Aims: The World Health Organisation five item Well-being index (WHO-5) has been used in many epidemiological studies to assess adolescent mental health, but cross-country comparisons of this instrument among adolescents are scarce, and no assessment of the invariance of the WHO-5 across countries among adolescent samples have been reported. The present study aims to evaluate whether the WHO-5 Well-being index is a valid measure for cross-country comparisons of adolescent mental health.

Methods: Using the 2018 Health Behaviour in School-aged Children study, we evaluated the measurement model and measurement invariance of the WHO-5 Well-being index. We used nationally representative samples of 11-, 13- and 15-year old adolescents (n = 74,071) from 15 countries and regions in Europe. Measurement invariance of the WHO-5 was assessed using a series (country, gender, and age) of multi-group confirmatory analysis (CFA). In addition, we evaluated convergent validity by testing the correlations with psychosomatic complaints, life satisfaction and self-rated health.

Results: Our results demonstrate that the WHO-5 Well-being index does not meet cross-national, gender and age measurement invariance. However, when removing the first item (“I have felt cheerful in good spirits.”) and examining the remaining four items (i.e., the WHO-4), the instrument met the partial scalar measurement invariance. Both the WHO-5 and WHO-4 were positively correlated with life satisfaction and self-rated health, and negatively correlated with psychosomatic complaints, although there were variations in their magnitude across countries and gender.

Conclusions: We discuss the implications of these results have when using WHO-5 Well-being Index (or WHO-4) for HBSC cross-national analyses.

Background: In the last two decades, adolescent mental health problems increased in many countries, although there also is considerable variation across countries in this respect. Currently, little is known about the national-level processes associated with time trends in adolescent mental health problems.

Objective: The current study investigated whether and to what extent several changes on the national level were associated with national-level changes in mental health problems. More specifically, we studied whether changes in country-level (1) schoolwork pressure, (2) family structure, (3) internet use, and (4) adolescent obesity explained changes in country-level mental health problems in 13- and 15-year-olds, for boys and girls separately.

Methods: Data from adolescents from 43 countries participating in the HBSC study from 2002-2018 were used. HBSC data were linked to three international data sources: the PISA study, WHO’s Global Health Observatory, and World Bank Open data. Three-level fixed effects models were adopted to study the research questions.

Results: Preliminary findings showed that national-level (1) increases in the proportion of boys and girls experiencing schoolwork pressure, (2) decreases in the proportion of boys and girls living with both parents, (3) increases in boys’ and girls’ average time spent on internet, and (4) increases in the proportion of boys and girls with obesity were associated with increases in the proportion of boys and girls reporting mental health problems. Associations for schoolwork pressure and obesity were stronger among girls than boys.

Conclusions: Findings suggest that changes on the national level contribute to changes in adolescents’ mental health problems.

Background: Adolescent health is influenced by factors from individual characteristics, immediate social contexts, conditions in their neighborhoods/communities, as well as from the wider social, cultural, and economic conditions in their geographic region. These multi-level influences that impact adolescents’ health have been conceptualised within the framework of ecological models.

Objective: This work aims to examine life satisfaction among adolescents through an ecological perspective, besides exploring sex, age, and countries differences.

Method: This study includes data from 39,247 students (aged 11-18) from six Mediterranean countries (Greece, Israel, Italy, Malta, Portugal, and Spain) that participated in the 2017/2018 edition of the Health Behaviour in School-aged Children (HBSC) study. Sociodemographic, health and health behaviours, as well as context variables were selected from the HBSC questionnaire.

Results: Being a boy, younger, with higher socioeconomic level, less psychological symptoms, frequent physical activity, daily fruit and vegetables consumption, not drinking alcoholic beverages, high family support, positive relations with teachers and school friends, and not been bullied, explained a 31% of adolescent life satisfaction. Stratified by countries, more similarities than differences were found. Moreover, boys and younger adolescents reported greater satisfaction with life and presented a different risk dynamic.

Conclusions: From a public health and a public policy perspective, relevant messages must address changeable behaviours. Being gender nor geographic life areas not easily changeable, there is a generalized need to decrease inequalities, by means of sustainable and multisectorial public policies, in order to better provide organized educational, health and local services to cope with developmental life challenges.

Objectives: It is well known that adolescent girls consistently report worse mental health outcomes than boys. This study quantitatively explored the reasons why such gender-based differences exist among young Canadians.

Methods: We examined reports from 11,373 young people (6,124 girls; 5,249 girls) who had responded to a 2018 national health promotion survey. Using causal mediation analyses and intersectionality theory, we examined factors that may underlie the emergence of these gender-based differences for indicators of depression, poor psychosomatic health, and diagnosed mental illness. Possible mediators included social supports within family and friends, engagement in problematic social media use, and overt risk-taking. Analyses were performed with the full sample and in specific high-risk groups.

Results: Higher levels of problematic (addictive) social media use and lower perceived levels of family support among girls accounted for a significant proportion of the gender difference in each of the mental health outcomes. More frequent engagement in overt risk-taking among boys was associated with a narrowing of gender-based differences between boys and girls. In few cases mediation effects were strongest in high-risk subgroups, particularly family support among those from the least affluent groups and problematic social media use among those in older grades and living without both parents.

Conclusion: Study findings point to the deeper, root causes of potential gender-based mental health inequalities that emerge during childhood. Contemporary focus on the impact of social media use on girls, overt risk-taking among boys, and social supports in both girls and boys, warrants study as the basis for public health and clinical interventions.