Spain: social contexts and psychological adjustment in Spanish adolescents

198 Editorial note Two case studies were presented by Spain through the WHO/HBSC Forum 2007 process: from the Autonomous Community of Andalusia; and from Alcalá de Henares, Autonomous Community of Madrid. These are preceded by an introductory section that focuses on analysis of HBSC data and describes the national policy context. Editors wish to acknowledge Begoña Merino Merino, Chief, Department of Health Promotion, Ministry of Health and Consumer Affairs, Spain, for her collaboration in enabling Spain’s contribution to the Forum process. Spain: social contexts and psychological adjustment in Spanish adolescents Carmen Moreno¹, Francisco Rivera², Pilar Ramos¹, Victoria Muñoz-Tinoco¹, Inmaculada Sánchez-Queija³, Carmen Granado-Alcón¹. ¹ Department of Developmental and Educational Psychology, University of Seville, Seville. ² Department of Behavioural Sciences, University of Huelva, Huelva. ³ Department of Developmental and Educational Psychology, National University of Distance Education (UNED), Madrid. Executive summary The HBSC survey carried out in the spring of 2006 had access to 21 811 adolescent schoolboys and schoolgirls between 11 and 18 years of age. They came from various regions, belonged to families with a range of purchasing power and attended schools in both the private and public sectors. This study presents the most signifi cant results regarding adolescent social relationships and mental health. The results clearly demonstrate that there is a relationship between adjustment changes and age in adolescence. As adolescents mature, fi ghts decrease, accompanied by decreases in ease of communication with their father and mother, parental supervision, enjoyment of school, school performance and satisfaction with life. Increases are seen in diffi culties associated with psychological adjustment. In addition, the variable of gender indisputably produces social inequalities. Girls are more likely to be closely supervised by parents (especially mothers), to be successful academically and enjoy secondary school. Girls are also more likely to have support from a close relationship with a special friend (usually a girlfriend) and are less likely to be involved in fi ghts or abuse (as either victims or aggressors). It is also true, however, that girls are more likely to have problems in communicating with their father, are less satisfi ed with their relationships in the family, demonstrate lower levels of self-esteem and satisfaction with life and, in general, have more problems in terms of emotional adjustment. The data demonstrate that, within the population of adolescent schoolchildren in Spain, there is one group that is particularly vulnerable: immigrants. More problems were found in the emotional development of this group (less satisfaction with life and more problems of psychological adjustment) and a signifi cant number of immigrants have problems in their relationships with peers (a particularly important fi nding due to the importance at this age of feeling accepted and belonging). It is also more probable that they do not have a special friend (someone who acts as a confi dant and a key support) and are more involved in fi ghts and abuse (as both victims and aggressors). A signifi cant fi nding, however, was their evaluation of school. Immigrants have a very positive perception of their academic performance and are also the group that most enjoys being at school. This latter fi nding calls attention to the need for schools to actively work to improve the social integration of immigrants. The data also demonstrate that a signifi cant proportion of differences in adolescent mental well-being are associated with socioeconomic status. Adolescents of families with lower purchasing power are, for example, more likely to have selfperceptions of problems in communicating with both parents, have less parental supervision and report less satisfaction with relationships within their family. It is these same adolescents who also indicate that they have lower academic achievement, more problems having a best friend, less satisfaction in their relationships with peers, less satisfaction with life and lower self-esteem, in addition to experiencing more diffi culties in emotional adjustment in general. Differences by region were not particularly signifi cant. Nevertheless adolescents in the region of Madrid tended to be more supervised (especially by the father), had better communication with their mother and father (especially from the latter) and 199 Spain The HBSC study in Spain The data on Spanish adolescents presented in this study have been taken from the last two HBSC surveys, completed in 2002 and 2006. These were made possible through a Collaboration Agreement between the Ministry of Health and Consumer Affairs (General Public Health Offi ce) and the University of Seville. As established by international methodological guidelines, a representative sample of adolescent Spanish schoolchildren aged 11, 13 and 15 was studied in 2002 and 2006. Samples of 17-year-olds and adolescents in the intermediate ages (12, 14 and 16) were also incorporated as a national option. Consequently, the Spanish sample in 2006 consisted of a total of 21 811 adolescents ranging from 11 to 18 years of age (Table 1). The 2006 sample was somewhat larger than that obtained in 2002 (13 552 adolescents) due to the fact that a randomized, multiphase sample was taken. This allowed an independent representative sample to be obtained for each of Spain’s 18 regions. Since this study focuses on the total national data and, specifi cally, those of the regions of Andalusia and Madrid, data referring to the samples taken from these two regions have been included in Table 1. Andalusia and Madrid have welldifferentiated socioeconomic characteristics, with Andalusia being below the national average income per capita and Madrid being above. Table 1 Total make-up of the Spanish HBSC 2006 national sample and of two regional samples (Andalusia and Madrid) Age Girls Boys Total Income per capita (*) Total Spanish sample 11ï12 2 884 2 985 5 869 €22 152 13ï14 2 748 2 751 5 499 15ï16 2 801 2 932 5 733 17ï18 2 065 2 645 4 710 Total 10 498 11 313 21 811 Andalusia 11ï12 241 254 495 €17 251 13ï14 216 216 432 15ï16 239 245 484 17ï18 123 192 315 Total 819 907 1 726 Madrid 11ï12 125 132 257 €28 850 13ï14 130 153 283 15ï16 184 154 338 17ï18 95 79 174 Total 534 518 1 052 *National Institute of Statistics, 2006. Below is a synopsis of some of the most signifi cant results obtained in relation to psychological adjustment and development in social contexts. More details of the study can be found in the complete reports (1–3). were particularly satisfi ed with this aspect of the relationship with their parents. It was also in Madrid, however, that more fi ghts and episodes of abuse among adolescents were found. In Andalusia, key fi ndings include high satisfaction in communication with siblings and family relationships (including the relationships between siblings and among parents as a couple). These adolescents also demonstrated the most satisfaction with life. Explaining these differences would require the analysis of a signifi cant number of factors that would exceed the scope of this study, but differences in socioeconomic status certainly play a role in the differences found by region. 200 Positive health Life satisfaction Age was clearly associated with adolescents’ life satisfaction. As age increased, satisfaction with life decreased in both boys and girls. The decrease was particularly noticeable between the ages of 11 and 13 in both. Gender also played an important role; although 11-year-old girls expressed a higher level of satisfaction than did boys of the same age, girls systematically demonstrated lower scores than boys from that age onwards. Differences were also associated with family purchasing power (adolescents from the most affl uent families demonstrated greater life satisfaction) and with immigrant status (immigrant adolescents recorded lower scores). By region, Andalusian adolescents scored above the national average and those from Madrid scored slightly below (Fig. 1). Fig. 1 Average scores given by adolescents to the question: “Here is a picture of a ladder. The top of the ladder, ‘10’, is the best possible life for you, and the bottom, ‘0’, is the worst possible life for you. In general, where on the ladder do you feel you stand at the moment?” 7 Total Spain 2006 Total Madrid Total Andalusia FAS High FAS Medium FAS Low Native Spaniard Immigrant Girl 17-18 year-old Girl 15-16 year-old Girl 13-14 year-old Girl 11-12 year-old Boy 17-18 year-old Boy 15-16 year-old Boy 13-14 year-old Boy 11-12 year-old 8910 Life satisfaction Score 7.28 7.38 7.73 8.84 7.43 7.65 7.97 8.65 8.06 7.84 7.49 7.87 7.82 8.01 7.88 7.72 201 Spain Psychological adjustment Gender, age, family purchasing power and native/immigrant status were important variables in psychological adjustment (Fig. 2), with very similar results being found in relation to self-esteem (Fig. 3). Boys demonstrated better levels of well-being than girls of all ages, especially from 13 years onwards, but both boys and girls recorded poorer adjustment as adolescence advanced. Adolescents from families with better economic resources had higher scores for well-being, while immigrants (as opposed to native Spaniards) appeared to have more problems in this area. There were no signifi cant differences by region. Fig. 2 Average score of adolescents with different sociodemographic characteristics for psychological well-being (scores on the Mental Health Index, Kidscreen: maximum value = 100, minimum = 0) Source: Ravens-Sieberer et al. (4) 40 Total Spain 2006 Total Madrid Total Andalusia FAS High FAS Medium FAS Low Native Spaniard Immigrant Girl 17-18 year-old Girl 15-16 year-old Girl 13-14 year-old Girl 11-12 year-old Boy 17-18 year-old Boy 15-16 year-old Boy 13-14 year-old Boy 11-12 year-old 50 60 Psychological adjustment 42.43 43.86 45.84 52.6 44.94 46.32 48.54 53.31 48.05 46.99 45.18 47.12 47.15 47.28 47.2 45.92 Score 202 2 Total Spain 2006 Total Madrid Total Andalusia FAS High FAS Medium FAS Low Native Spaniard Immigrant Girl 17-18 year-old Girl 15-16 year-old Girl 13-14 year-old Boy 17-18 year-old Boy 15-16 year-old Boy 13-14 year-old 3 Self-esteem Score 2.38 2.33 2.41 2.57 2.57 2.55 2.52 2.44 2.38 2.46 2.44 2.47 2.46 2.46 Fig. 3 Measurement of the self-esteem of Spanish adolescents according to different sociodemographic characteristics (values: 1 = low, 2 = medium, 3 = high) Source: Rosenberg (5) The family context Family structure Just over 83% of the households of Spanish adolescents interviewed in 2006 were biparental, with 10.6% being monoparental and 3.4% being reconstituted. The remaining 2.7% of adolescents lived in diverse family circumstances, such as with stepmothers or stepfathers, with grandparents as main caregivers, in foster homes, with siblings or in other types of households. The 2006 data show that family structure in Spain has changed since 2002, mostly due to a decrease in the percentage of biparental households from 85.9% to 83.3%. Data collected in 2006 show that Andalusia maintained a higher biparental percentage than the national average (87.1%), while the region of Madrid was lower (80.4%). The average number of adults in the households of Andalusian adolescents was the same as the national average (2.06 adults), while the average number of children was greater (2.54 compared to 2.33 national). Both values in Madrid were below the national average (1.99 adults and 2.23 children). An average of 4.22 people lived together in a household in Madrid, while the average household in Andalusia had 4.6 people; the national average was 4.39. 203 Spain Communication with parents Data on the ease with which adolescents communicated with their parents were similar between 2002 and 2006. The 2006 data seem to indicate a slight improvement in communication with both parents, but general trends established in 2002 remained unchanged. These are: • self-perception of ease of communication with both parents decreases as age increases, although ease of communication with the mother is always higher; and • boys and girls do not differ in their perceptions regarding ease of communication with mothers, but boys clearly indicate that they fi nd it easier to communicate with fathers. Fig. 4 shows the perceived ease with which adolescents communicated with a range of signifi cant people. Focusing on the data from 2006, there were no appreciable differences between the two regions with regard to communication with friends, but differences did appear in relation to communication with parents. Adolescents in Madrid reported that they found it easier to communicate with the father (66.8% claiming it was “very easy” to talk to their father, against 59.7% in Andalusia and a national average of 57.8%), while those in Andalusia reported a better level of communication with older siblings (71.3% for older brothers and 81% for older sisters; the respective fi gures for Madrid were 69.4% and 79.6%, and for Spain 67.2% and 77.5%). The data indicate that while mothers continue to play a signifi cant role in the lives of adolescents, peers (especially best friends) are of key importance. Older siblings are also an important source of support, especially when the older sibling is a sister. Parental supervision Answers to questions about mothers’ and fathers’ knowledge of the details of adolescents’ lives were similar in 2002 and 2006: • adolescents, especially adolescent girls, felt more supervised by mothers than fathers • maternal and paternal supervision ebbed as adolescence advanced. Fig. 4 Adolescent responses (“Easy” or “Very Easy”) to the question: “How easy do you fi nd it to talk to the following people about things that really worry you?” National data from 2002 and 2006, and regional data from 2006 (Andalusia and Madrid) Note: The percentages were calculated once those subjects who replied “I don’t have/don’t see that person” were eliminated. Mother 80.1 80.0 82.8 84.5 100 90 80 70 60 50 40 30 Father Older brother Older sister Best friend Friends of the same sex Friends of the opposite sex Total Spain 2002 Total Spain 2006 Andalusia 2006 Madrid 2006 57.8 62.1 59.7 66.8 67.2 71.1 71.3 69.4 77.5 79.7 81.0 79.6 92.2 92.7 92.9 93.1 85.9 86.8 88.0 88.1 63.0 64.6 64.0 62.1 Percentage 204 The latter result deserves further analysis. It is important that adolescents are supervised by parents to prevent risky behaviours, but it is also important that parents know how to allow their children more freedom so they can develop their sense of independence. External paternal control is subsequently gradually replaced by internal control mechanisms; in other words, as children grow, adults reduce their supervision. The 2006 data showed that children from families with higher purchasing power indicated that both their fathers and mothers knew more about them than did adolescents from families with lower purchasing power. This was also the case with those born in Spain compared to adolescents and parents who were born in another country. There were no signifi cant regional differences between what mothers in Andalusia and Madrid knew about their offspring compared to the national average, but fathers from the region of Madrid knew more about their children than the national average, while those from Andalusia were below the average. Fig. 5 Percentage of adolescents who responded “It’s OK” to the question: “What would you like to change in your family?” The relation between my mother and my father Arguments with my father Arguments with my mother Affection shown by my father Affection shown by my mother Communication with my father Communication with my mother The relation I have with my brothers/sisters or with one of them Total Spain 2006 Andalusia 2006 Madrid 2006 66.6 72.8 70.7 69.3 65.1 66.3 82.0 77.2 79.4 50.5 51.3 54.7 73.4 80.0 74.4 50.1 56.9 52.2 43.4 44.0 42.9 45.1 45.0 44.8 0 10 20 30 40 50 60 70 80 90 Percentage 205 Spain Perception of aspects of family life that need to be improved Adolescents felt particularly satisfi ed with (in order of importance): • affection from, and communication with, their mothers • the relationship their father and mother have with each other. The areas in which they want their families to improve are (in order of importance): • arguments with the father • arguments with their mother • their relationship with their siblings (or some of them) • communication with, and affection from, their father. When examined by region, Andalusian adolescents were satisfi ed with their relationship with siblings and the relationship they perceived their fathers and mothers had with each other, while those from Madrid demonstrated satisfaction with affection from and communication with both their father and mother (Fig. 5). Global satisfaction with family relationships Data revealed that adolescents’ satisfaction with their family environment was related to age (as they matured, satisfaction decreased), gender (boys reported more satisfaction than girls), family purchasing power (adolescents from more affl uent households tended to be more satisfi ed), whether they were native Spaniards or immigrants (the former reported more satisfaction) and, to a lesser degree, the region in which the adolescent matured (adolescents from Madrid were below the national average in this variable and Andalusians were above) (Fig. 6). The academic context Academic achievement by girls (based on adolescents’ self-perception of how their teachers felt about them) was higher at all ages, but it decreased with age in both girls and boys. Academic performance tended to improve according to the purchasing power of individuals’ families. Regional differences in performance were seen, with Andalusians performing above adolescents from Madrid and the national average. Immigrant adolescents had better results than those from the native population and their enjoyment of school was particularly striking: immigrants reported the greatest satisfaction with school, after 11-year-old girls and boys (in that order) (Fig. 7). The peer context Having a special friend Adolescents, particularly girls, tended to identify with an especially important fi gure of support as they matured. It was more likely that those from families with higher purchasing power would have a best friend (97.3% of those scoring high on the FAS, against 92% scoring “medium” and 89% “low”). The most important differences, however, could be found in comparisons between those born in Spain and those who had emigrated from another country and had foreign parents: 92.6% of native Spaniards reported that they had a special friend, against only 79.6% of immigrants. Satisfaction with the peer group Girls and boys of all ages showed similar levels of satisfaction in their relationships with peers, with all groups demonstrating a similar decrease in the level of satisfaction with increasing age. While there were no appreciable differences in this topic by region, differences in satisfaction were seen in relation to family purchasing power (with adolescents from the most affl uent families being most satisfi ed) and by immigrant status (immigrant adolescents were less satisfi ed). 206 Fig. 6 Average scores to the question: “How satisfi ed are you with the relationships in your family?” (0 = “In my family, our relationships are very bad”; 10 = “In my family, our relationships are very good”) 7 Total Spain 2006 Total Madrid Total Andalusia FAS High FAS Medium FAS Low Native Spaniard Immigrant Girl 17-18 year-old Girl 15-16 year-old Girl 13-14 year-old Girl 11-12 year-old Boy 17-18 year-old Boy 15-16 year-old Boy 13-14 year-old Boy 11-12 year-old 8910 In general, how satisfied are you with the relationships in your family? 7.81 7.91 8.21 9.01 8.08 8.21 8.51 9.02 8.60 8.31 7.90 8.31 8.21 8.41 8.20 8.42 Satisfaction score Fights and abuse among peers There were clear gender differences in relation to fi ghts with peers, with males being more likely to become involved in a fi ght (13ï14-year-old boys reported being involved in 1.07 fi ghts in the last year, while girls of the same age reported 0.53). Age also played an important role, with involvement in fi ghts decreasing as age increased. Family purchasing power did not appear to be associated with fi ghts, but immigrant status did; adolescents from immigrant families were the group most likely to be involved in physical fi ghts (0.81 in the past year, against 0.55 for native Spaniards). Region was associated with participating in fi ghts to a lesser degree, but adolescents from Madrid were involved in more fi ghts in the last year (0.68) than those from Andalusia (0.54) and the Spanish average (0.56). Peer abuse occurred most frequently among males. Adolescent males reported that abusive behaviour reached a peak at the age of 13, and then declined. There was also a clear decrease with age in relation to being a victim, a feature that was also