Coping Style, Health-risk Behaviors And Sub-health Among Young People

Objectives The purpose of the present study was to determine the dimensionality of the Trait Coping Style Questionnaire (TCSQ), and to evaluate the reliability and validity of TCSQ. The interrelationships between the coping style, health-risk behaviors and the influence on sub-health in adolescents would be further examined.Methods A total of 7 104 students were selected by cluster sampling who came from two colleges (from freshmen to junior), three middle schools (from grade one to grade six) in urban area and three middle schools (from grade one to six) in suburb in Bengbu. Three hundreds and thirty one students were re-tested with the TCSQ during two weeks interval. The internal consistency reliability of the TCSQ was assessed by Cronbach's alpha coefficient. Test-retest stability was evaluated using Paired t-test and Pearson correlations. Factor Analysis was applied to assess construct validity. Questionnaire surveys were carried out on 17 622 students from eight selected cities. Two classes were selected in grade 1 and 2 from middle schools, high schools and universities. TCSQ, Multidimensional Sub-health Questionnaire of Adolescents (MSQA), Multi-dimensional Life Events Rating Questionnaire for Middle School Students (MLERQ) are administered, and the information relating the suicidal ideation and behaviors within one year, self-injurious behaviors, tobacco and alcohol use within one month, physical activity intensity within one year was also collected. Chi-square test was used to compare the rates of coping style status, suicidal ideation and behaviors, self-injurious behaviors, tobacco and alcohol use and these indexes by various numbers of coping style in adolescents. Pearson's correlation analysis was used to test the relation between coping style and stressful life events and sub-health symptoms. Linear Regression analysis was used to analyze the mediating effect of coping style. Results The results of exploratory factor analysis showed that 2 factors were extracted and the cumulative common variance was 40.5%. Each factor included 10 items, which is classified as negative and positive. The exploratory factor analysis was carried out on the negative coping style. Two factors were extracted and the cumulative common variance was 49.3%. Factor 1 was depression and factor 2 was withdrawal. There is no statistical significance for positive factors. The test-retest reliability coefficient and Cronbach's alpha coefficient were 0.69 and 0.78, respectively. Total-to-dimension correlations coefficient ranged from 0.72 to 0.77 and total-to-item correlations coefficient ranged from 0.19 to 0.47. AMOS 7.0 software were employed to perform confirmatory factor analysis, which indicated that the values of GFI, NFI, RFI, CFI and RMSEA were 0.93,0.86,0.84,0.87and 0.07, respectively.Adolescents who had withdrawal coping style were inclined to have the health-risk behaviors of smoking, alcohol use, drunkenness, Internet addiction and lower level of physical activity. The significant difference displayed in alcohol use, internet addiction and low intensity physical exercise of the adolescents who selected depression coping styles, rates of the behaviors in high-score groups were 15.7%, 31.8% and 38.6% respectively, and the differences were significant (P<0.05), while the difference of high intensity physical exercise was not statistically significant(P>0.05). The detection rate of suicide ideation, suicide plan, suicide behaviors and self-injurious behaviors among adolescents was simultaneously increasing with the scores of depression and withdraw coping styles, in addition the difference between groups was significant(P<0.01). The rates of physical and psychological sub-health symptoms among groups had significant difference (P<0.05), furthermore the scores of depression and withdrawing coping styles was simultaneously increasing with the detection rates of various symptoms. Mediating effect test results showed that depression and withdrawal coping styles played partial mediating effect on relation between stressful life events and the sub-health. Conclusions The TCSQ have the credibility, effectiveness and sensitivity that could be served as an assessing instrument to evaluate the coping style of adolescents. And 2 factors could be extracted from negative coping style, which can be classified as depression and withdrawal coping styles, respectively. Sub-health, Suicidal ideation and behaviors, self-injurious behaviors, tobacco and alcohol use are common problems in Chinese adolescents. The negative coping style is statistically related with the psychosocial and behavior problems.