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Anniko, M., Boersma, K. & Tillfors, M. (2019). Sources of stress and worry in the development of stress-related mental health problems: A longitudinal investigation from early- to mid-adolescence. Anxiety, Stress, and Coping, 32(2), 155-167
Open this publication in new window or tab >>Sources of stress and worry in the development of stress-related mental health problems: A longitudinal investigation from early- to mid-adolescence
2019 (English)In: Anxiety, Stress, and Coping, ISSN 1061-5806, E-ISSN 1477-2205, Vol. 32, no 2, p. 155-167Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: Stress and stress-related mental health complaints are common and increasing among adolescents, especially girls. Identifying typical sources of stress as well as central intervention targets is an important effort in the development of effective prevention and treatment protocols. This study investigated worry as potential mediator in the development of mental health problems in response to common stressors in adolescence. We also examined to what sources adolescents ascribe their stress over the years from the 7th through the 9th grade.

DESIGN: Prospective cohort study.

METHODS: Self-reported subjective stressor load, worry, anxiety and depressive symptoms were assessed in a sample of Swedish 7th graders (N = 1137; 46% girls, mean age 13.2) with follow-up assessments one and two years later.

RESULTS: School was the most common source of stress across all time-points, with girls reporting considerable more stress than boys. Worry mediated the relationship between overall stressor load and depressive symptoms and anxiety over time and was not moderated by gender.

CONCLUSIONS: Worry may be an important target in stress prevention and efforts to prevent stress-related problems would benefit from focusing on early adolescence as especially school stress is already relatively common in grade 7.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Stress, adolescence, anxiety, depressive symptoms, worry
National Category
Psychology Psychiatry
Identifiers
urn:nbn:se:oru:diva-70348 (URN)10.1080/10615806.2018.1549657 (DOI)000457241400003 ()30465445 (PubMedID)2-s2.0-85057340641 (Scopus ID)
Funder
Swedish Research Council Formas, 2012-00065
Available from: 2018-11-27 Created: 2018-11-27 Last updated: 2019-02-13Bibliographically approved
Anniko, M., Boersma, K., van Wijk, N. P. L., Byrne, D. & Tillfors, M. (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. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 6(1), 4-15
Open this publication in new window or tab >>Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents
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2018 (English)In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, E-ISSN 2245-8875, Vol. 6, no 1, p. 4-15Article in journal (Refereed) Published
Abstract [en]

Background: Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic.

Objective: To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender.

Method: The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used.

Results: A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms.

Conclusions: Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.

Place, publisher, year, edition, pages
New York, NY, USA: Exeley Inc., 2018
Keywords
Adolescents, stress measurement, psychometrics, sex invariance, emotional distress
National Category
Psychology (excluding Applied Psychology) Psychiatry
Identifiers
urn:nbn:se:oru:diva-67064 (URN)10.21307/sjcapp-2018-001 (DOI)000438366500002 ()
Funder
Swedish Research Council FormasSwedish Research CouncilVINNOVA
Note

Funding Agency:

Forskningsradet for Arbetsliv och Socialvetenskap (FAS) 

Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-08-16Bibliographically approved
Anniko, M., Boersma, K. & Tillfors, M. (2018). Investigating the mediating role of cognitive emotion regulation in the development of adolescent emotional problems. Nordic Psychology, 70(1), 3-16
Open this publication in new window or tab >>Investigating the mediating role of cognitive emotion regulation in the development of adolescent emotional problems
2018 (English)In: Nordic Psychology, ISSN 1901-2276, E-ISSN 1904-0016, Vol. 70, no 1, p. 3-16Article in journal (Refereed) Published
Abstract [en]

Previous research has indicated that cognitive emotion regulation strategies contribute to the development and maintenance of emotional problems in adults and adolescents. However, there is a lack of longitudinal research with adolescent samples, hence knowledge of exactly how these strategies influence the development of emotional problems in adolescence is sparse. This study investigated maladaptive cognitive emotion regulation (cognitive avoidance and repetitive negative thinking) as a potential mediator in the development of anxiety and depressed mood over time in adolescence. Self-reported depressed mood, anxiety, and cognitive emotion regulation strategies were assessed during school hours in a sample of Swedish 10th graders (N=149; 53% girls), with follow-up assessments one and two years later. Repetitive negative thinking and cognitive avoidance formed a unidimensional factor of cognitive emotion regulation. Cognitive emotion regulation was found to mediate the development of both anxiety and depressed mood over time, lending support to the previous findings that cognitive emotion regulation strategies such as cognitive avoidance and repetitive negative thinking might act as transdiagnostic mechanisms in the development of emotional symptoms in adolescence. This suggests that maladaptive forms of cognitive emotion regulation could be important targets in prevention and treatment of emotional problems in adolescence.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
Emotion regulation, anxiety, depressed mood, adolescence, longitudinal design
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-65648 (URN)10.1080/19012276.2017.1323665 (DOI)000425787700002 ()2-s2.0-85019197348 (Scopus ID)
Available from: 2018-03-12 Created: 2018-03-12 Last updated: 2018-05-22Bibliographically approved
Wurm, M., Anniko, M., Tillfors, M., Flink, I. & Boersma, K. (2018). Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender. Journal of Psychosomatic Research, 111, 76-82
Open this publication in new window or tab >>Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender
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2018 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 111, p. 76-82Article in journal (Refereed) Published
Abstract [en]

Objective: Adolescence is a time of change during which several health problems, such as pain problems, increase. Psychosocial mechanisms involved in this development, such as interpersonal stressors and worry, are still understudied, especially longitudinally. The first aim of this study was to investigate the prevalence of musculoskeletal pain in Swedish adolescents between the ages 13 and 15 using pain grades. The second aim was to study the role of peer-related stress, worry, and gender in the development of musculoskeletal pain problems over time.

Methods: Adolescents in 18 public schools were followed from 7th to 9th grade (N=1181) and answered selfreport questionnaires at three time points. Prevalence was assessed at all three time points and a moderated mediation analysis investigated if peer-related stress in 7th grade predicted musculoskeletal pain two years later and if this relationship was mediated by worry in 8th grade. Gender was entered as a moderator.

Results: In 7th grade, 8.4% of adolescents reported musculoskeletal pain with some functional impairment. In 8th and 9th grade around 10% of adolescents reported musculoskeletal pain problems, with girls reporting a higher prevalence than boys. Peer-related stress in 7th grade predicted musculoskeletal pain problems in 9th grade, mediated by worry in 8th grade. The mediation was moderated by gender: peer-related stress predicted worry for girls, but not for boys.

Conclusion: Peer-related stress and worry seem to be involved in the development of pain over time. These factors should therefore be targeted in preventative interventions and during treatment.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Psychology (excluding Applied Psychology) Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-67289 (URN)10.1016/j.jpsychores.2018.05.016 (DOI)000437386600012 ()29935758 (PubMedID)2-s2.0-85048472319 (Scopus ID)
Funder
Swedish Research Council FormasSwedish Research CouncilVINNOVA, 2012-65Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2018-06-17 Created: 2018-06-17 Last updated: 2018-07-25Bibliographically approved
Anniko, M. (2018). Stuck on repeat: Adolescent stress and the role of repetitive negative thinking and cognitive avoidance. (Doctoral dissertation). Örebro: Örebro University
Open this publication in new window or tab >>Stuck on repeat: Adolescent stress and the role of repetitive negative thinking and cognitive avoidance
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stress and stress-related mental health problems such as anxiety and depressive symptoms are common in adolescents and seem to be increasing, especially in mid- to late-adolescent girls. Although adolescence, as a period of rapid growth and profound change, is often marked by an increase in normal stressors (e.g. conflicts with parents, fitting in with peers, increased academic demands), most adolescents do not develop more persis-tent problems with stress. To be able to develop effective preventive interventions there is a need to understand both what adolescents are ascribing their stress to, how different stressor domains relate to outcomes, and why some adolescents go on to develop stress-related mental health problems while others do not.          

This dissertation aimed to answer some of these questions by investigating the role of cognitive avoidance and repetitive negative thinking (RNT) in the development of stress-related mental health problems (Study I & III). It also aimed to develop and validate a shortened version of a questionnaire designed to measure stressor load within different life domains in adolescence (Study II). Findings show that the shortened version of the Adolescents Stress Questionnaire seems to be a valid measure of stressor load within different domains in adolescence. School-related stressors were the most prevalent sources of stress, but social stressors seem to have a stronger link to increases in mental health symptoms. Also, adolescents who report higher levels of distress and stressor load tend to increase their engagement in cognitive avoidance and RNT over time which in turn predicts further increases in mental health symptoms. This suggests that cognitive avoidance and RNT may be important mechanisms in the development of stress-related mental health problems in adoles-cence.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 75
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 41
Keywords
Adolescents stress, cognitive avoidance, repetitive negative thinking, anxiety, depression
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-66859 (URN)978-91-7529-251-9 (ISBN)
Public defence
2018-06-14, Örebro universitet, Långhuset, Hörsal L2, Fakultetsgatan 1, Örebro, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-09-12Bibliographically approved
Wurm, M., Flink, I., Anniko, M., Tillfors, M. & Boersma, K.Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time.
Open this publication in new window or tab >>Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time
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(English)Manuscript (preprint) (Other academic)
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-66950 (URN)
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-06-18Bibliographically approved
Anniko, M., Boersma, K. & Tillfors, M.Stress-related Mental Health Problems in Adolescence: What are Adolescents Stressed About and Could Worry be a Potential Target in Prevention? A Longitudinal Investigation .
Open this publication in new window or tab >>Stress-related Mental Health Problems in Adolescence: What are Adolescents Stressed About and Could Worry be a Potential Target in Prevention? A Longitudinal Investigation
(English)Manuscript (preprint) (Other academic)
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-67066 (URN)
Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-05-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6014-5226

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