Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study

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Abstract

Background

School drop-out is a problem all over the world with adverse life-course consequences. The aim of this paper is to study how internalising and externalising problems in the 10 ^th grade are associated with non-completion of upper secondary school, and to examine the mediating role of grade points in the 10 ^th grade across general academic and vocational tracks in upper secondary school. We also study the impact of health behaviour.

Methods

Population-based health surveys were linked with Norwegian registries on education and sociodemographic factors (n = 10 931). Mental health was assessed by the self-report Strengths and Difficulties Questionnaire. Logistic regression was used to analyse the relations between mental health and health behaviour in 10 ^th grade and non-completion of upper secondary school. The mediating effect of grade points was studied by causal mediation analysis.

Results

Adolescents not completing upper secondary school reported more externalising problems and girls more internalising problems in the 10 ^th grade, after adjustments. Smoking and physical inactivity increased the odds of non-completion of upper secondary school. Causal mediation analyses showed that a reduction in externalising problems of 10 percentage points led to lower rates of non-completion of 4–5 percentage points, and about three-quarters of this total effect was mediated by grades. For internalising problems the total effect was significant only for girls (1 percentage point), and the mediated effect of grades was about 30%. The effect of mental health problems on school dropout was mainly the same in both vocational and general tracks.

Conclusions

Assuming a causal relationship from mental health problems to school performance, this study suggests that externalising problems impair educational attainment. A reduction of such problems may improve school performance, reduce school drop-out and reduce the adverse life-course consequences.

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Most cited references 14

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Show me the child at seven: the consequences of conduct problems in childhood for psychosocial functioning in adulthood.

David M. Fergusson, L John Horwood, Elizabeth M Ridder (2005)

This paper seeks to extend research into the adult sequelae of childhood conduct problems by investigating the associations between conduct problems in middle childhood and psychosocial outcomes in adulthood. Data were gathered during the course of a 25-year longitudinal study of a birth cohort of New Zealand young people. Information was collected on: a) parent and teacher reports of child conduct problems at ages 7, 8 and 9 years; b) measures of crime, substance use, mental health, sexual/partner relationships, education/employment; c) confounding factors, including childhood, family and educational characteristics. There were statistically significant associations between childhood conduct problems from 7-9 years and risks of adverse outcomes across all domains of functioning. After control for confounding factors the associations between conduct problems and education/employment outcomes became statistically non-significant. Associations persisted for other outcomes (crime, substance dependence, mental health and sexual/partner relationships). Children in the most disturbed 5% of the cohort had rates of these outcomes that were between 1.5 and 19 times higher than rates for the least disturbed 50% of the cohort. The associations between conduct problems and adult outcomes were similar for males and females. Childhood conduct problems were associated with a wide range of adverse psychosocial outcomes (crime, substance use, mental health, sexual/partner relationships) even after control for confounding factors. The results reinforce the need for greater investment into interventions to address these problems.

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To review recent progress in child and adolescent psychiatric epidemiology in the area of prevalence and burden. The literature published in the past decade was reviewed under two headings: methods and findings. Methods for assessing the prevalence and community burden of child and adolescent psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease. There is mounting evidence that many, if not most, lifetime psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.

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Richard A. Miech, Avshalom Caspi, Terrie E Moffitt … (1999)

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central

ISSN (Electronic): 1471-2458

Publication date Collection: 2014

Publication date (Electronic): 9 January 2014

Volume: 14

Page: 16

Affiliations

[1 ]Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway

[2 ]Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway

[3 ]National Centre for Dual Diagnosis, Innlandet Hospital Trust, Sanderud, Brumundal, Norway

[4 ]Faculty of Public Health, Hedmark University College, Elverum, Norway

Article

Publisher ID: 1471-2458-14-16

DOI: 10.1186/1471-2458-14-16

PMC ID: 3905670

PubMed ID: 24406098

SO-VID: ffe0fea4-1e13-438b-94b2-73ea93cac674

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.