A systematic review of how stress affects the academic performance of high school students

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Abstract

School can constitute a very stressful environment for adolescents. The constant demands and the need to succeed create a vicious circle of distress. The number of studies and interventions during adolescence are increased. The observational surveys are conducted in school environments; consequently, the sample is more under control and more reliable. We systematically reviewed the literature on academic performance and stress and found that there is evidence which prove the correlation between them. The percentage of studies in age range 12-18 is insufficient, so the need of further study is compulsory.

Adolescence constitutes a tremendous transitional phase and is characterized by an intense rapid developmental rhythm; it is referred as “the second most crucial developmental period after infancy” (Rew et al., 2014). Adolescence is defined as “the period in which secondary sexual characteristics are formed and reproductive capacity is developed” (Dunkel and Quinton, 2014).
Puberty constitutes a crucial period which foresees future health problems but also is open to interventions and changes. It is characterized by physical and psychosocial changes, which are affected by genetic, hormonal and environmental factors (Chulani VL, 2014).

From childhood to adolescence is observed an increase in the sense of demand and in the adoption of risky behaviors, whose dynamic is declined strongly in adulthood (Casey et al., 2008, Steinberg et al., 2008).

An important feature of the transition of childhood into adolescence is the change of appearance. The development of secondary sexual characteristics constitutes a milestone of adolescence (Gasser et al., 2013). According to contemporary data, body constitutes a basic element for the individual (Lu et al., 2015). Appearance highly influences the individual’s perception about his/her image and if there is a hidden psychopathology, it is highly possible to develop psychological and physical problem such as eating disorder (Peat et al., 2008), depression (Stice et al., 2000) and psychological stress (Johnson and Wardle, 2005).

The exploration of personal identity comes to the foreground (Collier et al., 2013, Tornello et al., 2014). However, except for internal struggles which are hidden and cultivated due to the adolescent’s development, the interpersonal relationships (siblings, peers, classmates) (Susan M. McHale, 2005), the systems/environments which surround the individual, such as family (Foxman et al., 1989) and school (Judi Kidger, May 2012) play an important role.

The adolescents-students have to face daily demands and obligations; their judgment, perception and skills reflect their coping skills. From one hand, certain individuals perceive these challenges as constructive stressful events which enhance eustress (Chrousos, 2009). From the other hand, each one disposes different perception about stress; other individuals think that stress functions like a negative force and they perceive stressful situations as threats; then they “adopt” distress, namely lack of coping skills oppose to stress (Ridner, 2004, Chrousos, 2009).

Across this range of changes during puberty, it keeps surfacing new articles concerning the impact of adolescents’ stress. Thus, the purpose of this paper is to report the findings from a systematic review of the literature on studies referred to how stress can affect the academic performance of high school students. The range of age, 12-18, was selected because the six last school years constitute a crucial transcendental period, a step before adulthood.

Background

The “father” of stress, Hans Selye, made the first introduction of the concept of stress by coining the term of “stressor” and “stress”(Selye, 1978). Influenced by the work of Claude Bernard about “milieu intérieur” and Walter Cannon about “homeostasis”, Hans Selye referred to “General Stress Syndrome” (GAS) (Selye, 1950). Stress could be harmful for an organism if there is an insufficient respond, however, there is the tenet that every living organism can respond to stress(Selye, 1950).

The essence lies on individual’s perception about plentiful events (Folkman, 1986, Cohen et al., 1982). Lazarus and Folkman noted the triangle of “stress-appraisal-coping”; stress constitutes the transaction between environment and individual. A stimuli can be characterized as a challenge or a threat; it depends on individuals’ cognitive appraisal and coping skills (Folkman, 1986).

Antonovsky coined a new word which was related to stress, “salutogenesis” of the origins (genesis) of health (saluto)(Antonovsky, 1979). He focused on social stressors, for instance, poverty; stressors which are inevitable, and the individual is called to manage them(Antonovsky, 1979).

One of the most contemporary definition of stress is “the state of threat or supposed threat of homeostasis of the organism, which is called to be restored through a complex matrix of behavioral and physiological adaptation responses of the organism “(Chrousos, 1998). Furthermore, constructive stressors can function as challenges and cultivate the “eustress” (Chrousos, 2009). However, there is not the same appraisal due to lack of supplies or supportive environment. As a result, certain individuals are overwhelmed by stress, enhancing the state of “distress”, ie the lack of problem-solving skills (Chrousos, 2009, Ridner, 2004).

Academic stress can be deleterious to adolescents since it promotes maladaptive behaviors such as smoking and alcohol consumption (Glozah and Pevalin, 2014). According to plentiful studies, academic stress tend to extend and influence and other aspects of individual as adjustment, mental health, suicidal intention, substance use and academic achievement (Park and Kim, 2018, Park, 2014, Staff et al., 2010).

The effect of stressors depends on the type, number, intensity and duration (Tottenham and Sheridan, 2010). During these stressful events not only the hormonal composition of the brain, but also the cognitive functions and the general behavior change. Negative events that occur during adolescence increase the likelihood of depression and anxiety in adulthood (Blaustein et al., 2016).
It is accepted that acute stress contributes to better learning and memorization while chronic suppresses the function of the hippocampus (Esteban-Cornejo et al., 2016). As a result, the stress affects physically, cognitively and physically (Viner, 1999, Chrousos, 2009).

Miscellaneous stressors can affect students’ psychosynthesis and their academic performance. The mood and the socio-economic level are related to subjective well-being and constitute key pillars by influencing academic image (Manstead, 2018). It has been proven that even unhealthy nutrition at school and family environment deteriorate academic performance (Correa-Burrows et al., 2016).

Most of puberty period is consumed and enriched in the school environment. During their everyday life, students face an amount of stressful situations whether positive or negative. These situations result from the sharpening of critical thinking, the development of skills and nonetheless the relationships with teachers and peers. (Judi Kidger, May 2012).
Adolescents identify school, family, and friends as tremendous stressors and especially school is classified as a major hassle(Wright, 2010, LaRue and Herrman, 2008). Evaluation constitutes a tremendous stressor for adolescents, as they are called to cope challenges regardless of their ability or their preparation (Ochsner et al., 2004).

Methods

This systematic review of the literature was guided by the 27 items on the checklist of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, known as PRISMA
(Liberati et al., 2009). The purpose of PRISMA is to ensure completeness and transparency in the reporting of literature reviews.

Research Questions

The review of literature was designed to answer the following research questions:

  • How can stress affect academic performance of high school students?
  • What were the characteristics (i.e. content, methods, measurements) of researches (interventions or reviews) about the relation between stress and academic performance?
  • What were the outcomes of these studies reported for adolescents?

The retrieval and inclusion of information reported in this systematic literature review was guided by the four phases of PRISMA: “identification, screening, eligibility, and included”
(Liberati et al., 2009).

Identification

PubMed was the search engine which was used for identification of relevant literature. It was conducted one search using the following terms: academic performance or grades or academic outcome or academic achievement or academic image and psychological stress or psychological distress or academic stress in high school. We reviewed all articles by hand searching and we included all eligible ones.

Screening

All references were screened for duplicates and whether or not they conform with the inclusion/exclusion criteria. Those references which did not meet the eligibility and inclusion criteria or were duplicated, were removed from the final dataset.

Procedure

When the identification, screening and eligibility were completed of all articles, we conducted hand searches of all articles that were to be included in the report; hence the determination for included articles. The selected articles using a spreadsheet with headings to match
our research questions. Data were then analyzed and synthesized to comprise this report.

Eligibility

A final set of 5 articles was deemed eligible for the systematic review. The inclusion criteria were that the articles had to be written in English, published the last decade, proved the correlation between stress and academic performance. Also, the sample should be consisted by healthy individuals, aged 12-18years old and for them to be high school students. Exclusion criteria included books, reports, dissertations and clinical guidelines.

Findings

Figure 1 shows the summary of articles included in each phase of data identification, screening, eligibility, and inclusion. The search using the terms academic performance or grades or academic outcome or academic achievement or academic image and psychological stress or psychological distress or academic stress in high school yielded 1480 articles. Then we added two filters: 1Last ten years publication (1146 articles) and ii) to be addressed for 12 to 18 years old (357 articles). The final sample of articles were 5.

 

Study designs

According to Table 1, all studies were observational. Two studies needed parental and participant consent as to be included into the study (Arsenio and Loria, 2014, Yoo et al., 2015). All studies used self-reports questionnaires (Arsenio and Loria, 2014, Yoo et al., 2015, Tuominen-Soini and Salmela-Aro, 2014, Ansary and Luthar, 2009, Feld and Shusterman, 2015). Three studies administered self-report questionnaires into school campus (Yoo et al., 2015, Arsenio and Loria, 2014, Tuominen-Soini and Salmela-Aro, 2014), two studies are based on past data (Tuominen-Soini and Salmela-Aro, 2014, Ansary and Luthar, 2009) and one online(Feld and Shusterman, 2015). One study was separated in two periods; the first measurement was conducted in school and the second ones via internet or postal questionnaires (Tuominen-Soini and Salmela-Aro, 2014). Another study was separated in three periods and there was a money price for each period (Ansary and Luthar, 2009). The scientists in another survey, before the questionnaires’ administration, gave school supplies and pizza for lunch to participants (Yoo et al., 2015). Anonymous were only two studies (Arsenio and Loria, 2014, Yoo et al., 2015). One survey aimed to validate a questionnaire (Yoo et al., 2015).

Sample Sizes and Attrition

Across studies, baseline sample sizes ranged from 119 to 979. The four studies had sample size under 350, only one had N=979 (Tuominen-Soini and Salmela-Aro, 2014). As the last one had two measurement periods, at second time, a total of 663 (68% of the original) young adults participated in the study(Tuominen-Soini and Salmela-Aro, 2014). Another study pointed that 89% of subjects (n = 256) completed at least two waves of data collection and were thus included in the final sample(Ansary and Luthar, 2009). For Feld’s survey participation rates were 11.29% for the Massachusetts school and 48.3% for the Washington high school, with a combined total of 380 students participating in the study. Forty-seven participants (12%) were removed from the data set because they had not completed a sufficient portion of the survey, leaving a final sample of 333students. The final sample included 106 students from the Massachusetts school and 227 students from the Washington school (Feld and Shusterman, 2015). The other two did not mention any drop-outs (Yoo et al., 2015, Arsenio and Loria, 2014).

Sample Demographics

All studies had a mean age range from 12 to 18.5. Two studies had mean age around to 16 (Ansary and Luthar, 2009, Yoo et al., 2015), one to 15 (Arsenio and Loria, 2014), another study ranged around 18 (Tuominen-Soini and Salmela-Aro, 2014) and the last one doesn’t infer the mean age, however the participants belonged from 9th to 12th grade (Feld and Shusterman, 2015). All measurements were addressed to both two genders and females outweighed. Three studies are comprised by multi-nationalities (Yoo et al., 2015, Arsenio and Loria, 2014, Ansary and Luthar, 2009), one study only Finnish speakers (Tuominen-Soini and Salmela-Aro, 2014) and one inferred to color (51%) (Feld and Shusterman, 2015). Four studies conducted in USA and one in Finland(Tuominen-Soini and Salmela-Aro, 2014). Two studies were focused on financial status(Arsenio and Loria, 2014, Ansary and Luthar, 2009).

Content

One study conducted to validate the Model Minority Myth Measure and how it affects psychological adjustment (affective distress, somatic distress, performance difficulty, academic expectations stress), the potential moderating effect of academic performance (cumulative grade point average) and the inter correlations amongst these variables (Yoo et al., 2015). Other study focused on the profiles schoolwork engagement and burnout (i.e., exhaustion, cynicism, inadequacy) and on gender differences, group differences in academic and socioemotional functioning and long-term educational outcomes, and temporal stability in the group memberships (Tuominen-Soini and Salmela-Aro, 2014). A survey examined connections among adolescents’ emotional dispositions, negative, academic affect, coping strategies, academic stress, and overall grade point average (GPA) (Arsenio and Loria, 2014). Having as a sample wealthy adolescents, the relationship between externalizing (substance use and delinquency) and internalizing (depression and anxiety) dimensions and academic achievement (grades and classroom adjustment were examined (Ansary and Luthar, 2009). Last study surveyed physiological and behavioral indicators of stress, the relationship between stress and student attitudes and coping behaviors in response to stress, among a sample of students in two academically high-achieving environments(Feld and Shusterman, 2015).

Results

High-achieving students who experienced internal minority, proved that they were feeling less distress in contrast with low academic students. The scale proved an adequate fit with the examined variables. Internalization of the model minority type showed correlation only with the academic stress (Yoo et al., 2015). Another survey was examining the latent profile of students. It is proved that engaged and engaged–exhausted students who showed commitment and satisfying academic performance, were more stressed and preoccupied with possible failures. Cynical and burned-out students were less engaged, valued school less, and had lower academic achievement. As a consequence, they felt less stressed, exhausted, and depressed than burned-out students. Students who are preoccupied with success and performance, are susceptible to psychological distress despite their high academic achievement. Students high committed to school are more vulnerable to emotional distress and exhaustion. The engaged-exhausted students are more stressed (Tuominen-Soini and Salmela-Aro, 2014). Adolescents’ higher negative academic affect was related to lower Great Point Averages. Higher levels of adolescents’ academic stress were related to both more negative academic affect, as well as higher negative and lower positive general moods. Higher academic stress presented a correlation with disengaged coping. However, GPA was not related to academic stress (Arsenio and Loria, 2014). Conversely, another study supported that internalizing distress may not be associated with poor academic competence. Even if an individual experienced distress, it doesn’t mean that pour academic performance could be predicted (Ansary and Luthar, 2009). According to self-reports, high-achieving students reported that they experienced plentiful physical and psychological symptoms, such as fatigue, lack of concentration, inability to sleep and panic attacks due to school-related stress. Stressors may provoke maladaptive behaviors, but in this survey is presented that this type of students would not prefer high-risk behaviors, such as smoking or substance use. Higher stress was highly associated with lower scores on the Life Satisfaction scale and was related to lowered factors of satisfaction with school, including lower academic self-perception, higher goal valuation, and higher motivation and self-regulation. Stress was not related to quantitative measures of school success such as GPA, but it was related to students’ perceptions of their performance and their overall happiness and satisfaction in their school environment (Feld and Shusterman, 2015).

Discussion

Puberty consists the milestone of an individual’s life. The contemporary way of living forces the adolescents to be more mature and to develop coping skills so as to ensure their physical and psychological health.

During this transcendental period the priorities change; the individual broadens his horizons, distances himself from the family microsystem and the important others, friends, professors. The most of students’ time is spent at school, as a consequence, they identify it with tremendous significance. The stressors could be miscellaneous, but one of the most common is academic performance. School success may constitute the beginning for a positive outcome, high academic status, better job possibilities, high financial earnings and better self-perception (Li and Lerner, 2011, Wang and Peck, 2013). As a result, the pressure is accelerated, and stress comes to the surface.

Based on this systematic review, it is observed that high achieving students experience intense distress, especially if they origin from high financial status (Ansary and Luthar, 2009, Tuominen-Soini and Salmela-Aro, 2014).

There are not sufficient surveys upon high school students and the relation between stress and academic performance in a healthy sample. In recent years the stress management interventions are augmented (Rew et al., 2014), however, the need of observation is necessary.

Studies upon physiological changes cause of stress, exist (Urwyler et al., 2015, Yaru Zou et al., 2017), but it would be more helpful, if the number of surveys will enhance referring ages 12-18.
The main goal of these findings should be the establishment of stress management programs and the enhancement of self-esteem and self-perception; their self-perception should not be only defined by their academic performance.

Limitations

We have identified only 5 papers (conducted from 2008 to 2018) related to stress and academic performance. If we have chosen to study older articles, we might have had more results. Moreover, each article noted different instruments for measuring distress and academic performance, making it difficult to compare outcomes across studies. Furthermore, adolescents prefer the use of internet, as a result, the online questionnaires’ administration would be more pleasant procedure. Last but not least, there were heterogeneity of sample, as the range of age, the nationality and the socioeconomical status.

Conclusion

The literature review reflects the burden of students which affects their self-perception. The distress should be diminished and be replaced by eustress; school environment should provide the necessary psychological support to maintain students’ self-image and to enhance their coping skills. The sample of all surveys was sufficient; maybe, a more homogenous sample would have been more helpful. Even though an absolute linear causality between stress and academic performance can not be proven, a boosted educational system could be constructive.


Bibliography

ANTONOVSKY, A. 1979. Health, stress, and coping., San Francisco.
BLAUSTEIN, J. D., ISMAIL, N. & HOLDER, M. K. 2016. Review: Puberty as a time of remodeling the adult response to ovarian hormones. J Steroid Biochem Mol Biol, 160, 2-8.
CASEY, B. J., GETZ, S. & GALVAN, A. 2008. The adolescent brain. Dev Rev, 28, 62-77.
CHROUSOS, G. P. 2009. Stress and disorders of the stress system. Nat Rev Endocrinol, 5, 374-81.
CHULANI VL, G. L. 2014. Adolescent growth and development. Primary care. , 41(3):465-87.
COHEN, P. A., KULIK, J. A. & KULIK, C.-L. C. 1982. Educational Outcomes of Tutoring: A Meta-analysis of Findings. American Educational Research Journal, 19, 237-248.
COLLIER, K. L., VAN BEUSEKOM, G., BOS, H. M. W. & SANDFORT, T. G. M. 2013. Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes. Journal of sex research, 50, 299-317.
CORREA-BURROWS, P., BURROWS, R., BLANCO, E., REYES, M. & GAHAGAN, S. 2016. Nutritional quality of diet and academic performance in Chilean students. Bulletin of the World Health Organization, 94, 185-192.
DUNKEL, L. & QUINTON, R. 2014. Transition in endocrinology: induction of puberty. Eur J Endocrinol, 170, R229-39.
ESTEBAN-CORNEJO, I., IZQUIERDO-GOMEZ, R., GOMEZ-MARTINEZ, S., PADILLA-MOLEDO, C., CASTRO-PINERO, J., MARCOS, A. & VEIGA, O. L. 2016. Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study. Eur J Nutr, 55, 1133-40.
FOLKMAN, S., LAZARUS, R. S., DUNKEL-SCHETTER, C., DELONGIS, A., & GRUEN, R. J. 1986. Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 992-1003.
FOXMAN, E. R., TANSUHAJ, P. S. & EKSTROM, K. M. 1989. Adolescents’ influence in family purchase decisions: A socialization perspective. Journal of Business Research, 18, 159-172.
GASSER, T., MOLINARI, L. & LARGO, R. 2013. A comparison of pubertal maturity and growth. Ann Hum Biol, 40, 341-7.
GLOZAH, F. & PEVALIN, D. 2014. Perceived social support and parental education as determinants of adolescents’ physical activity and eating behaviour: A cross-sectional survey.
JOHNSON, F. & WARDLE, J. 2005. Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis. J Abnorm Psychol, 114, 119-25.
JUDI KIDGER, R. A., JENNY DONOVAN, DAVID GUNNELL May 2012. The Effect of the School Environment on the Emotional Health of Adolescents: A Systematic Review. Pediatrics, 129.
LARUE, D. E. & HERRMAN, J. W. 2008. Adolescent stress through the eyes of high-risk teens. Pediatr Nurs, 34, 375-80.
LIBERATI, A., ALTMAN, D. G., TETZLAFF, J., MULROW, C., GOTZSCHE, P. C., IOANNIDIS, J. P., CLARKE, M., DEVEREAUX, P. J., KLEIJNEN, J. & MOHER, D. 2009. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Bmj, 339, b2700.
MANSTEAD, A. S. R. 2018. The psychology of social class: How socioeconomic status impacts thought, feelings, and behaviour. The British journal of social psychology, 57, 267-291.
OCHSNER, K. N., RAY, R. D., COOPER, J. C., ROBERTSON, E. R., CHOPRA, S., GABRIELI, J. D. & GROSS, J. J. 2004. For better or for worse: neural systems supporting the cognitive down- and up-regulation of negative emotion. Neuroimage, 23, 483-99.
PARK, S.-H. & KIM, Y. 2018. Ways of coping with excessive academic stress among Korean adolescents during leisure time. International journal of qualitative studies on health and well-being, 13, 1505397-1505397.
PARK, S. 2014. Associations of physical activity with sleep satisfaction, perceived stress, and problematic Internet use in Korean adolescents. BMC Public Health, 14, 1143.
PEAT, C. M., PEYERL, N. L. & MUEHLENKAMP, J. J. 2008. Body image and eating disorders in older adults: a review. J Gen Psychol, 135, 343-58.
REW, L., JOHNSON, K. & YOUNG, C. 2014. A systematic review of interventions to reduce stress in adolescence. Issues Ment Health Nurs, 35, 851-63.
RIDNER, S. H. 2004. Psychological distress: concept analysis. J Adv Nurs, 45, 536-45.
SELYE, H. 1950. Stress and the general adaptation syndrome. British medical journal, 1, 1383-1392.
SELYE, H. 1978. The stress of life (Revised ed.). New York.
STAFF, J., SCHULENBERG, J. E., MASLOWSKY, J., BACHMAN, J. G., O’MALLEY, P. M., MAGGS, J. L. & JOHNSTON, L. D. 2010. Substance use changes and social role transitions: proximal developmental effects on ongoing trajectories from late adolescence through early adulthood. Development and psychopathology, 22, 917-932.
STEINBERG, L., ALBERT, D., CAUFFMAN, E., BANICH, M., GRAHAM, S. & WOOLARD, J. 2008. Age differences in sensation seeking and impulsivity as indexed by behavior and self-report: evidence for a dual systems model. Dev Psychol, 44, 1764-78.
STICE, E., HAYWARD, C., CAMERON, R. P., KILLEN, J. D. & TAYLOR, C. B. 2000. Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study. J Abnorm Psychol, 109, 438-44.
SUSAN M. MCHALE, K. A. U., LILLY SHANAHAN, ANN C. CROUTER, SARAH E. KILLOREN 2005. Siblings’ Differential Treatment in Mexican American Families. Journal of Marriage and Family, 67, 1259-1267.
TORNELLO, S. L., RISKIND, R. G. & PATTERSON, C. J. 2014. Sexual orientation and sexual and reproductive health among adolescent young women in the United States. J Adolesc Health, 54, 160-8.
TOTTENHAM, N. & SHERIDAN, M. A. 2010. A review of adversity, the amygdala and the hippocampus: a consideration of developmental timing. Frontiers in human neuroscience, 3, 68-68.
VINER, R. 1999. Putting Stress in Life: Hans Selye and the Making of Stress Theory. Social Studies of Science, 29, 391-410.
WRIGHT, M., CREED, P., & ZIMMER-GEMBECK, M. J. 2010. The development and initial validation of a brief daily hassles scale suitable for use with adolescents European Journal of Psychological Assessment, 26, 220-226.
ANSARY, N. S. & LUTHAR, S. S. 2009. Distress and academic achievement among adolescents of affluence: a study of externalizing and internalizing problem behaviors and school performance. Dev Psychopathol, 21, 319-41.
ARSENIO, W. F. & LORIA, S. 2014. Coping with negative emotions: connections with adolescents’ academic performance and stress. J Genet Psychol, 175, 76-90.
FELD, L. D. & SHUSTERMAN, A. 2015. Into the pressure cooker: Student stress in college preparatory high schools. J Adolesc, 41, 31-42.
LI, Y. & LERNER, R. M. 2011. Trajectories of school engagement during adolescence: implications for grades, depression, delinquency, and substance use. Dev Psychol, 47, 233-47.
REW, L., JOHNSON, K. & YOUNG, C. 2014. A systematic review of interventions to reduce stress in adolescence. Issues Ment Health Nurs, 35, 851-63.
TUOMINEN-SOINI, H. & SALMELA-ARO, K. 2014. Schoolwork engagement and burnout among Finnish high school students and young adults: profiles, progressions, and educational outcomes. Dev Psychol, 50, 649-62.
URWYLER, S. A., SCHUETZ, P., SAILER, C. & CHRIST-CRAIN, M. 2015. Copeptin as a stress marker prior and after a written examination–the CoEXAM study. Stress, 18, 134-7.
WANG, M. T. & PECK, S. C. 2013. Adolescent educational success and mental health vary across school engagement profiles. Dev Psychol, 49, 1266-76.
YARU ZOU, W. L., MINGLING YAO, XUEFEI HU, SIXIAO LU, XIAOWEI, ZHU, L. C., JIANJING TONG, JINGYI SHI, ERIC GILSON, JING YE & LU, A. Y. 2017. Test anxiety and telomere length: Academic stress in
adolescents may not cause rapid telomere erosion. oncotarget, 8, 10836-10844.
YOO, H. C., MILLER, M. J. & YIP, P. 2015. Validation of the internalization of the Model Minority Myth Measure (IM-4) and its link to academic performance and psychological adjustment among Asian American adolescents. Cultur Divers Ethnic Minor Psychol, 21, 237-46.

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