Neil, LE; (2016) Teachers’ identification of anxiety and somatic symptoms in their pupils. Doctoral thesis , UCL (University College London).

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Abstract

Anxiety and somatic symptoms are some of the most common and debilitating mental health problems in childhood yet frequently go unnoticed and untreated. UK schools have been urged to take a more prominent role in promoting good mental health in their pupils; yet whether their teachers can recognise children’s anxiety and somatic symptoms, and how teachers identify these symptoms has not been investigated. This two-stage study involved 1346 7-11 year old children, their class teachers and a subsample of parents. Standardised scales and a simple rating scale were used to collect data on children’s anxiety and somatic symptoms and teachers’ psychological wellbeing. Qualitative interviews were conducted with a smaller purposively selected group of teachers to investigate how teachers identified symptomatic pupils. A modest positive association was found between teachers’ and children’s reports of anxiety and somatic symptoms, and teachers were rarely able to identify children whose self-reported or parent-reported anxiety and somatic scores suggested clinical levels of symptoms. Themes identified from interviews included the perception that anxiety can be identified through oppositional behaviour, and the perception that somatic symptoms vary in their authenticity. The associations between teachers’ own psychological wellbeing, feelings of responsibility and attitudes towards the causes and presentation of children’s symptoms were investigated for any relationship with sensitivity to pupils’ symptoms. Teachers’ obsessive-compulsive symptoms were positively associated with sensitivity to pupils’ anxiety symptoms. Findings from two short, newly developed scales suggested that teachers felt highly responsible for pupils’ wellbeing and believed children were more likely to exaggerate somatic symptoms than anxiety, but these constructs were not associated with sensitivity to children’s symptoms. Results suggest that teachers are somewhat sensitive to the variation in pupils’ levels of anxiety and somatic symptoms, but struggle to distinguish children who self-report particularly high levels of symptoms from the rest of their class.

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