Stability of High School Students' Mental Health in a Dual-Factor Model

McMahan, Melanie M.; Suldo, Shannon M.; Chappel, Ashley M.; Bateman, Lisa M.

doi:10.1037/e648772012-001

Cited by 9 publications

(11 citation statements)

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“…In total, 62% of the students showed changes in their mental health status during the first year of medical school, which means that only 38% remained in their initial mental health group across all measurement points. In line with studies in other populations [ 19–21 , 33 , 51 ], the complete mental health group emerged as the most common (50% at T0) and the most stable group (47% remained in the same group at all measurement points). This means that half of the investigated sample started medical school with complete mental health .…”

Section: Discussionsupporting

confidence: 87%

“…However, all studies – primarily conducted in the school context – consistently demonstrated the highest stability for the complete mental health group (64%–86%) regardless of the examined period ranging from five months to three years [ 19–21 , 32–34 ]. Furthermore, all groups showed patterns of instability, with the vulnerable [ 19 , 20 , 34 ], symptomatic but content [ 33 ] or troubled groups [ 21 , 32 ] displaying the greatest instability. Even if the findings regarding instability are not consistent, those studies provide good insight into patterns of change that occur at certain life stages and thus provide a comprehensive understanding of mental health changes [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

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Uncovering heterogeneity in mental health changes among first-year medical students

Polujanski,

Nett,

Rotthoff

et al. 2024

Medical Education Online

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Introduction The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school. Methods Students from eight German medical schools ( N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school. Results We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester. Conclusions Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Uncovering heterogeneity in mental health changes among first-year medical students

Polujanski,

Nett,

Rotthoff

et al. 2024

Medical Education Online

View full text Add to dashboard Cite

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“…Overall, the dual-factor model is applicable to adolescents and has been supported by adolescents themselves [16]. Studies have reported quite some variation in adolescents who experience Complete mental health, with estimates from 19 to 78% [9,15,[17][18][19][20][21][22][23][24]. Further, in these studies, 5 to 50% of the participants were classified as having Vulnerable mental health status, and 4 to 36% as having Symptomatic but content status.…”

Section: Introductionmentioning

confidence: 86%

“…Hence, the proportion of participants classified in the different mental health status groups differs widely between studies. Apart from different settings and ages of participants, these variations might be explained by different measures used and whether established score-based or relative distribution-based cut-offs have been used to assess well-being and mental health problems [9,[17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

“…Assessment of mental well-being alongside an assessment of mental health problems, in the dual-factor model, acknowledges adolescents in the Symptomatic but content group and the Vulnerable mental health status group, who might be overlooked using traditional mental health assessments [9,10,27]. If assessed using traditional methods, adolescents with Vulnerable mental health status might not receive mental health interventions, despite having low levels of mental well-being [9,10,22]. Hence, descriptions of adolescents in the four mental health status groups are needed to guide decisions on mental health interventions based on both status of mental well-being and mental health problems [10].…”

Section: Introductionmentioning

confidence: 99%

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Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender

Hermann,

Söderqvist,

Karlsson

et al. 2024

PLoS ONE

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In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents’ mental health.

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Relevance of well-being, resilience, and health-related quality of life to mental health profiles of European adolescents: results from a cross-sectional analysis of the school-based multinational UPRIGHT project

Hayas

Mateo-Abad

Vergara

et al. 2021

Soc Psychiatry Psychiatr Epidemiol

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Purpose The existing evidence suggests that a complete evaluation of mental health should incorporate both psychopathology and mental well-being indicators. However, few studies categorize European adolescents into subgroups based on such complete mental health data. This study used the data on mental well-being and symptoms of mental and behavioral disorders to explore the mental health profiles of adolescents in Europe. Methods Data collected from adolescents (N = 3767; mean age 12.4 [SD = 0.9]) from five European countries supplied the information on their mental well-being (personal resilience, school resilience, quality of life, and mental well-being) and mental and behavioral disorder symptoms (anxiety, depression, stress, bullying, cyber-bullying, and use of tobacco, alcohol, or cannabis). Multiple correspondence analysis and cluster analysis were combined to classify the youths into mental health profiles. Results Adolescents were categorized into three mental health profiles. The "poor mental health" profile (6%) was characterized by low levels of well-being and moderate symptoms of mental disorders. The "good mental health" profile group (26%) showed high well-being and few symptoms of mental disorders, and the "intermediate mental health" profile (68%) was characterized by average well-being and mild-to-moderate symptoms of mental disorders. Groups with higher levels of well-being and fewer symptoms of mental disorders showed lower rates of behavioral problems. Mental well-being indicators strongly contributed to this classification. Conclusion Adolescents with the "intermediate" or "poor" mental health profiles may benefit from interventions to improve mental health. Implications for school-based interventions are discussed. Trial registration number (TRN) and date of registration ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019.

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Stability of High School Students' Mental Health in a Dual-Factor Model

Cited by 9 publications

References 0 publications

Uncovering heterogeneity in mental health changes among first-year medical students

Uncovering heterogeneity in mental health changes among first-year medical students

Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender

Relevance of well-being, resilience, and health-related quality of life to mental health profiles of European adolescents: results from a cross-sectional analysis of the school-based multinational UPRIGHT project

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