Academic Stress and Adolescents Mental Health: A Multilevel Structural Equation Modeling (MSEM) Study in Northwest of Iran

Background: we aimed to determine the relation of different sources of academic stress andadolescents mental health through mediator variables on the student and school levels.study design: a cross-sectional study.methods: overall, 1724 students aged 12-19 yr were selected from 53 high schools in qazvin city,northwest instead of central iran through stratified cluster sampling. the sources of academicstress include family conditions, education system, future concerns, academic competitions,interaction with teachers, school disciplines, peer pressure, parental involvement, and financialproblems. academic self-efficacy and self-concept were the mediator constructs. the students andschools information were considered on levels 1 and 2, respectively. a multilevel structuralequation modeling (msem) analysis was done.results: high value of academic stress was associated with reduction of mental health. on thestudent level, the academic stress caused by the families 0.31 (95% ci: 0.28, 0.34), peers 0.29(95% ci: 0.27, 0.32), and the education system 0.21 (95% ci: 0.18, 0.24) had the highest impacton the adolescentsˊ mental health, respectively. there was a direct and indirect relation betweenacademic stress and mental health through the self-concept. on the school level, only familyconditions stress had a relation with mental health (p=0.015, b=1.08). academic self-efficacyshowed no significant relation in the model.conclusion: the stress from the family is the most important source of stress associated withadolescent mental health. self-concept unlike academic self-efficacy had an important mediatingrole in the relation between different sources of academic stress and adolescents' mental health.