1.08) | 0.86 (0.73, 1.01) | 0.90 (0.76, 1.07) |
High school | 0.83 (0.68, 1.02) | 0.70 (0.60, 0.82) *** | 0.73 (0.62, 0.87) *** | 0.63 (0.53, 0.75) *** | 0.78 (0.65, 0.94) ** | 0.74 (0.60, 0.91) ** | 0.79 (0.65, 0.97) * | 0.81 (0.67, 0.99) * | 0.83 (0.68, 1.02) |
University | 0.61 (0.45, 0.83) ** | 0.59 (0.48, 0.73) *** | 0.59 (0.46, 0.75) *** | 0.59 (0.46, 0.76) *** | 0.58 (0.45, 0.77) *** | 0.64 (0.48, 0.86) ** | 0.66 (0.49, 0.88) ** | 0.64 (0.49, 0.86) ** | 0.60 (0.45, 0.80) ** |
Graduate and above | 0.77 (0.41, 1.43) | 0.41 (0.24, 0.72) ** | 0.47 (0.26, 0.84) * | 0.44 (0.24, 0.81) ** | 0.54 (0.28, 1.00) | 0.73 (0.39, 1.39) | 0.63 (0.33, 1.23) | 0.49 (0.26, 0.93) * | 0.49 (0.25, 0.95) * |
PA | |||||||||
0 times pw | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
1–2 times pw | 0.59 (0.51, 0.68) *** | 0.60 (0.54, 0.67) *** | 0.55 (0.49, 0.62) *** | 0.52 (0.46, 0.59) *** | 0.58 (0.51, 0.66) *** | 0.62 (0.53, 0.71) *** | 0.59 (0.52, 0.69) *** | 0.53 (0.46, 0.61) *** | 0.51 (0.44, 0.59) *** |
3–4 times pw | 0.54 (0.44, 0.66) *** | 0.52 (0.45, 0.61) *** | 0.46 (0.39, 0.55) *** | 0.44 (0.37, 0.52) *** | 0.55 (0.46, 0.65) *** | 0.60 (0.50, 0.73) *** | 0.51 (0.41, 0.62) *** | 0.54 (0.45, 0.66) *** | 0.51 (0.42, 0.62) *** |
5–6 times pw | 0.57 (0.43, 0.74) *** | 0.51 (0.42, 0.63) *** | 0.45 (0.36, 0.56) *** | 0.40 (0.31, 0.51) *** | 0.49 (0.38, 0.63) *** | 0.54 (0.41, 0.71) *** | 0.54 (0.42, 0.71) *** | 0.47 (0.36, 0.62) *** | 0.45 (0.34, 0.59) *** |
≥7 times pw | 0.77 (0.56, 1.04) | 0.75 (0.59, 0.95) * | 0.70 (0.55, 0.91) ** | 0.70 (0.54, 0.91) ** | 0.67 (0.50, 0.89) ** | 0.72 (0.53, 0.99) * | 0.70 (0.51, 0.95) * | 0.71 (0.53, 0.96) * | 0.62 (0.45, 0.85) ** |
Social Competence | |||||||||
Peer relations | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 0.78 (0.64, 0.96) * | 1.01 (0.86, 1.19) | 0.87 (0.73, 1.03) | 0.92 (0.77, 1.10) | 0.88 (0.73, 1.05) | 0.77 (0.63, 0.93) ** | 0.88 (0.72, 1.07) | 0.72 (0.60, 0.88) ** | 0.73 (0.60, 0.89) ** |
High | 0.48 (0.37, 0.62) *** | 0.67 (0.55, 0.82) *** | 0.58 (0.47, 0.72) *** | 0.65 (0.52, 0.81) *** | 0.58 (0.46, 0.74) *** | 0.57 (0.44, 0.73) *** | 0.61 (0.47, 0.79) *** | 0.49 (0.38, 0.63) *** | 0.44(0.34, 0.57) *** |
Self management/Compliance | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 0.88 (0.71, 1.09) | 1.15 (0.96, 1.38) | 1.02 (0.85, 1.23) | 0.80 (0.66, 0.97) * | 0.82 (0.68, 1.00) | 0.84 (0.68, 1.03) | 0.92 (0.74, 1.13) | 0.86 (0.70, 1.05) | 0.80 (0.65, 0.98) * |
High | 0.85 (0.65, 1.12) | 1.11 (0.89, 1.38) | 0.90 (0.71, 1.13) | 0.64 (0.50, 0.81) *** | 0.69 (0.54, 0.88) ** | 0.58 (0.44, 0.76) *** | 0.80 (0.61, 1.05) | 0.69 (0.53, 0.90) ** | 0.66 (0.50, 0.86) ** |
Academic behavior | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 0.78 (0.66, 0.94) ** | 0.74 (0.65, 0.85) *** | 0.70 (0.61, 0.81) *** | 0.74 (0.63, 0.86) *** | 0.78 (0.67, 0.91) ** | 0.72 (0.61, 0.86) *** | 0.71 (0.60, 0.84) *** | 0.76 (0.64, 0.89) ** | 0.78 (0.66, 0.93) ** |
High | 0.67 (0.52, 0.85) ** | 0.49 (0.41, 0.59) *** | 0.45 (0.36, 0.55) *** | 0.52 (0.42, 0.64) *** | 0.56 (0.44, 0.69) *** | 0.55 (0.43, 0.70) *** | 0.52 (0.41, 0.66) *** | 0.58 (0.46, 0.74) *** | 0.63 (0.49, 0.80) *** |
Antisocial Behavior | |||||||||
Hostile/Irritable | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 2.46 (1.79,3.37) *** | 1.47 (1.09, 1.98) * | 1.66 (1.22, 2.26) ** | 2.04 (1.50, 2.76) *** | 2.25 (1.66, 3.06) *** | 2.04 (1.49, 2.81) *** | 2.44 (1.78, 3.35) *** | 2.66 (1.96, 3.62) *** | 2.20 (1.61, 3.02) *** |
High | 0.97(0.35,2.68) | 0.39 (0.14, 1.10) | 0.42 (0.14, 1.26) | 0.68 (0.24, 1.91) | 0.70 (0.24, 2.03) | 0.82 (0.28, 2.36) | 0.85 (0.29, 2.44) | 1.05 (0.38, 2.90) | 1.73 (0.67, 4.45) |
Antisocial/Aggressive | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 1.51 (1.05, 2.17) * | 1.15(0.82, 1.63) | 1.14(0.80, 1.61) | 1.11 (0.78, 1.58) | 1.27 (0.89, 1.81) | 1.49 (1.04, 2.14) * | 1.24 (0.85, 1.80) | 1.15 (0.80, 1.66) | 1.31 (0.91, 1.87) |
High | 2.64 (0.78, 8.92) | 3.04 (0.90, 10.20) | 6.45(1.91, 21.75) ** | 1.95 (0.57, 6.63) | 3.08 (0.91, 10.47) | 5.37 (1.60, 18.01) ** | 4.31 (1.28, 14.55) * | 2.91 (0.87, 9.67) | 1.60 (0.47, 5.40) |
Defiant/Disruptive | |||||||||
Low | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) | 1.0 (Referent) |
Middle | 2.09 (1.48, 2.94) *** | 1.51 (1.09, 2.09) * | 1.60 (1.15, 2.22) ** | 1.99 (1.44, 2.77) *** | 1.63 (1.17, 2.28) ** | 1.92 (1.37, 2.69) *** | 1.95 (1.38, 2.76) *** | 1.97 (1.41, 2.76) *** | 2.18 (1.56, 3.05) *** |
High | 3.74 (1.18, 11.9) * | 7.16 (2.26, 22.71) ** | 3.75 (1.21, 11.67) * | 8.06 (2.51, 25.81) ** | 6.25 (1.97, 19.82) ** | 4.53 (1.46, 14.06) * | 3.18 (1.00, 10.07) | 6.06 (1.94, 18.98) ** | 4.15 (1.30, 13.29) * |
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Xiu, X.; Qian, Q.; Wu, S. Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 8478. https://doi.org/10.3390/ijerph19148478
Xiu X, Qian Q, Wu S. Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2022; 19(14):8478. https://doi.org/10.3390/ijerph19148478
Chicago/Turabian StyleXiu, Xiaolei, Qing Qian, and Sizhu Wu. 2022. "Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 19, no. 14: 8478. https://doi.org/10.3390/ijerph19148478