Youth Psychopathology and School Attendance Problems

青少年精神病理学和入学问题

• 批准号: 7296242
• 负责人: Jeffrey James Wood
• 金额: $ 7.27万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7296242
• 关键词: Absenteeism; Adolescent; American; Applications Grants; Arts; Attention; Characteristics; Child; Chronic; Class; Data Set; Development; Diagnostic; Disease; End Point; Environment; Equation; Exhibits; Exposure to; Failure; Foundations; Future; Goals; High Prevalence; Incidence; Intervention; Interview; Lead; Left; Longitudinal Studies; Markov Chains; Measures; Medical; Mental Health; Mental disorders; Modeling; National Institute of Mental Health; Nature; Outcome; Patient Self-Report; Phase; Play; Preventive Intervention; Probability; Procedures; Psychopathology; Public Health; Rate; Relative (related person); Reporting; Research; Research Design; Risk; Risk Factors; Role; Sampling; Schedule; Schools; Social Phobia; Social Problems; Statistical Methods; Students; Symptoms; Techniques; Testing; Theoretical model; Time; Virulent; Wood material; Youth; base; catalyst; children' s depression inventory; clinically significant; elementary school; intervention program; person centered; prevent; programs; selective prevention; social; sound; stressor; teacher; theories

DESCRIPTION (provided by applicant): Among likely risk factors for youth psychopathology, chronic school absenteeism is a widespread problem that is potentially preventable, yet its role in the development of mental illness remains poorly understood. With the high prevalence rates of psychiatric disorders among youth in the U.S., increasing attention has been paid to the 8-11% of American children and adolescents who exhibit chronic absenteeism. Theory suggests that chronic absenteeism can trigger or exacerbate psychiatric disorders, and is not merely an effect or marker of pre-existing psychopathology. However, previous research has been unable to clarify the nature of the psychopathology-absenteeism relationship due to a lack of methodologically-sound longitudinal studies and causal modeling. The proposed study seeks to (a) test a causal model of absenteeism as a determinant of future psychopathology and (b) identify possible causes of absenteeism to inform selective prevention models. Four nationally or regionally representative school-based longitudinal datasets that feature repeated measures of youth psychopathology, school attendance, and relevant covariates spanning 1st through 12th grade will be employed to test hypotheses (Ns = 20,745; 2,311; 678; and 671). Measures of psychopathology administered repeatedly in these studies vary and include validated diagnostic interviews and self-report forms such as the Diagnostic Interview Schedule for Children-IV (DISC-IV, Shaffer et al., 2000), the Children's Depression Inventory (CDI; Kovacs, 1983), and the Teacher Report Form (TRF; Achenbach, 1991). By employing multiple datasets, the invariance of the conceptual model across samples with differing demographic characteristics may be tested. Structural Equation Modeling (SEM) and Latent Mixed Markov Chain Analysis (LMM) will be used to generate a transition-focused analysis of youth psychiatric functioning over time. These causal modeling techniques can test whether being categorized as chronically absent at one time point increases the probability of transitioning to a higher-psychopathology class (i.e., exacerbation) or remaining at a high- psychopathology class (i.e., persistence) in subsequent years, relative to other children and controlling for prior psychiatric functioning and relevant covariates. Potential determinants of absenteeism (e.g., medical problems, social problems, academic difficulties, exposure to risky environments) will then be tested in parallel causal models to assess their influence on emerging school attendance problems over time. These person-centered analyses will permit conclusions about clinically significant transitions over time and will thereby clarify the role of absenteeism as a true risk factor versus a marker or effect of psychopathology. This research may promote public health efforts to reduce the incidence of psychopathology by (a) providing an empirical basis for identifying youth at high risk of developing new or worsening psychiatric problems, and (b) informing the development of preventive interventions to help such youth avoid negative mental health sequelae. The proposed research will advance public health efforts to identify US youth who are at risk for developing mental illness. If poor school attendance is found to be a precursor of psychiatric disorders as hypothesized, at-risk youth may then be offered intervention programs that could prevent the onset of mental illness.

描述（由申请人提供）：在青少年精神病理学的可能风险因素中，长期缺勤是一个普遍存在的问题，而且是可以预防的，但它在精神疾病发展中的作用仍然知之甚少。随着美国青少年精神疾病的高患病率，8-11% 长期缺勤的美国儿童和青少年越来越受到关注。理论表明，长期缺勤可能引发或加剧精神疾病，而不仅仅是先前存在的精神病理学的影响或标志。然而，由于缺乏方法论上合理的纵向研究和因果模型，先前的研究无法阐明精神病理学与缺勤关系的本质。拟议的研究旨在（a）测试缺勤的因果模型作为未来精神病理学的决定因素，以及（b）确定缺勤的可能原因，为选择性预防模型提供信息。将采用四个具有全国或地区代表性的学校纵向数据集来检验假设（Ns = 20,745；2,311；678；和 671），这些数据集重复测量青少年精神病理学、就学率和跨度 1 至 12 年级的相关协变量。这些研究中重复实施的精神病理学测量方法各不相同，包括经过验证的诊断访谈和自我报告表，例如儿童诊断访谈表-IV（DISC-IV，Shaffer等，2000）、儿童抑郁量表（CDI；Kovacs，1983）和教师报告表（TRF；Achenbach，1991）。通过使用多个数据集，可以测试具有不同人口统计特征的样本之间的概念模型的不变性。结构方程模型（SEM）和潜在混合马尔可夫链分析（LMM）将用于对青少年精神功能随时间的变化进行重点分析。这些因果建模技术可以测试相对于其他儿童并控制先前的精神功能和相关协变量，在一个时间点被归类为长期缺席是否会增加在随后几年中过渡到较高精神病理学类别（即恶化）或保持在较高精神病理学类别（即持续）的可能性。然后，将在并行因果模型中测试缺勤的潜在决定因素（例如，医疗问题、社会问题、学业困难、暴露于危险环境），以评估它们随着时间的推移对新出现的学校出勤问题的影响。这些以人为中心的分析将得出关于随着时间的推移临床上显着转变的结论，从而澄清缺勤作为真正的危险因素与精神病理学标志或影响的作用。这项研究可以通过以下方式促进公共卫生工作，以减少精神病理学的发生率：（a）为识别出现新的或恶化的精神问题的高风险提供经验基础，以及（b）为制定预防性干预措施提供信息，以帮助这些青少年避免负面的心理健康后遗症。拟议的研究将推动公共卫生工作，以确定有患精神疾病风险的美国青少年。如果按照假设的那样，出勤率低是精神疾病的先兆，那么就可以为高危青少年提供干预计划，以预防精神疾病的发生。