Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, 10691, Stockholm, Sweden.
Swedish Institute for Social Research (SOFI), Stockholm University, 10691, Stockholm, Sweden.
BMC Public Health. 2023 Sep 9;23(1):1754. doi: 10.1186/s12889-023-16505-x.
A non-negligible proportion of children grow up with problematic alcohol use in the family. Problematic familial drinking can be regarded as a stressor, and prior studies have consistently reported poorer mental health among adolescents who are exposed. However, it is also of relevance to identify modifiable protective factors which may buffer against stress-related ill-health in this group of adolescents. One context where such factors may be present is the school. The aim of this study is to examine the relationship between perceived problematic familial alcohol use and students' stress-related complaints, and specifically to explore if the school's degree of student focus can buffer against any such negative health consequences of problem drinking at home.
Data were drawn from four separate surveys, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS) conducted in 2014 and 2016 among 7,944 students (~ 15-16 years) and 2,024 teachers in 147 Stockholm senior-level school units. Perceived problematic familial alcohol use was measured by one item in the SSS. Stress-related complaints were captured by co-occurring somatic complaints and psychological distress, and reported by students in the SSS. The school's student focus was measured by an index based on teachers' ratings of four items in the STS. A set of covariates at the student and the school level were also included. Two-level binary logistic and linear regression models were performed.
Perceived problematic familial alcohol use was linked with an increased likelihood of reporting co-occurring somatic complaints as well as psychological distress. Cross-level interactions revealed that the association between perceived problematic familial alcohol use and co-occurring somatic complaints was weaker among students attending schools with stronger teacher-rated student focus. Regarding psychological distress, the association was weaker for students attending schools with intermediate or strong teacher-rated student focus, compared with those attending schools with weaker teacher-rated student focus.
The findings provide support for the assumption that favourable conditions in schools can buffer against negative health consequences of problematic conditions in the family, thus serving a compensatory role.
相当一部分儿童在家庭中存在问题性饮酒行为。问题性家庭饮酒可被视为一种应激源，先前的研究一致表明，暴露于这种环境中的青少年心理健康状况较差。然而，确定可改变的保护因素也很重要，这些因素可能缓冲这组青少年与应激相关的健康不良。存在这些因素的一个环境是学校。本研究旨在检验感知到的家庭饮酒问题与学生应激相关抱怨之间的关系，并特别探讨学校对学生的关注程度是否可以缓冲家庭饮酒对健康的负面影响。
数据来自于 2014 年和 2016 年在斯德哥尔摩的 147 所高级中学进行的四项独立调查，即斯德哥尔摩学校调查（SSS）和斯德哥尔摩教师调查（STS），共有 7944 名学生（约 15-16 岁）和 2024 名教师参与。感知到的家庭饮酒问题通过 SSS 中的一个项目进行测量。应激相关抱怨通过共病的躯体抱怨和心理困扰来捕获，并由 SSS 中的学生报告。学校对学生的关注程度通过基于教师对 STS 中四个项目的评分的指数来衡量。还包括了学生和学校层面的一组协变量。采用两水平二元逻辑回归和线性回归模型进行分析。
感知到的家庭饮酒问题与报告共病躯体抱怨以及心理困扰的可能性增加有关。交叉水平交互作用显示，在感知到家庭饮酒问题与共病躯体抱怨之间的关联在学生关注度较高的学校中较弱。对于心理困扰，与学生关注度较弱的学校相比，学生关注度处于中等或较强的学校，其关联较弱。
研究结果为这样一种假设提供了支持，即学校的有利条件可以缓冲家庭中问题状况对健康的负面影响，从而起到补偿作用。
