Anxiety in the School Setting: A Framework for Evidence-Based Practice

Parental mathematics anxiety is related to children's mathematical development in preschool and the first school years

Math anxiety is a well-known predictor of mathematics skills, with its effects ranging from reducing performance in high-stakes tests to interfering with learning novel mathematics contents. Although the intergenerational transmission of generalized anxiety is well-documented, research on the associations between parents' math anxiety and children's math anxiety and mathematics outcomes is still limited. In this longitudinal study (N = 126), we investigated the associations between parents' math anxiety (as measured when children were 3 years of age) and children's math anxiety and math skills at 8 years of age. The development of children's mathematics skills from 3 to 8 years was also investigated. Results of longitudinal structural equation models revealed that parents' math anxiety was associated with children's mathematics skills in the preschool years even after controlling for parental education. In turn, children's mathematics skills in the preschool years were associated both with children's mathematics skills and their mathematics anxiety at age 8. In addition, there was an indirect link between parents' math anxiety, as measured when their children were age 3, and children's mathematics skills at age 8, which was mediated by children's early mathematics skills in the preschool years. In sum, these findings suggest that although parents' math anxiety is not directly related to the development of math anxiety in their children, it may be negatively related to the development of children's early mathematical skills, which are strong predictors not only of academic achievement but also of success and well-being in adulthood.

The Role of Adolescent Anxious Mood, Marijuana Use, and Locus of Control in the School to Prison Pipeline

Racial disparities are evident in both educational outcomes and incarceration rates when comparing African American and white youth. It is essential to understand the school-to-prison pipeline and the ways in which school discipline practices and other factors disproportionately affect African American students, limit educational attainment, and increase risk for future incarceration in order to improve students' educational and life outcomes. This study explores how marijuana, anxiety and locus of control interact with school disciplinary practices in pushing students out of schools and into the criminal justice system. Analyses utilizing data from the Woodlawn Study, a longitudinal study of African Americans followed from first grade through adolescence, young adulthood, and midlife (n = 1,242), reveal that suspension or expulsion, frequent marijuana use, and locus of control (males only) all predict criminal justice system involvement above and beyond not graduating from high school, but do not interact significantly. This study offers avenues for intervention to reduce disparities.

Investigating school absenteeism and refusal among Australian children and adolescents using Apriori association rule mining

Identifying and determining the multitude of reasons behind school absences of students is often challenging. This study aims to uncover the hidden reasons for school absence in children and adolescents. The analysis is conducted on a national survey that includes 2967 Australian children and adolescents aged 11-17. The Apriori association rule generator of machine learning techniques and binary logistic regression are used to identify the significant predictors of school absences. Out of 2484, 83.7% (n = 2079) aged (11-17) years children and adolescents have missed school for various reasons, 42.28% (n = 879) are (11-15) years old, 24.52% (n = 609) and 16.9% (n = 420) are 16- and 17-years old adolescents respectively. A considerable proportion of adolescents, specifically 16.4% (n = 407) and 23.4% (n = 486) of 16 and 17 years old, respectively, have selected 'refused to say' as their reason for not attending school. It also highlights the negative outcomes associated with undisclosed reasons for school absence, such as bullying, excessive internet/gaming, reduced family involvement, suicide attempts, and existential hopelessness. The findings of the national survey underscore the importance of addressing these undisclosed reasons for school absence to improve the overall well-being and educational outcomes of children and adolescents.

Psychological characteristics and emotional difficulties underlying school refusal in adolescents using functional near-infrared spectroscopy

BACKGROUND

This study aims to explore the psychological characteristics, related emotional problems and potential NIR brain function mechanism of adolescents who refuse to attend school.

METHODS

The study included 38 adolescents (12-18 years old) who were not attending school and 35 healthy controls (12-18 years old) who are attending school regularly. Participants completed (1) general demographics, (2) Eysenck Personality Questionnaire (EPQ), (3) Zung Self-Rating Depression Scale (SDS), (4) Zung Self-Rating Anxiety Scale (SAS), and (5) Symptom Checklist-90 (SCL-90). In addition to the clinical tests, participants completed functional near-infrared spectroscopy (fNIRS). Mental health, personality, and emotional state were evaluated in both groups to explore the differences and to understand the underlying mechanisms of school refusal during adolescence.

RESULTS

Adolescents who did not attend school had higher neuroticism scores on the Eysenck Personality Questionnaire than healthy controls (p(FDR) < 0.001), introversion and concealment scores were lower than those of healthy controls (p(FDR) < 0.001), there was no significant difference in psychoticism scores between groups. SDS, SAS, SCL-90 scores and factor scores were higher than those of healthy control group (p(FDR) < 0.001), NIR functional brain imaging was different from healthy control group in the 12 and 27 channels (p(FDR) = 0.030, p(FDR) = 0.018), and no difference was found in the remaining channels (p(FDR) > 0.05). There were statistically significant differences in age and gender between the adolescents who refused school and the control group (p(FDR) < 0.001).

CONCLUSION

School refusal adolescents are relatively introverted and sensitive and need more attention in daily life. Although the adolescents' emotional problems did not reach the diagnostic criteria of depressive disorder and anxiety disorder, their scores were still higher than those of the control group, suggesting that we should pay more attention to their emotional problems in order to better help them return to school. Using fNIRS, it was found that abnormalities in frontal lobe regions in adolescents with school refusal behaviors, which would contribute to early diagnosis and timely intervention of school refusal behaviors.

Compassionate pedagogy for neurodiversity in higher education: A conceptual analysis

The neurodiversity paradigm challenges pathologising accounts of neurodevelopmental differences, including autism, attention deficit disorder (ADHD), dyslexia, developmental language disorder (DLD) and others. From a neurodiversity perspective, these differences in the way people perceive, learn about and interact with the world are conceptualised as naturally occurring cognitive variation, akin to biodiversity in the natural environment, which may bring unique strengths and challenges for individuals. An implication of this approach is that interventions designed to create contexts in which neurodivergent people can thrive are needed, in addition to those that seek to ameliorate individual-level difficulties. In this conceptual review, we consider how higher education can offer a context in which cognitive diversity can be noticed, welcomed and accepted with warmth. In universities, neurodiversity is one dimension of difference within an increasingly diverse student population, which overlaps - but is not synonymous - with disability. We argue that improving experience and outcomes for neurodivergent students should be a priority for universities aiming to produce graduates equipped to tackle the complex problems of contemporary society. Drawing on the foundational principles of compassion-focused psychological therapies, we consider how compassion can be enacted within interpersonal interaction, curriculum design, and leadership culture in universities. We apply the insights of double empathy theory to the problem of overcoming barriers of difference in the classroom. Finally, we make recommendations for Universal Design for Learning (UDL) and strengths-based pedagogical approaches, which create a fit-for-purpose educational environment for the widest possible range of learners. This realignment with the neurodiversity paradigm offers an antidote to bolt-on provisions for students who differ from the neuro-normative, and might enable neurodivergent thinkers to flourish within and beyond higher education.

Emotional Self-Regulation in Primary Education: A Heart Rate-Variability Biofeedback Intervention Programme

This study investigated the benefits of using a biofeedback intervention programme to train children in controlling their heart rate variability (HRV) through slow-paced breathing in real time. HRV biofeedback interventions focused on showing subjects to breathe such that their HRV numbers rise, improving their self-regulation. The HRV biofeedback intervention, focused on breathing, was conducted with primary education students aged between 7 and 11 years. The programme consisted of five biofeedback sessions, where students were taught to breathe six long and slow pairs of breaths per minute, to increase their HRV. After participation in the programme, students, regardless of gender, increased their HRV in a statistically significant fashion with a large effect, but this effect was not the same for all ages. HRV biofeedback interventions are rarely applied in schools and given the effectiveness of the intervention to improve HRV in children, the applied implications of our results in educational settings are discussed, especially taking into account the children’s ages.

Implications of the Online Teaching Model Derived from the COVID-19 Lockdown Situation for Anxiety and Executive Functioning in Spanish Children and Adolescents

Given the seriousness of the existing situation regarding the mental health of children and adolescents relating to the confinement period imposed due to COVID-19, we conducted this study to describe the effects of the confinement on state anxiety and executive functioning dimensions in a period of online educational modality. A sample of 953 children and adolescents was assessed. A sociodemographic questionnaire, the State Anxiety Inventory for Children (STAIC), and the Behavioral Evaluation of Executive Function (BRIEF-2) scale were applied. The analysis of the results indicates that 68.8% of children and adolescents presented medium–high levels of anxiety. Regarding sex, females showed higher levels of anxiety and worse levels of executive functioning. Although the group aged 11 to 18 years showed methodologically higher state anxiety (p = 0.041) than the group aged 6 to 10 years, the difference was not clinically relevant (δ = −0.113). The state anxiety variable was also correlated positively and significantly to the three executive functioning dimensions explored. In conclusion, it seems evident that COVID-19 lockdowns could have psychological and emotional effects on children and adolescents.

Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States

The Project to Learn About Youth-Mental Health (PLAY-MH; 2014-2018) is a school-based, two-stage study designed to estimate the prevalence of selected mental disorders among K-12 students in four U.S.-based sites (Colorado, Florida, Ohio, and South Carolina). In Stage 1, teachers completed validated screeners to determine student risk status for externalizing or internalizing problems or tics; the percentage of students identified as being at high risk ranged from 17.8% to 34.4%. In Stage 2, parents completed a structured diagnostic interview to determine whether their child met criteria for fourteen externalizing or internalizing disorders; weighted prevalence estimates of meeting criteria for any disorder were similar in three sites (14.8%-17.8%) and higher in Ohio (33.3%). PLAY-MH produced point-in-time estimates of mental disorders in K-12 students, which may be used to supplement estimates from other modes of mental disorder surveillance and inform mental health screening and healthcare and educational services.

Harnessing Home-School Partnerships and School Consultation to Support Youth With Anxiety

Youth with anxiety often experience significant impairment in the school setting. Despite the relevance and promise of addressing anxiety in schools, traditional treatment approaches to school-based anxiety often do not adequately address generalization to the school setting, or they require removing the student from the classroom to deliver time- and staff-intensive programs. Such programs often leave teachers and caregivers feeling ill-equipped to support the student with anxiety throughout the natural course of the school day. Given the heavy demands placed on teachers and documented burnout among school professionals, providing effective school supports requires collaborative partnerships among outpatient therapists/specialists, school personnel, and caregivers. Drawing from literature on collaborative models for externalizing problems, we offer recommendations for outpatient therapists and specialists working to implement evidence-based supports in school settings and promote home-school partnerships to benefit youth with anxiety in the school setting. Our recommendations touch upon several components of such school consultation, including (a) identification of key parties involved, (b) conducting a needs assessment, (c) collaborative goal setting and development of a fear hierarchy, (d) plan development and implementation (e.g., facilitating a school-based exposure mindset, promoting home-school communication, enhancing school relationships), and (e) progress monitoring and ongoing support. We conclude with a case example to bring these recommendations to life.

Engaging Teachers and School Leaders in Participatory Data Analysis for the Development of a School-Based Mental Health Intervention

The success of school-based mental health interventions is often inconsistent, in part due to lack of input from teachers and students in the programme design. Therefore, the involvement and engagement of teachers in the co-production of an intervention, especially within data analysis, can create more innovative and effective solutions. This paper presents a teacher-led qualitative data analysis using a new approach within the field, participation theme elicitation. This approach will be used to gather information relevant to the initial development of a school-based mental health intervention. Teachers identified the following themes: (1) physical activity as a stress reliever, (2) programme facilitation, (3) exam pressure and (4) solutions to improve negative mental health. Results from the teacher-led analysis are broadly similar to previous research in the field. Our findings demonstrate that teachers can have a valuable input into research findings which should help address the development of a school-based mental health intervention. In summary, the findings suggest that the use of participatory theme elicitation is a valid and effective method to address the gaps and limitations of participatory qualitative data analysis.

Latent Profiles of Anxious Children and Their Differences in Aggressive Behavior

Children tend to develop forms of anxiety that can be associated with school violence. However, the previous scientific literature on anxiety and aggression is scarce. In addition, it has only focused on examining differential relationships between both variables. This study aimed to analyze the relationships between three forms of anxiety (anticipatory anxiety, school-based performance anxiety, and generalized anxiety) and the components of aggression (physical and verbal aggression, anger, and hostility) by adopting a person-centered approach. The sample consisted of 1161 Spanish students from 8 to 11 years old (M = 9.72, SD = 1.14); 46.2% were boys. Informed written consent from the parents or legal guardians was obtained. The Visual Analogue Scale for Anxiety—Revised and the Aggression Questionnaire were used. The latent profile analysis technique identified three profiles of anxious children: Low Anxiety, High School-based Performance Anxiety, and High Anxiety. The High Anxiety group scored significantly higher than the Low Anxiety group in all components of aggression, with effect sizes ranging from moderate to large (d = 0.59 to 0.99). The High Anxiety profile showed significantly higher scores than the high school-based performance anxiety profile only in anger (d = 0.56) and hostility (d = 0.44). The results have relevant implications for practice, since there is evidence that different intervention strategies should be applied according to the risk profile.

Providers’ Experiences with Delivering School-Based Targeted Prevention for Adolescents with Anxiety Symptoms: A Qualitative Study

The school setting is important for delivering targeted prevention to adolescents with anxiety. However, schools may not have available providers with training or experience in delivering evidence-based interventions, e.g., school psychologists. Training providers available in the schools, e.g., school nurses, is important. Further, to investigate their experiences in delivering targeted prevention to adolescents with anxiety could help understand factors promoting implementation success. A qualitative study including focus groups with providers of school-based targeted prevention cognitive-behavioral therapy for anxiety in adolescents was conducted. Focus group interviews were audiotaped and transcribed verbatim. Systematic Text Condensation, a method for thematic cross-case analysis was used. The Active Implementation Framework (AIF) was used to contextualize the results. Seventeen providers participated in the study. They reported several facilitators contributing to successful implementation: Their feeling of competence in delivering the interventions were built through skills-based training, supervision, and collegial support. Conducting initial assessment of each adolescent helped the providers individualize the interventions. Seeing positive outcomes in adolescents gave the providers motivation to continue implementation. Further, collaborating with teachers facilitated both recruitment of adolescents and administering group sessions. Minimal leadership-oriented factors were reported. Overall, the findings correspond to some of the drivers in AIF. This study offers providers’ perspectives on implementation of targeted prevention for anxiety in the school setting. Our results show that providers experience mastery in delivery when receiving support, training, and supervision. This seems to be essential facilitators for implementing much needed targeted prevention for youth with anxiety.

Students' Trait Emotional Intelligence and Perceived Teacher Emotional Support in Preventing Burnout: The Moderating Role of Academic Anxiety

The current study sought to investigate the role of trait emotional intelligence and perceived teacher emotional support in school burnout. Furthermore, the moderating role of academic anxiety in these relationships was examined. A sample of 493 Italian high school students (81.9% female) aged 14–19 years (M = 16.27, SD = 1.48) was involved in the study. A latent moderated structural equation approach was performed to test the hypothesized model. The results showed that both trait emotional intelligence and perceived teacher emotional support were negatively associated with school burnout. Moreover, academic anxiety moderated the relation between perceived teacher emotional support and school burnout. Specifically, when the level of anxiety was high, the protective role of perceived teacher emotional support toward burnout was weakened. Findings are discussed in light of the protective role of resources on burnout and considering the detrimental impact of academic anxiety in school settings.

Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6-19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems.

Reconciling Contemporary Approaches to School Attendance and School Absenteeism: Toward Promotion and Nimble Response, Global Policy Review and Implementation, and Future Adaptability (Part 2)

As noted in Part 1 of this two-part review, school attendance is an important foundational competency for children and adolescents, and school absenteeism has been linked to myriad short- and long-term negative consequences, even into adulthood. Categorical and dimensional approaches for this population have been developed. This article (Part 2 of a two-part review) discusses compatibilities of categorical and dimensional approaches for school attendance and school absenteeism and how these approaches can inform one another. The article also poses a multidimensional multi-tiered system of supports pyramid model as a mechanism for reconciling these approaches, promoting school attendance (and/or prevention of school absenteeism), establishing early warning systems for nimble response to school attendance problems, assisting with global policy review and dissemination and implementation, and adapting to future changes in education and technology.