Improving Positive Mental Wellbeing among Adolescents ... - medIND

DELHI PSYCHIATRY JOURNAL Vol. 15 No.1 APRIL 2012 

Review Article 

Improving Positive Mental Wellbeing 

among Adolescents: Current need 

“I am stressed out” is a phrase that has been 

echoed by teens down through the ages. The level 

of stress experienced by teens on a daily basis has 

been described in lay and professional literature. 

Adults often underestimate this level of stress and 

may not always be cognizant of the potential 

consequences of stress on teens and young adults. 

This lack of appreciation of the stress experienced 

by adolescents may be partially related to a lack of 

awareness of the sources of stress in teen life, the 

changing nature of stressors through time, the everevolving 

complexities of adolescent life, and the 

tendency for adults to minimize their own personal 

stress during the teen years or compare their teen 

years to the experiences of others. Physiological 

development, cognitive differences, pubertal 

changes, immature coping mechanisms, slower 

recovery from stressful events, and lack of 

experience in dealing with stress may intensify the 

stressful events experienced by adolescents 1 . 

Teens can experience a spectrum of stresses 

ranging from ordinary to severe 2 . Stress has been 

associated with a variety of high-risk behaviors, 

including smoking, suicide, depression, drug abuse, 

behavioral problems, and participating in high-risk 

sexual behaviors 3,4 . In addition, long-term exposure 

to stress is associated with a variety of chronic 

psychological and physical illnesses. High-risk 

teens, or those who live in social disadvantage, may 

be at increased risk for illness related to chronic 

exposure to stress, discrimination, stigma, and a 

“harsh social environment” 5 . It has also been 

purported by the researchers that assessing 

adolescent stressors and the impact of stress is the 

first step in the prevention and treatment of its 

associated chronic diseases 6 . 

22 

LR Anuradha 1 , Yagnik 2 , Vibha Sharma 3 

1,2 Department of Psychology, S.P. University, Vallabh Vidyanagar (Gujarat) 

3 Department of Clinical Psychology, IHBAS, Delhi 

Delhi Psychiatry Journal 2012; 15:(1) © Delhi Psychiatric Society 

The latest research work showed a clear 

increase in stress consequences for adolescent 

related to experience, behavior and health (among 

other things, fear to fail and psychosomatic 

disorders). In contrast, only a few stress handling 

programmes are available specifically for 

adolescents; a large part covers stress handling 

training courses orientated to behavior and 

cognition. 

Adolescents of today’s world are living in a 

world of competition and there is cut throat 

competition in every sphere of life. The theory of 

“SURVIVAL OF THE FITTEST” applies to each 

and every walk of the society. Adolescent today are 

living in an increasingly anxiety ridden atmosphere 

. In today’s competitive world, it is not uncommon 

to find academic achievement playing the most 

important role in an adolescent’s growing up. Being 

academically successful and making a place for 

oneself in the society is their priority. 

Social problems can be a significant stressor 

for adolescents. Disturbed youth often experience 

negative outcomes to social problems, solve 

problems poorly, and display distortions in 

reasoning about social problems. The social 

experiences of adolescence have an impact on 

identity formation. Peer pressure to use drugs or 

have intercourse can affect a teen’s life in significant 

ways, depending on the behavioral choices made 

in response to these social problems. Recent 

incidents of school shootings and the high rate of 

teen suicide underscore the potentially devastating 

outcomes of ineffective social problem solving. 

Disturbed adolescents were found more likely 

to select negative alternatives to social problems 

such as alcohol abuse, isolation, and running away


from home. Disturbed youth with internalizing 

problems such as stress, depression, anxiety, 

loneliness, and social withdrawal perceive and 

process social problems differently from those who 

are normal or those with externalizing problems 

such as aggression. Depressed adolescents were 

found more likely to select negative alternatives to 

social problems such as alcohol abuse, isolation, 

and running away from home. 

Internalizing problems have been associated 

with cognitive distortions in perceiving and solving 

social problems, including selective abstraction, 

personalizing, overgeneralization, and catastrophizing 

7 . Involvement in prosocial activities is a 

protective factor against problem drinking among 

teenagers 8 . 

Various stresses and their impact on life of an 

adolescent can be understood with the help of the 

following diagram. The figure shows the 

consequences of stress among adolescent which 

makes them highly vulnerable and they are at high 

risk to face various physical, psychological and 

social problems in life. 

Mental health problems affect 10—20% of 

children and adolescents worldwide. Despite their 

relevance as a leading cause of health-related 

disability in this age group and their long lasting 

effects throughout life, the mental health needs of 

children and adolescents are neglected, especially 

in low-income and middle-income countries. 

Mental Health and Wellbeing in Adolescence 

Mental health is an essential part of holistic 

wellbeing. The general well-being of adolescents 

has been the topic of considerable debate in recent 

years. Evidence has suggested that the current level 

of behavioral and emotional problems in teenagers 

is higher than in the past. 

Mental health is a way of describing social and 

emotional wellbeing. Good mental health is central 

to the adolescent’s healthy development. It is 

associated with: 

• Feeling happy and positive about yourself 

and enjoying life 

• Healthy relationships with family and 

friends 

• Participation in physical activity and eating 

a healthy diet 

• The ability to relax and to get a good night’s 

sleep 

• Community participation and belonging. 

Risk and Protective Factors of Adolescent’s 

Mental Health 

A mental health risk factor is an internal (e.g. 

temperament) or external (e.g. environment) condition 

that increases the likelihood of the development 

of a mental health problem. Alternatively, a mental 

health protective factor is an internal or external 

condition that mitigates against the development 

of mental health problems and helps to promote 

resiliency. 

While no single risk factor can predict the 

development of mental illness nor any single 

protective factor assure immunity, the following 

chart identifies risk and protective factors that are 

known to correlate with mental health functioning 

in children and youth. 9 

Delhi Psychiatry Journal 2012; 15:(1) © Delhi Psychiatric Society 23


Mental Health Risk Factors Mental Health Protective Factors 

Individual Factors 

Prenatal brain damage Easy temperament 

Prematurity Adequate nutrition 

Birth injury Above average intelligence 

Low intelligence Problem solving skills 

Chronic illness Internal locus of control 

Poor health in infancy Social competence 

Insecure attachment in infancy/childhood Social skills 

Low birth weight, birth complications Good coping style 

Difficult temperament Optimism 

Physical and/or intellectual disability Moral beliefs 

Poor social skills Values 

Low self-esteem Positive self regard 

Impulsivity Good physical health 

Family Factors 

Absence of either parent in childhood Attachment to family 

Anti-social role models Supportive, caring parents 

Marital discord in parents, divorce Family harmony 

Long term parental unemployment Secure and stable family 

Parental criminality and disharmony Small family size 

Parental substance abuse More than 2 years between siblings 

Parental mental health disorder High level of family responsibility 

Poor supervision and monitoring Strong family norms and morality 

Family social isolation Economic security 

Lack of warmth and affection 

Death of a family member 

School Factors 

Poor attachment to school School achievement 

Bullying Sense of belonging at school 

Peer rejection Positive school climate 

Inadequate behavior mgmt Pro-social peer group 

Deviant peer group High expectations 

School failure Required responsibility & service to others 

Frequent school transitions Opportunities for success & recognition of 

achievement 

Community and Cultural Factors 

Socio-economic disadvantage Sense of connectedness to community 

Social /cultural discrimination Attachment to community networks 

Neighborhood violence &crime Strong cultural identity and ethnic pride 

Overcrowded housing conditions Access to support services 

Lack of recreational opportunities Community norms against violence 

Lack of support services Caring neighborhood 

24 

Delhi Psychiatry Journal 2012; 15:(1) © Delhi Psychiatric Society


Adolescent mental health is a concern for 

health professionals as the prevalence of mental 

health problems appears to peak in adolescence and 

early adulthood because of the biological and 

psychosocial transitions that are occurring in this 

age group. Adolescence is a major transitional 

period between childhood and adulthood and many 

changes—physical, emotional and social—occur 

during this time. These changes can precipitate and 

perpetuate mental health difficulties in young 

people. Due to the amount of changes that occur in 

adolescence, younger and older adolescents are at 

quite distinct life stages and are biologically, 

cognitively, socially and emotionally distinct. There 

are also differences between younger and older 

adolescents in the prevalence of different disorders 

and in how they express their difficulties. It is, 

therefore, important for healthcare professionals to 

be mindful of the development level of the 

adolescents with whom they are working and the 

impact that this can have on the young person’s 

presentation, understanding of their problems and 

in their ability to use different therapeutic 

interventions. 

Mental wellbeing can be improved 

The Mental wellbeing can be improved by 

focusing on the fundamentals of the way we live 

our life. It is not just whether we are exercising, 

eating well and not getting stressed, but what is 

underneath that impacts on the real change. The 

Mental Wellbeing Model takes into account existing 

and new research and suggests the following stages 

to wellbeing: 

Values 

The rules by which one live one’s life, the very 

core of one’s being. It is values that affect the 

decisions we make, the life choices and how we 

respond to situations we experience. 

Beliefs 

Figure-2. Mental Wellbeing Model 

These are more than beliefs in the religious 

sense; it is something that we believe to be true 

about ourselves and about the world that we live 

in. Beliefs are fundamental in either helping or 

hindering us to achieve what we want from life. 



Goals/Life Purpose 

This is the target we are aiming for and 

ultimately, what we need to do in our lives to feel 

fulfilled. Someone living to their life purpose will 

have their beliefs, values and goals aligned and are 

in accordance with how they want to live their life, 

it is at the very cornerstone of wellbeing. 

Cognitions 

This is the way we collect, store and process 

information. It is about the mood we wake up with 

in the morning and how we manage ourselves during 

the day, what emotions we are holding and whether 

they are serving us well. Happier people tend to 

have healthier lifestyles 9 , more friends, and also 

more positive interpersonal experiences” 10 . 

Emotional Intelligence 

Emotional intelligence as described refers to 

our ability to manage our emotions, respond to the 

emotions of others and how we emotionally cope 

with life. It affects our ability to stay resourceful, 

build and improve successful relationships, manage 

ourselves and to create the conditions of happiness, 

success and fulfillment in our lives. 

These points have been briefly explained with 

the help of Mental Well Being Model. In which the 

inter-connectedness of the above mentioned stages 

has been depicted to achieve the ultimate goal of 

Mental Well Being through developing ongoing 

processes viz. Personal Growth, Self Acceptance, 

Personal Relations & Environmental Mastery. 

The area of mental health has long been debated 

and is not a simple field to understand, there is not 

only the impact of mental wellbeing but also illbeing. 

Wellbeing is about alignment and that is 

exactly what coaching does, it takes account of the 

whole life and bases goals on this. Through 

improved intelligence around your emotions, beliefs 

and values, you can set meaningful goals, align 

yourself to your life purpose and as a result, you 

will then achieve the ways to wellbeing: you will 

know how to connect with others and benefit from 

the exchange, you can achieve your physical 

wellbeing goals, you will be more aware of yourself 

and others around you, you will be better placed to 

learn from your experiences and take on additional 

learning should you choose, and you will be more 

accepting of yourself and able to give to others as a 

26 

result. 

Importance of Promoting Adolescent Mental 

Well Being 

In the short term: 

Delhi Psychiatry Journal 2012; 15:(1) © Delhi Psychiatric Society 

Interrupting poor mental health as soon as 

possible in the childhood and adolescent years will 

reap instant rewards for young people. Those who 

are supported and have more positive mental health 

can learn better and are more likely to fulfill their 

social, academic and training potential. It is likely 

that intervening more effectively and imaginatively 

could significantly reduce adolescent mortality 

(through reducing suicide rates) and improve life 

experiences. If we can accurately assess mental 

health problems, and we know both how to 

intervene and also that intervention may work, then 

there is an ethical imperative to do something as 

soon as we can. 

In the longer-term 

Enhancing health and educational outcomes 

will benefit young people in the shorter term, but 

will of course benefit all of us in the longer term as 

well. A significant proportion of young people with 

mental health problems will go on to be adults with 

not just ongoing mental health problems, but also 

range of other poor outcomes as well – difficulties 

with relationships, unstable employment histories, 

involvement in crime, and social exclusion. 

Research has shown that by age 28, people with 

continuing high levels of antisocial behavior have 

cost society up to 10 times more than those with no 

problems – these are the costs of public services 

such as extra educational provision, foster and 

residential care, and unemployment benefits, quite 

apart from the personal costs to the individual (11) . 

References 

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through the eyes of high-risk teens. Pediatr 

Nurs 2008. 

2. Lau BWK. Does the stress of child-hood and 

adolescence matter? A psychological perspective. 

J Royal Soc Promotion Health 2002; 

122(4) : 238-244. 

3. Finkelstein DM, Kubzansky LD, Capitman J, 

and Goodman E. Socioeconomic differences in 

adolescent stress: The role of psychological


resources. J Adolesc Health 2007; 40(2) : 127- 

134. 

4. Finkelstein DM, Kubzansky LD, Goodman E. 

Social status, stress, and adolescent smoking. J 

Adolesc Health 2006; 39(5) : 678-675. 

5. Goodman E, McEwen BS, Dolan LM et al. 

Social disadvantage and adolescent stress. J 

Adolesc Health 2005; 37 : 484-492. 

6. Chandra A, Batada A. Exploring stress and 

coping among urban African-American 

adolescents: The shifting the lens study. 

Preventing Chronic Disease: Public Health Res 

Practice Policy 2006; 3(2) : 1-10. 

7. Leung PW, Wong MM. Can cognitive distortions 

differentiate between internalising and 

externalising problems? J Child Psychol 

Psychiatry 1998; 39 : 263-269. 

8. Costa FM, Jessor R, Turbin MS. Transition into 

adolescent problem drinking: the role of 

psychosocial risk and protective factors. J 

Studies Alcohol Drugs 1999; 60(4) : 480-90. 

9. Watson D, Clark LA, Tellegen A. Development 

and validation of brief measures of positive and 

negative affect: The PANAS scales. J Personal 

Soc Psychol 1988; 54 : 1063–1070. 

10. Diener Ed, Eunkook M, Suh, Robert E. Lucas 

and Heidi L. Smith. ‘Subjective Well-Being: 

Three Decades of Progress.’ Psychol Bull 1999; 

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Improving Positive Mental Wellbeing among Adolescents ... - medIND

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