Academic journal article Iranian Journal of Psychiatry

Mental Health Changes and Its Predictors in Adolescents Using the Path Analytic Model: A 7-Year Observational Study

Academic journal article Iranian Journal of Psychiatry

Mental Health Changes and Its Predictors in Adolescents Using the Path Analytic Model: A 7-Year Observational Study

Article excerpt

Psychiatric diseases may lead to several complications in adolescents' people. Psychiatric disorder is ranked second in terms of disease burden based on results of the national burden of disease, and Bushehr provinces had a large rate (1).

In the recent decades, previous studies on the mental health suggested that the prevalence of psychological symptoms among adolescents in Bushehr province is higher compared to other areas of Iran (2-3). This prompted the need to clarify the factors that influence psychiatric symptoms in Bushehr province. Despite the conducted studies (3-6), there is not substantial support for the assumption that the more use of the internet, TV-watching and phone conversation with friends are associated with mental health symptoms in adolescents' later life. It is known that subjective mental health is a complex and multidimensional concept that is not easy to define. Consequently, it will be difficult to determine the factors associated with mental health. On the other hand, the previous studies have used single-item measures (2-3). Therefore, identifying and recognizing those factors whose effect may change over time such as using the internet, TV, phone conversation with friends, physical activity level and previous mental health status may hardly predict mental health in later years. In addition, most studies on the association between mental health and cultural-socio-economic factors have been cross-sectional (2-7). In other words, cohort studies are useful for disentangling temporal relations, but not necessarily for addressing causality. Several studies have found that the majority of children who are exposed to violence, display psychological symptoms (7-9). The early detection of causal model of mental health in adolescence is of prime importance, because these years are critical for the onset and development of later disturbances (10-16).

In this study, we defined mental health on the basis of four different dimensions of general health: anxiety symptoms, depression symptoms, somatic symptoms and social dysfunction. The main objective of this study was to evaluate the association between using internet, TV watching, phone call, physical activity level and gender on mental disorder symptoms in 2005 and 2012, and also compare predictors of mental disorder symptoms in 2005 and 2012 among Iranian's southern students graded (9-11) For the purpose of the study direct and indirect effects of predictors on the mental health of the participants were examined using the path analysis model. The exogenous and endogenous variables were determined based on the literature (7-18), our own previous studies (2-3) and the preliminary analyses of the data of the present study.

Material and Methods

Sample and Data Set

Data were collected as a part of the Mental Health Study (MHS), which consisted of a series of cross-sectional and prospective studies on mental health of high-school students of Bushehr province (2). The MHS was conducted on 2697 high-school students aged 15-19 years in 2005.Of the participants, 113 dropped out of the study because they did not respond to the questionnaires. Therefore, the final data set included a sample of 2584 high school students in 9th -11th grade across 8 counties in south of Iran, Bushehr province. The sampling method of the MHS was multi-stage. In the first stage, 51 high schools were proportionally selected based on sex ratio and the number of schools in counties; in the second-stage, some grade of 9-11 were selected randomly, separately; and in the third-stage, the students were selected randomly from name recorded in each class. This data set has been used to examine the predictors of mental health among adolescents in south of Iran. At the baseline (in 2005), 45.6% of the participants were female (n = 1178) and 54.4% were male (n = 1406). About 30% of the available female (n = 353) and male participants (n = 422) were also selected for the follow-up (2012) using convenience sampling method. …

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