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Abstract：
In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents\' mental health.
摘要：
在这项横断面研究中，我们的目标是I)通过形成和描述四个参与者群体来调查心理健康的双因素模型，II)检查心理健康状态和背景因素之间的关联，学校相关因素，压力，瑞典社区人口中青少年的复原力。数据是通过对瑞典哥得兰岛初中和高中的2208名学生完成的一项调查收集的。删除丢失的数据后，共有1,833名参与者被纳入研究.调查包括用于评估心理健康的心理健康连续简短表格（MHC-SF）和用于评估心理健康问题的优势和困难问卷（SDQ）。这两个指标被组合成一个双因素模型，形成四个心理健康状况亚组：弱势群体(47.5%)，完全心理健康(36.2%)，陷入困境（13.9%），和症状，但含量（2.5％）。关于背景因素，探讨了这些群体之间的关联，学校相关因素，压力，和弹性通过卡方检验和逻辑回归。女孩（OR：1.88）和高压力水平的参与者（OR：2.23）的弱势心理健康状况的几率升高，而较高的心理弹性(OR:0.87)和学校主观社会地位(OR:0.76)是这种心理健康状况分类的几率降低的相关因素.女性性别（OR：5.02）也与不良心理健康状况相关。同样，高水平的压力（ORs：4.08和11.36）与症状但内容和问题的心理健康状况有关，弹性水平较高的参与者被归入这些组的几率降低(ORs:0.88和0.81).研究结果强调了干预措施对提高复原力的重要性，减轻压力，并解决刻板印象的性别规范以及社会地位等级制度，以支持青少年的心理健康。
