International Journal of Public Health

, Volume 61, Issue 4, pp 505–512 | Cite as

Does self-efficacy mediate the association between socioeconomic background and emotional symptoms among schoolchildren?

  • Charlotte Meilstrup
  • Lau Caspar Thygesen
  • Line Nielsen
  • Vibeke Koushede
  • Donna Cross
  • Bjørn Evald Holstein
Original Article



Emotional symptoms are widespread among adolescents with the highest prevalence among lower socioeconomic groups. Less is known about why and how to reduce this inequality but personal control, e.g., self-efficacy may be crucial. This study examines whether self-efficacy is a mediator in the association between occupational social class (OSC) and emotional symptoms.


Data stem from the cross-sectional Health Behavior in School-aged Children-Methodology Development Survey 2012 (HBSC-MDS) conducted among 11–15-year old schoolchildren in two Danish municipalities. Participation rate was 76.8 % of 5165 enrolled schoolchildren, n = 3969.


Low OSC is associated with higher odds of daily emotional symptoms and low selfefficacy. Schoolchildren with low self-efficacy have higher odds for daily emotional symptoms. We find a strong and statistically significant direct effect between low OSC and daily emotional symptoms (OR = 1.55, 95 % CI: 1.33; 1.84) and a borderline statistically significant indirect effect of self-efficacy [OR = 1.17 (0.99; 1.38)].


Socioeconomic inequality in emotional symptoms exists. This inequality is partly explained by socioeconomic inequality in self-efficacy. Promotion of personal competences like self-efficacy may reduce emotional symptoms among all socioeconomic groups, thereby reducing socioeconomic inequalities in emotional symptoms.


Mental health Adolescents Socioeconomic inequality Self-efficacy Emotional symptoms Mediation analysis 



We would like to acknowledge the Nordea Denmark Foundation (02-2011-0122) for funding the Health Behavior in School-aged Children Study (HBSC) 2012. The funders have had no influence on study design, data collection, analyses, and interpretation of results or writing of the manuscript.


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • Charlotte Meilstrup
    • 1
  • Lau Caspar Thygesen
    • 1
  • Line Nielsen
    • 1
  • Vibeke Koushede
    • 1
  • Donna Cross
    • 2
  • Bjørn Evald Holstein
    • 1
  1. 1.National Institute of Public HealthUniversity of Southern DenmarkCopenhagen KDenmark
  2. 2.Telethon Kids InstituteSubiacoAustralia

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