title: The association between adolescent risk behaviours and feelings of sadness or hopelessness: a cross-sectional survey of South African secondary school learners.
abstract: Poor mental health in adolescents has shown associations with engagement in other risk behaviours. However, evidence of this association in Sub-Saharan Africa, particularly South Africa, is lacking. This study examines the associations between pertinent risk behaviours and feelings of sadness or hopelessness amongst a nationally representative sample of South African school going adolescents. Data was analysed from the South African Youth Risk Behaviour Survey 2011 (n=10,997), a cross-sectional national survey among grades 8-11 school learners. Logistic regression examined the association of demographic, substance use, violent behaviour, sexual activity and suicidal plans and attempts with the primary outcome, feelings of sadness or hopelessness. Having feelings of sadness or hopelessness was significantly associated with more senior grades, being bullied (AOR:1.67, 95% CI: 1.42-1.96), being assaulted by a partner (1.33 [1.05-1.68]), forced sex (1.78 [1.37-2.32]); gang membership (1.32 [1.06-1.65]), binge drinking (1.37 [1.14-1.65]), ever having sex (1.23 [1.02-1.47]), having ≥1 partner/s in preceding three months (1.25 [1.02-1.53]), having made a plan to attempt suicide (2.50 [1.95-3.21]) and suicide attempt (1.49 [1.21-1.85]). Adolescents in South Africa are experiencing a multiple burden of risk. Health promotion strategies targeting adolescent mental health and risk behaviours need to be developed and implemented in a timely and comprehensive manner.
authors.affiliation: a Wits Reproductive Health & HIV Institute, School of Clinical Medicine , University of the Witwatersrand, Hillbrow Health Precinct , Johannesburg , South Africa.
authors.forename: Shamagonam
authors.initials: S
authors.lastname: James
authors.affiliation: b Population Health, Health Systems & Innovation (PHHSI) , Human Sciences Research Council (HSRC) , Cape Town , South Africa.|c Department of Family Studies , University of the Western Cape , Cape Town , South Africa.
authors.forename: Sasiragha Priscilla
authors.initials: SP
authors.lastname: Reddy
authors.affiliation: d ARCH Actuarial Consulting , Cape Town , South Africa.
authors.forename: Afzal
authors.initials: A
authors.lastname: Ellahebokus
authors.affiliation: b Population Health, Health Systems & Innovation (PHHSI) , Human Sciences Research Council (HSRC) , Cape Town , South Africa.
authors.forename: Ronel
authors.initials: R
authors.lastname: Sewpaul
authors.affiliation: b Population Health, Health Systems & Innovation (PHHSI) , Human Sciences Research Council (HSRC) , Cape Town , South Africa.|e Department of Psychology , University of the Western Cape , Cape Town , South Africa.
authors.forename: Pamela
authors.initials: P
authors.lastname: Naidoo
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006117:Grief; D006293:Health Promotion; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D012309:Risk-Taking; D012574:Schools; D012725:Sexual Behavior; D013019:South Africa; D019966:Substance-Related Disorders; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Adolescents; South Africa; feelings of sadness or hopelessness; mental health; suicidal behaviour; youth risk