Data_Sheet_1_Social Disconnectedness, Loneliness, and Mental Health Among Adolescents in Danish High Schools: A Nationwide Cross-Sectional Study.pdf

Background: Previous research has suggested that social disconnectedness experienced at school is linked to mental health problems, however, more research is needed to investigate (1) whether the accumulation of various types of social disconnectedness is associated with risk for mental health problems, and (2) whether loneliness is a mechanism that explains these associations.
Methods: Using data from the Danish National Youth Study 2019 (UNG19), nation-wide cross-sectional data from 29,086 high school students in Denmark were analyzed to assess associations between social disconnectedness experienced at school (lack of classmate support, lack of teacher support, lack of class social cohesion, and not being part of the school community) and various mental health outcomes, as well as the mediating role of loneliness for each type of disconnectedness. Multilevel regression analyses were conducted to assess the associations.
Results: Descriptive analyses suggest that 27.5% of Danish high school students experience at least one type of social disconnectedness at school. Each type of social disconnectedness was positively associated with mental health problems (depression symptoms, anxiety symptoms, stress, sleep problems, suicidal ideation, non-suicidal self-injury, eating disorder, body dissatisfaction, and low self-esteem) and negatively associated with mental well-being. In all cases, loneliness significantly mediated the associations. We found a clear dose-response pattern, where each addition in types of social disconnectedness was associated with (1) stronger negative coefficients with mental well-being and (2) stronger positive coefficients with mental health problems.
Conclusion: Our results add to a large evidence-base suggesting that mental health problems among adolescents may be prevented by promoting social connectedness at school. More specifically, fostering social connectedness at school may prevent loneliness, which in turn may promote mental well-being and prevent mental health problems during the developmental stages of adolescence. It is important to note that focusing on single indicators of school social connectedness/disconnectedness would appear to be insufficient. Implications for practices within school settings to enhance social connectedness are discussed.

背景：过往研究表明，在校期间遭遇的社会疏离（social disconnectedness）与精神健康问题存在关联，但仍需开展更多研究以探究两个问题：一是各类社会疏离的累积是否与精神健康问题风险相关，二是孤独感是否为解释这些关联的中介机制。
方法：本研究使用丹麦2019年全国青少年研究（Danish National Youth Study 2019, UNG19）的数据，对丹麦29086名高中生的全国性横断面数据进行分析，以评估在校社会疏离（包括缺乏同学支持、缺乏教师支持、班级社会凝聚力不足以及未融入学校社区）与各类精神健康结局之间的关联，同时分析孤独感在每一类社会疏离中的中介作用。本研究采用多层回归分析方法对上述关联进行评估。
结果：描述性分析显示，27.5%的丹麦高中生在校期间至少经历过一种类型的社会疏离。每一类社会疏离均与精神健康问题（抑郁症状、焦虑症状、压力、睡眠问题、自杀意念、非自杀性自伤、进食障碍、身体不满以及低自尊）呈正相关，与精神福祉呈负相关。在所有分析场景中，孤独感均显著中介了上述关联。研究还观察到明确的剂量-反应关系：在校社会疏离的类型越多，（1）与精神福祉的负向关联越强，（2）与精神健康问题的正向关联越强。
结论：本研究结果进一步丰富了现有证据体系，表明通过提升学校中的社会联结（social connectedness）可预防青少年的精神健康问题。具体而言，培育学校中的社会联结或可减少孤独感，进而在青少年的发育阶段提升精神福祉并预防精神健康问题。值得注意的是，仅关注单一的学校社会联结/疏离指标似乎并不足够。本文还讨论了在学校场景中提升社会联结的实践启示。