m0 x0 hd y5a ff1 fs8 fc0 sc0 ls0 ws2">significant stigma and stress associated with school failure (An-
derson, Jimerson, & Whipple, 2005). These early experiences
may have a direct bearing on adolescent well-being as per-
ceived school stress could influence adolescent emotional de-
velopment and increase the risk for depression (Hankin, Mer-
melstein, & Roesch, 2007).
Depression can have damaging effects on adolescent social
and cognitive functioning (Kovacs & Goldstone, 1991). De-
clining concentration and attention for instance, can undermine
academic achievement and increase the risk of school failure.
This may pose an even greater threat to students with a history
of grade retention who are already more susceptible to aca-
demic difficulties. Thus, research suggests that depression may
play a part in the school dropout process by precipitating drop-
out for students who are more vulnerable to academic problems.
One possibility that has yet to be investigated is whether the
effect of depression on school dropout is independent from the
effect of other risk factors, such as grade retention, or whether
its effect is multiplicative, acting as a vulnerability factor that
increases the risk associated with grade retention.
This study aims to verify whether depression moderates the
relationship between grade retention and school dropout after
taking into account known risk factors of school dropout (i.e.
academic competence, educational tracking, school rebellious-
ness, etc.). As such, we expected depression to predict school
dropout not only in itself, but by interacting with grade reten-
tion. We hypothesized that depression in the seventh grade con-
stitutes a vulnerability factor of dropout partly by aggravating
the risk associated with earlier grade retention. Accounting for
gender differences in depression, we also proposed an interac-
tion between gender and depression considering boys greater
emotional responsiveness to school-related problems (Rudolph,
2004) and girls higher sensitivity to interpersonal issues (Sund,
Larsson, & Wichstrom, 2003). Further, an interaction between
grade retention and gender was anticipated as studies have
shown that being held behind is more frequent among boys
(Byrd & Weitzman, 1994; Frey, 2005; Guèvremont, Roos, &
Brownell, 2007; McCoy & Reynolds, 1999). Finally, we pro-
posed a three-way interaction involving gender, grade retention
and depression.
Methods
Participants
This study draws on data from a high-risk longitudinal sam-
ple (2000-2006) of French-speaking adolescents from Montreal
(Quebec, Canada). Participants were recruited from two
low-SES secondary schools. The schools were ranked by the
Ministry of Education of Quebec (MEQ) in the three lowest
deciles of SES based on maternal education and the proportion
of unemployed parents. In 2000, students in seventh grade were
invited to voluntarily participate in the study at the beginning of
the school year. From an initial 602 students, we obtained pa-
rental consent for 496 students (82.4%). Of these, we excluded
43 cases that failed to complete the depression inventories. We
verified potential bias due to missing data by comparing the
characteristics of respondents and non-respondents. There was
a larger proportion of school dropouts among non-respondents
compared to respondents, x2 (1) = 8.09, p < .01. No other dif-
ference was found. The final sample comprised 453 participants.
We followed this cohort during 6 years to identify participants
who withdrew from school.
Data
Self-reported questionnaires were administered to partici-
pants in class by trained research assistants three times during
the seventh grade. Wave I occurred at the beginning of the
school year, wave II was in February, and wave III was in May.
Self-reported lifetime depression was measured at wave I, and
seventh-grade depression at wave III. Unless otherwise speci-
fied, control variables were measured at waves I, II, and III, and
the results collected at each wave were averaged out to obtain a
global score reflecting student experience in the seventh-grade.
Gender and parental education were measured at wave I. Grade
retention and school dropout status were obtained through
MEQ’s registry.
Measures
Moderating Variable—Depression. Self-reported depression
symptoms were measured with the French version of the In-
ventory to Diagnose Depression (IDD; Pariente, Smith, & Gu-
elfi, 1989; Zimmerman & Coryell, 1987a). This 22-item in-
strument covers the main symptoms of depression according to
DSM-IV-TR criteria (American Psychiatric Association, 2000).
Each item is rated using a five-point scale from 0 to 4, denoting
increasing severity. A threshold is applied on each symptom to
determine clinical severity: a score of 0 indicates no distur-
bance, a score of 1 indicates only subclinical severity, while a
score 2 indicates clinical severity. Depression was determined
when participant reported severe anhedonia or depressive mood,
one symptom in at least four of the other symptom groups, and
did not meet the criteria for bereavement, bipolar disorder, or
depression-like health problems (e.g. thyroid dysfunction). No
depression was coded 0 and depression was coded 1. The life-
time IDD was administered at wave I to control for history of
depression, and the annual IDD was used in wave III to assess
the severity of depression symptoms in seventh grade. Al-
though the retrospective nature of the IDD could introduce bias,
studies have shown that recall of depression in childhood and
adolescence is reliable (Masia et al., 2003). Both versions pre-
sent remarkably strong psychometric properties (α = .90 to .92)
across cultures and populations with adolescents and adults
(Ackerson, Weigman Dick, Manson, & Baron, 1990; Ruggero,
Johnson, & Cuellar, 2004; Sakado, Sato, Uehara, Sato, & Ka-
meda, 1996). More specifically, IDD cases show a 91% con-
vergence with Diagnostic Interview Schedule (Robins, Hlezer,
Croughan, & Ratcliff, 1981), with a sensitivity of 74% and a
specificity of 93% (Zimmerman & Coryell, 1987b). Our sample
yielded Cronbach’s alphas ranging from .90 - .93.
Focal Variable—Grade retention. We measured participant
history of grade retention in primary school with two categories:
never retained (0) and retained (1).
Outcome Variable—Dropout Status. We followed partici-
pants during six years, from the 7th grade until one year beyond
expected graduation year, to determine their dropout status
through the MEQ databank. The MEQ monitors student en-
rollment across the province, including school transfers, voca-
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750
C. V. QUIROGA ET AL.
tional and adult education. We considered students who were
continuously enrolled or had obtained secondary education
certification as non-dropouts. Students who were not enrolled a
particular year and had not obtained a diploma were considered
as dropouts. Non-dropout was the reference group.
Control Variables—Sociodemographic Variables. We con-
trolled for gender and parental education. Parental education
was measured by calculating the mean of mother and father
educational attainment (1 = incomplete secondary education, 2
= completed secondary education, 3 = post-secondary enroll-
ment, 4 = university enrollment) reported by participants.
Academic Experience. Seventh-grade educational tracking
had two categories: special education and general education.
Student academic competence (LeBlanc, 1998) was measured
with a 4-item Likert type scale (rated from 1 to 4) that was
adapted in French from Skinner’s questionnaire (Skinner, 1995)
and assesses self-perceived competency and control in school
(α = .74). To assess student academic achievement we used the
mean of self-reported performance in two basic subjects, Lan-
guage arts and mathematic, on a scale ranging from 0 - 100.
Socioemotiona l Problems. Self-reported anxiety was assessed
with the French version of the Beck Anxiety Inventory (Beck &
Steer, 1993; Freeston, Ladouceur, Thibodeau, Gagnon, & Rhé-
aume, 1994). This 21-item instrument measures the main symp-
toms of anxiety which are rated according to the degree of dis-
turbance felt in the last seven days on a 4-point (0 to 3) Likert
scale (α = .91). Student school rebelliousness (LeBlanc, 1998)
was assessed with a 6-item scale measuring the frequency of
self-reported misbehavior in school such as classroom disrup-
tion, cheating on tests or truancy (α = .79). The answers (rang-
ing from 0 to 3) were then recoded into two categories (0, and
1) and added up on a scale ranging from 0 to 6 reflecting the
variety of inappropriate behavior. Friends school engagement
(Le Blanc, 1998) was assessed with three items (rated on a 1 to
4 Likert-type scale) asking students to evaluate the attitudes of
their closest friends toward school failure and dropout (α = .74).
Student-teacher conflict was measured using the 7-item French
adaptation (Fallu & Janosz, 2003) of Pianta’s Student-Teacher
Relationship Scale (Pianta & Steinberg, 1992) (α = .85). This
instrument asks participants to assess, on a 5-point Likert scale
whether they experience conflict with their teachers.
Statistical Analysis
Data analysis began with the examination of correlations
among study variables. The main hypotheses were tested with
multivariate logistic regressions. Continuous predictors were
standardized to facilitate the interpretation of odds ratios (OR)
across variables. ORs can thus be interpreted as the expected
change in outcome when the predictor changes by 1 standard
deviation. For dichotomous predictors, the expected change in
outcome is in comparison to the reference group. We first
tested the simple effects of all predictors and then built multi-
variate hierarchical models. Sociodemographic, academic ex-
perience, socioemotional problems, lifetime and seventh-grade
depression variables were entered first in the model, followed
by grade retention. Next, two- and three-way interactions be-
tween grade retention, depression, and gender were tested.
Moderation is established when the interaction term contributes
to the model over and above the main effects of the variables
involved in the interaction (Hosmer & Lemeshow, 2000). The
results reported are for the final model and include only statis-
tically significant interactions.
Results
Table 1 shows the characteristics of the sample. The average
age of participants was 12.53 years old (SD = .73), and 48%
were female. Almost 16% of participants reported lifetime de-
pression symptoms, and 13% reported depression symptoms in
the seventh grade. There was a significant effect of gender for
lifetime depression, x2 = 21.05 (1), p < .000, and for seventh
grade depression, x2 = 11.25 (1), p < .001, with more girls re-
porting depression symptoms at both times. Overall, 25% of
students had a history of grade retention, 40% received special
education, and 32% dropped out of school. Correlations among
study variables are presented in Table 2.
Unadjusted Effects Predicting Dropping Out
Table 3 reports odds ratios and 95% confidence intervals
(95% CI) of unadjusted effects for school dropout. The results
show that students who repeated a grade in primary school were
4.40 times more likely to dropout of school than their counter-
parts. Students in special education were 3.52 times more likely
to dropout. As expected, depressed students in seventh grade
were almost twice as likely to discontinue their education (OR
= 1.97). School rebelliousness, friends’ school engagement, and
student-teacher conflict were also significant risk factors of
Table 1.
Characteristics of participants.
Characteristics All participants (n = 453)
Age, mean (SD), y 12.53 (.73)
Parental education, mean (SD) 2.2 (1.0)
Gender, No. (%)
Girls 215 (47.5)
Boys 238 (52.5)
Lifetime depression, No. (%)
No depression 381 (84.1)
Depression 72 (15.9)
Seventh-grade depression, No. (%)
No depression 394 (87.0)
Depression 59 (13.0)
Grade retention, No. (%)
No retention 340 (75.1)
Retention 113 (24.9)
Educational tracking, No. (%)
General education 274 (60.5)
Special education 179 (39.5)
Academic competence, mean (SD) 3.3 (.5)
Academic achievement, mean (SD) 72.9 (8.8)
Anxiety, mean (SD) 8.9 (8.3)
School rebelliousness, mean (SD) 2.2 (1.5)
Friends school engagement, mean (SD) 1.7 (.6)
Student-teacher conflict, mean (SD) 2.3 (.9)
Dropout, No. (%)
No 308 (68.0)
Yes 145 (32.0)
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C. V. QUIROGA ET AL.
Copyright © 2012 SciRes.
752
Table 2.
Correlations among variables in the study.
Variables 1 2 3 4 5 6 7 8 9 10
1. Parental education -
2. Educational tracking –.113* -
3. Grade retention –.104* .358*** -
4. Academic competence .100* –.198*** –.208*** -
5. Achievement .212*** –.265*** –.178*** .420*** -
6. Lifetime depression –0.04 –0.003 0.073 –.118* –.028 -
7. Seventh-grade depression –.071 0.051 .139** –.235*** –.102* .514*** -
8. Anxiety –.028 0.037 .129** –.210*** –.019 .451*** .511*** -
9. School rebelliousness –.139** .276*** .158** –.364*** –.368*** .223*** .290*** .236*** -
10. Friends school engagement .195*** –.314*** –.185*** .382*** .391*** -.094* –.157** –.113* –.496***-
11. Student-teacher conflict –.116* 0.001 0.003 –.264*** –.212*** .211*** .236*** .207*** .481*** –.339***
Note: ***p < .000. **p < .01. *p < .05.
Table 3.
Summary of simple and multiple logistic regression analysis for vari-
ables predicting school dropout.
Unadjusted Adjusteda
Variable OR (95% CI) OR (95% CI)
Parental education .73 (.59 - .90)* .87 (.68 - 1.10)
Gender 1.22 (.82 - 1.81) .99 (.61 - 1.62)
Educational tracking 3.52 (2.33 - 5.32)*** 1.78 (1.08 - 2.92)*
Academic competence .63 (.51 - .77)*** .97 (.75 - 1.25)
Achievement .57 (.46 - .71)*** .82 (.63 - 1.08)
Anxiety 1.20 (.99 - 1.46) .91 (.70 - 1.18)
School rebelliousness 1.98 (1.60 - 2.44)*** 1.46 (1.10 - 1.94)**
Friends school engagement 2.07 (1.66 - 2.57)*** 1.45 (1.12 - 1.87)**
Student-teacher conflict 1.40 (1.15 - 1.71)** 1.07 (.82 - 1.39)
Lifetime depression .92 (.54 - 1.59) .62 (.31 - 1.26)
Seventh-grade depression 1.97 (1.13 - 3.44)* 2.75 (1.18 - 6.42)*
Grade retention 4.40 (2.81 - 6.90)*** 5.54 (2.46 - 12.46)***
Grade retention X
seventhgrade depression 7.26 (1.46 - 36.17)*
Note: aOdds ratios reported are for the final model with interaction and are ad-
justed for all other variables included. ***p < .000. **p < .001. *p < .01.
dropout. Parental education, academic competence, and achieve-
ment on the other hand diminished the risk of dropping out.
Gender, anxiety, and lifetime depression symptoms were not
related to dropout.
Adjusted Models Testing the Moderat ion Effect of
Depression
Adjusted ORs for the final model are also displayed in Table
3. The results show that students who had repeated a grade in
primary school were 5.54 times more likely to be in the dropout
group. Depression symptoms in the seventh grade were also
associated with a 2.75 higher risk of dropping out with results
indicating the likelihood of dropout for an adolescent reporting
depression during the first year of secondary school could be as
low as 1.18 or as high as 6.42 (according to 95% CI). Students
receiving special education (OR = 1.78), showing rebellious
behavior (OR = 1.46) or affiliating with academically disen-
gaged peers (OR = 1.45) also presented a higher probability of
dropping out of school. Parental education, gender, academic
competence, achievement, anxiety, student-teacher conflict and
lifetime depression symptoms did not significantly predict
dropout when adjusting for other variables.
Consistent with our hypothesis, there was a significant inter-
action between grade retention and seventh-grade depression
symptoms. The interaction term in the logistic regression equa-
tion significantly improved the overall model, x2 = 6.84 (1), p
< .00. The interaction confirmed that depression amplified the
effect of the focal variable, grade retention, on school dropout.
The likelihood of dropping out for students with a history of
grade retention that also reported depression symptoms in sev-
enth grade was 7.26 times higher than for those who did not
report depression (Table 3). However, none of the two- or
three-way interactions involving gender were significant. These
additional effects were thus excluded from the final model. The
chi-square for the final model was x2 = 112.4 (13), p < .000.
Discussion
We examined the moderating effect of seventh-grade depres-
sion symptoms on the relation between grade retention and
dropout up to six years later. Our results indicated that depres-
sion is a vulnerability factor considerably aggravating the pre-
existing risk of dropping out associated with early grade reten-
tion. Previous studies have reported limited direct effect of
depression on dropout (Fergusson & Woodward, 2002; Miech
et al., 1999). However, focusing on the multiplicative relation
between depression symptoms and grade retention yielded
highly different results. It is essential, when studying vulner-
ability (and protection) effects, to “unpack” the underlying
processes that explain the relation between risk factors (Luthar,
Sawyer, & Brown, 2006). Research has suggested a number of
mechanisms through which grade retention and depression
might become linked in the prediction of school dropout. It may
be that children who face academic failure and grade retention
feel confused about their situation and interpret grade retention
as a punishment for their lack of success; they could also begin
to doubt their own ability and give up on their schooling. This
puts them at-risk of developing low self-perceived academic
competence, decreased perseverance in academic tasks, and
adolescent depression by the time they transition into secondary
C. V. QUIROGA ET AL.
school (Cole, Martin, & Powers, 1997; Nolen-Hoeksema, Gir-
gus, & Seligman, 1992). During adolescence, students who
present multiple-risk factors, like school problems and emo-
tional distress, are increasingly likely to face academic self-
regulation problems (Roeser et al., 2002), helpless school be-
havior (Nolen-Hoeksema et al., 1992) and academic disengage-
ment (Roeser et al., 2001). According to Anderson (Anderson et al.,
2005), as children transition into adolescence they become in-
creasingly concerned about doing well in school. As such, they
rate grade retention as one the most stressful life events they
can experience. Coping with this stress is likely to present a
serious challenge for depressed students who have been held
behind, as they may feel stigmatized by teachers and peers, and
experience social and cognitive impairment (Kovacs & Gold-
stone, 1991) that could result in further academic failure. Thus
the current findings are consistent with reports of depression
symptoms in high-risk students undermining academic success
and demonstrate its effect on school dropout.
Academic Experience and Socioemotional Predictors
of Dropout
The third most important risk factor for dropping out in this
high-risk sample was educational tracking. Others have re-
ported that 30% of special education students leave school be-
fore graduation, and when emotional disturbance is involved
dropout nears 50% (Wagner, Kutash, Duchnowski, Epstein, &
Sumi, 2005). Generally, special education students cumulate
multiple risk factors for dropout, showing lower performance
(Blackorby et al., 2003), motivation, academic engagement
(Reschly & Christenson, 2006), and receiving more disciplinary
sanctions (Krezmien et al., 2006) than those in the general
population. Consistent with research on the role of behavior
problems in early school leaving, school rebelliousness and
friends’ school engagement also predicted dropout, indicating
that adolescents who adhere to more deviant behavior are more
likely to leave school without qualification (Loeber, Pardini,
Stouthamer-Loeber, & Raine, 2007; Newcomb et al., 2002).
Gender Differences
The gap in the prevalence of depression between girls and
boys did not translate into an incremental risk for dropout sug-
gesting that gender differences are not involved in the complex
relationship linking grade retention, depression and dropout.
While it has been argued that boys are more reactive to school-
related stressors (Rudolph, 2002), and girls exhibit more de-
pression when facing interpersonal stressors (Sund et al., 2003),
others have found no gender differences in reactivity to school
stressors (Hankin et al., 2007; Shih, Eberhart, Hammen, &
Brennan, 2006). Our findings are consistent with this and indi-
cate that intervention for students with depression symptoms
should target boys and girls equally.
Implications for Research and Intervention
This study demonstrates that depression symptoms play an
important role in the process of dropping out of school for
high-risk youth. Results underscore the necessity to integrate
the study of mental health and schooling to promote positive
development and improve intervention (Adelman & Taylor,
2010; Aviles, Anderson, & Davila, 2006; Becker & Luthar,
2002; Roeser et al., 1998). Prevention and intervention target-
ing adolescents at-risk for depression would benefit both
short-term mental health and long-term school perseverance.
Yet, in the current context of school reform students’ emotional
needs are seldom addressed. Instead most school-based inter-
ventions focus on increasing academic performance or reducing
problematic behavior (Becker & Luthar, 2002; Jimerson et al.,
2006). Efforts to promote school success must include inter-
ventions that target emotional wellbeing.
This research also builds on a large body of knowledge
showing the deleterious consequences of primary-school grade
retention persist into late adolescence (Alexander et al., 2001;
Jimerson et al., 2002; Pagani et al., 2008). The practical impli-
cations of these findings for high-risk children and adolescents
are very significant. Grade retention has often been used as the
first type of intervention for children later diagnosed with
learning difficulties or emotional disturbance (Barnett, Clarizio,
& Payette, 1996; Mattison, 2000). The present results clearly
show that this form of intervention, particularly when used
among depressive youth, does not yield the expected benefits.
Children that have been held back in grade should be thor-
oughly screened for depression symptoms and provided appro-
priate care when indicated.
Limitations
Limitations of this study should be mentioned. Our findings
rely on a sample of adolescents from low-SES schools with a
high rate of special education. Generalization is restricted to
high-risk students. Future research should extend these results
to the general population. We also had limited information
about participant characteristics at the time of grade retention.
To account for family SES, we adjusted for parental education,
and can only presume that this had remained unchanged for
most participants since grade retention. We also adjusted for
participant prior history of depression. But other indicators of
family and individual adversity could help understand the pre-
sent results, such as family income, welfare, or learning dis-
abilities. Despite these limitations, this study encompasses sev-
eral strengths. It is based on a 6-year prospective design that
allowed conclusions about the long-term impact of adolescent
depression and academic experience on educational attainment.
Whereas previous research on depression and dropout relied on
observations in middle adolescence (Fergusson & Woodward,
2002; Miech et al., 1999), we investigated outcomes of depres-
sion based on information gathered at 12-years-old thus shed-
ding light on the consequences of early adolescent experience
on schooling.
Conclusion
An important contribution of this study is to demonstrate
adolescent depression symptoms’ strong relation to grade reten-
tion in predicting school dropout. Depression proved to be a
notable vulnerability factor during the adolescent transition
considerably increasing the risk associated with grade retention
in primary school. Implications for practice and policy are sig-
nificant and point to the consequences of depression for high-
risk adolescents and to the long-term effect associated with the
practice of grade retention on dropout. Findings underscore the
relevance of integrating the study of mental health and school-
ing. Future studies should investigate processes that will im-
prove our understanding of adolescent depression among high-
risk students.
Copyright © 2012 SciRes. 753
C. V. QUIROGA ET AL.
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