Mental health problems and educational attainment in adolescence: 9-year follow-up of the TRAILS study
Background. This study examines if mental health problems at age 11 and changes in mental health problems between age 11 and 16 predict educational attainment of adolescents at age 19, overall and stratified by gender. Methods. Data from 1711 adolescents (76.8% from initial cohort) of the Tracking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 9 year follow-up, were used. Mental health problems (externalizing, internalizing and attention problems) were measured by the Youth Self Report and the Child Behavior Checklist at ages 11 and 16. Difference scores for mental health problems between age 11 and 16 were calculated. Educational attainment was assessed at age 19. Results. Externalizing, internalizing and attention problems at age 11 were significantly associated with low educational attainment at age 19 (crude model). When adjusted for demographic variables and the other mental health problems, only the association for attention problems remained significant (odds ratio (OR), 95% confidence interval: 3.19, 2.11-4.83). Increasing externalizing problems between age 11 and 16 also predicted low educational attainment at age 19 (OR 3.12, 1.83-5.32). Among girls, increasing internalizing problems between age 11 and 16 predicted low educational attainment (OR 2.21, 1.25-3.94). For boys, no significant association was found for increasing internalizing problems and low educational attainment. For increasing attention problems between age 11 and 16 no significant association with low educational attainment was found. Conclusions. Externalizing, internalizing and attention problems at age 11 and an increase of these problems during adolescence predicted low educational attainment at age 19. Early treatment of these mental health problems may improve educational attainment, and reduce socioeconomic health differences in adulthood.