Cross-sectional time trends in psychological and somatic health complaints among adolescents: a structural equation modelling analysis of ‘Health Behaviour in School-aged Children’ data from Switzerland
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This study examined cross-sectional time trends in health complaints among adolescents living in Switzerland, including differences between population subgroups and sources of differential response to items.
Swiss data were analysed from the Health Behaviour in School-aged Children (HBSC; including 11–15 years old) from 1994 (n = 7008), 1998 (n = 8296), 2002 (n = 9066) and 2006 (n = 9255). Structural equation modelling was used to assess (1) the structure of the HBSC Symptom Checklist (HBSC-SCL; questionnaire, which asks about the frequency of eight health complaints) and (2) associations between the HBSC-SCL with year of data collection and demographic characteristics of the participants.
Two correlated factors fitted the data better than a single factor. The psychological factor included the items ‘feeling low,’ ‘irritability and bad temper,’ ‘nervousness’ and ‘difficulties in getting to sleep,’ and the somatic factor the items ‘headache’, ‘backache’, ‘stomach ache’ and ‘dizziness’. Relative to 1994, lower levels of psychological health complaints were experienced in 1998, 2002 and 2006. However, the changes were only minor. In contrast, somatic health complaints increased monotonically over the years of the survey. Experiencing psychological and somatic health complaints was more pronounced with age among females relative to males and was associated with living in particular language regions of Switzerland.
Different cross-sectional time trends were identified for the psychological and somatic latent variables, indicating that both factors should be investigated when studying period effects.
KeywordsHealth Behavior in School-aged Children (HBSC) Health complaints Time trends Structural equation modelling Differential item functioning
The authors wish to acknowledge all the people who were responsible for the HBSC surveys conducted in Switzerland: Yann Le Gauffey in 1994 , Béatrice Janin Jacquat in 1998 , Holger Schmid in 2002 and 2006 [16, 17] and Marina Delgrande Jordan in 2006 . We would also like to thank Charlotte Eidenbenz, Natalia Estévez and Ivan Lamorte for their valuable evaluation regarding language differences in items of the HBSC-SCL and Stefan Cvetkovski for his methodological input. Michelle Dey is supported by a fellowship (P2ZHP1_148710) from the Swiss National Science Foundation.
Conflict of interest
The authors declare that they have no conflicts of interest.
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