“It is like a mind attack”: stress and coping among urban school-going adolescents in India

Abstract

Background Mental health problems are leading contributors to the global disease burden in adolescents. This study aims to highlight (1) salient context-specific factors that influence stress and coping among school-going adolescents across two urban sites in India; and (2) potential targets for preventing mental health difficulties. Methods Focus group discussions were undertaken with a large sample of 191 school-going adolescent boys and girls aged 11–17 years (mean = 14 years), recruited from low- and middle-income communities in the predominantly urban states of Goa and Delhi. Framework analysis was used to identify themes related to causes of stress, stress reactions, impacts and coping strategies. Results Proximal social environments (home, school, peers and neighborhood) played a major role in causing stress in adolescents’ daily lives. Salient social stressors included academic pressure, difficulties in romantic relationships, negotiating parental and peer influences, and exposure to violence and other threats to personal safety. Additionally, girls highlighted stress from having to conform to normative gender roles and in managing the risk of sexual harassment, especially in Delhi. Anger, rumination and loss of concentration were commonly experienced stress reactions. Adolescents primarily used emotion-focused coping strategies (e.g., distraction, escape-avoidance, emotional support seeking). Problem-focused coping (e.g., instrumental support seeking) was less common. Examples of harmful coping (e.g., substance use) were also reported. Conclusions The development of culturally sensitive and age-appropriate psychosocial interventions for distressed adolescents should attend to the challenges posed by home, school, peer and neighborhood environments. Enhancements to problem- and emotion-focused strategies are needed in order to bolster adolescents’ repertoire of adaptive coping skills in stressful social environments. Electronic supplementary material The online version of this article (10.1186/s40359-019-0306-z) contains supplementary material, which is available to authorized users.

Effectiveness of a brief lay counsellor-delivered, problem-solving intervention for adolescent mental health problems in urban, low-income schools in India: a randomised controlled trial

“…The far-reaching implications of these challenges to youth mental health are evident in India, which is home to some 250 million 10 to 19-year-olds, 20% of the total adolescent population worldwide. High levels of stress are a feature of daily life for many adolescents, 5 especially in metropolitan areas, as shown by the 2016 Indian National Mental Health Survey, 6 which estimated that mental disorders are experienced by 13% of adolescents. India also has one of the highest youth suicide rates globally, and suicide is the leading cause of death in Indian adolescents.…”

Estructura interna e invarianza de medición del Children’s Hassles Scale en adolescentes

“…En base a los criterios cuantitativos y cualitativos, el presente estudio planteó y evaluó una estructura parsimoniosa de dos factores oblicuos que hacen referencia a factores estresantes cotidianos orientados a la escuela y la familia. Esto es teóricamente coherente y relevante porque la literatura indica que los acontecimientos cotidianos tienen alta probabilidad de ocurrencia y son propios de la interacción diaria de la persona (Seiffge-Krenke, 2000Sominsky & Spencer, 2014), por lo tanto, estos eventos reciben esta valoración cuando se presentan en entornos cercanos al adolescente como es el caso de la escuela y la familia (Parikh et al, 2019;Trianes et al, 2012), motivo por el que son catalogados entre las principales fuentes generadoras de estrés (Masarik & Conger, 2017;Pascoe et al, 2020).…”

“…Durante la etapa adolescente, los acontecimientos cotidianos estresantes pueden originarse de fuentes relacionadas a la salud, el ámbito académico, los compañeros, el vecindario y el ambiente familiar. Es así que en el ámbito de la salud se encuentran las enfermedades y la preocupación por la imagen corporal; en el ámbito académico, la relación con los docentes y las actividades académicas; en lo relacionado a compañeros y vecindario están las relaciones románticas, la exposición a la violencia y las amenazas a la seguridad personal por parte de pares; y en el ámbito familiar, se encuentra las discusiones con miembros de la familia y aspectos económicos (Parikh et al, 2019;Trianes, 2002;Trianes et al, 2009;Trianes, Blanca, Fernández-Baena, Escobar, & Maldonado, 2012). Es importante recalcar que las fuentes de estrés provenientes del ámbito educativo y familiar están entre las más importantes (Masarik & Conger, 2017;Pascoe, Hetrick, & Parker, 2020) y que las consecuencias de estas fuentes de estrés pueden quedar latentes por muchos años hasta la etapa adulta (McDougall & Vaillancourt, 2015).…”

The effectiveness of a low-intensity problem-solving intervention for common adolescent mental health problems in New Delhi, India: protocol for a school-based, individually randomized controlled treatment trial with an embedded stepped-wedge cluster randomized controlled recruitment trial

“…Our formative and pilot studies have led to the design of a stepped care architecture involving two interventions of incremental intensity (19)(20)(21)(22). The current trial protocol focuses on the first step: a low-intensity intervention designed for delivery by non-specialist school counsellors.…”

“…It has been applied successfully as the main element in other low-intensity psychological interventions in LMICs (24)(25)(26). The emphasis on problem solving also reflects the primacy of psychosocial factors in adolescents' narratives around explanatory models of distress and help-seeking (21). Our provisional theory of change for the intervention draws on evidence-based principles of stress and coping (27), such that the impact of an ecological stressor is assumed to be mediated by appraisals of the stressor and of the repertoire of available coping resources.…”