Adolescents’ future academic prospects : predictors and mental health outcomes

In the context of a changing labor market and increasing demand for higher education, young people may face challenges and uncertainty about their futures. Sweden has also faced many changes to the education system, as well as decreasing trends in youth mental health, especially among girls. These factors may affect how young people perceive their futures, and how they envision their future academic prospects. While academic stress is generally perceived as negative, motivation and goal setting tend to correlate with better achievement and well-being. Academic expectations refer to how far people believe that they will go in school, while academic aspirations refer to how far people want to go in school. Less is known about how these perceived future academic prospects relate to mental health. Additionally, little is known about which modifiable factors may predict future academic prospects. This thesis aims to explore the relationship between future academic prospects and mental health among adolescents and to better understand the contextual and individual factors which predict the formation of adolescents’ future academic prospects. The studies included in this thesis are based on the KUPOL (a Swedish acronym for Knowledge about Young People’s Mental Health and Learning) cohort study. Adolescents (age 13 at baseline) answered questionnaires during three annual waves encompassing measures of their academic expectations, aspirations, and future goals, as well as their mental health, sense of identity, relationships with their parents, and academic achievement. Parents of the adolescents also answered questionnaires encompassing measures of their academic expectations and aspirations for their children as well as sociodemographic characteristics. School-level data were also collected at the schools that the adolescents attended using anonymous questionnaires measuring the pedagogical and social climate of the school given to teachers and 9th grade students. Adolescents future aspirations and goals at baseline were found to be associated with better mental health in terms of both internalizing and externalizing symptoms at one year follow up (study I). This relationship did not appear to differ according to gender. Similarly, parents’ expectations for their adolescent children to attend university, as well as the agreement of parents’ and children’s university expectations were associated with a decreased likelihood of the adolescent experiencing problematic externalizing symptoms (study II), though these associations were not found when considering internalizing symptoms. Furthermore, teacher-rated measures of the overall school climate, as well as the specific domains of academic and disciplinary expectations and support for students were associated with an increased likelihood of the adolescents aspiring to university (study III), but no such relationships were apparent when using the student report of the school climate measures. Finally, adolescents’ academic grades, engagement and parental engagement were associated with adolescents resolving their uncertainty in expectations between 7th and 9th grade, while academic grades, engagement, and parental expectations were associated with adolescents raising their expectations between 7th and 9th grade (study IV). Identity synthesis and mental health, however, were not associated with either of these outcomes. In light of these findings, it is important to find ways to encourage adolescent future prospects at the family and school level with the potential to improve their mental health

Individual and familial factors predict formation and improvement of adolescents' academic expectations: A longitudinal study in Sweden.

BACKGROUND:Adolescents' high academic expectations predict future health and successful societal integration. Yet, little is known about which factors may promote adolescents' expectations of their future education and academic achievement. AIMS:To explore whether potentially modifiable factors such as parents' engagement and expectations regarding their child's education; or student individual factors such as school engagement, academic achievement, sense of identity, and positive mental health predict positive development of academic expectations in early adolescence. METHODS:A longitudinal study of 3,203 adolescents and their parents was conducted with information collected between 7th grade (13 years of age) and 9th grade (16 years of age). Parental and adolescents' own academic expectations and engagement in school, academic achievement, identity synthesis, and mental health were self-reported in annual questionnaires. We used logistic regression to analyze the associations between the aforementioned factors and two binary outcomes related to changes in expectations from 7th to 9th grade: A. resolved uncertainty regarding own academic expectations; B. raised academic expectations. RESULTS:Student engagement, and higher academic grades predicted both resolved uncertainty in expectations and raised academic expectations. Higher parental involvement in education was related to resolved uncertainty, while high parental expectations were related to raised student expectations. Identity synthesis and mental health did not appear to predict either outcome. CONCLUSION:Our findings indicate that a supportive parental attitude concerning their child's education during adolescence, student engagement, and positive progressions in academic achievements may contribute to a positive development of academic expectations, thus to positive educational trajectories

Prevalence and factors associated with severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal: a comparative study using multilevel analysis

Abstract Despite economic growth and poverty reduction, under-5 child undernutrition is still rampant in South Asian countries. This study explored the prevalence and risk factors of severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal for comparison using the Composite Index of Severe Anthropometric Failure. We utilised information on under-5 children from recent Demographic Health Surveys. We used multilevel logistic regression models for data analysis. The prevalence of severe undernutrition among under-5 children was around 11.5%, 19.8%, and 12.6% in Bangladesh, Pakistan, and Nepal, respectively. Children from the lowest socioeconomic quintile, and children born with low birth weight were key factors associated with severe undernutrition in these countries. The factors, parental education, maternal nutritional status, antenatal and postnatal care, and birth order were not homogeneous in explaining the determinants of child severe undernutrition across the countries. Our results suggest that the poorest households, and low birth weight of children have significant effects on severe undernutrition among under-5 children in these countries, which should be considered to formulate an evidence-based strategy to reduce severe undernutrition in South Asia

School environment and mental health in early adolescence - a longitudinal study in Sweden (KUPOL)

Background: Longitudinal studies indicate strong associations between school proficiency and indicators of mental health throughout adulthood, but the mechanisms of such associations are not fully elucidated. The Kupol study is a prospective cohort study in Sweden set up in order to: (i) describe the association of school pedagogic and social environment and its specific dimensions with the risk of mental ill-health and psychiatric disorders in adolescence; (ii) evaluate the direct effects of school pedagogic and social environment on mental health and the effects mediated by the individual's academic achievements; and (iii) assess if school pedagogic and social environment are associated with mental ill-health through epigenetic mechanisms, in particular those involving genes regulating the response to stress. Methods: The Kupol cohort at baseline consists of 3959 children attending the 7th grade of compulsory school (13-14 years old) in 8 regions of central Sweden in the school years 2013-2014 or 2014-2015. Three follow-up surveys in subsequent years are planned. Teachers' and students' perceptions of the culture, climate and ethos of their schools, and students' mental ill-health are assessed at the whole school level by annual questionnaire surveys. In order to conduct epigenetic analyses saliva specimens are collected from a nested sample of students at inception and two years later. Further, class-, family-and child-level information is collected at baseline and during each year of follow-up. Self-reported information is being complemented with register data via record-linkages to national and regional health and administrative registers. Discussion: The topic being investigated is new, and the sample constitutes the largest adolescent cohort in Sweden involved in an ad hoc study. Epigenetic analyses centered on environmental cues to stress response are a thoroughly new approach. Finally a notable feature is the multi-informant and multi-method data collection, with surveys at the school, class, family, and student level. Collaboration and data access: interested investigators should contact the coordinating centre. Additional information is available on the study's website, http://kupolstudien.se/

Unequal access? Use of sickness absence benefits by precariously employed workers with common mental disorders: a register-based cohort study in Sweden

Objective: This study compares the use of sickness absence benefits (SABs) due to a common mental disorder (CMD) between precariously employed and non-precariously employed workers with CMDs. Design: Register-based cohort study. Participants: The study included 78 215 Swedish workers aged 27-61 who experienced CMDs in 2017, indicated by a new treatment with selective serotonin reuptake inhibitors (SSRIs). Excluded were those who emigrated or immigrated, were self-employed, had an annual employment-based income 90 days of unemployment per year, had student status, had SABs due to CMDs during the exposure measurement (2016) and the two previous years, had an SSRI prescription 1 year or less before the start of the SSRI prescription in 2017, had packs of >100 pills of SSRI medication, had a disability pension before 2017, were not entitled to SABs due to CMDs in 2016, and had no information about the exposure. Outcome: The first incidence of SABs due to CMDs in 2017. Results: The use of SABs due to a CMD was slightly lower among precariously employed workers compared with those in standard employment (adjusted OR [aOR] 0.92, 95% CI 0.81 to 1.05). Particularly, women with three consecutive years in precarious employment had reduced SABs use (aOR 0.48, 95% CI 0.26 to 0.89), while men in precarious employment showed weaker evidence of association. Those in standard employment with high income also showed a lower use of SABs (aOR 0.74, 95% CI 0.67 to 0.81). Low unionisation and both low and high-income levels were associated with lower use of SABs, particularly among women. Conclusions: The study indicates that workers with CMDs in precarious employment may use SABs to a lower extent. Accordingly, there is a need for (1) guaranteeing access to SABs for people in precarious employment and/or (2) reducing involuntary forms of presenteeism