Fifteen, female and stressed: changing patterns of psychological distress over time

Background: Despite a widespread view that the mental health of young people has deteriorated, the evidence base is limited by the lack of comparable datasets over time, and their capacity to test specific hypotheses about the causes of such change, in this case those particularly affecting young females. Method: Two cohorts of 15-year-olds in the West of Scotland, surveyed in 1987 and 1999, were compared, using the 12-item version of the General Health Questionnaire to measure psychological distress (GHQ caseness, cut-off 2/3), together with items and indices of personal and performance worries. Results: Between 1987 and 1999, GHQ caseness increased significantly for females (from 19% to 33%), but not males (13% to 15%), a change particularly experienced by females from non-manual and skilled manual backgrounds. With one notable exception (unemployment), most worries also increased for both sexes, a gender gap emerging in respect of worries about school performance, females worrying more. While the effect of personal worries (e.g., looks and weight) on GHQ caseness persisted over time in both sexes, that of performance worries only emerged for females in 1999. Using survey date as an indicator, a relationship between proximity to exams and GHQ caseness was also only found among females in 1999. Conclusion: The increase in levels of psychological distress among young females over this period may be explained by an increase in educational expectations, which together with more traditional concerns about personal identity, appear to have elevated levels of stress, with adverse consequences for mental health.