Mental well-being among Icelandic adolescents in the 10th grade measured by a short version of the Warwick–Edinburgh Mental Well-being Scale

Abstract

The importance of adolescents’ health and well-being has been an increasing issue in both public discourse and scientific research over the past years. In many international studies, a general trend of declining mental health in this age group has been observed. This has been met with a call to arms by the scientific community, emphasising more rigorous studies and implementation of evidence-based interventions and policies. However, given the predominant clinical emphasis of studies in this field, it is important to contemplate what mental health means in a more holistic sense. The World Health Organization (WHO) defines it as a state of well-being, in which people are aware of their own abilities, can successfully deal with the stressors of daily life, can succeed in their work and contribute to society. This definition emphasises that mental health is not merely the absence of disease or feeling good. Rather, it centres around the age-old question of the good life, that has been around from the time of Aristotle to modern day positive psychology; that is, whether it would be more beneficial to focus on the momentary joys of life (hedonia), or whether it is more important to do something worthwhile (eudaimonia). The hedonic aspect focuses on being happy, experience pleasure, and freedom from discomfort. The eudaimonic view is more centred on human possibilities, meaning and self-discovery. In the international Health Behaviour in School-Aged Children Study (HBSC), the largest of its kind in the world, mental wellbeing has been measured by various means. Growing concerns about the deterioration in mental health among adolescents led researchers from the Nordic countries to include more variables dealing with this topic in the 2017/2018 wave of the study, including a shorter version of the Warwick–Edinburgh Mental Well-Being Scale (SWEMWBS). This scale includes 7 items that are phrased in a positive manner and target positive aspects of mental health. Previous studies, including some within adolescent samples, have shown it to be reliable and valid. A total of 2,245 Icelandic students answered the questionnaire in 2017–2018. Of those, 1,1084 were boys (48.4%), 1,111 were girls (49.5%) and 48 (2.1%) defined their gender as “Other”. The mean score on the SWEMWBS for all participants was 24.8; 25.7 for boys, 24.2 for girls and19.8 for those that defined their gender as “Other”. In all analyses, the last-mentioned group had much worse scores than boys and girls. Also interesting in terms of gender was the fact that Icelandic boys scored significantly higher than girls on the SWEMWBS in all our analyses. The scores fell within the range of normal distribution as estimated by skewness and kurtosis values. A strong correlation was found between both the total score on SWEMWBS and its individual items, and other measurements that had previously been used to assess wellbeing in the HBSC- -study, such as the Cantril scale, self-rated health and the HBSC Symptom Checklist. It was clear, though, that the SWEMWBS scores did not represent exactly the same phenomena as the previously used measures. Background variables such as family financial status, country of birth, and relations with parents, school and friends, all influenced the distribution of SWEMWBS scores. Adolescents coming from poorer families, born outside of Iceland, and with worse relations with parents, school and friends, scored consistently and significantly lower on the SWEMWBS than their peers. We conclude that the scores from the current study of the shorter version of the Warwick–Edinburgh Mental Well-Being Scale, are a valid and valuable addition to research measures focusing on adolescent health.