Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall.

BACKGROUND: The aim of this study is to examine the relationship between personal values in adolescence retrospectively assessed and psychological distress in adults in a representative sample of community adults in Japan.
METHODS: We used the J-SHINE data collected in 2010 and 2017. Personal values in adolescence were retrospectively measured in the 2017 survey in two ways: (1) value priorities developed from Schwartz's theory of basic values; and (2) commitment to values measured by Personal Values Questionnaire II (PVQ-II). Psychological distress was measured by using K6 in 2010. Multiple regression analysis was conducted to clarify the association between personal values in adolescence and psychological distress in adults, adjusting for sociodemographic variables, smoking, alcohol drinking, and economic status at age 15.
RESULTS: Enduring active challenging, cherishing family and friends, and the commitment to values were significantly and negatively associated with psychological distress in adults. Pursuing one's interest was significantly and positively associated with psychological distress.
CONCLUSIONS: Having a value priority of enduring active challenging, cherishing family and friends, and the commitment to values in adolescence may reduce psychological distress in adults.

Introduction

Personal value is a broad goal, varying in importance and underlying and guiding attitudes and behavior [1, 2]. Personal value is divided into two major components: the content of values and the commitment to those values [3, 4]. The content of values are the things people value, such as power, achievement, hedonism, stimulation, self-direction, universalism, benevolence, tradition, conformity, and security [3]. The commitment to values represents how much a person emphasizes and acts according to those values [5].

Personal values are formed in adolescence, which may affect long-term cognitions, behaviors, and finally health and well-being [1, 2]. Previous studies found that one’s personal values in adolescence, both the content of and commitment to those values, were associated with positive mental well-being [6, 7]. However, no study has clarified the associations between personal values in adolescence and psychiatric symptoms, such as depression and anxiety. Investigating this association is important because it could lead researchers to know if personal values could improve mental health and prevent mental disorders in adulthood.

The purpose of this study is to examine the association between personal values in adolescence retrospectively assessed and psychological distress (depression and anxiety) in a large representative sample of community-residing adults in Japan.

Materials and methods

Participants

The study protocol was approved by the Research Ethics Committee of the Graduate School of Medicine and the Faculty of Medicine, The University of Tokyo, Japan [No.630-7,3361]. This study was a cross-sectional study based on a retrospective recall by using wave 1 and wave 3 data of the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) survey [8]. The sample was randomly selected from adult residents aged 20 to 50 years from four municipalities (two in Tokyo; two in neighboring prefectures). Systematic sampling methods were used from a residents’ register. There were no inclusion and exclusion criteria except for age. The participants were received invitation letters, and trained surveyors visited their houses. The participants were also asked to provide written informed consent and answered the self-administered questionnaire with a computer-aided personal instrument (CAPI). Three investigations have been conducted to date (Fig 1). In the wave 1 survey in 2010, 4,357 people completed the questionnaire (response rate: 31.3%). In the wave 2 survey in 2012, 2,961 people who had responded to the survey in wave 1 were recruited (response rate: 69.0%). In the wave 3 survey in 2017, those who responded to both the wave 1 and wave 2 surveys were selected; 2,787 people answered the questionnaire (response rate: 64.9%). Psychological distress and socio-demographics were measured in wave 1 and personal values in adolescence were measured in wave 3.

Fig 1

Flowchart of participant recruitment in J-SHINE.

Personal values in adolescence

We measured personal values in adolescence by using the value priorities and the commitment to values. For the value priorities, we developed 11 items based on the 57- item Portrait Values Questionnaire (PVQ-57; [9]) to be suitable to assess value priorities in adolescence. First, based on Schwartz’s 10 motivationally distinct priorities, we selected and revised eight items from the PVQ-57: avoiding causing trouble, positive evaluation, belief, improving society, social influence, enduring active challenging, cherishing family and friends, and stable lifestyle. Then, we developed three additional items that could motivate behavior, especially in adolescence: financial success, pursuing one’s interest, and graduating from school. These items are rated on a seven-point Likert scale (1 = Not at all, 7 = Very important) following the question, “When you were 15–16 years old, how important did you think the following values were in your life?” The commitment to values was measured by the Japanese version of the Personal Values Questionnaire II (PVQ-II) [5]. The reliability and validity of Japanese version of PVQ-II has already been confirmed. In this study, we revised the items to the past tense and instructed the participants to answer the items they considered the most important when they were 15–16 years old.

Psychological distress

We used Japanese version of K6 for measurement of psychological distress (depression and anxiety) [10]. It consists of six items answered on a 5-point Likert scale. Higher scores represent higher degrees of psychological distress. The reliability and validity of Japanese version of K6 has already been confirmed.

Data analysis

Multiple regression analysis was used to estimate the association between personal values in adolescence and psychological distress in adults. Model 1 was adjusted for socio-demographics variables; model 2 was adjusted for smoking and drinking alcohol; model 3 was adjusted for economic status at age 15. A p-value less than 0.05 was statistically significant. We used SPSS (Windows version 25) for statistical analysis. Imputation of missing responses on the variables was not conducted.

Results

Among 2,787 total survey respondents, 2,723 completed the value priorities and PVQ-II. Some of the respondents had missing values on K6, demographic variables, smoking, drinking alcohol and economic status in 15 years old (n = 117) and were excluded from the study. The final sample that had no missing values and was used for analysis comprised 2,606 respondents (Fig 1). S1 Table showed demographic and psychosocial characteristics of the study. According to S2 Table, pursuing one’s interest was significantly and positively associated with psychological distress after adjusting for socio-demographics variables (model 1), smoking and drinking alcohol (model 2) and economic status in 15 years old (model 3). Enduring active challenging was significantly and negatively associated with psychological distress after adjusting for model 2 and model 3, however, there were no significant associations after adjusting for model 1. Cherishing family and friends and the commitment to values were significantly and negatively associated with psychological distress after adjusting for model 1, model 2 and model 3.

Discussion

The results revealed that enduring active challenging, cherishing family and friends and the commitment to values were significantly and negatively associated with psychological distress in adults; pursuing one’s interest was significantly and positively associated with psychological distress.

Considering Schwartz’s 10 basic values theory, previous studies revealed that values related to openness to change (self-direction, stimulation and hedonism), achievement, and benevolence were positively associated with mental health and well-being [6][11][12]. In this study, enduring active challenging and cherishing family and friends were almost the same concepts as stimulation, self-direction and benevolence, respectively. Enduring active challenging and cherishing family and friends were consistent with the previous studies, however, pursuing one’s interest was opposite to previous findings. Considering possible reasons for this finding, pursuing one’s interest might be considered less socially acceptable in Japan, because the Japanese believe that harmony is the greatest of virtues [13].

Previous studies have indicated that the commitment to values was associated with well-being [7], which showed that this study was consistent with the literature. Those who committed themselves to their own values may have created high self-efficacy and/or self-esteem, which could decrease psychological distress in adults.

This study has two strengths. One is that the topic of personal values in adolescence had not yet been fully researched before this study. The other is that, as a practical implication, moral education to enduring active challenging and cherishing family and friends in adolescence could improve mental health in adulthood.

However, there were five limitations. First, recall bias may have occurred because the participants had to remember the values that were important to them when they were 15 years old. Second, childhood adversity should be taken into account as a confounding factor because it affected psychological distress and was presumably associated with personal values in adolescence. Third, test-retest reproducibility, internal consistency and construct validity of the measurement of value priorities in adolescence used in this study has not been fully evaluated, so random error is a possibility. Fourth, the low response rate of this study could cause the possibility of selection bias, which could also lead to uncertainty in the representativeness and the generalization of the results. Fifth, as this study was cross-sectional, so a cohort study should be conducted to clarify the causality of this association.

Conclusions

Despite these limitations, the present study showed that enduring active challenging, cherishing family and friends and the commitment to values in adolescence could help to reduce psychological distress in adults.

Demographics and psychosocial characteristics of the participants.

(DOCX)

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Personal values in adolescence and psychological distress in adulthood: Multiple Linear regression analysis of data from community residents in Japan.

(DOCX)

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22 Oct 2019

PONE-D-19-19474

Brief report: Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall

PLOS ONE

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Dear authors,

I believe this is an interesting and relevant article, and may contribute to the understanding of the influence of personal values in adolescence on adulthood mental health. However, before publication, some minor revision is needed:

Regarding data availability, it is not possible to find them in the article, which only contains a regression table. Plos One requires that the data are made available as an attached file or at a public repository. Eventually, data may be offered upon request, due to ethical or privacy issues.

Another important issue if the low response rate in wave 1 (31.3%) – and, therefore, for the whole study, since wave 1 was the basis for the recruitment of all participants in the study. This may have led to a lack of representativeness and limits to the generalization of the results. It is important to make a reflection on this on the discussion. Moreover, since there was such a low response rate in the study, I suggest avoiding the following expression in the discussion: “It was able to avoid selection bias by using systematic sampling”.

Regarding the “value priorities”, you have developed 11 items based on the 57- item Portrait Values Questionnaire (PVQ-57). How was this done? Which procedures were adopted? Which were the criteria for the selection of the items included in the study? Was any psychometric analysis performed?

I would suggest placing the first paragraph of the results on the methods section. It is more related to “participants” than to “results”.

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1 Nov 2019

Dear Editor in chief

Thank you for inviting us to submit a revised manuscript entitled, “Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall” to PLOS ONE. We also appreciate the time and effort you and each of the reviewers have dedicated to providing insightful feedback on ways to strengthen our paper. Thus, it is with great pleasure that we resubmit our article for further consideration.

We have incorporated changes that reflect the detailed suggestions you have graciously provided. We prepared point-by-point responses to the questions and comments on separate sheets. We hope that our edits and the responses we provide below satisfactorily address all the issues and concerns you and the reviewers have noted.

Again, thank you for giving us the opportunity to revise and strengthen our manuscript with your valuable comments and queries. We look forward to your positive decision on our submission.

Sincerely,

Norito Kawakami

Reply to Journal Requirements

Thank you very much for your valuable and helpful suggestions. We have revised the manuscript in accordance with your suggestions. Revisions are shown in highlighted text in the revised manuscript. We would be pleased if you could have a look at the revised manuscript and check if we responded to your comments appropriately.

Comment 1

When submitting your revision, we need you to address these additional requirements. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

http://www.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf

and

http://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

Response: Thank you very much for your comment. We revised our manuscript in accordance with PLOS ONE’s style.

Comment 2

Please provide additional information about the participant recruitment method and the demographic details of your participants.

Response: Thank you very much for your comment. We added the participant recruitment method in the manuscript and also explained with a newly added figure (Fig 1). We also created a new table concerning about demographic details of the participants (Table 1).

The sample was randomly selected from adult residents aged 20 to 50 years from four municipalities (two in Tokyo; two in neighboring prefectures). Systematic sampling methods were used from a residents’ register. There were no inclusion and exclusion criteria except for age. The participants were received invitation letters, and trained surveyors visited their houses. The participants were also asked to provide written informed consent and answered the self-administered questionnaire with a computer-aided personal instrument (CAPI). Three investigations have been conducted to date (Fig 1). (p3, line25-32)

Comment 3

We note that the manuscript title begins with "Brief report". Please note that PLOS ONE does not have an article type of this name. Please consider removing this from your article title."

Response: Thank you very much for your comment. We removed "Brief report" from the title.

Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall (p1, line1-2)

Reply to Additional Editor Comments

Thank you very much for your valuable and helpful suggestions. We have revised the manuscript in accordance with your suggestions. Revisions are shown in highlighted text in the revised manuscript. We would be pleased if you could have a look at the revised manuscript and check if we responded to your comments appropriately.

Comment 1

Regarding data availability, it is not possible to find them in the article, which only contains a regression table. Plos One requires that the data are made available as an attached file or at a public repository. Eventually, data may be offered upon request, due to ethical or privacy issues.

Response: Thank you very much for your comment. We added the following sentences in the manuscript.

Data Availability Statement

Data are available from the Data Committee of the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) for researchers who meet the criteria for access to data. The ethical approval of the J-SHINE study was obtained with a clear statement that the data would be used with the permission of the Data Management Committee. The Data Management Committee is concerned that sharing data, even when these are anonymous, might happen to result in identifying some of the respondents, if it is not well controlled. We cannot share the data without the permission of the Data Management Committee, according to our research plan submitted to the ethics committee at the University of Tokyo. Data access requests may be directed to Prof Hideki Hasimoto, the Chair of the Data Management Committee of the JSHINE study, at hidehasimoto-circ@umin.ac.jp. (p7, line1-12)

Comment 2

Another important issue if the low response rate in wave 1 (31.3%) – and, therefore, for the whole study, since wave 1 was the basis for the recruitment of all participants in the study. This may have led to a lack of representativeness and limits to the generalization of the results. It is important to make a reflection on this on the discussion. Moreover, since there was such a low response rate in the study, I suggest avoiding the following expression in the discussion: “It was able to avoid selection bias by using systematic sampling”.

Response: Thank you very much for your comment. We added the possibility of causing selection bias, the limitation of the representativeness and the generalization of this study. We also removed the following sentences from the manuscript. “It was able to avoid selection bias by using systematic sampling.”

Fourth, the low response rate of this study could cause the possibility of selection bias, which could also lead to uncertainty in the representativeness and the generalization of the results. (p6, line18-20)

This study has two strengths. One is that the topic of personal values in adolescence had not yet been fully researched before this study. The other is that, as a practical implication, moral education to enduring active challenging and cherishing family and friends in adolescence could improve mental health in adulthood. (p6, line7-10)

Comment 3

Regarding the “value priorities”, you have developed 11 items based on the 57- item Portrait Values Questionnaire (PVQ-57). How was this done? Which procedures were adopted? Which were the criteria for the selection of the items included in the study? Was any psychometric analysis performed?

Response: Thank you very much for your comment. We added the following explanation and limitation of the measurement tool to the manuscript.

For the value priorities, we developed 11 items based on the 57- item Portrait Values Questionnaire (PVQ-57; [9]) to be suitable to assess value priorities in adolescence. First, based on Schwartz’s 10 motivationally distinct priorities, we selected and revised eight items from the PVQ-57: avoiding causing trouble, positive evaluation, belief, improving society, social influence, enduring active challenging, cherishing family and friends, and stable lifestyle. Then, we developed three additional items that could motivate behavior, especially in adolescence: financial success, pursuing one’s interest, and graduating from school. These items are rated on a seven-point Likert scale (1=Not at all, 7=Very important) following the question, “When you were 15-16 years old, how important did you think the following values were in your life?” (p4, line9-19)

Third, test-retest reproducibility, internal consistency and construct validity of the measurement of value priorities in adolescence used in this study has not been fully evaluated, so random error is a possibility. (p6, line15-18)

Comment 4

I would suggest placing the first paragraph of the results on the methods section. It is more related to “participants” than to “results”.

Response: Thank you very much for your comment. According to the STROBE statement , this information is recommended to listed at the beginning of the results. Therefore, we would like not to change the position of the sentences. We hope that this is acceptable.

Submitted filename: Response to Reviewers.docx

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6 Nov 2019

Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall

PONE-D-19-19474R1

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Congratulations for your paper.

Good luck!

Reviewers' comments:

12 Nov 2019

PONE-D-19-19474R1

Personal values in adolescence and psychological distress in adults: A cross-sectional study based on a retrospective recall

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