Adolescents with depressive symptoms and their challenges with learning in school

Cognitive functioning in children and adolescents with depression: A systematic review and meta-analysis

Although cognitive dysfunction is associated with depression in adults, the link in children and adolescents is unclear. This systematic review and meta-analysis quantifies the association between depression and cognitive function in children and adolescents. Systematic searches were conducted in six databases: Child Development and Adolescent Studies, Ovid MEDLINE, Ovid Embase, Ovid APA PsycINFO, EBSCO CINAHL Plus, Scopus (last search: April 2023). Studies including measures of cognitive outcomes (memory, attention, executive function, processing speed, language) among children (≤18 years) with depression were included. The Joanna Briggs Institute Critical Appraisal Tools were used to determine study risk of bias. Random-effects meta-analyses of study outcomes were performed. Seventeen studies were included (15 were cross-sectional, 1 prospective, 1 randomized control trial). Participants (N = 13,567) were 10 to 17 years old (mean 13.8 ± 2.2 years; 60 % female). Compared with healthy controls, depressed participants had lower performance on tests of working memory (g = -0.40; 95 % CI: -0.67, -0.13), long-term memory (g = -0.48; 95 % CI: -0.72, -0.25), attention (g = -0.15; 95 % CI: -0.26, -0.04), executive function (g = -0.16; 95 % CI: -0.24, -0.08), and language (g = -0.23; 95 % CI: -0.36, -0.09). No performance differences were observed on tests of short-term memory or processing speed. Children and adolescents with depression demonstrated lower performance on tests of working and long-term memory, attention, executive function and language. These findings emphasize the importance of considering cognitive functioning among children with depression, and greater understanding of the effect of treatment on these outcomes. PROSPERO (CRD42022332064).

The relationship between depression symptoms and academic performance among first-year undergraduate students at a South African university: a cross-sectional study

Background:

South African universities face a challenge of low throughput rates, with most students failing to complete their studies within the minimum regulatory time. Literature has begun to investigate the contribution of well-being, including mental health, with depression among students being one of the most common mental disorders explored. However, locally relevant research exploring associations between depression and academic performance has been limited. This research hypothesizes that the presence of depression symptoms, when controlling for key socio-demographic factors, has an adverse impact on student academic outcomes and contributes to the delay in the academic progression of students.

Methods:

The study used a cross-sectional design. Data were collected in 2019 from first-time, first-year undergraduate students using a self-administered online questionnaire. In total, 1,642 students completed the survey. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depression symptoms. Data on students’ academic performance were obtained from institutional records. Bivariate and multivariate regression analyses were used to examine associations between depression symptoms and academic performance.

Results:

Most participants (76%) successfully progressed (meeting the requirements to proceed to the second year of university study). Of the participants, 10% displayed symptoms of severe depression. The likelihood of progression delay (not meeting the academic requirements to proceed to the second year of university study) increased with the severity of depression symptoms. Moderate depression symptoms nearly doubled the adjusted odds of progression delay (aOR = 1.98, 95% CI: 1.30-3.00, p = 0.001). The likelihood of progression delay was nearly tripled by moderate severe depression symptoms (aOR = 2.70, 95% CI:1.70–4.36, p < 0.001) and severe depression symptoms (aOR = 2.59, 95% CI:1.54–4.36, p < 0.001). The model controlled for field of study, financial aid support as well as sex and race.

Conclusion:

Higher levels of depression symptoms among first-year university students are associated with a greater likelihood of progression delay and may contribute to the low throughput rates currently seen in South African universities. It is important for students, universities and government departments to recognize student mental wellness needs and how these can be met.

Association of Depressive Symptoms in Late Adolescence and School Dropout

The present study investigated the association between symptoms of depression in late adolescence and completion of upper secondary school, taking symptoms of ADHD and conduct disorder, and parental education into account. The study is based on the youth@hordaland-survey, conducted in Western Norway in 2012. A total of 9157 adolescents (aged 16–19 years, 53% girls) consented to participation and registry linkage and comprised the sample of the present study. Symptoms of depression, ADHD, and conduct disorder were based on adolescent self-report. Information on parental education, grade point average (GPA), and upper secondary school completion was retrieved from the National Education Database. In the sample, 14.8% had not completed upper secondary education within 5 years. Symptoms of depression were associated with higher odds of failure to graduate within 5 years (adjusted odds ratio (AOR) = 1.50). The association was attenuated but remained significant when adjusting for symptoms of ADHD, conduct disorder, and parental education. Adolescents reporting high levels of both depression and conduct disorder had the highest odds of dropout (AOR = 4.15). GPA partially mediated the association between symptoms of depression and dropout. The results show a consistent, but small association between symptoms of depression in late adolescence and failure to complete upper secondary education within five years. Given the high rate of depressive symptoms in the adolescent population, it is important to identify protective factors that promote school functioning and graduation for adolescents experiencing such symptoms.

Depressive Symptoms and Negative Experiences in School: A Network Analysis

Negative experiences in school predict adolescents' depression. However, the dynamic interactions of depressive symptoms with adolescents' negative experiences in school remain unclear. This study aims to applied network analysis to detect the complex relationships between early adolescents' depressive symptoms and negative experiences in school. We adopted the data from a Chinese national survey conducted in 2018. Eight hundred ninety-seven adolescents from 10 to 15 years old were included. The measurements include an 8-item depression screener scale and a 14-item scale assessing negative experiences in school. The centrality analysis suggests that Chinese early adolescents' core depressive symptoms are negative affections. Regarding "negative experiences in the school," the most central nodes are poor academic performance and peer relationships. The bridge-centrality results show negative emotions in school and difficulties in peer relationships are significantly linked to depression. Educators should pay attention to adolescents' negative affection and difficulties in peer relationships in school settings because they are potential signs of depression. Relevant peer support intervention aiming for adolescents' social development should be underscored.

The feasibility of using life skills training in primary schools to improve mental health and academic performance: a pilot study in Kenya

BACKGROUND

There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance.

METHODS

We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) to their parents, followed by eight sessions of life skills training. We extracted data from the individual records of each child on overall performance pre and post training separated by one year. We conducted descriptive statistics, paired sample t-tests, multivariate linear regression analysis and linear mixed model analysis to assess changing patterns of academic performance and any predictive characteristics.

RESULTS

There was significant (p < 0.05) improvement in overall academic performance (aggregate marks and all individual subjects) for both lower primary and upper primary classes after the life-skills training intervention. For lower classes (2-4 grades) increase in academic performance was significantly associated with fathers and mothers education levels, region and class. For upper classes, (5-7 grades) increase in academic performance was associated with region, class and age.

CONCLUSIONS

Life skills training is recommended as it could improve academic performance, but predicted by socio-demographic factors.

Stress Mediates the Relationship between Personality and the Affordance of Socially Distanced Online Education

The novel coronavirus pandemic has made life significantly more stressful for large populations of people. As one such demographic, university students worldwide have experienced a sudden shift toward the provision of socially distanced online education, often in the absence of a coherent institutional plan. The mechanisms of stress appraisal and response differ between individuals in part determined by personality. With a sample of 293 undergraduate students at a Japanese university operating under prohibitions relating to face-to-face education, this article examines the impact of personality on the affordance of socially distanced online education mediated through generalized life stress and online learning stress appraisal. A retrimmed structural model returned an acceptable goodness of fit accounting for 31.6% of the criterion variance. The model indicates that conscientiousness (positive) and neuroticism (negative) hold a significant mediated impact on the affordance of socially distanced online education through generalized life stress and online learning stress appraisal. Moreover, and in the absence of face-to-face social interaction, the model shows that extroverted students experience greater online learning stress appraisals than neurotic students. Neurotic students were, however, negatively impacted by appraisals of generalized life stress but not online learning stress. Informed by personality characteristics and stress appraisals, the outcomes are discussed in relation to educational improvements and appropriate pedagogies for the delivery of socially distanced online education.

Identifying barriers and facilitators to implementing mindfulness-based programmes into schools: A mixed methods study

Mindfulness-based initiatives have been shown to improve psychological wellbeing and increase academic engagement in school settings. The current study explored barriers and facilitators to the implementation of mindfulness-based (MB) programmes in schools. Ninety-five teachers completed an online survey, and six principals were interviewed, with questions for both informed by the Theoretical Domains Framework (TDF). Quantitative data was analysed via descriptive statistics and independent sample t tests. Qualitative interview data were analysed via thematic analysis. Teachers reported facilitators to successful MB programme implementation as self-efficacy and motivation, knowledge about MB programmes, acceptance of responsibility to deliver MB programmes and belief of negative consequences if MB programmes are not delivered. Principals reported organisational-level facilitators as having a school-wide positive education framework relevant to the school context, taking a long-term approach, school leaders supporting the initiatives and understanding the evidence behind MB programmes and empowering staff to engage in mindfulness. Individual-level facilitators included staff buy-in and commitment to practice and understanding mindfulness. Barriers included time, resources/money, staff buy-in and competing strategic priorities within the school. These findings are important for consideration by policymakers determining the way forward for more widespread implementation of MB programmes in Australia.

The Conceptualization of the Positive Cognitive Triad and Associations with Depressive Symptoms in Adolescents

The positive cognitive triad (positive cognitions about the self, world, and future) has been considered a protective factor against depressive symptoms. This study examines three conceptualizations of the positive cognitive triad and their relation to depressive symptoms. Analyses were replicated in two samples in order to provide evidence for the validity of findings. Two samples (n₁ = 2982, M_age = 13.04, Range_age = 11-15 years; n₂ = 2540, M_age = 13.11, Range_age = 11-16 years) of Australian adolescents completed the Positive Cognitive Triad Inventory and Center for Epidemiological Studies Depression Scale. Findings supported the notion that the overall positive cognitive triad is a protective factor for depressive symptoms, and specifically, the role of positive cognitions about the self in this protection. After future studies examine the directionality of the relation between positive cognitions and depressive symptoms, mental health providers using cognitive behavioral approaches may consider examining positive cognitions with patients.

A study of negative life events driven depressive symptoms and academic engagement in Chinese college students

Negative life events (NLEs) are an important predictor of depressive symptoms (DS). College students experiencing NLEs are at risk of developing DS that could further weaken their academic engagement (AE), while social supports may assuage such negative effect. The aim of this study was to examine the relationship between negative life events, depressive symptoms, and academic engagement, and how the NLE-DS-AE relationship is affected by the level of social support among Chinese college students. To test this hypothesis, we applied data from the Decoding Happiness Gene Cohort Study (DHGCS). Baseline depressive symptoms and academic engagement were measured at the beginning of the first academic year. Approximately 12 months later, negative life events and social support over the past year were assessed retrospectively along with current depressive symptoms and academic engagement. A total of 3629 college students (Age = 18.67 ± 0.82) were included in the study. The prevalence of depressive symptoms was 26.7% and 36.7% in college students at the beginning of the first and second academic year, respectively. Depressive symptoms predicted subsequent academic engagement rather than the reverse based on cross-lagged analyses. Using structural equation modeling analyses, findings revealed a partial mediation effect of social support between negative life events and the development of depressive symptoms, and a partial mediation effect between negative life events and academic engagement. The findings presented negative life events jeopardize the academic engagement via depressive symptoms, while social supports are able to cancel such negative effect among college students under the Chinese cultural context.

A Scoping Review and Content Analysis of Common Depressive Symptoms of Young People

School nurses are the most accessible health care providers for many young people including adolescents and young adults. Early identification of depression results in improved outcomes, but little information is available comprehensively describing depressive symptoms specific to this population. The aim of this study was to develop a taxonomy of depressive symptoms that were manifested and described by young people based on a scoping review and content analysis. Twenty-five journal articles that included narrative descriptions of depressive symptoms in young people were included. A total of 60 depressive symptoms were identified and categorized into five dimensions: behavioral (n = 8), cognitive (n = 14), emotional (n = 15), interpersonal (n = 13), and somatic (n = 10). This comprehensive depression symptom taxonomy can help school nurses to identify young people who may experience depression and will support future research to better screen for depression.

Evaluating a Modular Approach to Therapy for Children With Anxiety, Depression, Trauma, or Conduct Problems (MATCH) in School-Based Mental Health Care: Study Protocol for a Randomized Controlled Trial

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems (MATCH) on students' mental health and academic outcomes.

Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five school districts. School clinicians are randomized to either MATCH or usual care (UC) treatment conditions. The target sample includes 168 youths (ages 7–14) referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.

Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board (IRB14-3365). We plan to publish the findings in peer-reviewed journals and present them at academic conferences.

Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016.

The Heterogeneous Effects of Participation in Shadow Education on Mental Health of High School Students in Taiwan

The effect of shadow education or private supplementary education (PSE) on school achievement has been prolifically studied, but its impact on well-being remains understudied. This study examines the heterogeneous effect of PSE participation on school achievement and depression symptoms among high schoolers in Taiwan. The study uses panel data of the Taiwan Upper Secondary Database (TUSD) in the 2014 and 2015 academic years. We join the inverse-probability-of-treatment weighting (IPTW) approach and the seemingly unrelated regression (SUR) model to estimate the effects of PSE participation patterns on two correlated outcomes, comprehensive assessment of high school entrance examination and self-reported depression symptoms in the 11th grade. The latent class analysis identifies five PSE participation patterns: always-taker, early-adopter, dropout, late-adopter, and explorer, to predict the effect of PSE on the scores of entrance examination and later depression symptoms in high school (n = 7708, mean age = 15.33). The findings suggest that PSE participation in junior high is positively associated with academic achievement. However, PSE participation also increases depression symptoms, particularly in the case of always-takers. In other words, while always-takers increase their school achievement in transition into high school, their risks of suffering from depression are also higher than their peers.

Understanding Adolescent Expressions of Sadness: A Qualitative Exploration

PURPOSE

Primary care providers are positioned to identify adolescents at risk for depression and prevent major depressive disorder. To identify subthreshold depression, we examined the language adolescents use to describe their symptoms.

METHODS

Adolescents ages 13-18 with elevated levels on the Center for Epidemiologic Studies Depression (CES-D) scale and/or a history of depression who were part of a large randomized clinical trial to prevent depressive disorder were included. We used content analysis to analyze transcripts of semi-structured interviews.

RESULTS

Saturation was reached at 37 interviews. Adolescents self-identified as African American (N = 15), Hispanic (N = 10), and White (N = 21). Three domains were revealed; external sources of stress, adolescent expressions of sadness, and seeking help and care. Within these domains, 12 distinct themes emerged contextualizing these domains. No variations in the expression of the themes identified for subthreshold depression were found between the three ethno-cultural groups.

IMPLICATIONS FOR PRACTICE

Our study identifies, in adolescents' own words, how adolescents with subthreshold depression express feelings and cope with symptoms, and may guide primary care providers to recognize subthreshold depression early. These findings are a step toward filling the gap in the empirical literature needed to improve identification of adolescents at risk for depression in nonspecialist settings.

Are self-esteem and academic achievement reciprocally related? Findings from a longitudinal study of Mexican-origin youth

OBJECTIVE

Previous research has shown that self-esteem is associated with academic achievement. However, few studies have used longitudinal data to examine how self-esteem and achievement co-develop over a long time span, and even fewer have focused on ethnic minority youth.

METHOD

We used data from a longitudinal study of Mexican-origin youth (N = 674) to examine the bidirectional associations between self-esteem and academic achievement from 5th to 11th grade. Global and domain-specific self-esteem (academic, honesty, peer relationships, appearance) were assessed at ages 10, 12, 14, and 16 using Marsh et al.'s (2005) Self-Description Questionnaire. Academic achievement was assessed at the same ages using self-reported grades and standardized test scores from school records.

RESULTS

Youth with high global and academic self-esteem showed relative improvements in their grades (but not test scores), and youth who received higher grades and test scores showed relative increases in global and academic self-esteem. Youth with high honesty self-esteem showed relative increases in grades and test scores, and youth with higher grades showed relative increases in peer relationship self-esteem.

CONCLUSION

Students who feel better about themselves tend to show improvements in their grades, and getting better grades and test scores promotes more positive self-views.

Interpersonal Relationship Aspects as Perceived Risk and Social Support Factors in a Clinical Sample of Adolescents With Depression

The goal of this qualitative study was to explore how adolescents with diagnosed depression describe their social relationships with peers, parents and teachers. Several previous findings have revealed the dual role of interpersonal relationships — as a stressor and contributor to different mental disorders, and also as a source of social support for mental health. Previous studies confirmed the value of a qualitative approach in exploring the self-perceived experiences of adolescents. The research group consisted of 28 adolescents, aged 13–17, with a diagnosis of depression. Individual semistructured interviews (Children's Depression Rating Scale Revised; CDRS-R) were applied in this study, which were analysed using thematic analysis. The results have both scientific and practical value, as well as relevance for the development of preventive interventions targeted at well-being and mental health of adolescents.

Inpatient Psychiatric Care Outcomes for Adolescents: A Test of Clinical and Psychosocial Moderators

Financial pressures have led to a reduced length of stay (LOS) in inpatient psychiatric facilities for adolescents, yet research on the outcomes of short-term programs remains scant. The present study evaluated the outcomes of an adolescent inpatient program by: (1) probing depression, anxiety, and suicidal ideation at admission and discharge and (2) testing whether clinical or psychosocial factors moderate treatment response. Participants included adolescents (n = 777) aged 13-19 years admitted to an inpatient treatment program for acute psychiatric concerns. Clinical interviews were administered to probe mental disorders and past suicidal thoughts and behaviors (STBs), and self-report measures assessed symptom severity, child abuse, and peer victimization (i.e., bullying). Results showed a significant decrease in depression, anxiety, and suicidal ideation from admission to discharge. Comorbidity, past month NSSI, and lifetime suicide attempts emerged as moderators of treatment response, and peer victimization predicted symptom severity at discharge. Although findings suggest an overall improvement, participants with more severe clinical presentations (e.g., comorbidity, past month NSSI, lifetime suicide attempts, and more severe bullying) reported greater symptom severity at admission and discharge, suggesting that these patients may benefit from longer inpatient stays to achieve further symptom reduction. Although this may incur greater costs in the short-term, it also may prevent unintended economic and psychosocial consequences in the long-term.

LARS&LISA: a universal school-based cognitive-behavioral program to prevent adolescent depression

Adolescent depression is a prevailing international mental health concern as up to 27% of adolescents experience either subsyndromal depression or a major depressive episode by the age of 18. Depression in adolescence has been found to negatively impact current and future academic achievement, functioning, mental health, and quality of life. Accordingly, the authors emphasize the importance of proactively preventing depression (and its negative outcomes) instead of waiting and having to "fix" the problems after they have already developed. The current article begins with a discussion of the various types of prevention, including their respective advantages and disadvantages. Further and more importantly, the article's primary focus is to provide a summary of the theoretical basis, development of, empirical support for, and content of a universal school-based cognitive-behavioral program to prevent adolescent depression entitled LARS&LISA (Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag). As the program exists within the overlapping realms of universal prevention, school-based programs, and cognitive-behavioral interventions, the content of this article is relevant to all three areas and offers insight into the development of depression prevention in general. Finally, empirical support for the positive effects of the program is presented and some ideas for further research are discussed.

An investigation of African American and European American students' perception of teaching behavior

Teaching behaviors are associated with a range of student academic and mental health outcomes. Substantial academic, school disciplinary, and mental health disparities across African American and European American students suggest that diverse students may view and interpret teaching behaviors differently. The Teaching Behavior Questionnaire measures students' perceptions of teaching behaviors. The purpose of the current study was to examine the scale's factor structure among European American high school students using exploratory factor analysis and, subsequently, cross-validate using confirmatory factor analysis based on African American student data. Results supported reconceptualizing the scale according to a three-factor model in both groups. Implications related to the interpretation and use of scores are discussed.

Depression Screening in the School Setting: Identification of the Depressed Adolescent

Adolescent depression is a silent epidemic in this country. Untreated depression has detrimental effects on physical health, psychosocial well-being, and academic productivity. It is important for school nurses to be able to recognize depression and refer students promptly for treatment. This article and its associated learning module will provide school nurses with updated information on adolescent depression, discuss barriers in depression screening, use of the PHQ-9 (Patient Health Questionaire-9 Item) as an evidence-based depression screening tool in the educational setting, and the important role of school nurses in depression screening. It is anticipated that by increasing awareness and knowledge about adolescent depression and providing training in the use of an evidence-based screening tool, school nurses will have greater confidence in identifying and referring students in need. (A free online depression screening education module developed by the lead author is available at https://sites.google.com/view/depressionscreeningtraining .).

Longitudinal influence of alcohol and marijuana use on academic performance in college students

BACKGROUND

Alcohol and marijuana are the two most abused substances in US colleges. However, research on the combined influence (cross sectional or longitudinal) of these substances on academic performance is currently scant.

METHODS

Data were derived from the longitudinal 2-year Brain and Alcohol Research in College Students (BARCS) study including 1142 freshman students who completed monthly marijuana use and alcohol consumption surveys. Subjects were classified into data-driven groups based on their alcohol and marijuana consumption. A linear mixed-model (LMM) was employed using this grouping factor to predict grade point average (GPA), adjusted for a variety of socio-demographic and clinical factors.

RESULTS

Three data-driven clusters emerged: 1) No/low users of both, 2) medium-high alcohol/no-low marijuana, and 3) medium-high users of both substances. Individual cluster derivations between consecutive semesters remained stable. No significant interaction between clusters and semester (time) was noted. Post-hoc analysis suggest that at the outset, compared to sober peers, students using moderate to high levels of alcohol and low marijuana demonstrate lower GPAs, but this difference becomes non-significant over time. In contrast, students consuming both substances at moderate-to-high levels score significantly lower at both the outset and across the 2-year investigation period. Our follow-up analysis also indicate that when students curtailed their substance use over time they had significantly higher academic GPA compared to those who remained stable in their substance use patterns over the two year period.

CONCLUSIONS

Overall, our study validates and extends the current literature by providing important implications of concurrent alcohol and marijuana use on academic achievement in college.

Depression and Political Participation

In this paper, I propose that depression is a political phenomenon insofar as it has political sources and consequences. I then investigate one aspect of this argument-whether depression reduces participation. I hypothesize that individuals with depression lack the motivation and physical capacity to vote and engage in other forms of political participation due to somatic problems and feelings of hopelessness and apathy. Moreover, I examine how depression in adolescence can have downstream consequences for participation in young adulthood. The analyses, using both cross-sectional and longitudinal data, show that voter turnout and other forms of participation decrease as the severity of depressed mood increases. These findings are discussed in light of disability rights and potential efforts to boost participation among this group.

Interdependence of depressive symptoms, school involvement, and academic performance between adolescent friends: A dyadic analysis

BACKGROUND

Friendships play an important role in the development of school involvement and academic performance during adolescence. This study examined the interdependence of depressive symptoms, school involvement, and academic performance between adolescent same-sex friends.

AIMS

Using cross-sectional data, we examined whether the link between depressive symptoms and academic performance would be mediated by school involvement at the intrapersonal (actor) and interpersonal (partner) levels.

SAMPLE

Data came from 155 pairs of same-sex adolescent friends (80 boys; M(age) = 16.17, SD = 0.44). The actor-partner interdependence model was used to examine the dyadic data and mediation hypotheses.

RESULTS

Mediated actor effects showed that adolescents who had more depressive symptoms reported lower academic performance, and such an association was mediated by their own and their friend's lower school involvement. Mediated partner effects showed that adolescents who had more depressive symptoms also had a friend with lower academic performance, and such an association was mediated by both individuals' lower school involvement.

CONCLUSIONS

This study provided evidence to support the broader interpersonal framework for understanding school involvement and academic performance. The current findings also have potential practical implications, especially for programmes targeted at addressing adolescents' school problems.

Challenges of Documenting Schoolchildren’s Psychosocial Health

The aim of this study was to explore school nurses’ experience of challenges related to documenting schoolchildren’s psychosocial health in Sweden. Six focus group discussions were carried out. Areas for discussions included questions about situations, especially challenging to document as well as what constrains and/or facilitates documenting psychosocial health problem issues. Qualitative content analysis was used for interpreting the data. The analysis resulted in one overarching theme: having to do one’s duty and being afraid of doing wrong; and three subthemes: uncertainty related to one’s own ability, concerns related to future consequences, and strategies to handle the documentation. School nurses relying on their intuition and using a structured documentation model may increase the opportunities for a reliable documentation. To further develop their professional skills with regular, clinical supervision can be of great importance. This in turn may increase contributions to research and development for the benefit of schoolchildren’s psychosocial health.

Neurological and biological foundations of children's social and emotional development: an integrated literature review

This article provides an integrated review of the expert literature on developmental processes that combine social, biological, and neurological pathways, and the mechanisms through which these pathways may influence school success and health. It begins with a historical overview of the current understanding of how attachment relationships and social environments influence brain development and plasticity and are, therefore, central to the physical and mental health of individuals and populations. It then expands on the effect of plasticity in relation to behavior and learning at school. This article concludes with a discussion of the role the school nurse may play in supporting health and learning by recognizing signs of relational stress and by advocating for prevention strategies.

Addressing diabetes and depression in the school setting; the role of school nurses

What Can School Nurses Do to Address Diabetes and Depression in the School Setting? 1. Remember that depression and diabetes are common comorbidities. If you see signs of depression, remember to obtain the appropriate consent and approvals for students under the age of 18 before screening. 2. Remember that depression can interfere with self-management skills and may make diabetes worse--so connect students to community resources to help them reduce the risk of complications. 3. Remember that depression and risk-taking behaviors are common in adolescents with diabetes. Have educational materials ready and available to help students in need.

Interpersonal Psychotherapy-Adolescent Skills Training: Effects on School and Social Functioning

This paper reports on school and social functioning outcomes in a randomized depression prevention study that compared Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) with usual school counseling (SC). Outcome analyses were performed utilizing hierarchical linear models and mixed model analysis of variance. IPT-AST adolescents had significantly greater improvements than SC adolescents in total social functioning and friend functioning during the intervention. IPT-AST adolescents also demonstrated improvements in school, dating, and family functioning and emotional engagement in school, although these improvements were not significantly greater than seen in SC adolescents. Finally, in the 18 months following the intervention, IPT-AST adolescents were less likely than SC adolescents to be asked to leave school for academic or behavioral reasons. These findings extend the potential range of impact of depression prevention programs such as IPT-AST and provide preliminary evidence of the benefits of these programs on school and social functioning.

Adolescent and parent experiences with a primary care/Internet-based depression prevention intervention (CATCH-IT)

This article describes a mixed-methods approach to understand the experience of adolescents involved in the Internet-based intervention for depression, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training (CATCH-IT), as well as the experiences of their parents while they were involved. Qualitative analysis was done with grounded theory-based categorization of interview comments and typed program responses (adolescents only) into themes. Quantitative analysis was done with self-report surveys. The article describes the nine themes reflecting the adolescent experience and the three themes reflecting the parent experience. The article also describes the results of the quantitative surveys of helpfulness and attitudes change, which were favorable of the Internet-based intervention. Separate models explaining the psychological transformation of the adolescents and the experience of the parents are proposed. The positive experience of the adolescents and parents involved in CATCH-IT is discussed in the context of growing interest in how best to utilize Internet-based interventions for mental illness, and suggestions are made for future investigation.