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Erschienen in: Social Psychiatry and Psychiatric Epidemiology 4/2014

01.04.2014 | Original Paper

School effects on risk of non-fatal suicidal behaviour: a national multilevel cohort study

verfasst von: Beata Jablonska, Viveca Östberg, Anders Hjern, Lene Lindberg, Finn Rasmussen, Bitte Modin

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 4/2014

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Abstract

Objective

Research has demonstrated school effects on health, over and above the effects of students’ individual characteristics. This approach has however been uncommon in mental health research. The aim of the study was to assess whether there are any school-contextual effects related to socioeconomic characteristics and academic performance, on the risk of hospitalization from non-fatal suicidal behaviour (NFSB).

Methods

A Swedish national cohort of 447,929 subjects was followed prospectively in the National Patient Discharge Register from the completion of compulsory school in 1989–93 (≈16 years) until 2001. Multilevel logistic regression was used to assess the association between school-level characteristics and NFSB.

Results

A small but significant share of variation in NFSB was accounted for by the school context (variance partition coefficient <1 %, median odds ratio = 1.26). The risk of NFSB was positively associated with the school’s proportion of students from low socioeconomic status (SES), single parent household, and the school’s average academic performance. School effects varied, in part, by school location.

Conclusion

NFSB seems to be explained mainly by individual-level characteristics. Nevertheless, a concentration of children from disadvantaged backgrounds in schools appears to negatively affect mental health, regardless of whether or not they are exposed to such problems themselves. Thus, school SES should be considered when planning prevention of mental health problems in children and adolescents.
Literatur
2.
Zurück zum Zitat Sellström E, Bremberg S (2006) Is there a “school effect” on pupil outcomes? A review of multilevel studies. J Epidemiol Community Health 60:149–155PubMedCentralPubMedCrossRef Sellström E, Bremberg S (2006) Is there a “school effect” on pupil outcomes? A review of multilevel studies. J Epidemiol Community Health 60:149–155PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Spirito A, Esposito-Smythers C (2006) Attempted and completed suicide in adolescence. Annu Rev Clin Psychol 2:237–266PubMedCrossRef Spirito A, Esposito-Smythers C (2006) Attempted and completed suicide in adolescence. Annu Rev Clin Psychol 2:237–266PubMedCrossRef
4.
Zurück zum Zitat Barnekow V, Currie C, Letsch C, de Looze M, Morgan A (2009) A snapshot of the health of young people in Europe. A report prepared for the European commission conference on youth health, Brussels, Belgium, 9–10 July 2009. WHO Regional Office for Europe, Copenhagen Barnekow V, Currie C, Letsch C, de Looze M, Morgan A (2009) A snapshot of the health of young people in Europe. A report prepared for the European commission conference on youth health, Brussels, Belgium, 9–10 July 2009. WHO Regional Office for Europe, Copenhagen
5.
Zurück zum Zitat National Board of Health and Welfare (2010) Skador och förgiftningar behandlade i sluten vård 2009 (Hospitalisation due to injuries and poisoning in Sweden 2009). www.socialstyrelsen.se National Board of Health and Welfare (2010) Skador och förgiftningar behandlade i sluten vård 2009 (Hospitalisation due to injuries and poisoning in Sweden 2009). www.​socialstyrelsen.​se
6.
Zurück zum Zitat Kalff AC, Kroes M, Vles JSH, Hendriksen JGM, Feron FJM, Steyaert J, van Zeben TMCB, Jolles J, van Os J (2001) Neighbourhood level and individual level SES effects on child problem behaviour: a multilevel analysis. J Epidemiol Community Health 55:246–250PubMedCentralPubMedCrossRef Kalff AC, Kroes M, Vles JSH, Hendriksen JGM, Feron FJM, Steyaert J, van Zeben TMCB, Jolles J, van Os J (2001) Neighbourhood level and individual level SES effects on child problem behaviour: a multilevel analysis. J Epidemiol Community Health 55:246–250PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Xue Y, Leventhal T, Brooks-Gunn J, Earls F (2005) Neighborhood residence and mental health problems of 5- to 11-year-olds. Arch Gen Psychiatry 62:554–563PubMedCrossRef Xue Y, Leventhal T, Brooks-Gunn J, Earls F (2005) Neighborhood residence and mental health problems of 5- to 11-year-olds. Arch Gen Psychiatry 62:554–563PubMedCrossRef
8.
Zurück zum Zitat Bernburg JG, Thorlindsson T, Sigfusdottir ID (2009) The spreading of suicidal behavior: the contextual effect of community household poverty on adolescent suicidal behavior and the mediating role of suicide suggestion. Soc Sci Med 68:380–389PubMedCrossRef Bernburg JG, Thorlindsson T, Sigfusdottir ID (2009) The spreading of suicidal behavior: the contextual effect of community household poverty on adolescent suicidal behavior and the mediating role of suicide suggestion. Soc Sci Med 68:380–389PubMedCrossRef
9.
Zurück zum Zitat Karvonen S, Vikat A, Rimpela M (2005) The role of school context in the increase in young people’s health complaints in Finland. J Adolescence 28:1–16CrossRef Karvonen S, Vikat A, Rimpela M (2005) The role of school context in the increase in young people’s health complaints in Finland. J Adolescence 28:1–16CrossRef
10.
Zurück zum Zitat Saab H, Klinger D (2010) School differences in adolescent health and wellbeing: findings from the Canadian health behaviour in school-aged children study. Soc Sci Med 70:850–858PubMedCrossRef Saab H, Klinger D (2010) School differences in adolescent health and wellbeing: findings from the Canadian health behaviour in school-aged children study. Soc Sci Med 70:850–858PubMedCrossRef
11.
Zurück zum Zitat Zammit S, Gunnell D, Lewis G, Leckie C, Dalman C, Allebeck P (2013) Individual- and are-level influence on suicide risk: a multilevel longitudinal study of Swedish schoolchildren. Psychol Med (published online: 24 April):1–11 Zammit S, Gunnell D, Lewis G, Leckie C, Dalman C, Allebeck P (2013) Individual- and are-level influence on suicide risk: a multilevel longitudinal study of Swedish schoolchildren. Psychol Med (published online: 24 April):1–11
12.
Zurück zum Zitat Jablonska B, Lindberg L, Lindblad F, Rasmussen F, Östberg V, Hjern A (2009) School performance and hospital admissions due to NFSB: a Swedish national cohort study. Int J Epidemiol 38:1334–1341PubMedCrossRef Jablonska B, Lindberg L, Lindblad F, Rasmussen F, Östberg V, Hjern A (2009) School performance and hospital admissions due to NFSB: a Swedish national cohort study. Int J Epidemiol 38:1334–1341PubMedCrossRef
13.
Zurück zum Zitat Jonsson U, Goodman A, von Knorring AL, von Knorring L, Koupil I (2012) School performance and hospital admission due to unipolar depression: a three-generational study of social causation and social selection. Soc Psychiatry Psychiatr Epidemiol 47:1695–1706PubMedCrossRef Jonsson U, Goodman A, von Knorring AL, von Knorring L, Koupil I (2012) School performance and hospital admission due to unipolar depression: a three-generational study of social causation and social selection. Soc Psychiatry Psychiatr Epidemiol 47:1695–1706PubMedCrossRef
15.
Zurück zum Zitat Modin B, Östberg V (2009) School climate and psychosomatic health. A multilevel analysis of nearly 20,000 ninth grade students in the larger Stockholm area. Sch Eff Sch Improv 20:433–455CrossRef Modin B, Östberg V (2009) School climate and psychosomatic health. A multilevel analysis of nearly 20,000 ninth grade students in the larger Stockholm area. Sch Eff Sch Improv 20:433–455CrossRef
16.
Zurück zum Zitat Lee MT, Wong BP, Chow BW (2006) Predictors of suicide ideation and depression in Hong Kong adolescents: perceptions of academic and family climates. Suicide Life Threat Behav 36:82–96PubMedCrossRef Lee MT, Wong BP, Chow BW (2006) Predictors of suicide ideation and depression in Hong Kong adolescents: perceptions of academic and family climates. Suicide Life Threat Behav 36:82–96PubMedCrossRef
17.
Zurück zum Zitat Marsh HW (1984) Self-concept: the application of a frame of reference model to explain paradoxical results. Aust J Educ 28:165–181 Marsh HW (1984) Self-concept: the application of a frame of reference model to explain paradoxical results. Aust J Educ 28:165–181
18.
Zurück zum Zitat Aberg-Bengtsson L (2009) The smaller the better? A review of research on small rural schools in Sweden. Int J Educ Res 48:100–108CrossRef Aberg-Bengtsson L (2009) The smaller the better? A review of research on small rural schools in Sweden. Int J Educ Res 48:100–108CrossRef
19.
Zurück zum Zitat The Swedish National Agency for Education (2009) Vad påverkar resultaten i svensk grundskola? Kunskapsöversikt om betydelsen av olika faktorer. (Which factors affect the results of Swedish comprehensive school? An overview of the importance of different factors). Stockholm, Fritzes The Swedish National Agency for Education (2009) Vad påverkar resultaten i svensk grundskola? Kunskapsöversikt om betydelsen av olika faktorer. (Which factors affect the results of Swedish comprehensive school? An overview of the importance of different factors). Stockholm, Fritzes
20.
Zurück zum Zitat Rasbash J, Steele F, Browne W, Prosser B (2004) A user’s guide to MLwiN Version 2.10. Centre of Multilevel Modelling, Institute of Education, University of London, London Rasbash J, Steele F, Browne W, Prosser B (2004) A user’s guide to MLwiN Version 2.10. Centre of Multilevel Modelling, Institute of Education, University of London, London
21.
Zurück zum Zitat Larsen K, Merlo J (2005) Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression. Am J Epidemiol 161:81–88PubMedCrossRef Larsen K, Merlo J (2005) Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression. Am J Epidemiol 161:81–88PubMedCrossRef
22.
Zurück zum Zitat Young R, Sweeting H, Ellaway A (2011) Do schools differ in suicide risk? The influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils. BMC Public Health 11:874PubMedCentralPubMedCrossRef Young R, Sweeting H, Ellaway A (2011) Do schools differ in suicide risk? The influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils. BMC Public Health 11:874PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Merlo J, Chaix B, Ohlsson H, Beckman A, Johnell K, Hjerpe P, Rastam L, Larsen K (2006) A brief conceptual tutorial of multilevel analysis in social epidemiology: using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Community Health 60:290–297PubMedCentralPubMedCrossRef Merlo J, Chaix B, Ohlsson H, Beckman A, Johnell K, Hjerpe P, Rastam L, Larsen K (2006) A brief conceptual tutorial of multilevel analysis in social epidemiology: using measures of clustering in multilevel logistic regression to investigate contextual phenomena. J Epidemiol Community Health 60:290–297PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Page A, Lewis G, Kidger J, Heron J, Chittleborough C, Evans J, Gunnell D (2013) Parental socio-economic position during childhood as a determinant of self-harm in adolescence. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-013-0722-y PubMed Page A, Lewis G, Kidger J, Heron J, Chittleborough C, Evans J, Gunnell D (2013) Parental socio-economic position during childhood as a determinant of self-harm in adolescence. Soc Psychiatry Psychiatr Epidemiol. doi:10.​1007/​s00127-013-0722-y PubMed
25.
Zurück zum Zitat Due P, Lynch J, Holstein B, Modvig J (2003) Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health 57:692–698PubMedCentralPubMedCrossRef Due P, Lynch J, Holstein B, Modvig J (2003) Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health 57:692–698PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Goodman E, Huang B, Wade TJ, Kahn RS (2003) A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter? J Pediatr 143:451–456PubMedCrossRef Goodman E, Huang B, Wade TJ, Kahn RS (2003) A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter? J Pediatr 143:451–456PubMedCrossRef
27.
Zurück zum Zitat Gutman LM, Feinstein L (2008) Children’s well-being in primary school: Pupil and school effects. Institute of Education, Centre for Research on the Wider Benefits of Learning, London Gutman LM, Feinstein L (2008) Children’s well-being in primary school: Pupil and school effects. Institute of Education, Centre for Research on the Wider Benefits of Learning, London
28.
Zurück zum Zitat Zammit S, Lewis G, Rasbash J, Dalman C, Gustafsson J-E, Allebeck P (2010) Individuals, schools, and neighborhood. A multilevel longitudinal study of variation in incidence of psychotic disorders. Arch Gen Psychiatry 67:914–922PubMedCrossRef Zammit S, Lewis G, Rasbash J, Dalman C, Gustafsson J-E, Allebeck P (2010) Individuals, schools, and neighborhood. A multilevel longitudinal study of variation in incidence of psychotic disorders. Arch Gen Psychiatry 67:914–922PubMedCrossRef
29.
Zurück zum Zitat Ringbäck Weitoft G (2003) Lone parenting, socioeconomic conditions and severe ill-health. Dissertation, Umeå University Ringbäck Weitoft G (2003) Lone parenting, socioeconomic conditions and severe ill-health. Dissertation, Umeå University
30.
Zurück zum Zitat Pong S (1998) The school compositional effect of single parenthood on 10th grade achievement. Sociol Educ 71:23–42CrossRef Pong S (1998) The school compositional effect of single parenthood on 10th grade achievement. Sociol Educ 71:23–42CrossRef
31.
Zurück zum Zitat Bradshaw CP, Sawyer AL, O’Brennan LM (2009) A social disorganization perspective on bullying-related attitudes and behaviors: the influence of school context. Am J Community Psychol 43:204–220PubMedCrossRef Bradshaw CP, Sawyer AL, O’Brennan LM (2009) A social disorganization perspective on bullying-related attitudes and behaviors: the influence of school context. Am J Community Psychol 43:204–220PubMedCrossRef
32.
Zurück zum Zitat Kim YS, Leventhal B (2008) Bullying and suicide. A review. Int J Adolesc Med Health 20:133–154PubMedCrossRef Kim YS, Leventhal B (2008) Bullying and suicide. A review. Int J Adolesc Med Health 20:133–154PubMedCrossRef
Metadaten
Titel
School effects on risk of non-fatal suicidal behaviour: a national multilevel cohort study
verfasst von
Beata Jablonska
Viveca Östberg
Anders Hjern
Lene Lindberg
Finn Rasmussen
Bitte Modin
Publikationsdatum
01.04.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 4/2014
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-013-0782-z

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