|Year : 2015 | Volume
| Issue : 2 | Page : 48-56
Determinants of adolescent stress: A narrative review
Kallol Roy, Veena Ganesh Kamath, Asha Kamath
Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
|Date of Web Publication||30-Nov-2015|
Department of Community Medicine, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka
Source of Support: None, Conflict of Interest: None
Aim: Stress has become an inevitable part of our daily life. Adolescence can be considered one such stage in our life where we experience various stressors. Globally, studies have reported the adolescent stress levels range from 20% to 45%. The objective of this literature review was to identify the common determinants of stress and coping strategies among mid aged adolescents by reviewing observational studies published between the years 2003 and 2013. Methodology: Academic databases including PubMed, PsychInfo, EMBASE, Biomedcentral, and Science Direct were included for the search. STROBE checklist was used to assess the quality of the studies and data extraction. Result: A total of 12 studies were selected for the review for the study design; sample and population; settings; tools used; objectives and the results of the study. Based on our review, it could be reported that adolescents were more concerned about the socioeconomic status of parents, financial conditions, and academic life. The most common coping strategies used by adolescent boys are distraction and relaxation. Contrasting these features, the girls use more avoidance coping, more willing to seek support, resolving conflicts, and the always openly express their emotions. With comparison to boys, girls are kept under a strict supervision and given much less freedom which makes them prone to be more stressed. Conclusion: Focus should be directed to the mental health issues faced by adolescents. Studies addressing the prevalence of stress and interventions to counter the same must be conducted. Both adolescent boys and girls seem to be affected by stress in some way or the other. Supportive care from parents, teachers and health professionals is the need of the hour.
Keywords: Adolescent stress, coping abilities, determinants, global, narrative review, stress
|How to cite this article:|
Roy K, Kamath VG, Kamath A. Determinants of adolescent stress: A narrative review. Eur J Psychol Educ Studies 2015;2:48-56
|How to cite this URL:|
Roy K, Kamath VG, Kamath A. Determinants of adolescent stress: A narrative review. Eur J Psychol Educ Studies [serial online] 2015 [cited 2021 Jun 18];2:48-56. Available from: https://www.ejpes.org/text.asp?2015/2/2/48/170719
| Introduction|| |
Stress can be defined as the imprecise response of the body to any demand for change. Stress in terms of equilibrium can be defined as a state of equilibrium where individuals ability to cope with stressor is productively less as compared to the demands of the situation. Even in our life span, adolescence can debatably be one of the stages that is most marked by rapid and potentially tumultuous transition, including various changes in biological, social, and psychological aspects. Adolescents can be broadly classified into three stages. First being the early adolescents (11–13 years of age), second being the middle adolescents (14–16 years) and third being the late adolescents (17–19 years). The stress associated with adolescent changes is termed as adolescent stress, and factors that produce stress are termed as “stressors.”
Globally, studies have reported the adolescent stress levels range from 20% to 45%., Adolescent stressors can be broadly classified under five broad dimensions namely stressors at school, family, peers, personal health, and appearance. Probably these stressors could be the possible determinants of adolescent stress, which was further substantiated by. School environment and socioeconomic status (SES) of children determine the stress levels among adolescents. Studies have shown that the type of schools does affect the adolescents stress levels.,, The socioeconomic factor which includes occupation, income, and cultural features at home (Stephan, 1980) has been widely researched among adolescents.
There are enormous volumes of stress related research, but research on stress among adolescents has received less attention than comparable research among adults. Moreover, the research done among them have focussed more among the higher age group.,,, However, studies specific to the determinants of stress and coping strategies, among mid-age adolescents is largely unexplored.
| Methodology|| |
The objective of this literature review was to identify the common determinants of stress and coping strategies among mid-aged adolescents by reviewing observational studies published between the years 2003 and 2013.
What are the common determinants of stress and coping strategies among mid-aged adolescents?
Academic databases including PubMed, PsychInfo, EMBASE, Biomedcentral and Science Direct was included for the search. Other sources were Google Scholar and the list of references of other research articles and reviews. Authors of certain research articles were contacted to provide their full papers for this review. The last search for this review was completed on March 11, 2014, and it included the studies published between January 2003 and March 10, 2013.
- All observational and longitudinal studies that addressed the research question
- Studies carried out among age group 12–16 years
- Studies in English language and papers which were retrieved for the synthesis of review.
- Cluster randomized trials, randomized controlled trials, quasi – experimental studies, qualitative studies
- Studies with subjects suffering from any other mental, physical illness, posttraumatic stress disorders.
Keywords for the search strategy
Stress, adolescents, daily hassles, psychological stress, coping, stress symptoms.
Data collection and analysis
[Figure 1] displays the entire data collection.
STROBE checklist was used to assess the quality of the studies and data extraction. The 12 studies were reviewed for the study design; sample and population; settings; tools used; objectives and the results of the study. Owing to the diversity of the outcomes in the included studies a quantitative synthesis of study findings was not feasible. Thus, a narrative synthesis was undertaken.
| Results|| |
A total of 12 studies were selected for the review. The summary of the studies are displayed in [Table 1]. The total sample size of the studies was 12,787. Three studies each have been done in Asia (two in India and one in Pakistan) and Europe (Germany, Canada and Sweden). Five studies were done in North America. Only one cross-cultural study was done which included 20 countries. The objective of the studies were to assess any association among social, economic, cultural determinants of stress, and its outcomes on adolescent health status. It was observed that higher stress perception was more in females as compared to males. However, the stressors were common for both. However, the coping strategies differed. SES of parents, financial conditions and academic life of students were the main determinants of stress identified in this review. Various tools were employed to assess the stress levels. The only common study tool employed in five studies was Perceived Stress Scale (PSS-14).
| Discussion|| |
In our lifespan, stress plays a significant role during adolescence. Researchers have concluded that adolescence is a tumultuous phase. The pattern of stressors during each phase of adolescence, i.e. early, middle and late adolescence differs. An early adolescent (12–14 years) may consider academic life stressful whereas a late adolescent (17–19 years) may be much worried about future jobs etc., The mode of interaction of adolescents with their surroundings and oneself predict their stress levels. Stress arises when adolescents face new, unpredictable situations, anticipations of something odd, and the fear of losing something.
As a child grows up, he or she starts experiencing stress. The places where an adolescent first gets exposed to matters of self, social surroundings, academic achievements, etc., is at home and then school. The most common stressors that adolescents face are mainly classified as daily hassles and life events. Byrne et al. prepared a questionnaire to identify adolescent stressors. He concluded ten different domains. They were stress at home, performance at school, school attendance, romantic relationships, sexual attraction, peer pressure, teacher interaction, leisure activities, financial pressure, and emerging adult responsibility. These domains are the ones which are mostly followed and researched upon by researchers.
A similar study by Elgar et al. reported its findings on eight domains of daily hassles which were social isolation, excessive demands, romantic concerns, decisions about personal future, loneliness and unpopularity, assorted annoyances and concerns, social mistreatment, and academic difficulties.
Based on our review, it could be reported that adolescents were more concerned about the SES of parents, financial conditions and academic life. These determinants have been discussed further.
Social status is the position of an individual within the social relationships whereas economic status refers to the financial conditions and facilities possessed by the parents. These parameters are widely researched in terms of an adolescent. Urban adolescents had lower stress as compared to rural adolescents.,, It is evident that if family conditions are fragile then it directly affects children. Stress symptoms were reported just in two studies., Most of the symptoms go unchecked among adolescents. Thus, studies which aim to evaluate the effects of social factors such as race/ethnicity, parental SES, educational qualification, type of household, and a number of siblings should be carried out among adolescents. Sleep disturbances, smoking, hopelessness, and poor self-esteem were the physical and mental health outcomes as a result of stress. As parental educational level increased, it was accompanied by a decrease in risk of smoking among adolescents. The linkage of social disadvantage and stress is a piece in the puzzle of how social inequalities lead to an effect in health status among adolescents.
Financial and academic stressors
In developing countries, poverty is accompanied by a range of financial stressors such as a struggle to make ends meet, interpersonal conflicts over money matters, inadequate health care, ineffective schooling, and disruptions to essential services., In spite of financial stressors, an emotional bondage of parents, and children tend to counter the stress mediated effects. An interesting hypothesis was framed that rural adolescents are more family oriented, and thus these economic issues directly do not leave an impact on adolescent functioning.
Due to the current global recession, adolescents have become concerned about their academics rank. In addition, future unemployment has become high in many countries. Almost everywhere, adolescents have become increasingly concerned about academic performance which makes it the largest contributor to academic stress determinants. The three studies in Asia reported that adolescents considered academic life to be more stressful as compared to other determinants. This could highlight the fact on the need of a much better educational system.
Peer and parental stressors
Human expectations are boundless. Research has suggested that as an adolescent undergoes pubertal transitions, they seem to become progressively self-conscious and easily get affected with the opinion of others. Distinct changes are evident in terms of relationships with peers, family and society. Adolescents give more importance to their independent control on decisions, emotions and actions, and start to isolate from parental control. Parallel to this, school context involves a strong socialization process during which they become more conscious about the perspectives of teachers, friends, and other societal influences. Surroundings of adolescents mould them for future related stressor. With respect to peer relationships, adolescents tend to be keener to uphold their position in the peer group. Further, when it comes to close friendship then adolescents also experience stress; particularly when they begin to advance their approach toward romantic relationships. Only one cross-cultural study highlighted the fact that peer and romantic relationships are major determinants of stress among adolescents.
Gender differences in stress perception
Although both boys and girls are equally prone to stress and tend to have the same level of worry regarding social adequacy, academics, and economics, girls are much more prone to increased stress regarding issues surrounding family, personal appearance, future events, classmates, and personal health. Adolescent boys report more stressful self-relevant events than girls. Adolescent girls have been found to perceive negative interpersonal events as more stressful than do boys.
An interesting explanation had been devised that compared to boys, girls are kept under strict supervision and given much less freedom as compared to boys. Since it is less frequent for girls to experience that everything is under their control, they can easily feel more stressed.
The theory of coping as suggested by Lazarus and Folkman  is the active, behavioural, emotional, and cognitive attempts made by an individual to respond to needs imposed by certain stressors is termed as coping.
Preferences of coping styles
From all the above studies that we have reviewed, our understanding become more evidence based that when adolescents fail to use the appropriate coping for the specific stressor; the health status is at risk. Studies have shown that in different cultures adolescents coping deficits during adolescence are the main contributing factors for the psychopathology.
The most common coping strategies used by adolescent boys are distraction and relaxation, also focus on more positive aspects of the situation is adopted by them along with an approach-oriented coping style. Denying their emotions is one of the traits seen among adolescent boys.
Contrasting these features, the girls use more avoidance coping, more willing to seek support, resolving conflicts and the always openly express their emotions. They tend to prefer those coping strategies which will not jeopardize their relationships and uphold the relationship.
| Summary|| |
From our review, we could summarize that a healthy relationship at home and school was of central importance for a proper upbringing of an adolescent. It was seen that even the financial worries could be buffered by strong family relations. Peer stressors and romantic relationships were few determinants which need further research. Adolescent stress constitutes an issue of central importance to the understanding of adolescent health.
Adolescents preferred using involvement or avoidance strategies most often. These strategies when used for a much longer time, proved to be maladaptive. Given the strong impact of maladaptive coping styles on health  these issues are of interest to design effective prevention and intervention programs across countries.
| Conclusions|| |
Our review concludes that the pattern of stressors for mid-adolescents revolves around interpersonal relationships, financial conditions at home and also personal issues regarding oneself such as doubts, hopelessness, and anxiety. Coping strategies adopted by adolescents were more of avoidance and distraction coping. More research focusing on stress management interventions is required.
All the 12 studies included for this review were published between 2003 and 2013. Few studies whose full papers could not be retrieved were not included in this search.
What more we can we know?
Does the SES contribute the most to adolescent stress levels or are there any other factors? How could the educational background of parents affect the stress level of adolescents? Can peer group affect the frequency and uptake of risky behaviors? Would the promotion of hopefulness among adolescents be a better way to control stress? Is a peer group helpful or harmful for adolescents to cope with stress? Do media influence rural and urban adolescent stress? Are the stress levels of adolescents in private school and government school different?
The authors would like to thank all the contributors who have read and suggested their views on the article drafting process.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mahoney C. Stress: Sham epidemic or pathway to Ill health? A sociological analysis of a contested concept. J Soc Psychol Sci 2009;2.
Clark-Lempers DS, Lempers JD, Ho C. Early, middle, and late adolescents' perceptions of their relationships with significant others. J Adolesc Res 1991;6:296-315.
Yusoff MS, Hamid AH, Rosli NR, Zakaria NA, Rameli NA, Rahman NS, et al
. Prevalence of stress, stressors and coping strategies among secondary school students in Kota Bharu, Kelantan, Malaysia. Malays J Med Sci 2011;17:30-7.
Sbaraini CR, Schermann LB. Prevalence of childhood stress and associated factors: A study of schoolchildren in a city in Rio Grande do Sul State, Brazil. Cad Saude Publica 2008;24:1082-8.
Compas BE, Davis GE, Forsythe CJ, Wagner BM. Assessment of major and daily stressful events during adolescence: The adolescent perceived events scale. J Consult Clin Psychol 1987;55:534-41.
Byrne DG, Davenport SC, Mazanov J. Profiles of adolescent stress: The development of the adolescent stress questionnaire (ASQ). J Adolesc 2007;30:393-416.
Arun P, Chavan BS. Stress and suicidal ideas in adolescent students in Chandigarh. Indian J Med Sci 2009;63:281-7.
Augustine LF, Vazir S, Rao SF, Rao MV, Laxmaiah A, Nair KM. Perceived stress, life events and coping among higher secondary students of Hyderabad, India: A pilot study. Indian J Med Res 2011;134:61-8.
McAndrew FT, Akande A, Turner S, Sharma Y. A cross-cultural ranking of stressful life events in Germany, India, South Africa, and the United States. J Cross Cult Psychol 1998;29:717-27.
Grant KE, Compas BE, Stuhlmacher AF, Thurm AE, McMahon SD, Halpert JA. Stressors and child and adolescent psychopathology: Moving from markers to mechanisms of risk. Psychol Bull 2003;129:447-66.
Brobeck E, Marklund B, Haraldsson K, Berntsson L. Stress in children: How fifth-year pupils experience stress in everyday life. Scand J Caring Sci 2007;21:3-9.
Kadapatti MG, Vijayalaxmi A. Stressors of academic stress – A study on pre-university students. Indian J Sci Res 2012;3:171-5.
Elgar FJ, Arlett C, Groves R. Stress, coping, and behavioural problems among rural and urban adolescents. J Adolesc 2003;26:577-88.
Finkelstein DM, Kubzansky LD, Goodman E. Social status, stress, and adolescent smoking. J Adolesc Health 2006;39:678-85.
Goodman E, McEwen BS, Dolan LM, Schafer-Kalkhoff T, Adler NE. Social disadvantage and adolescent stress. J Adolesc Health 2005;37:484-92.
Guszkowska M. Physical fitness as a resource in coping with stress among high school students. J Sports Med Phys Fitness 2005;45:105-11.
Schraml K, Perski A, Grossi G, Simonsson-Sarnecki M. Stress symptoms among adolescents: The role of subjective psychosocial conditions, lifestyle, and self-esteem. J Adolesc 2011;34:987-96.
Starfield B, Riley AW, Witt WP, Robertson J. Social class gradients in health during adolescence. J Epidemiol Community Health 2002;56:354-61.
Evans GW, English K. The environment of poverty: Multiple stressor exposure, psychophysiological stress, and socioemotional adjustment. Child Dev 2002;73:1238-48.
Esterman K, Hedlund D. Comparing rural adolescents from farm and nonfarm families. J Res Rural Educ 1995;11:84-91.
Persike M, Seiffge-Krenke I. Competence in coping with stress in adolescents from three regions of the world. J Youth Adolesc 2012;41:863-79.
Steinberg L. Cognitive and affective development in adolescence. Trends Cogn Sci 2005;9:69-74.
Bouchey HA, Furman W. Dating and romantic experiences in adolescence. Blackwell Handbook of Adolescence. 2003. p. 312-29.
Furman W, Low S, Ho MJ. Romantic experience and psychosocial adjustment in middle adolescence. J Clin Child Adolesc Psychol 2009;38:75-90.
Davis MC, Matthews KA, Twamley EW. Is life more difficult on Mars or Venus? A meta-analytic review of sex differences in major and minor life events. Ann Behav Med 1999;21:83-97.
Washington TD. Psychological stress and anxiety in middle to late childhood and early adolescence: Manifestations and management. J Pediatr Nurs 2009;24:302-13.
Lazarus RS, Folkman S. Stress, Appraisal, and Coping. 1984. p. 456.
Hunter SC, Boyle JM. Appraisal and coping strategy use in victims of school bullying. Br J Educ Psychol 2004;74 (Pt 1):83-107.
Rudolph KD. Gender differences in emotional responses to interpersonal stress during adolescence. J Adolesc Health 2002;30 4 Suppl:3-13.