Skip to main content
Open AccessOriginal Article

Physical Health Complaints in Adolescents

Findings From the 2018 Brandenburg HBSC Study

Published Online:https://doi.org/10.1027/2512-8442/a000090

Abstract.Background: Some of the physical health complaints adolescents have, such as headaches and stomachaches, cannot be explained on a somatic level. It is unclear which psychological factors can explain these complaints: stress and social support are often discussed, but emotions rarely are. Aims: This cross-sectional study aims to use social support, stress, the tendency toward negative emotions, and health behaviors to predict physical health complaints in adolescents. Method: The 2018 HBSC (Health Behavior in School-aged Children) data from the German state of Brandenburg was analyzed via structural equation and path modeling (N = 3,068, age M = 13.05). Results: Results showed that the tendency toward negative emotions seems to be a better predictor for health complaints (β = .35) than stress (β = .17), and even better suited than social support (β = −.08) or health behavior (β = −.06 to β = .16). In the analysis of specific emotions (anger, sadness, and fear), correlations were low and between sadness and complaints they were highest (average β = .19). Limitations: The present cross-sectional study could not examine long-term outcomes. In addition, the results are limited to only a few physical complaints. Future long-term studies should examine multiple disease symptoms in adolescence. Conclusion: The investigated tendency toward negative emotions demonstrated promising results to better understand the relationship between psychological factors and physical health complaints. As negative emotions were particularly important in predicting physical health, prevention programs for adolescents should focus on dealing with negative emotions to improve their health.

References

  • Appelhans, B. M., & Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Review of General Psychology, 10(3), 229–240. https://doi.org/10.1037/1089-2680.10.3.229 First citation in articleCrossrefGoogle Scholar

  • Badenes, L. V., Prado-Gascó, V., & Barrón, R. G. (2016). Emotion awareness, mood and personality as predictors of somatic complaints in children and adults. Psicothema, 28(4), 383–388. https://doi.org/10.7334/psicothema2015.265 First citation in articleGoogle Scholar

  • Beelmann, A., & Lösel, F. (2006). Child social skills training in developmental crime prevention. Psicothema, 18(3), 603–610. First citation in articleGoogle Scholar

  • Bilz, L., Sudeck, G., Bucksch, J., Klocke, A., Kolip, P., Melzer, W., Ravens-Sieberer, U., & Richter, M. (2016). Schule und Gesundheit: Ergebnisse des WHO-Jugendgesundheitssurvey „Health Behaviour in School-aged Children“ [School and health: Results of the WHO Youth Health Survey]. Beltz/Juventa. First citation in articleGoogle Scholar

  • Braverman, M. T., Stawski, R. S., Samdal, O., & Aarø, L. E. (2017). Daily smoking and subjective health complaints in adolescence. Nicotine and Tobacco Research, 19(1), 102–110. https://doi.org/10.1093/ntr/ntw133 First citation in articleCrossrefGoogle Scholar

  • Chen, E., Brody, G. H., & Miller, G. E. (2017). Childhood close family relationships and health. American Psychologist, 72(6), 555–566. https://doi.org/10.1037/amp0000067 First citation in articleCrossrefGoogle Scholar

  • Cohen, S. (2004). Social relationships and health. American Psychologist, 59(8), 676–684. https://doi.org/10.1037/0003-066X.59.8.676 First citation in articleCrossrefGoogle Scholar

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404 First citation in articleCrossrefGoogle Scholar

  • Conner, T. S., & Feldmann Barrett, L. (2012). Trends in ambulatory self-report: The role of momentary experience in psychosomatic medicine. Psychosomatic Medicine, 74(4), 327–337. https://doi.org/10.1097/PSY.0b013e3182546f18 First citation in articleCrossrefGoogle Scholar

  • Danner, D. D., Snowdon, D. A., & Friesen, W. V. (2001). Positive emotions in early life and longevity. Journal of Personality and Social Psychology, 80(5), 804–813. https://doi.org/10.1037/0022-3514.80.5.804 First citation in articleCrossrefGoogle Scholar

  • Eminson, M. (2007). Medically unexplained symptoms in children and adolescents. Clinical Psychology Review, 27(7), 855–871. https://doi.org/10.1016/j.cpr.2007.07.007 First citation in articleCrossrefGoogle Scholar

  • Faller, H., & Lang, H. (2019). Medizinische Psychologie und Soziologie [Medical psychology and sociology]. Springer. First citation in articleCrossrefGoogle Scholar

  • Franken, U. (2004). Emotionale Kompetenz: Eine Basis für Gesundheit und Gesundheitsförderung (Doctoral dissertation) [Emotional Competence: A Base for Health and Health Promotion]. University of Bielefeld Archive. https://pub.uni-bielefeld.de/record/2303721 First citation in articleGoogle Scholar

  • Glasscock, D. J., Andersen, J. H., Labriola, M., Rasmussen, K., & Hansen, C. D. (2013). Can negative life events and coping style help explain socioeconomic differences in perceived stress among adolescents? BMC Public Health, 2(13), 532–544. https://doi.org/10.1186/1471-2458-13-532 First citation in articleCrossrefGoogle Scholar

  • Goodman, A., & Goodman, R. (2009). Strengths and Difficulties Questionnaire as a dimensional measure of child mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 48(4), 400–403. https://doi.org/10.1097/CHI.0b013e3181985068 First citation in articleCrossrefGoogle Scholar

  • Gross, J. T., & Cassidy, J. (2019). Expressive suppression of negative emotions in children and adolescents: Theory, data, and a guide for future research. Developmental Psychology, 55(9), 1938–1950. https://doi.org/10.1037/dev0000722 First citation in articleCrossrefGoogle Scholar

  • Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2018). Multivariate data analysis. Cengage Learning. First citation in articleGoogle Scholar

  • Haugland, S., & Wold, B. (2001). Subjective health complaints in adolescence – reliability and validity of survey methods. Journal of Adolescence, 24(5), 611–624. https://doi.org/10.1006/jado.2000.0393 First citation in articleCrossrefGoogle Scholar

  • Henry, J. P. (1989). The arousal of emotions: Hormones, behavior, and health. Advances, 6(2), 59–62. First citation in articleGoogle Scholar

  • Henry, J. P. (1992). Biological basis of the stress response. Integrative Physiological and Behavioral Science, 27(1), 66–83. https://doi.org/10.1007/BF02691093 First citation in articleCrossrefGoogle Scholar

  • Holt-Lunstad, J., & Smith, T. B. (2012). Social relationships and mortality. Social and Personality Psychology Compass, 6(1), 41–53. https://doi.org/10.1111/j.1751-9004.2011.00406.x First citation in articleCrossrefGoogle Scholar

  • Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), 1–20. https://doi.org/10.1371/journal.pmed.1000316 First citation in articleCrossrefGoogle Scholar

  • Hostinar, C. E., Sullivan, R. M., & Gunnar, M. R. (2014). Psychobiological mechanisms underlying the social buffering of the hypothalamic-pituitary-adrenocortical axis. Psychological Bulletin, 140(1), 256–282. https://doi.org/10.1037/a0032671 First citation in articleCrossrefGoogle Scholar

  • Hoyle, R. H. (2012). Handbook of structural equation modeling. Guilford Press. First citation in articleGoogle Scholar

  • Hu, L.-T., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424 First citation in articleCrossrefGoogle Scholar

  • Inchley, J., Currie, D., Cosma, A., Piper, A., & Spanou, G. (2018). Health Behaviour in School-Aged Children (HBSC) study protocol: Background, methodology and mandatory items for the 2017/18 survey. World Health Organization. First citation in articleGoogle Scholar

  • Izard, C. E. (2009). Emotion theory and research: Highlights, unanswered questions, and emerging issues. Annual Review of Psychology, 60(1), 1–25. https://doi.org/10.1146/annurev.psych.60.110707.163539 First citation in articleCrossrefGoogle Scholar

  • John, N., & Bilz, L. (2020). Kinder- und Jugendgesundheit in Brandenburg: Ergebnisse der HBSC-Gesundheitsstudie 2018 im Auftrag der WHO [Child and adolescent health in Brandenburg: Results from the 2018 HBSC Health Survey commissioned by WHO]. Pabst Science. First citation in articleGoogle Scholar

  • Jovic-Vranes, A. S., Vranes, B., Marinkovic, J., & Cucic, V. (2005). Adolescent substance abuse, the importance of family, school and peers. International Journal of Public Health, 50(2), 119–124. https://doi.org/10.1007/s00038-004-4014 First citation in articleCrossrefGoogle Scholar

  • Kao, S., Lai, K. L., Lin, H. C., Lee, H. S., & Wen, H. C. (2005). WHOQOL-BREF as predictors of mortality. Quality of Life Research, 14(6), 1443–1454. https://doi.org/10.1007/s11136-004-7709-9 First citation in articleCrossrefGoogle Scholar

  • Kinnunen, P., Laukkanen, E., & Kylmä, J. (2010). Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. International Journal of Nursing Practice, 16(1), 43–50. https://doi.org/10.1111/j.1440-172X.2009.01782.x First citation in articleCrossrefGoogle Scholar

  • Klein, E. M., Brähler, E., Dreier, M., Reinecke, L., Müller, K. W., Schmutzer, G., Wölfling, K., & Beutel, M. E. (2016). The German version of the Perceived Stress Scale. BMC Psychiatry, 16, 159–168. https://doi.org/10.1186/s12888-016-0875-9 First citation in articleCrossrefGoogle Scholar

  • Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford Press. First citation in articleGoogle Scholar

  • Kröner-Herwig, B., Morris, L., & Heinrich, M. (2008). Biopsychosocial correlates of headache: What predicts pediatric headache occurrence? headache, 48(4), 529–544. https://doi.org/10.1111/j.1526-4610.2007.00945.x First citation in articleCrossrefGoogle Scholar

  • Lazarus, R. S. (1993). From psychological stress to the emotions. Annual Review of Psychology, 44(1), 1–22. https://doi.org/10.1146/annurev.ps.44.020193.000245 First citation in articleCrossrefGoogle Scholar

  • Lazarus, R. S., & Folkman, S. (1987). Transactional theory and research on emotions and coping. European Journal of Personality, 1(3), 141–169. https://doi.org/10.1002/per.2410010304 First citation in articleCrossrefGoogle Scholar

  • Leys, C., Delacre, M., Mora, Y. L., Lakens, D., & Ley, C. (2019). How to classify, detect, and manage univariate and multivariate outliers, with emphasis on pre-registration. International Review of Social Psychology, 32(1), 1–10. https://doi.org/10.5334/irsp.289 First citation in articleCrossrefGoogle Scholar

  • Liu, Y., Wang, M., Tynjälä, J., Lv, Y., Villberg, J., Zhang, Z., & Kannas, L. (2010). Test-retest reliability of selected items of HBSC Survey Questionnaire in Beijing, China. BMC Medical Research Methodology, 10, 1–9. https://doi.org/10.1186/1471-2288-10-73 First citation in articleCrossrefGoogle Scholar

  • Lohbeck, A., Schultheiß, J., Petermann, F., & Petermann, U. (2015). Die deutsche Selbstbeurteilungsversion des “Strengths and Difficulties Questionnaire” [The German Self-Assessment version of the SDQ]. Diagnostica, 61(4), 222–235. https://doi.org/10.1026/0012-1924/a000153 First citation in articleLinkGoogle Scholar

  • McEwen, B. S. (2008). Central effects of stress hormones in health and disease. European Journal of Pharmacology, 583(2–3), 174–185. https://doi.org/10.1016/j.ejphar.2007.11.071 First citation in articleCrossrefGoogle Scholar

  • Mikolajczak, M., Avalosse, H., Vancorenland, S., Verniest, R., Callens, M., van Broeck, N., Fantini-Hauwel, C., & Mierop, A. (2015). A nationally representative study of emotional competence and health. Emotion, 15(5), 653–667. https://doi.org/10.1037/emo0000034 First citation in articleCrossrefGoogle Scholar

  • Miller, G. E., Chen, E., & Parker, K. J. (2011). Psychological stress in childhood and susceptibility to the chronic diseases of aging. Psychological Bulletin, 137(6), 959–997. https://doi.org/10.1037/a0024768 First citation in articleCrossrefGoogle Scholar

  • Moffitt, T. E. (2006). Life course persistent versus adolescence limited antisocial behavior. In D. CicchettiD. J. CohenEds., Handbook of developmental psychopathology (pp. 570–588). Wiley. First citation in articleGoogle Scholar

  • Mund, M., & Mitte, K. (2012). The costs of repression: A meta-analysis on the relation between repressive coping and somatic diseases. Health Psychology, 31(5), 640–649. https://doi.org/10.1037/a0026257 First citation in articleCrossrefGoogle Scholar

  • Niles, A. N., & O’Donovan, A. (2019). Comparing anxiety and depression to obesity and smoking as predictors of major medical illnesses and somatic symptoms. Health Psychology, 38(2), 172–181. https://doi.org/10.1037/hea0000707 First citation in articleCrossrefGoogle Scholar

  • Pandey, R., & Choubey, A. K. (2010). Emotion and health: An overview. Journal of Projective Psychology and Mental Health, 17(2), 135–152. First citation in articleGoogle Scholar

  • Pinel, J. P., Barnes, S. J., & Pauli, P. (2019). Biopsychologie [Biological psychology]. Pearson. First citation in articleGoogle Scholar

  • Prochaska, J. J., Sallis, J. F., & Long, B. (2001). A physical activity screening measure for use with adolescents in primary care. Archives of Pediatrics and Adolescent Medicine, 155(5), 554–559. https://doi.org/10.1001/archpedi.155.5.554 First citation in articleCrossrefGoogle Scholar

  • Ravens-Sieberer, U., Erhart, M., Torsheim, T., Hetland, J., Freeman, J., Danielson, M., Thomas, C., & The HBSC Positive Health Group. (2008). An international scoring system for self-reported health complaints in adolescents. European Journal of Public Health, 18(3), 294–299. https://doi.org/10.1093/eurpub/ckn001 First citation in articleCrossrefGoogle Scholar

  • Rein, G., Atkinson, M., & McCraty, R. (1995). The physiological and psychological effects of compassion and anger. Journal of Advancement in Medicine, 8(2), 87–105. First citation in articleGoogle Scholar

  • Salovey, P., Rothman, A. J., Detweiler, J. B., & Steward, W. T. (2000). Emotional states and physical health. The American Psychologist, 55(1), 110–121. https://doi.org/10.1037/0003-066x.55.1.110 First citation in articleCrossrefGoogle Scholar

  • Schubert, C. (2015). Psychoneuroimmunologie und Psychotherapie [Psychoneuroimmunology and psychotherapy]. Schattauer. First citation in articleGoogle Scholar

  • Shaw, T., Runions, K. C., Johnston, R. S., & Cross, D. (2018). Does the risk outweigh the benefits? Adolescent responses to completing health surveys. Journal of Research on Adolescence, 28(2), 412–426. https://doi.org/10.1111/jora.12343 First citation in articleCrossrefGoogle Scholar

  • Sinha, R., Lovallo, W. R., & Parsons, O. A. (1992). Cardiovascular differentiation of emotions. Psychosomatic Medicine, 54(4), 422–435. https://doi.org/10.1097/00006842-199207000-00005 First citation in articleCrossrefGoogle Scholar

  • Sood, S., Bakhshi, A., & Devi, P. (2013). An assessment of perceived stress, resilience and mental health of adolescents living in border areas. International Journal of Scientific and Research Publications, 3(1), 1–4. https://doi.org/10.1.1.299.3385 First citation in articleGoogle Scholar

  • Steptoe, A., & Vögele, C. (1986). Are stress responses influenced by cognitive appraisal? An experimental comparison of coping strategies. British Journal of Psychology, 77(2), 243–255. https://doi.org/10.1111/j.2044-8295.1986.tb01999.x First citation in articleCrossrefGoogle Scholar

  • Stice, E., Shaw, H., Bohon, C., Marti, C. N., & Rohde, P. (2009). A meta-analytic review of depression prevention in programs for children and adolescents. Journal of Consulting and Clinical Psychology, 77(3), 486–503. https://doi.org/10.1037/a0015168 First citation in articleCrossrefGoogle Scholar

  • Stock, C., & Badura, B. (1995). Fördern positive Gefühle die physische Gesundheit? [Do positive emotions promote physical health?] Zeitschrift für Gesundheitswissenschaften, 3(1), 74–89. https://doi.org/10.1007/BF02959947 First citation in articleCrossrefGoogle Scholar

  • Torsheim, B., & Wold, T. (2001). School-related stress, social support, and somatic complaints. Journal of Adolescence Research, 16(3), 293–303. https://doi.org/10.1177/0743558401163003 First citation in articleCrossrefGoogle Scholar

  • Van der Linde, R. M., Mavaddat, N., Luben, R., Brayne, C., Simmons, R. K., & Khaw, K. T. (2013). Self-rated health and cardiovascular disease incidence. PLoS One, 8(6), 1–8. https://doi.org/10.1371/jour-nal.pone.0103509 First citation in articleCrossrefGoogle Scholar

  • Veenhoven, R. (2008). Healthy happiness: Effects of happiness on physical health and the consequences for preventive health care. Journal of Happiness Studies, 9(3), 449–469. https://doi.org/10.1007/s10902-006-9042-1 First citation in articleCrossrefGoogle Scholar

  • Veiga, G., Oosterveld, P., Fernandes, J., & Rieffe, C. (2019). Validation of the Portuguese emotion awareness questionnaire for children and adolescents. European Journal of Developmental Psychology, 16(2), 215–224. https://doi.org/10.1080/17405629.2017.1344124 First citation in articleCrossrefGoogle Scholar

  • Watson, D., Clark, L. A., & Teilegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality & Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063 First citation in articleCrossrefGoogle Scholar

  • Webster-Stratton, C. H. (2000). How to promote children’s social and emotional competence. Paul Chapman. First citation in articleGoogle Scholar

  • Williams, E. J. (1959). The comparison of regression variables. Journal of the Royal Statistical Society: Series B, 21(2), 396–399. https://doi.org/10.1111/j.2517-6161.1959.tb00346.x First citation in articleGoogle Scholar

  • Yates, F., & Grundy, P. M. (1953). Selection without replacement from within strata with probability proportional to size. Journal of the Royal Statistical Society, 15(2), 253–261. https://doi.org/10.2307/2983772 First citation in articleGoogle Scholar

  • Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric properties of the Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 55, 610–617. https://doi.org/10.1023/A:1005109522457 First citation in articleCrossrefGoogle Scholar