The Role of School Engagement in the Link Between Adverse Childhood Experiences and Adolescent Mental Health.

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health Pub Date : 2024-11-13 DOI:10.1016/j.jadohealth.2024.09.025

Li Niu, Yun Chen, Yijie Wang, Yan Li, Angela Diaz

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引用次数: 0

Abstract

Purpose: Adverse childhood experiences (ACEs) increase the risk for poor adolescent mental health, yet mediational pathways that connect ACEs with mental health problems remain unaddressed. Our study investigates whether school involvement and disengagement mediate the longitudinal associations between ACEs and adolescent mental health problems.

Methods: Using data from the longitudinal Adolescent Brain Cognitive Development Study, this study included 7,558 adolescents aged 9-10 years at baseline. ACEs were a cumulative risk score of 21 adverse experiences (e.g., emotional abuse, community violence) reported by parents and youths at baseline or 1-year follow-up. School involvement and disengagement were reported by youths at two-year follow-up. Internalizing and externalizing problems were reported by parents using the Child Behavior Checklist at 3-year follow-up.

Results: A higher ACE score was associated with decreased school involvement (β = -0.08, 95% CI = [-0.10, -0.05]) and increased school disengagement (β = 0.09, 95% CI = [0.06, 0.11]) one year later, and with increased internalizing (β = 0.10, 95% CI = [0.07, 0.12]) and externalizing problems (β = 0.08, 95% CI = [0.06, 0.10]) 2 years later, adjusted for demographics and baseline mental health and school engagement levels. Decreased school involvement and increased disengagement mediated the associations between ACEs with the change in internalizing and externalizing problems over time.

Discussion: The present study highlights the roles of school involvement and disengagement in linking ACEs to worsened mental health outcomes. The findings may inform tailored school-based interventions that address mental health challenges faced by adolescents exposed to ACEs.

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学校参与在童年不良经历与青少年心理健康之间的联系中的作用。

目的：不良童年经历（ACEs）会增加青少年心理健康不良的风险，但ACEs与心理健康问题之间的中介途径仍未得到解决。我们的研究调查了学校参与和脱离学校是否会介导ACE与青少年心理健康问题之间的纵向联系：本研究利用青少年大脑认知发展纵向研究的数据，纳入了 7,558 名基线年龄为 9-10 岁的青少年。ACE是由家长和青少年在基线或1年随访时报告的21种不良经历（如情感虐待、社区暴力）的累积风险评分。青少年在两年的跟踪调查中报告了参与学校活动和脱离学校的情况。内化和外化问题由家长在 3 年随访时使用儿童行为检查表进行报告：结果：ACE 分数越高，一年后学校参与度越低 (β = -0.08, 95% CI = [-0.10, -0.05])，学校脱离度越高 (β = 0.09, 95% CI = [0.06, 0.11])，内化度越高 (β=0.10,95%CI=[0.06,0.11])。10, 95% CI = [0.07, 0.12]）和外化问题（β = 0.08, 95% CI = [0.06, 0.10]）。学校参与度的降低和脱离程度的增加在ACE与内化和外化问题随时间的变化之间起到了中介作用：讨论：本研究强调了学校参与和脱离学校在将 ACE 与心理健康恶化联系起来方面所起的作用。研究结果可为有针对性的校本干预措施提供信息，以应对受ACE影响的青少年所面临的心理健康挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Adolescent Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

10.40

自引率

3.90%

发文量

526

审稿时长

46 days

期刊介绍： The Journal of Adolescent Health is a scientific publication dedicated to enhancing the health and well-being of adolescents and young adults. Our Journal covers a broad range of research topics, spanning from the basic biological and behavioral sciences to public health and policy. We welcome a variety of contributions, including original research papers, concise reports, literature reviews, clinical case reports, opinion pieces, and letters to the editor. We encourage professionals from diverse disciplines such as Anthropology, Education, Ethics, Global Health, Health Services Research, Law, Medicine, Mental and Behavioral Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, and Youth Development to share their expertise and contribute to our mission of promoting adolescent health. Moreover, we value the voices of young individuals, family and community members, and healthcare professionals, and encourage them to submit poetry, personal narratives, images, and other creative works that provide unique insights into the experiences of adolescents and young adults. By combining scientific peer-reviewed research with creative expressions, our Journal aims to create a comprehensive understanding of the challenges and opportunities in adolescent and young adult health.