Sense of coherence and school-related stress as predictors of subjective health complaints in early adolescence: interactive, indirect or direct relationships?

The role of sense of coherence (SOC) on the relationship between adolescent school-related stress and subjective health complaints was tested with structural equation modelling. As part of the crossnational WHO-survey ‘Health behaviour in school-aged children 1997/98’ Norwegian representative samples of 1592 grade 6, 1534 grade 8, and 1605 grade 10 students completed measures on SOC, school-related stress and subjective health complaints. A test of nested structural models revealed that both stress-preventive (Δ χ2 814. 86, p<0.001), stress-moderating (Δ χ2 11.74, p<0.02) and main health-enhancing (Δ χ2 1289.1, p<0.001) effects of SOC were consistent with the data. A model including all these relationships fitted the data well (CFI=0.91, RMSEA=0.04). Age-group comparisons revealed that the association between SOC and stress grew weaker with age (p<0.05), whereas the direct association between SOC and health complaints grew stronger (p<0.001). The main effect of SOC accounted for between 39% (11 year olds) and 54% (15 year olds) of the variance in subjective health complaints. Findings indicate that SOC may potentially be a salutogenic factor in adolescents’ adaptation to school-related stress, and that relationships between SOC and healthy adaptation, may be evident in younger age-groups than previously anticipated.