Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status
Abstract
:1. Introduction
2. Methods
2.1. Sample
2.2. Measures
2.2.1. Perceived School-Related Stress
2.2.2. Family SES
2.2.3. Depressive Symptoms
2.3. Statistical Analysis
3. Results
Variables | High Family SES (N= 1166) | Low Family SES (N = 608) | p | |
---|---|---|---|---|
Age (mean ± SD) | 15.88 ± 1.53 | 16.13 ± 1.54 | 0.0010 | |
Gender (N; %) | Boys | 659; 56.52% | 334; 54.93% | 0.5236 |
Grades (N; %) | Grades 7–9 | 609; 52.23% | 287; 47.20% | 0.3540 |
Smoking (N; %) | No | 1142; 97.94% | 582; 95.72% | 0.0074 |
Alcohol drinking (N; %) | No | 945; 81.05% | 484; 79.61% | 0.4667 |
Physical inactivity (N; %) | Active | 339; 29.07% | 153; 25.16% | 0.0809 |
School-related stress (N; %) | Low (Effort-Reward ratio < = 1) | 687; 58.92% | 281; 46.22% | <0.0001 |
Effort (mean ± SD) | 17.44 ± 3.46 | 18.18 ± 3.30 | <0.0001 | |
Reward (mean ± SD) | 40.74 ± 5.23 | 38.57 ± 5.62 | <0.0001 | |
Academic performance (mean ± SD) | 10.25 ± 2.10 | 9.59 ± 2.03 | <0.0001 | |
Esteem (mean ± SD) | 26.59 ± 4.04 | 25.29 ± 4.51 | <0.0001 | |
Study prospects (mean ± SD) | 3.90 ± 0.92 | 3.69 ± 1.00 | <0.0001 | |
Depressive symptoms (N; %) | No | 942; 80.79% | 405; 66.61% | <0.0001 |
Total sample | Model I | Model II | Model III | ||
---|---|---|---|---|---|
School-related stress | Low | 1 | 1 | 1 | |
Effort | Increase per SD | 2.03 (1.76, 2.34) *** | 2.03 (1.76, 2.35) *** | 2.02 (1.74, 2.33) *** | |
Reward | Increase per SD | 0.43 (0.37, 0.49) *** | 0.43 (0.37, 0.49) *** | 0.43 (0.37, 0.50) *** | |
Academic performance | Increase per SD | 0.56 (0.49, 0.64) *** | 0.54 (0.47, 0.62) *** | 0.54 (0.48, 0.62) *** | |
Esteem | Increase per SD | 0.52 (0.46, 0.59) *** | 0.52 (0.45, 0.59) *** | 0.52 (0.46, 0.60) *** | |
Study prospects | Increase per SD | 0.78 (0.70, 0.88) *** | 0.78 (0.70, 0.88) *** | 0.78 (0.70, 0.88) *** | |
Family SES | High | 1 | 1 | 1 | |
High family SES sample (fully adjusted model) | Low family SES sample (fully adjusted model) | ||||
School-related stress | Low | 1 | 1 | ||
Effort | Increase per SD | 1.92 (1.59, 2.32) *** | 2.20 (1.74, 2.78) *** | ||
Reward | Increase per SD | 0.46 (0.39, 0.55) *** | 0.39 (0.31, 0.50) *** | ||
Academic performance | Increase per SD | 0.58 (0.47, 0.71) *** | 0.51 (0.43, 0.61) *** | ||
Esteem | Increase per SD | 0.57 (0.48, 0.67) *** | 0.47 (0.38, 0.58) *** | ||
Study prospects | Increase per SD | 0.84 (0.72, 0.98) * | 0.69 (0.57, 0.83) *** |
School-related stress | Family SES | Model I | Model II | Model III |
---|---|---|---|---|
Low | High | 1 | 1 | 1 |
Low | Low | 1.36 (0.88, 2.09) | 1.33 (0.86, 2.05) | 1.32 (0.86, 2.04) |
High | High | 4.51 (3.29, 6.19) *** | 4.45 (3.24, 6.12) *** | 4.26 (3.10, 5.87) *** |
High | Low | 9.66 (6.92, 13.46) *** | 9.48 (6.77, 13.29) *** | 9.18 (6.53, 12.89) *** |
Synergy index | 2.24 (1.55, 3.22) *** | 2.24 (1.55, 3.25) *** | 2.28 (1.56, 3.32) *** |
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Viner, R.M.; Ozer, E.M.; Denny, S.; Marmot, M.; Resnick, M.; Fatusi, A.; Currie, C. Adolescence and the social determinants of health. Lancet 2012, 379, 1641–1652. [Google Scholar] [CrossRef]
- Resnick, M.D.; Bearman, P.S.; Blum, R.W.; Bauman, K.E.; Harris, K.M.; Jones, J.; Tabor, J.; Beuhring, T.; Sieving, R.E.; Shew, M.; et al. Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. JAMA 1997, 278, 823–832. [Google Scholar] [CrossRef]
- Torsheim, T.; Aaroe, L.E.; Wold, B. Sense of coherence and school-related stress as predictors of subjective health complaints in early adolescence: Interactive, indirect or direct relationships? Soc. Sci. Med. 2001, 53, 603–614. [Google Scholar] [CrossRef]
- Torsheim, T.; Wold, B. School-related stress, support, and subjective health complaints among early adolescents: A multilevel approach. J. Adolesc. 2001, 24, 701–713. [Google Scholar]
- Gådin, K.G.; Hammarström, A. School-related health—A cross-sectional study among young boys and girls. Int. J. Health Serv. 2000, 30, 797–820. [Google Scholar] [CrossRef]
- Gådin, K.G.; Hammarström, A. Do changes in the psychosocial school environment influence pupils’ health development? Results from a three-year follow-up study. Scand. J. Public Health 2003, 31, 169–177. [Google Scholar] [CrossRef]
- Torsheim, T.; Aaroe, L.E.; Wold, B. School-related stress, social support, and distress: Prospective analysis of reciprocal and multilevel relationships. Scand. J. Psychol. 2003, 44, 153–159. [Google Scholar] [CrossRef]
- Sund, A.M.; Larsson, B.; Wichstrøm, L. Psychosocial correlates of depressive symptoms among 12–14-year-old Norwegian adolescents. J. Child Psychol. Psychiatry 2003, 44, 588–597. [Google Scholar] [CrossRef]
- Undheim, A.M.; Sund, A.M. School factors and the emergence of depressive symptoms among young Norwegian adolescents. Eur. Child Adolesc. Psychiatry 2005, 14, 446–453. [Google Scholar] [CrossRef]
- Murberg, T.A.; Bru, E. The role of neuroticism and perceived school-related stress in somatic symptoms among students in Norwegian junior high schools. J. Adolesc. 2007, 30, 203–212. [Google Scholar]
- Hjern, A.; Alfven, G.; Ostberg, V. School stressors, psychological complaints and psychosomatic pain. Acta Paediatr. 2008, 97, 112–117. [Google Scholar] [CrossRef]
- Lin, H.C.; Tang, T.C.; Yen, J.Y.; Ko, C.H.; Huang, C.F.; Liu, S.C.; Yen, C.F. Depression and its association with self-esteem, family, peer and school factors in a population of 9,586 adolescents in southern Taiwan. Psychiatry Clin. Neurosci. 2008, 62, 412–420. [Google Scholar] [CrossRef]
- Hesketh, T.; Zhen, Y.; Lu, L.; Dong, Z.X.; Jun, Y.X.; Xing, Z.W. Stress and psychosomatic symptoms in Chinese school children: Cross-sectional survey. Arch. Dis. Child. 2010, 95, 136–140. [Google Scholar] [CrossRef]
- Liu, Y.; Lu, Z. Chinese high school students’ academic stress and depressive symptoms: Gender and school climate as moderators. Stress Health 2012, 28, 340–346. [Google Scholar] [CrossRef]
- Grant, K.E.; Compas, B.E.; Stuhlmacher, A.F.; Thurm, A.E.; McMahon, S.D.; Halpert, J.A. Stressors and child and adolescent psychopathology: Moving from markers to mechanisms of risk. Psychol. Bull. 2003, 129, 447–466. [Google Scholar]
- Thapar, A.; Collishaw, S.; Pine, D.S.; Thapar, A.K. Depression in adolescence. Lancet 2012, 379, 1056–1067. [Google Scholar] [CrossRef]
- Bertha, E.A.; Balázs, J. Subthreshold depression in adolescence: A systematic review. Eur. Child Adolesc. Psychiatry 2013, 22, 589–603. [Google Scholar] [CrossRef]
- Siegrist, J. Adverse health effects of high-effort/low-reward conditions. J. Occup. Health Psychol. 1996, 1, 27–41. [Google Scholar]
- Siegrist, J. Chronic psychosocial stress at work and risk of depression: Evidence from prospective studies. Eur. Arch. Psychiatry Clin. Neurosci. 2008, 258 (Suppl. 5), 115–119. [Google Scholar] [CrossRef]
- Wege, N.; Dragano, N.; Erbel, R.; Jockel, K.H.; Moebus, S.; Stang, A.; Siegrist, J. When does work stress hurt? Testing the interaction with socioeconomic position in the Heinz Nixdorf Recall Study. J. Epidemiol. Community Health 2008, 62, 338–341. [Google Scholar] [CrossRef]
- Siegrist, J.; Lunau, T.; Wahrendorf, M.; Dragano, N. Depressive symptoms and psychosocial stress at work among older employees in three continents. Glob. Health 2012, 8. [Google Scholar] [CrossRef]
- Rugulies, R.; Aust, B.; Madsen, I.E.; Burr, H.; Siegrist, J.; Bültmann, U. Adverse psychosocial working conditions and risk of severe depressive symptoms. Do effects differ by occupational grade? Eur. J. Public Health 2013, 23, 415–420. [Google Scholar] [CrossRef]
- Li, J.; Weigl, M.; Glaser, J.; Petru, R.; Siegrist, J.; Angerer, P. Changes in psychosocial work environment and depressive symptoms: A prospective study in junior physicians. Am. J. Ind. Med. 2013, 56, 1414–1422. [Google Scholar] [CrossRef]
- Juvani, A.; Oksanen, T.; Salo, P.; Virtanen, M.; Kivimäki, M.; Pentti, J.; Vahtera, J. Effort-reward imbalance as a risk factor for disability pension: The Finnish Public Sector Study. Scand. J. Work Environ. Health 2014, 40, 266–277. [Google Scholar] [CrossRef]
- Wahrendorf, M.; von dem Knesebeck, O.; Siegrist, J. Social productivity and well-being of older people: Baseline results from the SHARE study. Eur. J. Ageing 2006, 3, 67–73. [Google Scholar] [CrossRef]
- Chandola, T.; Marmot, M.; Siegrist, J. Failed reciprocity in close social relationships and health: Findings from the Whitehall II study. J. Psychosom. Res. 2007, 63, 403–411. [Google Scholar] [CrossRef]
- Shang, L.; Li, J.; Li, Y.; Wang, T.; Siegrist, J. Stressful psychosocial school environment and suicidal ideation in Chinese adolescents. Soc. Psychiatry Psychiatr. Epidemiol. 2014, 49, 205–210. [Google Scholar] [CrossRef]
- Li, J.; Shang, L.; Wang, T.; Siegrist, J. Measuring effort-reward imbalance in school settings: A novel approach and its association with self-rated health. J. Epidemiol. 2010, 20, 111–118. [Google Scholar] [CrossRef]
- Goodman, E.; Huang, B.; Wade, T.J.; Kahn, R.S. A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: Does school context matter? J. Pediatr. 2003, 143, 451–456. [Google Scholar] [CrossRef]
- Goodman, E.; Slap, G.B.; Huang, B. The public health impact of socioeconomic status on adolescent depression and obesity. Am. J. Public Health 2003, 93, 1844–1850. [Google Scholar] [CrossRef]
- Tracy, M.; Zimmerman, F.J.; Galea, S.; McCauley, E.; Stoep, A.V. What explains the relation between family poverty and childhood depressive symptoms? J. Psychiatr. Res. 2008, 42, 1163–1175. [Google Scholar]
- Aslund, C.; Leppert, J.; Starrin, B.; Nilsson, K.W. Subjective social status and shaming experiences in relation to adolescent depression. Arch. Pediatr. Adolesc. Med. 2009, 163, 55–60. [Google Scholar] [CrossRef]
- Melchior, M.; Chastang, J.F.; Walburg, V.; Arseneault, L.; Galéra, C.; Fombonne, E. Family income and youths’ symptoms of depression and anxiety: A longitudinal study of the French GAZEL Youth cohort. Depress. Anxiety 2010, 27, 1095–1103. [Google Scholar] [CrossRef]
- Najman, J.M.; Hayatbakhsh, M.R.; Clavarino, A.; Bor, W.; O’Callaghan, M.J.; Williams, G.M. Family poverty over the early life course and recurrent adolescent and young adult anxiety and depression: A longitudinal study. Am. J. Public Health 2010, 100, 1719–1723. [Google Scholar] [CrossRef]
- Sun, P.; Unger, J.B.; Palmer, P.; Ma, H.; Xie, B.; Sussman, S.; Johnson, C.A. Relative income inequality and selected health outcomes in urban Chinese youth. Soc. Sci. Med. 2012, 74, 84–91. [Google Scholar]
- Piko, B.F.; Luszczynska, A.; Fitzpatrick, K.M. Social inequalities in adolescent depression: The role of parental social support and optimism. Int. J. Soc. Psychiatry 2013, 59, 474–481. [Google Scholar] [CrossRef]
- Mossakowski, K.N. Disadvantaged family background and depression among young adults in the United States: The roles of chronic stress and self-esteem. Stress Health 2013, 10. [Google Scholar] [CrossRef]
- Starfield, B.; Riley, A.W.; Witt, W.P.; Robertson, J. Social class gradients in health during adolescence. J. Epidemiol. Community Health 2002, 56, 354–361. [Google Scholar] [CrossRef]
- Siegrist, J.; Marmot, M. Health inequalities and the psychosocial environment—Two scientific challenges. Soc. Sci. Med. 2004, 58, 1463–1473. [Google Scholar] [CrossRef]
- Holstein, B.E.; Currie, C.; Boyce, W.; Damsgaard, M.T.; Gobina, I.; Kökönyei, G.; Hetland, J.; de Looze, M.; Richter, M.; Due, P.; HBSC Social Inequalities Focus Group. Socio-economic inequality in multiple health complaints among adolescents: International comparative study in 37 countries. Int. J. Public Health 2009, 54 (Suppl. 2), 260–270. [Google Scholar]
- Reiss, F. Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Soc. Sci. Med. 2013, 90, 24–31. [Google Scholar] [CrossRef]
- Patel, V.; Flisher, A.J.; Hetrick, S.; McGorry, P. Mental health of young people: A global public-health challenge. Lancet 2007, 369, 1302–1313. [Google Scholar] [CrossRef]
- Patel, V.; Flisher, A.J.; Nikapota, A.; Malhotra, S. Promoting child and adolescent mental health in low and middle income countries. J. Child Psychol. Psychiatry 2008, 49, 313–334. [Google Scholar] [CrossRef]
- Kidger, J.; Araya, R.; Donovan, J.; Gunnell, D. The effect of the school environment on the emotional health of adolescents: A systematic review. Pediatrics 2012, 129, 925–949. [Google Scholar] [CrossRef]
- Sun, J.; Dunne, M.P.; Hou, X.Y. Academic stress among adolescents in China. Australas. Epidemiol. 2012, 19, 9–12. [Google Scholar]
- United Nations Educational, Scientific and Cultural Organization. International Standard Classification of Education. 2011. Available online: http://www.uis.unesco.org/Education/Documents/isced-2011-en.pdf (accessed on 15 February 2014).
- Siegrist, J.; Starke, D.; Chandola, T.; Godin, I.; Marmot, M.; Niedhammer, I.; Peter, R. The measurement of effort-reward imbalance at work: European comparisons. Soc. Sci. Med. 2004, 58, 1483–1499. [Google Scholar] [CrossRef]
- Pickett, W.; Schmid, H.; Boyce, W.F.; Simpson, K.; Scheidt, P.C.; Mazur, J.; Molcho, M.; King, M.A.; Godeau, E.; Overpeck, M.; et al. Multiple risk behavior and injury: An international analysis of young people. Arch. Pediatr. Adolesc. Med. 2002, 156, 786–793. [Google Scholar] [CrossRef]
- Torsheim, T.; Currie, C.; Boyce, W.; Kalnins, I.; Overpeck, M.; Haugland, S. Material deprivation and self-rated health: A multilevel study of adolescents from 22 European and North American countries. Soc. Sci. Med. 2004, 59, 1–12. [Google Scholar]
- Liu, Y.; Wang, M.; Villberg, J.; Torsheim, T.; Tynjälä, J.; Lv, Y.; Kannas, L. Reliability and Validity of Family Affluence Scale (FAS II) among Adolescents in Beijing, China. Child Indic. Res. 2012, 5, 235–251. [Google Scholar] [CrossRef]
- Fendrich, M.; Weissman, M.M.; Warner, V. Screening for depressive disorder in children and adolescents: Validating the Center for Epidemiologic Studies Depression Scale for Children. Am. J. Epidemiol. 1990, 131, 538–551. [Google Scholar]
- Li, H.C.; Chung, O.K.; Ho, K.Y. Center for Epidemiologic Studies Depression Scale for Children: Psychometric testing of the Chinese version. J. Adv. Nurs. 2010, 66, 2582–2591. [Google Scholar] [CrossRef]
- Yang, H.J.; Soong, W.T.; Kuo, P.H.; Chang, H.L.; Chen, W.J. Using the CES-D in a two-phase survey for depressive disorders among nonreferred adolescents in Taipei: A stratum-specific likelihood ratio analysis. J. Affect. Disord. 2004, 82, 419–430. [Google Scholar]
- Andersson, T.; Alfredsson, L.; Källberg, H.; Zdravkovic, S.; Ahlbom, A. Calculating measures of biological interaction. Eur. J. Epidemiol. 2005, 20, 575–579. [Google Scholar] [CrossRef]
- Pearlin, L.I.; Schieman, S.; Fazio, E.M.; Meersman, S.C. Stress, health, and the life course: Some conceptual perspectives. J. Health Soc. Behav. 2005, 46, 205–219. [Google Scholar] [CrossRef]
- Newacheck, P.W.; Hughes, D.C.; Stoddard, J.J. Children’s access to primary care: Differences by race, income, and insurance status. Pediatrics 1996, 97, 26–32. [Google Scholar]
- Newacheck, P.W.; Hung, Y.Y.; Park, M.J.; Brindis, C.D.; Irwin, C.E., Jr. Disparities in adolescent health and health care: Does socioeconomic status matter? Health Serv. Res. 2003, 38, 1235–1252. [Google Scholar] [CrossRef]
- Podsakoff, P.M.; MacKenzie, S.B.; Lee, J.Y.; Podsakoff, N.P. Common method biases in behavioral research: A critical review of the literature and recommended remedies. J. Appl. Psychol. 2003, 88, 879–903. [Google Scholar] [CrossRef]
- Currie, C.; Molcho, M.; Boyce, W.; Holstein, B.; Torsheim, T.; Richter, M. Researching health inequalities in adolescents: The development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc. Sci. Med. 2008, 66, 1429–1436. [Google Scholar] [CrossRef]
- Grant, K.E.; Compas, B.E.; Thurm, A.E.; McMahon, S.D.; Gipson, P.Y. Stressors and child and adolescent psychopathology: Measurement issues and prospective effects. J. Clin. Child Adolesc. Psychol. 2004, 33, 412–425. [Google Scholar] [CrossRef]
- Ming, Q.S.; Zhang, Y.; Chai, Q.L.; Chen, H.Y.; Hou, C.J.; Wang, M.C.; Wang, Y.P.; Cai, L.; Zhu, X.Z.; Yi, J.Y.; et al. Interaction between a serotonin transporter gene promoter region polymorphism and stress predicts depressive symptoms in Chinese adolescents: A multi-wave longitudinal study. BMC Psychiatry 2013, 13. [Google Scholar] [CrossRef]
- Chen, J.; Li, X.; Natsuaki, M.N.; Leve, L.D.; Harold, G.T. Genetic and environmental influences on depressive symptoms in Chinese adolescents. Behav. Genet. 2014, 44, 36–44. [Google Scholar] [CrossRef]
- Weare, K.; Nind, M. Mental health promotion and problem prevention in schools: What does the evidence say? Health Promot. Int. 2011, 26 (Suppl. 1), i29–i69. [Google Scholar] [CrossRef]
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Guo, H.; Yang, W.; Cao, Y.; Li, J.; Siegrist, J. Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status. Int. J. Environ. Res. Public Health 2014, 11, 6085-6098. https://doi.org/10.3390/ijerph110606085
Guo H, Yang W, Cao Y, Li J, Siegrist J. Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status. International Journal of Environmental Research and Public Health. 2014; 11(6):6085-6098. https://doi.org/10.3390/ijerph110606085
Chicago/Turabian StyleGuo, Hongxiang, Wenjie Yang, Ying Cao, Jian Li, and Johannes Siegrist. 2014. "Effort-Reward Imbalance at School and Depressive Symptoms in Chinese Adolescents: The Role of Family Socioeconomic Status" International Journal of Environmental Research and Public Health 11, no. 6: 6085-6098. https://doi.org/10.3390/ijerph110606085