Please read chapters 6, and 10 and the article that I have provided to answer the questions. Also citation is apa Style and a reference sheet.
School Dropout and Suicide: Common Risk Factors and Prevention Strategies As you have read in chapter 6 of the textbook, a variety of factors contribute to high school dropout. While the dropout problem is not often discussed along with the issues of youth mental health and suicide, there are connections in terms of the risk and protective factors for both problems. For this discussion, please read textbook chapters 6 and 10 and this article from the Journal of Adolescent Health- Revisiting the Link Between Depression Symptoms and High School Dropout: Timing of Exposure Matters and then discuss the following points in a post of approximately 250 words: · What are some of the common risk and protective factors for school dropout and youth suicide? Cite specific facts from the reading and/or other sources. · Of the four types of dropout types described in chapter 6, which ones would be most at risk for mental health problems and suicide? Explain your reasoning. · Describe a strategy that a school might implement to prevent both dropouts and suicide among students. Explain why you believe this strategy is likely to be effective. The book is At-Risk Youth 6th edition from J. Jeffries McWhirter. Please use the pages provided to answer the questions. Also, there is an article that you have to read. Please provide a reference sheet in APA style when citing use APA style. I provided chapters 6 and 10 below this page. Chapter 10 Revisiting the Link Between Depression Symptoms and High School Dropout: Timing of Exposure Matters Original article Revisiting the Link Between Depression Symptoms and High School Dropout: Timing of Exposure Matters Véronique Dupéré, Ph.D. a,*, Eric Dion, Ph.D. b, Frédéric Nault-Brière, Ph.D. a, Isabelle Archambault, Ph.D. a, Tama Leventhal, Ph.D. c, and Alain Lesage, MD d a School of Educational Psychology (École de psychoéducation), Université de Montréal, Montreal, Quebec, Canada b Department of Special Education, Université du Québec à Montréal, Montréal, Quebec, Canada c Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, Massachusetts d Department of Psychiatry, Université de Montréal, Montréal, Quebec, Canada Article history: Received June 15, 2017; Accepted September 15, 2017 Keywords: Depression symptoms; High school dropout; Late adolescence A B S T R A C T Purpose: Recent reviews concluded that past depression symptoms are not independently asso- ciated with high school dropout, a conclusion that could induce schools with high dropout rates and limited resources to consider depression screening, prevention, and treatment as low- priority. Even if past symptoms are not associated with dropout, however, it is possible that recent symptoms are. The goal of this study was to examine this hypothesis. Methods: In 12 disadvantaged high schools in Montreal (Canada), all students at least 14 years of age were first screened between 2012 and 2015 (Nscreened = 6,773). Students who dropped out of school afterward (according to school records) were then invited for interviews about their mental health in the past year. Also interviewed were matched controls with similar risk profiles but who remained in school, along with average not at-risk schoolmates (Ninterviewed = 545). Interviews were conducted by trained graduate students. Results: Almost one dropout out of four had clinically significant depressive symptoms in the 3 months before leaving school. Adolescents with recent symptoms had an odd of dropping out more than twice as high as their peers without such symptoms (adjusted odds ratio = 2.17; 95% confi- dence interval = 1.14–4.12). In line with previous findings, adolescents who had recovered from earlier symptoms were not particularly at risk. Conclusions: These findings suggest that to improve disadvantaged youths’ educational out- comes, investments in comprehensive mental health services are needed in schools struggling with high dropout rates, the very places where adolescents with unmet mental health needs tend to concentrate. © 2017 Society for Adolescent Health and Medicine. All rights reserved. IMPLICATIONS AND CONTRIBUTIONS Recent reviews concluded that past symptoms of depression are not inde- pendently associated with high school dropout. Results of the present study find that recent symptoms are, thus underscoring the potential of school-based mental health programs to hit two targets with one shot, by improving adoles- cent mental health and educational/vocational outcomes. Adolescents should be a priority target for screening, preven- tion, and treatment of mental health problems [1,2]. First, adolescence is a critical developmental period during which many common mental health problems emerge [3]. For instance, among 15–16 years old, about one out of six adolescents experience major depression [4]. Second, untreated mental health problems during Conflicts of Interest: The authors have no conflicts of interest to disclose. * Address correspondence to: Véronique Dupéré, Ph.D., School of Educational Psychology (École de psychoéducation), Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, QC, H3C 3J7, Canada. E-mail address:
[email protected] (V. Dupéré). 1054-139X/© 2017 Society for Adolescent Health and Medicine. All rights reserved. https://doi.org/10.1016/j.jadohealth.2017.09.024 Journal of Adolescent Health 62 (2018) 205–211 www.jahonline.org http://crossmark.crossref.org/dialog/?doi=10.1016/j.jadohealth.2017.09.024&domain=pdf mailto:
[email protected] http://www.jahonline.org adolescence can lead to poor health and social outcomes through- out adulthood [5]. Third, compulsory schooling ends after high school; thus adolescence represent a final opportunity to reach, via school-based programs, virtually every individual in a given cohort [2]. In practice, however, implementing mental-health pro- grams in high schools is a challenge, especially in disadvantaged contexts where these programs are most needed [5–7]. A main barrier is the fact that “achieving health outcomes is not the core business of schools” [6]. Rather, high schools’ first mandate is to bring as many students as possible to graduation. If mental health programs do not clearly contribute to this primary goal, school personnel under pressure to improve substandard graduation rates may hesitate to channel scarce resources toward such pro- grams [2,8]. As such, health workers need to reconcile their priorities with those of educational workers and decision makers to achieve better collaboration and, ultimately, better out- comes [9]. A key way to promote such collaboration is to demonstrate that mental health problems are strongly associated with high school dropout, and that mental health prevention programs have the potential to improve graduation rates [2]. Such strong asso- ciations exist for one class of mental health problems, externalizing behaviors, most notably attention-deficit/ hyperactivity disorders (ADHD) and conduct disorders (CD) [10,11]. Evaluation studies show that school-based programs re- ducing these problems also prevent dropout [10]. From school personnel’s viewpoint, these programs hit two high-value targets with one shot: they reduce troublesome behaviors that are very disruptive for classroom functioning and improve graduation rates. In contrast, the link between high school dropout and inter- nalizing problems, first and foremost depression, is much less clear. Logically, depressed adolescents should be at risk of aban- doning school, as a core symptom of depression is of a lack of energy and interest to carry out daily activities like attending school. This potential risk, however, is often overlooked because depression symptoms are not overtly visible and often go un- noticed by teachers [12]. Even when manifest, they are often seen as less urgent because unlike externalizing behaviors, they typ- ically do not interfere with classroom activities [13]. Such perceptions are reinforced by recent reviews concluding that de- pressive symptoms are not linked with dropout once accounting for externalizing problems [11,14,15]. Rather, this null finding may reflect suboptimal timing of de- pression assessments in existing studies. Depression tends to be episodic: Most adolescents who experience an episode of de- pression at some point recover within a few months, and subsequently remain free of clinically significant symptoms for extended periods [16–18]. Such episodic mental health prob- lems are more subject to underreporting than stable problems like ADHD or CD, especially when measured retrospectively years after the fact [19]. Underreporting could have influenced the results of studies linking depression and dropout, as most are ret- rospective and based on information obtained years or even decades after participants were out of high school [11]. Another timing problem shared by all existing studies, in- cluding the few prospective ones, is their focus on depressive symptoms present during childhood or early- to mid-adolescence, that is, many years before dropout becomes legally possible (i.e., at age 16 or 17 in most jurisdictions). With this time frame, it is not surprising that depression symptoms were only weakly as- sociated with dropout, if at all. Theoretically, it is clear why a 17- year-old struggling with depression may be at risk of acting on his or her legal prerogative to drop out, but it is unclear why a classmate who had a bout with depression some years before and is fully recovered (with no relapse) should be particularly at risk. Empirically, some studies not explicitly addressing the link between depression and dropout still provide suggestive evi- dence that timing matters and that late adolescence is a key period. Among adolescents, the prevalence of depression peaks around 17 years old [20]. Moreover, it is around that age that ado- lescents are most likely to engage, when under pressure, in risk behaviors like dropping out that confer short-term relief at the potential cost of lasting negative consequences [21]. In addi- tion, a recent meta-analysis of studies examining the link between depression and academic grades, an outcome related to dropout, found effect sizes that were almost three times larger when de- pression symptoms were measured in late rather than early adolescence [22]. Finally, exposure to severely stressful (and depressogenic) life events in late adolescence is associated with a three-fold increase in the risk of dropping out shortly follow- ing exposure [23]. The goal of this study was to examine whether the presence of clinically significant depression symptoms during late ado- lescence would be associated with high school dropout, after accounting for externalizing ADHD and CD symptoms, as well as for other important family and school-related background characteristics. Methods Sample The project was approved by appropriate Institutional Review Boards at the University and School Board levels. The recruit- ment procedure is described in detail elsewhere [23]. Broadly, 12 francophone public high schools with high dropout rates (M = 36%, a rate more than twice the provincial average) in and around the city of Montreal, Canada, participated between 2012 and 2015. In each school, students were administered, early in the school year, a short screening questionnaire that measured their initial risk for dropout, as well as basic sociodemograph- ics (see Measures). All students at least 14 years of age were invited to participate, and the vast majority (97%) provided written consent and participated (Nscreened = 6,773). In a second phase, a selected subset of students was invited to participate in face-to-face interviews during which they were asked about their experiences in the last 12-month period, notably in terms of mental health (Ninterviewed = 545). For the interviews, a participation rate of 70% was obtained, a comparatively high rate, given the overrepresentation of socioeconomically disad- vantaged, academically vulnerable adolescents [24]. The interviews were conducted by trained graduate students in clinical/ educational psychology and related disciplines. The interviewed participants fell into three categories. First, all students who dropped out of school in the year following the initial screening were invited. School staff informed the re- search team as soon as a student dropped out, and meetings were quickly arranged for those who consented to be interviewed. Second, following a matched case-control logic, after each com- pleted interview with a recent dropout, a second interview was conducted with a persevering student from the same school, the same program, the same sex, and with a similar individual risk for dropout according to a risk index administered during the 206 V. Dupéré et al. / Journal of Adolescent Health 62 (2018) 205–211 screening phase (see Measures). To the extent possible, matched students were also similar to dropouts in terms of family back- ground. Third, schoolmates with scores on the risk index that were close to their school’s average were invited to participate to form a second, not at-risk or “average” comparison group. Measures Descriptive statistics for each measure are presented in Table 1. Separate estimates are shown for the three groups of participants. Background. During the screening phase, participants com- pleted a brief questionnaire booklet. They reported on their sociodemographic background, including their sex, age, visible mi- nority (i.e., non-white) and immigrant status (i.e., at least one parent born outside Canada), as well as their family structure and their parents’ employment status and level of education. The booklet also included two self-reported measures assess- ing students’ initial individual risk profile. First, a validated risk index captured participants’ general propensity for dropout based on seven questions about grade retention, appreciation of school, importance of grades, academic aspirations, percep- tions of grades, and language art and math grades [25]. In the current sample, this index showed good predictive validity (with an area under the receiver operating characteristic curve = .81), and predicted dropout more accurately than ad- ministrative data about failure, truancy, and disciplinary suspensions [26]. Second, students reported on enrollment in special education either because of learning or conduct/ emotional problems, another key marker of risk. These measures indirectly tapped relevant externalizing symptoms [27], but additional steps were taken during the interviews to assess ADHD and CD symptoms more directly, as described in the next section. Mental health symptoms. To maximize participation in this high-