Reacción a "Academic pressure during adolescence is linked to depression and self-harm into early adulthood"

This study analyzes the relationship between perceived academic pressure in adolescence (age 15) and the onset of depressive symptoms and self-harm, with or without suicidal intent, at different times between the ages of 16 and 22. The results show that greater academic pressure at age 15 predicts greater intensity of depressive symptoms and a higher probability of self-harm in subsequent assessments. In the case of depression, this relationship weakens over time, although it does not disappear. In contrast, the association with self-harm appears to remain stable regardless of the time of assessment.

Limitations:

1. Academic pressure was measured using a self-report consisting of several items. Although these items appear to constitute a measure with sufficient psychometric reliability, it is important to remember that perceived academic pressure does not necessarily equate to objective academic pressure. The experience of school demands depends as much on the educational environment as on personal and family expectations, as well as on individual and personality characteristics (e.g., the tendency toward perfectionism). Since these components cannot be separated in this measure, it is premature to assert that school pressure is a risk that can be modified solely through changes in the educational environment, as the article suggests.
2. The participants belong to a non-representative cohort born in 1991-1992, assessed for school pressure at age 15 (approximately in 2006) and subsequently at ages 16, 17, 18, 21, and 22. The follow-up, therefore, extended until around 2014. Although there are no clear reasons to believe that the impact of academic pressure on mental health has changed since then, it is true that significant social transformations have taken place during this period, such as digitalization, equality movements, and the COVID-19 pandemic. These changes could have altered the relative weight of academic pressure within the set of factors that influence mental health. This possibility is not considered in the study's limitations.
3. The size of the effects is difficult to interpret. It is indicated that a one-point increase in academic pressure predicts approximately a half-point increase on the depression scale, but no standardized coefficients or sufficient information on the scale are provided to adequately interpret the meaning of these scores and their increases. In the case of self-harm, the dependent variable is dichotomous, so the increase in risk is objectively interpretable, although we still do not know what an additional point of academic pressure represents qualitatively. In general, odds ratios below 1.5 are usually considered small effects, but this interpretation adds little in this context. In short, it is not advisable to limit oneself to reporting statistical significance without offering a qualitative interpretation of the effect size that allows it to be contextualized.

Strengths:

1. This is a longitudinal study with a large sample and a long follow-up period, which is an improvement over most previous studies, which tend to be cross-sectional and with small samples.
2. The control of possible confounding variables is comprehensive and detailed. In this type of research, it is particularly important to control baseline scores on mental health measures, i.e., to check whether academic pressure predicts subsequent development beyond the initial state of each participant. Failure to control these measures would prevent an estimation of whether academic pressure in adolescence really has predictive value for subsequent changes in mental health.
3. The results are consistent with previous literature, which suggests that perceived academic pressure is a relevant factor in explaining changes in mental health in adolescents and young adults. The study overcomes some of the methodological limitations common in this field, although not all.