Cross-sectional comparison of risk factors associated with mental illness and learning difficulties in kindergarten and elementary, middle, and high school children in the United States: a socio-ecological resilience framework

Lin, K; Sun, J

Cross-sectional comparison of risk factors associated with mental illness and learning difficulties in kindergarten and elementary, middle, and high school children in the United States: a socio-ecological resilience framework

Lin, K Sun, J

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Publisher:: SPRINGER HEIDELBERG
Publication Type:: Journal Article
Citation:: Journal of Public Health Germany, 2025
Issue Date:: 2025-01-01

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Field	Value	Language
dc.contributor.author	Lin, K
dc.contributor.author	Sun, J https://orcid.org/0000-0002-0097-2438
dc.date.accessioned	2026-02-03T00:09:33Z
dc.date.available	2026-02-03T00:09:33Z
dc.date.issued	2025-01-01
dc.identifier.citation	Journal of Public Health Germany, 2025
dc.identifier.issn	2198-1833
dc.identifier.issn	1613-2238
dc.identifier.uri	http://hdl.handle.net/10453/192689
dc.description.abstract	Aim: Mental illness and learning difficulties in children can be explained using the socio-ecological resilience (SER) model, which states that personal characteristics and an individual’s social relationships coupled with environmental factors of adverse life events influence mental health. We aimed to identify factors associated with anxiety, depression, and learning difficulties in kindergarten and elementary, middle, and high school children. Subject and methods: This study utilized data collected from the 2019 National Health Interview Survey (NHIS) questionnaire administered across the United States. Children aged 4 to 17 were included. Risk factors were categorized into personal characteristics, lack of peer support, adverse family events, and socioeconomic status (SES). Logistic regression was used to estimate the risk for each risk factor and SER layers for anxiety, depression, and learning difficulties. Results: In relation to the SER model, factors from personal, relational, and structural layers all influenced the likelihood of anxiety, depression, and learning difficulties in children across all ages. Negative personal characteristics of emotional dysregulation were the most significant risk factor associated with anxiety and depression. For children in kindergarten, relational factors of poor peer relations were more significant in influencing learning difficulties, while behavioural dysregulation measured by hyperactivity had a greater influence on learning difficulties for older children in elementary, middle, and high school. Having experienced adverse family events was significantly associated with worse mental health, while low SES was associated with worse depression and learning difficulties. Conclusion: Comprehensive interventions that strengthen personal characteristics, peer interactions, and environmental stressors are needed to address mental illness in children.
dc.language	English
dc.publisher	SPRINGER HEIDELBERG
dc.relation.ispartof	Journal of Public Health Germany
dc.relation.isbasedon	10.1007/s10389-025-02440-1
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.title	Cross-sectional comparison of risk factors associated with mental illness and learning difficulties in kindergarten and elementary, middle, and high school children in the United States: a socio-ecological resilience framework
dc.type	Journal Article
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Engineering and Information Technology
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2026-02-03T00:09:32Z
pubs.publication-status	Published

Abstract:

Aim: Mental illness and learning difficulties in children can be explained using the socio-ecological resilience (SER) model, which states that personal characteristics and an individual’s social relationships coupled with environmental factors of adverse life events influence mental health. We aimed to identify factors associated with anxiety, depression, and learning difficulties in kindergarten and elementary, middle, and high school children. Subject and methods: This study utilized data collected from the 2019 National Health Interview Survey (NHIS) questionnaire administered across the United States. Children aged 4 to 17 were included. Risk factors were categorized into personal characteristics, lack of peer support, adverse family events, and socioeconomic status (SES). Logistic regression was used to estimate the risk for each risk factor and SER layers for anxiety, depression, and learning difficulties. Results: In relation to the SER model, factors from personal, relational, and structural layers all influenced the likelihood of anxiety, depression, and learning difficulties in children across all ages. Negative personal characteristics of emotional dysregulation were the most significant risk factor associated with anxiety and depression. For children in kindergarten, relational factors of poor peer relations were more significant in influencing learning difficulties, while behavioural dysregulation measured by hyperactivity had a greater influence on learning difficulties for older children in elementary, middle, and high school. Having experienced adverse family events was significantly associated with worse mental health, while low SES was associated with worse depression and learning difficulties. Conclusion: Comprehensive interventions that strengthen personal characteristics, peer interactions, and environmental stressors are needed to address mental illness in children.

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http://hdl.handle.net/10453/192689