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Between performance and well-being: a multi-layered exploration of Swedish adolescents’ mental well-being in school
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0002-3079-4927
2025 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Mellan prestation och välbefinnande : en flernivåanalys av svenska ungdomars mentala välbefinnande i skolan (Swedish)
Abstract [en]

Aim and objectives:

The overarching aim of this doctoral thesis was to explore how different levels within the Swedish education system - from national policy to classroom practices and individual experiences - may influence adolescent mental well-being. Guided by a bioecological systems framework, the thesis sought to address four specific research objectives:

  1. to assess whether the Swedish educational reform package implemented in 2011 was associated with increases in adolescent school pressure and gender differences in this experience;
  2. to examine whether fear-of-failure mediates the relationship between educational expectations and negative affect, and whether this mediation differs by gender;
  3. to investigate how distinct teaching practices within Swedish schools impact students’ subjective well-being regarding stress and school satisfaction, and;
  4. to identify adolescent mental well-being profiles based on psychosomatic complaints, perceived sense of coherence, and satisfaction with health and family life.

Theoretical framework:

This work is conceptually informed by Bronfenbrenner and Morris’ bioecological systems model, which highlights the multi-layered and interactive influences of environmental contexts on development. The model draws attention to how adolescent development may be shaped not only by immediate settings such as family and school (microsystem), but also by the interactions between these settings (mesosystem) and broader institutional and policy structures (macro-system). In this thesis, the model is used conceptually in a top-down manner, starting from macro-level influences and tracing their potential effects through meso- and micro-level contexts. This multi-level perspective provides a framework for considering how different environmental layers might jointly contribute to mental well-being outcomes. Within this conceptual approach, the thesis applies the dual-factors model of mental health to understand adolescent mental well-being as encompassing both positive aspects (e.g., sense of coherence, satisfaction) and negative indicators (e.g., psychosomatic complaints, stress). Together, these frameworks offer a way to explore the complex interplay of individual, relational, and structural factors that may influence well-being in educational settings, enabling consideration of how influences at different levels potentially spill over to shape adolescents’ mental well-being experiences.

Dats and methods:

The research objectives were addressed by utilising multiple large-scale, nationally representative datasets spanning various years and cohorts collectively covering the period from 2001 to 2018. Study I utilised Health Behaviour in School-aged Children survey data from the period 2001 to 2018 and applied synthetic control methods to evaluate the association between the 2011 education reform and changes in school pressure. Study II drew on data from the Programme for International Student Assessment and employed structural equation modelling to test the mediating role of fear-of-failure in the association between educational expectations and negative affect. Study III used data from the Evaluation Through Follow-up database to identify teaching practices and their associations with subjective well-being. Study IV also used Evaluation Through Follow-up data and applied latent class analysis to identify distinct mental well-being profiles among adolescents. This methodological approach combined quantitative, longitudinal, and person-oriented techniques to capture both group-level patterns and individual variation.

Results and conclusions:

The findings demonstrated that the 2011 Swedish educational reform package coincided with a significant increase in reported school pressure among adolescents, with the rise especially pronounced among girls, reflecting a widening gender gap in experienced stress. The findings suggests that performance-oriented educational reforms may inadvertently intensify academic stressors, particularly among girls. Mediation analyses in Study II revealed that fear-of-failure partially mediated the relationship between adolescents’ educational expectations and their experience of negative affect, with the effect being stronger among girls than boys. This pattern points to how performance-related concerns, shaped by both structural demands and gendered norms around achievement, may contribute to differentiated well-being outcomes among adolescents in high-stakes educational settings. Study III identified three distinct teaching practice profiles - teacher-centred, student-centred, and student-dominated - each associated with different patterns of student subjective well-being. Student-centred teaching, involving collaborative group work and interactive teacher-student dialogue, was linked to lower stress and higher school satisfaction, indicating more favourable subjective well-being. In contrast, teacher-centred and student-dominated practices were associated with higher stress or lower satisfaction, underscoring the importance of a balanced instructional approach in supporting students’ subjective well-being. Finally, latent class analysis in Study IV uncovered four distinct adolescent mental well-being profiles: (1) resilient and satisfied students with low psychosomatic complaints and high coherence and satisfaction; (2) strained but satisfied students exhibiting moderate complaints but maintaining positive outlooks; (3) vulnerable and unsatisfied students marked by high psychosomatic complaints and low coherence and satisfaction; and (4) secure but uncertain students who displayed mixed indicators of well-being. Gendered patterns emerged across these profiles, with girls disproportionately represented in the vulnerable and unsatisfied group, underscoring the need for gender-sensitive interventions. Conceptually, these findings point to the complex and interacting influences of policy, teaching practice, and individual factors on adolescent mental well-being in Sweden. This thesis suggests that adolescent well-being may be shaped by processes operating across multiple levels of the education system, where reforms, school practices, and individual experiences potentially spill over and interact in ways that influence stress and well-being. Gendered patterns appear particularly salient within these dynamics and merit further attention. The findings emphasise the need for social work and educational policy to move beyond individual-focused interventions and adopt systemic, preventive approaches addressing broader institutional and relational determinants. By integrating these perspectives, more equitable and supportive school environments can be developed to promote adolescent mental well-being, learning, and future life opportunities.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2025. , p. 93
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 104
Keywords [en]
Adolescent mental health; Mental well-being; Psychosomatic complaints; Educational reform; Sweden; School; Compulsory school; Synthetic control; Structural equation modelling; Latent class analysis; Social Work
National Category
Social Work Educational Sciences Applied Psychology Public Health, Global Health and Social Medicine
Research subject
Public health; Psychology; education
Identifiers
URN: urn:nbn:se:umu:diva-243886ISBN: 978-91-8070-785-5 (print)ISBN: 978-91-8070-786-2 (electronic)OAI: oai:DiVA.org:umu-243886DiVA, id: diva2:2006174
Public defence
2025-11-07, Hörsal HUM.D.230 – Hohaj, Humanisthuset, Floor 2, UNIVERSITETSTORGET 4, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2025-10-17 Created: 2025-10-13 Last updated: 2025-10-16Bibliographically approved
List of papers
1. Have performance-based educational reforms increased adolescent school-pressure in Sweden?: A synthetic control approach
Open this publication in new window or tab >>Have performance-based educational reforms increased adolescent school-pressure in Sweden?: A synthetic control approach
2023 (English)In: International Journal of Educational Development, ISSN 0738-0593, E-ISSN 1873-4871, Vol. 103, article id 102922Article in journal (Refereed) Published
Abstract [en]

Increased levels of stress and other mental health problems have been reported among adolescents in high-income countries. In particular, rates of school pressure have increased significantly. Despite such increases, little is known about the underlying determinants of increased adolescent stress, making this an emerging public health concern. The educational stressors hypothesis contends that increased rates of stress result from pronounced performance pressures placed on adolescents resulting from educational policy initiatives which emphasize academic goal attainment. The present study tests this hypothesis using a synthetic control method and panel data techniques to analyze data from the Health Behavior in School-aged children (HBSC) survey, including more than 150,000 adolescents per survey wave in 25 European countries over 16 years, to assess if the Swedish Educational reforms implemented in the 2011–13 period were associated with increased self-reported school pressure. These reforms implemented increased summative assessments, new grading systems and increased eligibility criteria in accessing further education. Results demonstrate that following the reforms, Swedish adolescents experienced greater levels of school-pressure and led to a greater gender difference in experienced school-pressure where girls were relatively more affected. We conclude that, consistent with the educational stressors hypothesis, the educational reforms have likely contributed to increasing levels of school-pressure for Swedish adolescents.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Adolescent stress, School stress, Education, Educational policy, Educational stressors hypothesis, Cross-country comparative, Synthetic control, Gender differences
National Category
Social Work
Research subject
Social Medicine
Identifiers
urn:nbn:se:umu:diva-216711 (URN)10.1016/j.ijedudev.2023.102922 (DOI)001112368300001 ()2-s2.0-85176240362 (Scopus ID)
Funder
Swedish Research Council, 2018-03870Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-01062
Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2025-10-13Bibliographically approved
2. Does fear-of-failure mediate the relationship between educational expectations and stress-related complaints among Swedish adolescents?: A structural equation modelling approach
Open this publication in new window or tab >>Does fear-of-failure mediate the relationship between educational expectations and stress-related complaints among Swedish adolescents?: A structural equation modelling approach
2024 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 34, no 1, p. 101-106Article in journal (Refereed) Published
Abstract [en]

Background: This study investigated the possible mediating role of fear-of-failure between educational expectations and adolescent stress-related complaints with a specific focus on gender differences among Swedishadolescents, and related these findings more broadly to school-related demands and stress-related complaints.

Methods: A total of N¼ 5504 Swedish adolescents (Mage¼ 15 years, SD ¼ 0.0 years, 50.2% girls) were drawn from the2018 Swedish Programme for International Student Assessment study for our investigation. We used structural equation models to explore if fear-of-failure mediates the relationship between educational expectations and negativeaffect, with a specific focus on gender differences. Educational expectations were utilized in the measurement model.Fear-of-failure was constructed as a latent mediating variable. Negative affect was constructed as a latent variableand utilized as an outcome variable. We subsequently undertook bootstrapping tests of indirect effects and nonlinear comparisons of indirect effects to assess the reliability of the results.

Results: Fear-of-failure partially mediatedthe association between educational expectations and negative affect (39%). Our gender-specific structural equation model demonstrated that this relationship was more pronounced for girls, suggesting girls are more vulnerable to negative affect as a result of experiencing higher levels of fear of failing.

Conclusions: The findingssuggest that fear-of-failure partially explains the association between educational expectations and negativeaffect and that this association is more pronounced for girls. This study provides insights into better understanding adolescent stress-related complaints, and the differential role fear of failing has in regards to gender.

Place, publisher, year, edition, pages
Oxford University Press, 2024
National Category
Social Work Public Health, Global Health and Social Medicine
Research subject
Public health; Psychology; Sociology; Social Medicine; educational work
Identifiers
urn:nbn:se:umu:diva-216812 (URN)10.1093/eurpub/ckad200 (DOI)001102263800001 ()37968234 (PubMedID)2-s2.0-85183961814 (Scopus ID)
Funder
Swedish Research Council, 2018-03870_3Forte, Swedish Research Council for Health, Working Life and Welfare, 2022-01062
Available from: 2023-11-16 Created: 2023-11-16 Last updated: 2025-10-13Bibliographically approved
3. Behind the classroom door: variations in teaching practices and lowersecondary students’ subjective well-being
Open this publication in new window or tab >>Behind the classroom door: variations in teaching practices and lowersecondary students’ subjective well-being
(English)Manuscript (preprint) (Other academic)
National Category
Educational Work
Identifiers
urn:nbn:se:umu:diva-245517 (URN)
Available from: 2025-10-14 Created: 2025-10-14 Last updated: 2025-10-14
4. Beyond symptomology: Unpacking adolescent mental health through a person-centered latent class analysis of psychosomatic symptoms, coherence, and well-being among Swedish adolescents
Open this publication in new window or tab >>Beyond symptomology: Unpacking adolescent mental health through a person-centered latent class analysis of psychosomatic symptoms, coherence, and well-being among Swedish adolescents
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-245518 (URN)
Available from: 2025-10-14 Created: 2025-10-14 Last updated: 2025-10-14

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Cashman, Matthew R.

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