Term Paper, 2016, 37 Pages
2. Theoretical Framework
2.1 Erikson's psychosocial stages
2.2 Levinson's seasons
2.3 The IDEA: Inventory of the Dimensions of Emerging Adulthood
4. Results (from selected studies)
5.1 Social Factors
5.2 Health Factors
5.2.1 Stress response 20
5.2.2 Protective Factors 22
This review aims to clarify which factors contribute to a healthy development in the emerging adulthood. Social surrounding outcomes are a) direct impacts of diseases, and b) indirect impacts, which are stress response, protective factors and healthbehaviour. Health factors influence capacities for social interactions and are interconnected with social factors.
Family is one of the most important social networks for development. Socioeconomic status is a likely contributor to a healthy development, as parents’ psychological, demographic and economic disposition and behaviour. The individual’s education, social surrounding, control; social and personality characteristics contribute to the health-development in the emerging adulthood. The stress response is affected by personal and cognitive predisposition, expectancies, health beliefs or perceptions, and individual practices and plans.
Young adulthood refers to the timespan between 18 and 40 years of age (Erikson, 1968, 1993). It is the first of the three stages of adulthood, one that presents the crisis of intimacy versus isolation (Erikson, 1993). It is “a period of time in which men or women who recently passed through adolescence, reach the height of physical and mental vigor, attain basic independence from their families, and are ready to achieve an intimate, meaningful relationship with someone else” (Corsini, 1999, p. 1082). Usually during this time the choice of a profession and a partner takes place, which tests the youth's adaptability and maturity (Corsini, 1999). These challenges of adaptability and maturity pose significant danger to healthy development during EA.
Adopted from Erikson's intimacy vs. isolation stage (Negru, 2012) described Arnett (2000) the concept of emerging adulthood. Emerging adulthood (EA) encompasses ages 18 to 29 (Arnett, Žukauskienė, & Sugimura, 2014) and has been explained as “the age of identity explorations, the age of instability, the self-focused age, the age of feeling in-between, and the age of possibilities” (Arnett, 2007, p. 69). Observations of the differences between cultures experiencing EA as a phenomenon suggested that the age should be extended beyond 25 to 29 (Negru, 2012). Due to it’s nature, many emerging adults experience “an increase in agency” while exploring one’s identity (Parker, 2012, p. 1062). During the transitory phase of EA into young adulthood, people must often “restructure their existing social networks to be closer and more positive” (Parker, 2012, p. 1063). It is a period of the exploration of many life's possibilities, different directions remain possible and almost nothing about the future is certain (Arnett, 2000). EA “is consistently associated with higher risk for [risky behaviors and the] onset of psychological disorders, problematic substance use and onset of substance use disorders” (Baggio et al., 2015, p. 246; Mawson, 2015, p. 1).
EA is often referred to as the “prime” of life. Accordingly, healthy development in this period of life is important for healthy or successful ageing (Agren & Berensson, 2006). Thus, it is important to understand the factors that influence healthy development during EA in order to offer more thorough insights into early adulthood development. Factors which influence healthy development can be connected and also many of them can be manipulated (Agren & Berensson, 2006). The main purpose of this review is to analyze the social and health factors associated with healthy development in EA.
In 1946, health was defined by the World Health Organization as “a state of complete physical, social, and emotional well-being, and not merely the absence of disease or infirmity” (WHO, 1948). Health has since been conceptualized as a continuum varying over time with either increasing well-being or illness (Sarafino & Smith, 2014).
Regarding healthy development, stress is an important concept to consider. Stress is defined by the APA Dictionary of Psychology as “the physiological or psychological response to internal or external stressors. Stress involves changes affecting nearly every system of the body, influencing how people feel and behave” (VandenBos, 2015). Stress is experienced when a person perceives a discrepancy between his or her personal resources and the physical or psychological demands required by a situation (Sarafino & Smith, 2014). Physical stress directly challenges a person's physique. Psychological stress is determined by how one perceives their own life circumstances. There are two types of stress of which may be experienced. Eustress was coined by Hans Selye as literally meaning “good stress” or positive stress and has a beneficial effect on overall well-being in that it often enhances health, motivation and performance. Distress refers to negative stress that causes suffering. The APA Dictionary of Psychology explains that distress has a negative impact and can pose as a serious health risk (VandenBos, 2015). There are three ways in which an individual may evaluate stress: as a stimulus (stressor), as a response (strain), or as a process (transaction) (Sarafino & Smith, 2014). A person's emotional state can be used to evaluate the level of stress (Sarafino & Smith, 2014).
The Transactional Model of Stress and Coping (Lazarus, 1966; Lazarus & Folkman, 1984) relates to the processes of coping and emphasizes that the external stressor influences the transaction or process of coping. An individual will cognitively appraise a stressor before action is taken (Folkman, Lazarus, Dunkel- Schetter, DeLongis, & Gruen, 1986). Within the primary cognitive appraisal, the individual decides what the stressor means in relation to well-being: irrelevant, good, or stressful. If it is determined to be stressful, the individual will then evaluate the possible outcomes such as harm-loss (amount of damage), threat (expectation of future harm), and challenge (opportunity for growth, which can be beneficial). The individual will then continue to the secondary cognitive appraisal where he or she must ask “do I have enough resources to cope with this stress?” (Sarafino & Smith, 2014).
According to Ryff and Keyes (1995), the six dimensions of psychological well-being include autonomy, environmental mastery, personal growth, positive relations with others, and self-acceptance. Having no symptoms does not guarantee well-being, but having symptoms is no inhibition for well-being (Bos, Snippe, de Jonge, & Jeronimus, 2016). Ryff and Heidrich (1997) described, that the psychological well-being in EA was most predicted by life activities. Mental health as a continuum goes from flourishing over moderate to languishing states (Keyes, 2002). The research questions guiding the present review are: (a) which factors contribute to healthy development in EA? (b) how do these factors contribute to healthy development in EA? (c) how is EA experienced cross-culturally?
The life-span developmental theory from Erikson (1993) consists of eight psychosocial stages that are dependent on each other. In every stage the individual encounters a specific challenge. It starts with the crisis of basic trust versus mistrust in the first years of life and ends with the crisis of ego integrity versus despair in old age. The sixth stage of Erikson's Eight Ages of Man occurs during the young adulthood (Erikson, 1993). This stage shows the crisis of intimacy versus isolation. The previous stage during the adolescence presents the crisis of identity versus role confusion. After his search for identity, the young adult is willing to merge the identity of others with his own identity during the following stage. The young adult is mature for intimacy (Erikson, 1993). If the person is not sure of his own identity, he can not develop real intimacy (Erikson, 1968). A person who avoids close, intimate relationships can face isolation (Erikson, 1993). The outcome and thereby the strength of the sixth stage would be affiliation and love (Erikson, 1993).
In comparison to Erikson's stages in ego development, Levinson (1978) consists the cycle of life is a series of eras which overlap partly. Levinson (1978) defines early adulthood as the span between 17 and 45 years. He states it as the most dramatic of all periods in life. In focusing on men, Levinson (1978) explains that at the age of 20 years the mental and biological components reach their peak. It stays at the peak level until the late thirties. Young adulthood is characterized by lots of power and capacity in comparison to later phases. There is also pressure from the society and the young adult with his personal efforts may struggle with the external demands. The phase is a gratifying but also stressful period in life (Levinson, 1978).
The Inventory of the Dimensions of Emerging Adulthood is a 31 item inventory designed to evaluate the experiences of EA across the five dimensions. The dimension “other focus” is an additional dimension that is measured with the inventory. IDEA was originally used for the American population, but has since been adapted and translated to better understand how other cultures experience EA. (Negru, 2012; Reifman, Arnett, & Colwell, 2007). It has been assumed that EA can only be experienced by those of a specific socioeconomic status (SES) within the Western world, but it is more likely the case that there are differences between the experiences of EA depending upon the culture (Negru, 2012).
The content of this article was determined by its nature as a literature review of the factors associated with a healthy EA development. Commonly used terms/concepts, hypotheses, models, and theories of understanding development and social relations (including related aspects of identity, personality, behavior, cognition) are identified to serve as a basis of the discussion. We used several studies to search for the connections between factors and theory. Some information has been gathered from the APA, Psychology course textbooks, and lectures. Lectures and the referring material were in German, English, and Norwegian.
The databases that were used to gather relevant articles were Oria, PsycINFO, EBSCOhost and Google Scholar.
Searched terms included “psychology” AND “young adult*” OR “emerging adult*” OR “early adult*” AND “development*” OR “social” OR “mental” AND “health*” OR “stress*” OR “distress” OR “eustress” OR “positiv*” OR “thriv*” OR “flourish*” OR “well-being” OR “asset*” OR “capital” OR “trust” OR “optimiz*” OR “relation*” OR “family” “intimacy vs. isolation”. Further searched terms involved FAMILY AS AN IMPACT FACTOR ON CHILDREN'S DEVELOPMENT, Interactions and Relations, social networks, communication, social heritage and reproduction. Culture, Socioeconomic status, interactions&relations, applied to family (parents: age, behaviour, mental diseases).
We then narrowed down the articles through selection depending upon the wording of our topic and research question, the title and abstract of the article, the age range (18-30), language (English, German and Norwegian) and interaction of the factors. There was no set publication date limit.
In order to gain an understanding of how emerging adulthood is experienced across cultures we completed a search using “inventory of the dimensions of emerging adulthood” as the keyword using Google Scholar, PsycINFO, and EBSCOhost while restricting the results to English language only. There were 67 results but only five articles were chosen.
illustration not visible in this excerpt
The selected studies will be introduced individually:
a. Barlett & Barlett (2015) conducted a study with with 822 undergraduate students (average age: 21.53 years, 83% Caucasian, 59% female) in USA. The aim was to examine the risk and protective factors that increase/decrease the likelihood of psychopathy. Besides IDEA, used questionnaires evaluated demographics, psychopathy, and mindfulness. The results showed that being male, low mindfulness, low identity exploration, and low other focused are risk factors for primary psychopathy. Emerging adults with fewer protective factors (being female, high mindfulness, high identity exploration, and high other focused) are more likely to have a higher score on psychopathy.
b. Crocetti et al. (2015) conducted a study aiming to compare and examine the perceptions of EA in Italian and Japanese youth with 2,472 (1,513 Italian & 959 Japanese) participants (49,2 % males age 18 - 30 years 57,1% university students & 42,9% workers). The IDEA was translated into Italian and Japanese.The results revealed that Japanese youths were more likely to perceive EA as a period of possibilities compared to Italian youths and young women scored higher on instability and feeling in between compared to men in both countries. Another finding was that compared to university students, workers were less likely to perceive EA as a period of identity exploration, possibilities, and feeling in between in both countries.
c. Hill, Lalji, Rossum, Geest, & Blokland (2015) completed a study within the Netherlands that aimed to examine the differences between socioeconomic and ethnic groups within the population. There were 958 participants aged 18, 19.5, and 21 years with Dutch, Dutch Antillean (lower SES), and Moroccan (lowest SES) origin. Participants were chosen from the “transitions in Amsterdam study” and were presented with a Dutch version of IDEA and general self-efficacy scale. The difference between this study and the other studies is that the identity exploration dimension was divided into the two subcategories of a sense of self and a sense of future self. There was no falling in-between dimension as this was not typical. The results revealed that Dutch EA experiences are different from USA. SES differences did not affect experience of EA, but Moroccan participants experienced EA more negatively which may be due to it being a more collectivist culture concerned with family and community. Experimentation correlated positively with life satisfaction, sensation seeking, and substance use (Dutch and Antilleans experienced this more). Moroccans and Antilleans explore “future self” while Dutch explore “sense of self” (focused on now).
d. Negru (2012) conducted a study in Romania to test the assumption that new school context makes perception focused on exploration and experimentation. The participants included 237 senior high-school students (m age = 17.76, 53.6% males) and 298 first or second year undergraduate students (m age = 19.58, 70.5% females) evaluated by demographics, IDEA, and Well-being. The results revealed that gender and education level both influence characteristics of EA as girls have an advantage after entering university. Also, high self-focus predicts high satisfaction with life in both groups.
e. Wider, Bahari, Halik, & Mustapha (2015) conducted a study to investigate the EA phenomenon in Malaysian culture. The participants included 102 first year undergraduate students (60.2% female average age: 2)1 in Universiti Malaysia Sabah in Kota Kinabalu, Sabah, Malaysia. The evaluations included background information, Perceived Adult Status, and IDEA. Results revealed that the Instability/negativity dimension was the highest while the felt-in between dimension was the lowest. To answer the question “do you believe you have gotten to adulthood?” 27.8% responded with “yes”, 5.6% responded with “no”, and 66.7% said “in some respect yes/no”. The 72.3% emerging adults engaged in higher identity exploration while the 27.7% self-perceived adults engaged in other-focuses. There was no gender effect with this sample.
The Developmental Assets as introduced by Benson (2007) help with development in youth and include “Support, Empowerment, Boundaries and expectations, Constructive use of time, Commitment to learning, Positive values, Social competencies, Positive identity” (p. 41 ff.) of which are Personal, Social, Family, School and Community assets. Benson (2007) explains that the thriving indicators of an individual are that they “Succeed in school, Help others, Value diversity, Maintain good health, Exhibit leadership, Resist danger & overcome adversity, Delay gratification” (p. 45), all of which facilitate a healthy transition into adulthood.
The named factors are antecedents of a good development in the young adulthood, but also in this period itself a lot of factors can influence the healthy development. Those shall be outlined in the following sections. Being that EA development greatly depends upon social factors, this will be our main focus.
Big social networks are characterised by relations and interactions. We typically do not question the specific effects of those networks, but they exist. Social and individual dispositions are a connected and interacting complex, which influences our lives strongly (Stokols, 1992). Brendtro, Mitchell, and Jackson (2014) state that social factors are even as important as basic survival. Therefore, this chapter is focused on the social factors and their connections to a healthy development in the EA. Those are social networks, relations and occurring interactions inside the networks. These and examples will be defined, presented and discussed in the following section.
The capital forms of Coleman (1988) are outlined. The social factor family is emphasized (within studies), as it is one of the most important social networks for the children's, but also (later) emerging adults social and (emotional and physical) health development (Underdown, 2006). Ayoub, Bartlett, and Swartz (1992) state that children need the relation and contact to their parents not only to earn emotional and social abilities, but to survive.
To define social factors it is important to name the term social capital, which is characterised by a network of social relations (Coleman 1988). Social relations are an important part of the social capital, as they facilitate actions by determining certain roles and norms (Coleman, 1988). Coleman (1988) also states that through leading to obligations, expectations and credibility, relations provide the interdependence between individuals.
Social relations are based on interactions and can occur between family members, friends, colleagues, or acquaintances (Corsini, 1999). They influence the identity and personality formation and furthermore the behaviour through different socialisation, roles and norms, e.g. within situational behaviour rules (Schimank, 2013). Surveys, which examined the extent of the investment in social roles, found out about a relation of a higher level of agreeableness, conscientiousness, emotional stability, and a lower level of psychoticism to a higher social investment (Lodi-Smith & Roberts, 2007).
Communication (or the attempt of communication) is the substantial part of the functioning of social networks or in terms of Luhmann (2012) society itself. Contributing factors, as emotional control and emotion interpretation, same as understanding and expressing non-verbal and verbal communication are mainly learned in the childhood through interactions and relations in social networks (Ayoub et al., 1992; Underdown, 2006).
Coleman (1988) also names other capital forms, as financial and human capital. Financial capital plays the biggest role to get access to opportunities and to reach (thereby) human capital, but also until a certain point to reach social capital (Coleman, 1988). As they are connected, all of Coleman's (1988) different forms of capital are important for the identity formation and for following opportunities, behaviour and (social and health) states of the individual, as they are substantial for the social positions of both parents and children. The access to those capital forms is also influenced by the political, economic and religious situation of the society, as those systems are all sub-systems of the society (Schimank, 2013).
Besides social networks, or groups and societies in which individuals are (passive or actively) acting, the culture or the sociocultural surrounding is influencing the individual's and collective (health) development (Schimank, 2013; Stokols, 1992). Evaluative, cognitive and normative cultural orientations lead individuals to focus on different norms and rules, and to adapt their behaviour accordingly (Schimank, 2013). Schimank (2013) remarks in this context that the idea of progress dominates modern society, which leads to a multi-option culture (establishing as much choices as possible) with the contrary aim to reach more and more at the same time. This can lead to conflicts between and for individuals themselves and stress, concerning private and public life (Schimank, 2013; Stokols, 1992).
Social relations, or more general social capital does not only play a role to reach human- or financial capital, but also for the health of individuals. Social capital can influence healthy behaviour as it supports the informing about health, increases the chance for a re-adoption of health norms, values and behaviour, and impacts the social control concerning non-/healthy behaviour among communities (Kawachi, Kennedy, & Glass, 1999).
Stokols (1992) describes that research about the topic was mainly focused on behaviour, which can lead a) to avoid illness or b) to promote physical health. Not only physical, but also the psychological health is an important impact factor.
Giordano and Lindström (2011) found that people from Great Britain estimated their own health status higher over a time span if they started to trust people. According to that it is plausible that a lack of trust can lead to higher social stressors and to a “deteriorating physical and psychological health in individuals.” (Giordano & Lindström, 2011, p. 1225). Trust is not only established by positive experiences, but also by the individual's background: it's socialisation and the construction of it's social networks.
Stokols (1992) writes that media, society, and the social environment can especially contribute to a perceived health and quality of life if they promote, provide and support health. Positive outcomes are satisfaction, commitment, creativity and productivity in social networks and a promotion of healthy and preventive behaviour, e.g. through media campaigns and restrictions against smoking and alcohol abuse, but also through promoting sports and supportive political strategies to protect natural resources and the quality of the public environment (Stokols, 1992). Because also the individual's environment contributes through particular situations, stimuli under locational settings and also life domains or an overall life situation to a(n) (un)healthy development, for example within organizational culture and the work-environment at the workplace (Stokols, 1992).
Coleman (1988) emphasizes that especially the earlier mentioned social, but also the 2 other dimensions of capital are important for the education and the development of children. Several other findings show the importance of one specific capital form. A popular viewpoint is that the financial (capital) dimension is the most influencing for the social network (e.g. of the family) and following to that the most important one for the child's development and the later health development (e.g. Collins, 1971; Gauffin, Hjern, Vinnerljung, & Björkenstam 2016; Goldthorpe, 1996; Schimank, 2013).
Not only primary, direct effects (like chances and access), but also secondary effects (e.g. distress through emotion sharing) are caused through the SES. Unemployment can for example lead to an increased amount of distress, health problems, uncontrollable life events, and following mental illnesses as depression, probably supported by social control, pressure, and anxieties (Hurst, 2007; Perry, 1996).
Furthermore social support and empathy can play a crucial role to avoid distress and to reach a healthy development. Impacting for both is social support, which can be divided into four types that each achieve a specific purpose relative to the type: “Emotional/Esteem, Tangible/Instrumental, Informational, and Companionship” (Uchino, 2004). One’s perceived health can be influenced by social interaction. Social (solicitous) interaction may serve as a distraction from symptoms, but can also reinforce behaviors associated with the symptom. Women commonly rely heavily on female friends as they receive less support from their spouses (Sarafino & Smith, 2014).
Greater social support has been associated with lower physiological signs of stress (Berkman & Syme, 1979). Social support has been hypothesized to impact health in a few ways. The Buffering Hypothesis (Cohen & Wills 1985) suggests that when stress becomes high, social support becomes valuable because social support can aid in protection from the negative effects of stress. The Direct Effects Hypothesis says that regardless of stress, there are benefits from social support because humans are naturally social. The Stress Prevention Model explains that Social support has the potential to prevent experiencing a stressor. However, the social support itself may act as a stressor because it may be perceived as such by an individual rather than as the support it was intended to be.
As the health in the EA is strongly influenced by the behaviour of the individual, the extensive use and consequential impact of habits lines out the importance of the (learning process in the) family (Underdown, 2006). Various family context factors play a role for the young adult’s behaviour over the whole period of development, especially childhood and later adolescence are influencing the individual’s disposition, while the stress level is one of the most important factors (Mechling, 2015) . Those factors can be set up in the childhood thus the treatment by parents, and by the family's SES in the childhood, influences the socialisation (Schimank, 2013; Underdown, 2006). For example, a lower SES of the family in the childhood implies a higher risk for unhealthy behaviour and health problems in the adulthood (Van de Mheen, Stronks, Looman, & Mackenbach, 1998).
Parents with an anti-social conflict-behaviour “bequest” it to the children, which causes missing inhibition and and high impulsivity, can lead to risky behaviour (Moffitt, Caspi, Harrington, & Milne, 2002). Gauffin et al. (2016) found out about a connection between childhood household dysfunctions (CHD) and later alcohol addictions and death in EA in Sweden (same as alcohol addictions of parents) which influenced and were possibly bequested or impaired. A lower socioeconomic status (SES) was more likely to lead to a CHD then a higher SES (Gauffin et al., 2016). One explanation is that criminality, drug-abuse and mental disorders are more likely among groups with a lower SES (Gauffin, Hemmingsson, & Hjern, 2013). Gauffin, Vinnerljung, and Hjern (2015) show that less (social and performance) problems in school are supported by a higher education and lead both to a lower risk of alcohol- related disorders, and that a healthy and stress-free pregnancy can contribute to a healthy development (Gauffin et al., 2016).
Ravanera and Rajulton (2009) found out that “intact” or “healthy” families produce and own a higher social capital (in terms of the social network's size and norms of trust) than single-parent families. The importance of the size of a social network is dependent upon the individual, but extremes have extreme effects: Isolated individuals had a higher risk of a bad health development, as they had less social capital and following less emotional, informational and material access and support (Kawachi et al., 1999).
The findings of Ekeus, Olausson, and Hjern (2006) have shown that children of teenage mothers are susceptible to a worse health development than children born under “normal” conditions. Castellani et al. (2014) suggest that a younger age of the mother at the time of birth has a bigger likelihood to cause a higher level of an aggressive conflict behaviour at an older age. In addition, the mental health of parents is important as depressive parents can cause delinquent behaviour (among the males) and depression (among females) in the children's early adulthood, while aggressive conflicts have an even stronger indicator of causing anti-social behaviour (Castellani et al., 2014). Mechling (2015) adds that depressive parents can affect the emotional situation of children, their self-esteem and feeling of being accepted and supported in groups.
Beside the family, there are other factors influencing the individual and his or her social/psychological setting inside the environment such as friends, community, work, free time activities or hobbies, culture, (societal) attitudes, “school, peer group treatment, mental and juvenile justice, faith-based programs” (Brendtro et al., 2014, p. 2), etc.
According to the presented findings it seems important to find out more about the (specific) role of the social surrounding, relations, and interactions. The family is one of the most important social networks for the children's, adolescent's and later emerging adult's health development. Inside that network the SES tends to be a likely contributor to a healthy development (and behaviour) in the EA. A smaller social mobility supports the phenomena of negative social and psychological reproduction, possibly due to social inequalities (Gauffin et al., 2013). The parents’ psychological, demographic and economic disposition and behaviour cause non-/impairing behaviours among the children, highly affecting the emerging adult’s psychological health.
In order to understand how behavior affects a person's well-being, it is necessary to name key concepts associated with stress response which will be further discussed later.
Perceived health is facilitated by an interpretation of well-being which in turn evokes a response. Stress can be caused by life events, work, finances, or personal issues (Colman, 2014).
The Diathesis-stress model explains that some individuals may have an underlying predisposition to a disorder that can be triggered when faced with a significant stressor. In severe cases specific cues can alone cause distress. Personal control is achieved through behavioral and cognitive means. Stress can be reduced through actions or thought processes.
Rotter’s (1954) concept of locus of control suggests that those with an externalized locus of control may perceive things as beyond one’s own control when this may not be the case. This perception is often associated with distress.
Bandura’s self-efficacy is a term used to explain one’s “perceived capability to perform a behavior” (Williams, 2010). This perception is formed by both outcome expectancy (the belief of a behavior leading to an outcome) and self-efficacy expectancy (the belief of personal ability of performance) of which are highly influenced by past experiences (Williams, 2010). Generally, people do not like to experience failure so this perception allows for people to avoid the possibility of this as an outcome. However, this perception may not be “accurate” and some people may avoid or deny new possibilities as a result of inexperience or misjudgment.
The Health Belief Model (HBM) (Hochbaum, Rosenstock, & Kegels, 1952) proposes that the likeness of a person acting upon a health behavior after perceiving a susceptibility or threat is determined by the summation of the difference between the perceived benefits and the perceived barriers of performing that action. If there are more perceived benefits than perceived barriers, it is more likely a person will engage in that behavior. The perception of severity of the susceptibility or threat depends upon the individual, but perceptions can be restructured or altered using cognitive-behavioral methods.
The Theory of reasoned action / Theory of planned behavior (Fishbein & Ajzen, 1975) states that an intention of practicing a behavior is influenced by one’s subjective norm, (individual and societal) attitudes, and perceived behavior control. According to this theory, social norms and attitudes are influential over one’s behavior and intentions. All people take these attitudes and the social environmental context into consideration before acting upon the intended behavior - this likely occurs so that personal identity and social order is maintained.
Protective factors greatly consist of social support (with ethnic diversity), physical activity, mastery, self-esteem, education and religious involvement (Colman, 2014, p. 28; Harding et al., 2015, p. 1173). The Circle of Courage includes some with the most impact: belonging, mastery, independence, and generosity (Brendtro et al., 2014). Colman et al. (2014) state that social support acts as a protective factor against depression in early adulthood. The study was based upon the data of 1137 Canadian participants in adolescence. The findings show that after experiencing work or financial stress, adolescents with a higher social support are less likely to show depressive symptoms in adulthood in comparison to adolescents with low social support (Colman et al., 2014). The second principle of the Circle of Courage is mastery. The fear of making mistakes leads to negative emotions (Brendtro et al., 2014).
According to Colman et al. (2014), another significant protective factor against depression in young adulthood is high mastery in adolescence. Independence is also important, as responsible youths make better decisions and have control of their emotions (Brendtro et al., 2014). True happiness depends on the contribution of others involving empathy and kindness, which represents the last principle generosity. The four principles are good sources for positive life outcomes (Brendtro et al., 2014). Physical activity in adolescence is associated with less chance of depression, and higher education level reduced depression risk after experiencing personal stress (Colman, 2014, p. 28). Family support reduces the stress of transitioning to adulthood (Harding et al., 2015, p. 1173). Other factors associated with positive characteristics in young adulthood are wisdom (Webster, 2010) and self-compassion (Neff & McGehee, 2010).
Skogbrott Birkeland, Leversen, Torsheim, and Wold (2014) examined the pathways to adulthood in Norway. The results show that individuals whose father had higher education were more likely to choose a higher education. At age 30, their SES was also higher. An interesting finding of this study was that higher educated women reported higher life satisfaction compared to women who started working at an early age. For men, education seems not to be as important for life satisfaction in later adulthood as it is for women. Another finding was that living with a partner is related to a higher life satisfaction at age 30 (Skogbrott Birkeland et al., 2014).
Those with a Type A personality may be more susceptible to illness as they are known to “make choices that increase stress”, respond quickly and strongly to a stressor while interpreting it as a “threat to personal control” due to their competitive nature with wanting to have control over people or situations and responding “to frustrating situations with anger” (Burger, 2014). Pessimism also plays a role in stress response “higher pessimism was associated with worse psychological adjustment to stress” (Puig-Perez et al., 2015).
Family stressors include “parental conflict, divorce, physical or mental illness or sexual abuse” (Valdez, Chavez, & Woulfe, 2013, p. 1089). Attempts to manage stressors are interdependent with “meanings of self, sociality, physical and emotional expression, agency, place, space, and discourse” (Valdez et al., 2013, p. 1089). Health problems in adulthood can be predicted by how much the individual has been victimized during childhood. “The long-term effects of childhood victimization on physical health in adulthood are serious and warrant significant attention” (Miller-Graff, Cater, Howell, & Graham-Bermann, 2015, p. 265). Distress behaviors might be maladaptive support seeking which includes co-rumination and excessive reassurance seeking (Starr, 2015, p. 436).
A community has a responsibility to meet the needs of its citizens. Because families are private units within a community beyond regulation (except for severe cases), schools have the responsibility of properly educating children about physical and mental health for the sake of the community as a whole. Awareness needs to be increased and stigmas need to be reduced so that “social exclusion of people with mental illness” can be reduced in order for affected young people to “facilitate the use of mental health services” (Yamaguchi, Mino, & Uddin, 2011, p. 405). Coping skills are adaptive tasks that originate from an appraisal to provide relief from stress. Avoidance and negative coping strategies include “denying, suppressing, refusing” (Miller & Mangan, 1983) “to temporarily escape the pain” of life (Valdez et al., 2013 p. 1096). Active and positive coping strategies aim to “alter distressing thoughts”; through the use of cognitive techniques such as guided imagery, redefinition, or acceptance (Miller & Mangan, 1983). Acceptance is defined by Cosco et al. (2015) as “being able to accept historical events in one's life, the undergoing of change across the life course, and acceptance of where one's life is headed”. Furthermore, it is to be content within the present while not feeling regret about the past. Some strategies often mentioned by “emerging adults include seeking therapy, reaching out to friends, focusing on academics, taking care of nutrition and health, engaging in religious or spiritual practices, and participating in a variety of extracurricular activities” (Valdez et al., 2013, p. 1096). The mentioned activities allow for one to experience a “new sense of self and agency”.
Goals that are set often serve as a standard for individuals to judge themselves and decrease the sense of well-being when not reached, but it is within the nature of emerging adults to be resilient and flexible with goals (Hardie, 2014, p. 196). Goal pursuits may change as a result from individualization, and life satisfaction can be influenced by success from an individual's “perceived control over goal attainment” (Krings, 2008, p. 93).
“People can succeed in preserving mental health after a traumatic event” (Bos et al., 2016 p. 1). “Reasons for living may moderate risk factors and correlate with resilience factors” but “may depend on [...] coping abilities and social support” (Bakhiyi et al., 2015, p. 92). Individuals are more than their symptoms, and also have “character strengths” (Bos et al., 2016 p. 2). A change in identity is necessary in order for one to recover from substance dependence (Mawson, 2015 p. 1). Sneed, Whitbourne, Schwartz, and Huang (2012) examined the connections between identity and intimacy in EA and their impact on the middle years using longitudinal data from adults between the ages of 20 and 54. The findings show that intimacy directly predicted well-being in midlife and identity predicted well-being indirectly over the development from the age of 20 to 54 years. The results support Erikson's theory that in young adulthood identity and intimacy are essential psychosocial issues which indicate for later years (Sneed et al., 2012). According to Sneed et al. (2012), intimacy is on the one hand important for developing deep romantic relationships in EA but on the other hand it is also essential for maintaining them over time. A finding is that “men who experienced childhood [maltreatment] are more likely to have obese female partners during young adulthood” (Fletcher & Tefft, 2013, p. 1) but stressed women in young adulthood are more likely to have male partners to be thin.
While some research emphasizes support for Erikson's theory, the other question comes up, if a theory developed more than 50 years ago can still be valid for today's society and culture (Robinson, 2015). In the last decades young people tend to stay longer in education and there is a trend of getting married and having children later than in the past (Arnett et al., 2014). Due to these changes, postulates Robinson (2015) the need for an update of Erikson's theory concerning the crisis of intimacy vs. isolation in young adulthood.
According to Erikson (1993), the search for identity takes place during adolescence. However, today the transition to adulthood is prolonged and it is the period of EA which is associated with identity explorations (Arnett et al., 2014; Cote, 2006). Erikson proposed that a society could offer an “ institutionalized moratoria ” - or “structured contexts for working through identity confusion and resolving an identity crisis” (Cote, 2006, p. 85) for the transition to adulthood. The extended identity stage becomes normative in post-industrial societies as the movement from education to the entry into working environment takes longer. Therefore young individuals struggle with the difficulty of assuming stable adult roles, so that an early identity formation is hindered (Cote, 2006).
Identity exploration, as one of the five dimensions in EA, can be confusing and can lead to the experience of anxiety (Arnett et al., 2014). In general is it common that emerging adults feel more anxious and depressed during this unstable, self- focused time of life. In addition induces this period between adolescence and adulthood a feeling of in-between, which also impacts the youth's mental health (Arnett et al., 2014).
The results of the selected studies using the IDEA show that there exist cultural differences in how individuals experience the period of EA. Japanese youth are more likely to perceive EA as a period of possibilities compared to Italian youth (Barlett & Barlett, 2015). The findings of Hill et al. (2015) present that Dutch emerging adults experience it differently than in the United States. Moroccan participants experience the transition to adulthood more negatively as it is a more collectivistic culture and they are more concerned about family and community (Hill et al., 2015). Although the struggles of this period can have an impact on the mental health, EA is viewed as an age of possibilities (Arnett, 2000). Many emerging adults have an optimistic attitude and this optimism can be seen as a psychological resource (Arnett et al., 2014).
Some limitations encountered in this paper were that it is difficult to clearly discuss healthy development as there are many factors associated with this, and that there were different or unaccounted preconditions to the findings that may not have been addressed due to lack of transparency.
In this paper we have examined (a) which (social and health) factors may contribute to healthy development in EA, (b) how these factors contribute to healthy development in EA and (c) how EA is experienced cross-culturally.
Societies and individuals are interdependent upon one another. Considering this, it becomes clear that both society and individuals must work equally in order to achieve a functional balance. The health of the lowest or neglected members of society can serve as an indication of the overall status of the society. To simply ignore this has proven to be ineffective. Further exclusion of already isolated or suffering individuals has only lead to further problems spilling into society as a whole.
It is important that all members in a society have a sense of belonging to a social group. According to the “circle of courage”, generosity to others is of high importance because it is said that true happiness can only be experienced through selflessness (Brendtro et al., 2014). It is not only beneficial to be a receiver of generosity, but also a giver. It becomes more likely that an individual will behave generously if this has been reinforced within the social environment - those that have not been treated with generosity will not likely behave generously.
When a person internalizes the locus of control and begins to demonstrate self- efficacy, the individual becomes more capable of managing his or her life - It may be that the individual needs social support to reach this initial step. One may not be aware of his or her unhealthy lifestyle if he or she has had little to no exposure to true healthy living, and thus awareness/education is the most important influencer of behavior change - it is important to perceive that the benefits of change will outweigh the barriers (health belief model). Social norms and societal attitudes act as a great indicator of how the individuals within a society may react to (even the mere thought of) a specific action, as shown with the theory of reasoned action.
“A chain is only as strong as its weakest link” - each link represents an individual while the chain represents society as a whole. If a link is broken, so becomes the chain. The stigma and the prevalence/severity of mental health issues depends upon a community or culture - some individuals may suffer in silence out of shame while some may seek vengeance out of frustration. The first step to any recovery process is to acknowledge and admit that there is a problem. Ideally societal attitudes would promote both mental and physical health by implementing resources and support available to all members of a society. However, efforts must always be made by the people of a community in order to improve its conditions - things can always be improved upon as nothing can possibly reach perfection. Each person has something of value that can be offered to others (empathy, generosity). To care for others is truly to care for oneself as well.
Agren, G., & Berensson, K. (2006). Healthy ageing: a challenge for Europe. Swedish National Institute of Public Health, 29.
Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American psychologist, 55 (5), 469-480.
Arnett, J. J. (2004). Emerging Adulthood : The Winding Road from the Late Teens Through the Twenties. Cary, NC, USA: Oxford University Press. Retrieved from http://www.ebrary.com
Arnett, J. J. (2007). Emerging Adulthood: What Is It, and What Is It Good For? Child Development Perspectives, 1(2), 68-73.
Arnett, J. J., Žukauskienė, R., & Sugimura, K. (2014). The new life stage of emerging adulthood at ages 18-29 years: implications for mental health. The Lancet Psychiatry, 1 (7), 569-576.
Ayoub, C. C., Bartlett, J. D., Swartz, M. I., (1992). Parenting and Early Intervention. The Impact on Children's Social and Emotional Skill Development. In Wiley Clinical Psychology Handbooks: Wellbeing: A Complete Reference Guide, Wellbeing in Children and Families (1). Somerset, GB: Wiley-Blackwell.
Baggio, S., Iglesias, K., Studer, J., & Gmel, G. (2014). An 8-Item Short Form of the Inventory of Dimensions of Emerging Adulthood (IDEA) Among Young Swiss Men. Evaluation & the Health Professions, 38 (2), 246-254.
Bakhiyi, C. L., Calati, R., Guillaume, S., & Courtet, P. (2016). Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature. Journal of Psychiatric Research, 77, 92-108.
Barlett, C. P., & Barlett, N. D. (2015). Using the risk and resilience approach to predict psychopathy in an emerging adult sample. Emerging Adulthood, 4 (3), 186-191. doi:10.1177/2167696815579829
Benson, P. L. (2007). Developmental assets: An overview of theory, research, and practice. In R. K. Silbereisen, & R. M. Lerner (Eds.). Approaches to positive youth development (pp. 33-58). Sage.
Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology, 109 (2), 186-204.
Bos, E. H., Snippe, E., de Jonge, P., & Jeronimus, B. F. (2016). Preserving Subjective Wellbeing in the Face of Psychopathology: Buffering Effects of Personal Strengths and Resources. PloS one, 11 (3), e0150867.
Brendtro, L. K., Mitchell, M. L., & Jackson, W. C. (2014). The circle of courage: Critical indicators of successful life outcomes. Reclaiming Children and Youth, 23 (1), 9-13.
Burger, J. M. (2014). Personality (9th Edition). Stamford, CT: Cengage Learning. Castellani, V., Pastorelli, C., Eisenberg, N., Caffo, E., Forresi, B., & Gerbino, M. (2014). The development of perceived maternal hostile, aggressive conflict from adolescence to early adulthood: Antecedents and outcomes. Journal of Adolescence, 37 (8), 1517-1527.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98 (2), 310-357. doi:10.1037/0033-2909.98.2.310 Coleman, J. S. (1988). Social Capital in the Creation of Human Capital. American Journal of Sociology, 94, 95-120.
Collins, R. (1971). Functional and Conflict Theories of Educational Stratification. American Sociological Review, 36 (6), 1002-1019.
Colman, I., Zeng, Y., McMartin, S. E., Naicker, K., Ataullahjan, A., Weeks, M., ... & Galambos, N. L. (2014). Protective factors against depression during the transition from adolescence to adulthood: Findings from a national Canadian cohort. Preventive medicine, 65, 28-32.
Corsini, R. J. (1999). The dictionary of psychology. Psychology Press.
Cosco, T. D., Brehme, D., Grigoruta, N., Kaufmann, L., Lemsalu, L., Meex, R., . . . Brayne, C. (2015). Cross-cultural Perspectives of Successful Aging: Young Turks and Europeans. Educational Gerontology, 41 (11), 800-813.
Côté, J. E. (2006). Emerging Adulthood as an Institutionalized Moratorium: Risks and Benefits to Identity Formation. Emerging adults in America: Coming of age in the 21st century, 85-116. doi:10.1037/11381-004
Crocetti, E., Tagliabue, S., Sugimura, K., Nelson, L. J., Takahashi, A., Niwa, T., ... & Jinno, M. (2015). Perceptions of Emerging Adulthood A Study With Italian and Japanese University Students and Young Workers. Emerging adulthood, 3 (4), 229-243.
Ekeus, C., Olausson, P., & Hjern, A. (2006). Psychiatric morbidity is related to parental age: a national cohort study. Psychological Medicine, 36 (2), 269-276.
Erikson, E. H. (1993). Childhood and society. New York: Norton.
Erikson, E. H. (1968). Identity: Youth and crisis. New York: Norton.
Fishbein, M. & Ajzen, I. (1975). Belief, attitude, intention and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.
Fletcher, J. M., & Tefft, N. (2013). The Long-Term Effects of Stress on Partner Weight Characteristics. PLoS ONE, 8 (6).
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. Journal of personality and social psychology, 50 (5), 992- 1003.
Gauffin, K., Hemmingsson, T., & Hjern, A. (2013). The effect of childhood socioeconomic position on alcohol-related disorders later in life: a Swedish national cohort study. Journal of epidemiology and community health, 67 (11), 932.
Gauffin, K., Vinnerljung, B., & Hjern, A. (2015). School performance and alcohol- related disorders in early adulthood: a Swedish national cohort study. International Journal of Epidemiology, 44 (3), 919-927.
Gauffin, K., Hjern, A., Vinnerljung, B., & Björkenstam, E. (2016). Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study. PloS one, 11 (3), e0151755.
Giordano, G. N., & Lindström, M. (2011). Social capital and change in psychological health over time. Social Science & Medicine, 72 (8), 1219-1227.
Goldthorpe, J. H. (1996). Class Analysis and the Reorientation of Class Theory: The Case of Persisting Differentials in Educational Attainment. The British Journal of Sociology, 47 (3), 481-505.
Hardie, J. H. (2014). The consequences of unrealized occupational goals in the transition to adulthood. Social Science Research, 48, 196-211.
Harding, S., Read, U., Molaodi, O., Cassidy, A., Maynard, M., Lenguerrand, E., & ..., Enayat, Z. (2015). The Determinants of young Adult Social well-being and
Health (DASH) study: diversity, psychosocial determinants and health. Social Psychiatry & Psychiatric Epidemiology, 50 (8), 1173-1188.
Hill, J. M., Lalji, M., Rossum, G. V., Geest, V. R., & Blokland, A. A. (2015). Experiencing emerging adulthood in the Netherlands. Journal of Youth Studies, 18 (8), 1035-1056.
Hochbaum, G., Rosenstock, I., & Kegels, S. (1952). Health belief model. United States Public Health Service.
Hurst, Charles E. (2007). Social Inequality: Forms, Causes, and Consequences (6th ed.). Boston: Pearson Education.
Kawachi, I., Kennedy, B. P., Glass, R. (1999). Social capital and self-rated health: A contextual analysis. American Journal for Public Health, 89 (8), 1187-1193.
Keyes, C. L. (2002). The mental health continuum: From languishing to flourishing in life. Journal of health and social behaviour, 43 (2), 207-222.
Krings, F., Bangerter, A., Gomez, V., & Grob, A. (2008). Cohort Differences in Personal Goals and Life Satisfaction in Young Adulthood: Evidence for Historical Shifts in Developmental Tasks. Journal of Adult Development, 15 (2), 93-105.
Lazarus, R. S. 1966. Psychological Stress and the Coping Process. New York: McGrawHill.
Lazarus, R. S., & Folkman, S. (1984) . Stress, appraisal, and coping. Springer publishing company.
Levinson, D. J. (1978). The seasons of a man's life. New York: Random House, Inc.. Lodi-Smith, J., & Roberts, B. W. (2007). Social Investment and Personality: A Meta-Analysis of the Relationship of Personality Traits to Investment in Work, Family, Religion, and Volunteerism. Personality and Social Psychology Review, 11 (1), 68-86. doi: 10.1177/1088868306294590
Luhmann, N. (2012). Communication Media. In Cultural Memory in the Present : Theory of Society, Volume 1. Redwood City, US: Stanford University Press.
Mawson, E., Best, D., Beckwith, M., Dingle, G. A., & Lubman, D. I. (2015). Social identity, social networks and recovery capital in emerging adulthood: A pilot study. Substance Abuse Treatment, Prevention, and Policy, 10 (1).
Mechling, B. M. (2015). A cross-sectional survey of the effect on emerging adults living with a depressed parent. Journal of Psychiatric and Mental Health Nursing, 22, 570-578.
Miller, S. M. & Mangan, C. E. (1983). The interacting effects of information and coping style in adapting to gynaecologic stress: Should the doctors tell all? Journal of Personality and Social Psychology, 45, 223-236.
Miller-Graff, L. E., Cater, Å. K., Howell, K. H., & Graham-Bermann, S. A. (2015). Victimization in childhood: General and specific associations with physical health problems in young adulthood. Journal of psychosomatic research, 79 (4), 265-271.
Moffitt, T. E., Caspi, A., Harrington, H., & Milne, B. J. (2002). Males on the life- course-persistent and adolescence-limited antisocial pathways: Follow-up at age 26 years. Development and Psychopathology, 14 (1), 179-207.
Neff, K. D., & McGehee, P. (2010). Self-compassion and psychological resilience among adolescents and young adults. Self and Identity, 9 (3), 225-240.
Negru, O. (2012). The time of your life. Emerging adulthood characteristics in a sample of Romanian high-school and university students. Cognition, Brain, Behavior, 16 (5), 357-367.
Parker, P. D., Lüdtke, O., Trautwein, U., & Roberts, B. W. (2012). Personality and Relationship Quality During the Transition From High School to Early Adulthood. Journal of Personality, 80 (4), 1061-1089.
Perry, M. J. (1996). The Relationship between Social Class and Mental Disorder. Journal of Primary Prevention, 14 (1), 17-30. doi:10.1007/BF02262736
Puig-Perez, S., Villada, C., Pulopulos, M. M., Almela, M., Hidalgo, V., & Salvador, A. (2015). Optimism and pessimism are related to different components of the stress response in healthy older people. International Journal of Psychophysiology, 98 (2), 213-221.
Ravanera, Z., & Rajulton, F. (2009). Measuring social capital and its differentials by family structures. Social Indicators Research, 95 (1), 63-89.
Reifman, A., Arnett, J. J., & Colwell, M. J. (2007). Emerging adulthood: Theory, assessment, and application. Journal of Youth Development, 2 (1), 1-12.
Robinson, O. (2015). Emerging Adulthood, Early Adulthood, and Quarter-Life Crisis. Emerging Adulthood in a European Context, 17.
Rotter, J. B. (1954). Social learning and clinical psychology. New York: Prentice Hall.
Ryff, C. D., & Heidrich, S. M. (1997). Experience and well-being: Exploration on domains of life and how they matter. International Journal of Behavioral Development, 20 (2), 193-206.
Ryff, C. D., and C. L. Keyes. (1995). The Structure of Psychological Well- Being Revisited. Journal of Personality and Social Psychology, 69 (4), 719-727.
Sarafino, E. P., & Smith, T. W. (2014). Health Psychology: Biopsychosocial Interactions, 8 th Edition. Hoboken, NJ: Wiley.
Schimank, U. (2013). Gesellschaft. Bielefeld: transcript.
Skogbrott Birkeland, M., Leversen, I., Torsheim, T., & Wold, B. (2014). Pathways to adulthood and their precursors and outcomes. Scandinavian Journal Of Psychology, 55( 1), 26-32.
Sneed, J. R., Whitbourne, S. K., Schwartz, S. J., & Huang, S. (2012). The relationship between identity, intimacy, and midlife well-being: Findings from the Rochester Adult Longitudinal Study. Psychology and Aging, 27 (2), 318-323.
Starr, L. R. (2015). When Support Seeking Backfires: Co-Rumination, Excessive Reassurance Seeking, and Depressed Mood in the Daily Lives of Young Adults. Journal of Social and Clinical Psychology, 34 (5), 436-475.
Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a social ecology of health promotion. American Psychologist, 47 (1), 6-22.
Uchino, B. (2004). Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven, CT: Yale University Press. Underdown, A. (2006). Health and Well-Being in Early Childhood. Buckingham, GBR: Open University Press.
Valdez, C. R., Chavez, T., & Woulfe, J. (2013). Emerging Adults’ Lived Experience of Formative Family Stress The Family’s Lasting Influence. Qualitative Health Research, 23 (8), 1089-1102. doi:10.1177/1049732313494271
Van de Mheen, H., Stronks, K., Looman, C.W.N., & Mackenbach, J.P. (1998). Does childhood socioeconomic status influence adult health through behavioural factors? International Journal of Epidemiology. 27 (3), 431-437.
VandenBos, G. R. (2015). APA Dictionary of Psychology, Second Edition. Washington, DC: American Psychological Association.
Webster, J. D. (2010). Wisdom and positive psychosocial values in young adulthood . Journal of Adult Development, 17 (2), 70-80.
WHO: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. (1948).
Wider, W., Bahari, F., Halik, M., & Mustapha, M. (2015). A preliminary analysis of the perceptions of the five features of emerging adulthood: A comparison of perceived adult status among emerging adults in Malaysia. Projournal of Humanities and Social Science, 3 (1), 12-24.
Williams, D. M. (2010). Outcome Expectancy and Self-Efficacy: Theoretical Implications of an Unresolved Contradiction. Personality and Social Psychology Review, 14 (4), 417-425. doi:10.1177/1088868310368802
Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry and clinical neurosciences, 65 (5), 405-415.
GRIN Publishing, located in Munich, Germany, has specialized since its foundation in 1998 in the publication of academic ebooks and books. The publishing website GRIN.com offer students, graduates and university professors the ideal platform for the presentation of scientific papers, such as research projects, theses, dissertations, and academic essays to a wide audience.
Free Publication of your term paper, essay, interpretation, bachelor's thesis, master's thesis, dissertation or textbook - upload now!