College of Medicine and Health, University of Exeter, Exeter, UK.
Musgrove Park Hospital, Taunton, UK.
Child Adolesc Ment Health. 2020 Nov;25(4):217-223. doi: 10.1111/camh.12367. Epub 2020 Jan 21.
As the prevalence of childhood mental health conditions varies by age and gender, we explored whether there were similar variations in the relationship between psychopathology and exclusion from school in a prospective UK population-based birth cohort.
The Avon Longitudinal Study of Parents and Children collected reports of exclusion at 8 years and 16 years. Mental health was assessed at repeated time points using the Strengths and Difficulties Questionnaire (SDQ).
Using adjusted linear mixed effects models, we detected a nonlinear interaction between exclusion and age related to poor mental health for boys [adjusted coefficient 1.13 (95% confidence interval 0.55-1.71)] excluded by age 8, but not for girls. The SDQ scores of boys who were excluded in primary school were higher than their peers from age 3, and increasingly diverged over time. As teenagers, these interactions appeared for both genders [boys' adjusted coefficient 0.18 (0.10-0.27); girls 0.29 (0.17-0.40)]. For teenage girls, exclusion by 16 was followed by deteriorating mental health. Family adversity predicted exclusion in all analyses.
Prompt access to effective intervention for children in poor mental health may improve both mental health and access to education.
Children who were subsequently excluded from school often faced family adversity and had poor mental health, which suggests the need for an interdisciplinary response and a multiagency approach. Poor mental health may contribute to and result from exclusion from school, so both mental health and education practitioners have a key role to play. Boys who enter school with poor mental health are at high risk of exclusion in primary school, which prompt assessment and intervention may prevent. Both boys and girls who are excluded between the ages of 15 and 16 years may have poor, and in the case of girls, deteriorating, mental health.
由于儿童心理健康问题的患病率因年龄和性别而异，我们探讨了在一个前瞻性的英国基于人群的出生队列中，精神病理学与被学校排斥之间的关系是否存在类似的变化。
雅芳纵向研究父母与子女在 8 岁和 16 岁时报告了被排斥的情况。使用长处和困难问卷（SDQ）在多次时间点评估心理健康。
使用调整后的线性混合效应模型，我们检测到排斥与年龄之间的非线性相互作用与男孩的不良心理健康有关[调整后的系数为 1.13（95%置信区间为 0.55-1.71）]，但与女孩无关。在小学被排斥的男孩的 SDQ 评分从 3 岁开始就高于同龄人，而且随着时间的推移差异越来越大。到青少年时期，这种相互作用对两种性别都存在[男孩的调整系数为 0.18（0.10-0.27）；女孩为 0.29（0.17-0.40）]。对于十几岁的女孩，16 岁时被排斥后，心理健康状况恶化。在所有分析中，家庭逆境都预示着排斥。
及时为心理健康状况不佳的儿童提供有效的干预措施，可能会改善心理健康和受教育机会。
经常面临家庭逆境和心理健康状况不佳而被学校排斥的儿童表明需要跨学科应对和多机构方法。心理健康不良可能会导致被学校排斥，也可能是被学校排斥的结果，因此心理健康和教育从业者都发挥着关键作用。在进入学校时就存在心理健康问题的男孩，在小学被排斥的风险很高，及时进行评估和干预可能会预防这种情况。在 15 至 16 岁之间被排斥的男孩和女孩都可能会有较差的心理健康状况，而对于女孩来说，心理健康状况可能会恶化。
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