While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of counselling sessions with adolescents 10—18 years seeking help from a national youth counselling service for a romantic relationship concern to: In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age.
Relationship breakups were the most common concern for both male and female adolescents and for all age groups early, mid, late adolescence. Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns including breakups were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence.
These findings contribute to the development of targeted intervention and support programs. There is a growing body of work documenting the normative and salient nature of adolescent romance, as well as the behavioural, emotional and psychosocial sequelae of the experience [ 2Early dating is related to drug use delinquency and poor academic achievement456 ].
There have been a number of important theoretical contributions to the understanding of romantic relationships, from early through to late adolescence and the transition to young adulthood [ 79 ].
Theories of attachment [ 13 ], ego formation and psychosocial development [ 14 ] have been particularly influential. Adolescent romance typically begins as brief relationships in early adolescence, progresses into sexual relationships in mid-adolescence 14—15 years and onto more intense, committed relationships during later adolescence 16—18 years [ 21516 ].
Developmental-contextual theories of adolescent romantic stages also provide a framework for how romantic relationships assist young adults with addressing their identity and intimacy needs.
Connolly and colleagues propose a framework containing four stages of romantic relationships [ 17 ]: According to this model, the evolution of adolescent romantic involvement is highly sensitive to the peer context and corresponds with the course of individual identity development [ 18 ].
Data from both Australian and international youth counselling services report romantic relationship concerns are one of the most common reasons young people seek counselling support [ 22 ]. Romantic relationships have been found to impact on psychosocial development and mental health during adolescence.
For example, frequent or early dating and dating multiple partners has been linked with behavioural issues, poorer academic performance and employment prospects [ 10 ], and increased delinquency [ 2324 ]. Similarly, several studies have found elevated levels of stress, anxiety and depressive symptoms among adolescents who engaged in romantic experiences compared to those who did not [ 25262728 ].
The breakup stage of a romance has also been specifically examined, revealing links to heightened likelihood of first onset major depressive disorder among older adolescents [ 29 ].
However, little research has examined the association between breakups and poor mental health in earlier stages of adolescence. A number of variables related to adolescent romance have been associated with the risk of suicide attempts or completions in adolescents.
These include incongruent partnership role-identities [ 30 ], negative sexual experiences [ 31 ] and stressful events including breakups [ 32 ] and relationship disputes [ 33 ].
Nevertheless, the extent to which romantic relationship issues contribute to suicide risk remains unknown. present study sought to build on extant research by reporting rates of suicidal ideation and self-harm associated with romance specifically, including each of the discrete stages of romance, across early, middle and late adolescence.
Most research on adolescent romance has either looked at romantic involvement as a dichotomous variable e. Few studies have examined how age, gender and stages of romantic relationships may increase vulnerability to mental health issues. They found the initiation and maintenance stages of relationships e.
Clear age differences in the level of stress associated with adolescent romance have also emerged. Two longitudinal studies report that the highest stress levels occur at the age of 14 and then decline with age [ 27 ]. However, small samples i. Gender may also be an important determinant of vulnerability to mental health issues related to relationship concerns, although its impact remains unclear [ 3536 ]. Some research suggests that female adolescents are more likely to date [ 37 ] or become emotionally involved [ 38 ], and have an increased capability for developing and maintaining romantic relationships compared to their male peers.
Girls with early-onset puberty are more likely to enter into sexual relationships with older boys, to experience more psychological distress during their early teens, and to engage in risk-taking behaviours such as drug and alcohol consumption than their peers [ 39 ]. Whether these characteristics result in the higher levels of interpersonal stress [ 40 ] and depression [ 20 ] among female daters compared to males is unknown. This paper examined records of counselling sessions with adolescents 10—18 years seeking help from a national youth counselling service for a romantic relationship concern to explore: Participants were young people who sought support from a youth counselling service Kids Helpline between January and December and reported a romantic relationship concern.
Duringthe Kids Helpline dataset captured the details of 72, counselling sessions with young people, including 45, sessions with adolescents aged 10—18 years [ 31 ].
Support was provided via telephone, email and real-time web counselling. Further details are provided in Table 1. Romance help-seeking sample characteristics. The Kids Helpline is primarily funded by yourtown, an Australian Non-Government Organisation providing a variety of youth services.
Counsellors screen clients for suicidal thoughts and self-harm behavior, and assess their background and mental health during the counselling session in order to provide adequate and culturally appropriate counselling service. Assessment is based on self-report of existing diagnosis or counsellor expertise. Counselling sessions are regularly monitored by counselling supervisors and counselling advice or referral to another counsellor is provided when necessary. All data for this study were drawn from the Kids Helpline counsellor contact database, which captures non-identifying information on counselling sessions.
The dataset comprises 38 fields for logging data, including ten mandatory fields. The amount of information captured for non-mandatory items including age and gender varies depending on the privacy and confidentiality wishes of each client, the sensitivity of the concern i.
Recording the nature of the client concerns is done by first categorising the problem from a set list of 12 categories. More specific detail about the concern is then recorded by selecting from a pre-defined list of problem-specific descriptors. All counsellors undergo training on the definitions of each problem category to ensure consistent understanding and reporting. Mandatory reporting requires selection of at least one problem classification per counselling session, with the option to report up to four problems per counselling session.
Each counselling session is recorded as a separate contact resulting in some instances where multiple contacts correspond to one client. Age was recorded by counsellors then recoded into bands that broadly reflect key developmental stages of adolescence to allow for analysis between these stages, following established guidelines [ 4 ]. The three age bands were 10 to 14 years early adolescence15—16 years mid adolescenceand 17—18 years late adolescence.
The nature of the romance-related concern was assessed by counsellors and classified into one of eight categories see Table 2. Descriptive names were then given to the three relationship stages Initiation for the pre-relationship Early dating is related to drug use delinquency and poor academic achievement Maintenance for in-relationship stage; and Dissolution for the post-relationship stage.
Initiation relates to seeking information about dating and initiating contact and corresponds to the affiliate romantic stage.
The second stage, maintenance, corresponds to the intimate romantic stage in which a dyad is formed and assumes a more central role in structuring social interactions. Finally, dissolution, relates to the post-relationship stage where a commitment to a more stable relationship has not occurred.
An affirmative assessment of mental health is defined by Kids Helpline as representing those clients who disclosed a previously diagnosed mental health disorder or illness or the counsellor assessed the presence of significant mental health symptomology consistent with one or more mental health disorders.
This includes physical e. Counsellors are not expected to formulate a diagnosis as part of their assessment nor is it a requirement to report specific details of any symptoms presented. Risk of suicide and self-harm were also assessed by counsellors.
An affirmative assessment for suicide risk was recorded if the client disclosed that they were experiencing suicidal thoughts and further assessment by the counsellor verified the presence of a risk.
Self-harm is defined by Kids Helpline as deliberate, non-life threatening, self-effected bodily harm with the intent of causing physical harm to themselves in ways that are not intended to end their own lives. This study was ruled exempt from requiring ethical approval by the Queensland University of Technology Human Research Ethics Committee on the basis that the research was of negligible risk, involved the use of an existing dataset and only contained de-identified data collected as part of routine clinical practice at Kids Helpline.
To gain further insight, similar tests were performed for the eight specific relationship concern types. Associations of these variables with age as a continuous variable were analyzed with t -tests or one-way ANOVAs as appropriate.
A total of 8. The four other common reasons for seeking help were mental health and emotional wellbeing In the present sample, 92 cases sought help due to concern for another person.
These cases were excluded yielding a sample of Methods of communication with clients were telephone The presence or absence of a mental health issue as assessed by counsellors was recorded in cases. The presence or absence of a self-injury was recorded in cases.
The presence or absence of suicidal ideation was recorded in cases. When the eight types of relationship concerns were aggregated into the three relationship stages, the most common stage was dissolution Table 3 provides information on the age and gender characteristics for each area of romantic concern.
Mean ages were Help-seeking for pre-relationship concerns reduced as adolescents got older, while help-seeking for ongoing relationship challenges and dissolution concerns increased with age see Figure 1. Help-seeking for post-relationship issues was "Early dating is related to drug use delinquency and poor academic achievement" to dramatically rise between early and mid-adolescence and then plateau, showing little difference between mid and late adolescence. Early dating is related to drug use delinquency and poor academic achievement were significantly more likely than females to seek support regarding pre-relationship concerns No gender differences in romantic concerns during a relationship were found.
Of the eight types of relationship concerns the most commonly reported were 7 relationship breakdown, 4 maintaining and sustaining relationships, and 3 wanting to establish a relationship, being recorded in When types of concern were aggregated into the three relationship stages, the most common stage was dissolution Table 3 provides further information on the age and gender characteristics for each specific type of romantic concern. Early adolescence was associated with an increased concern regarding establishment and a decreased concern regarding maintenance.
Conversely, late adolescence was associated with a decreased concern regarding establishment and an increased concern regarding maintenance.
For most of the eight specific concern types, males showed greater concern in the establishment stage and females showed greater concern in the maintenance and dissolution stages. An exception was faithfulness concerns for which males showed the greatest concern.
In all cases, however, effects were small. Mental health issues were most prevalent in the dissolution stage Rates of mental health issues did not differ between genders. Self-harm was most prevalent in the dissolution stage There was no significant association between age and self-injury.
Suicidal ideation was most prevalent in the dissolution stage Rates of suicidal ideation did not differ between genders. Similarly suicidal ideation was not significantly related to age. v Youth engage in more civic activities into early adulthood. v Early dating relationships are related to drug use, delinquency, and poor academic achievement. The major personality achievement of adolescence and as a crucial step toward becoming a productive, content adult. Constructing an identity involves.