Change over time in perceived schoolwork pressure and associations with emotional problems among 11-16-year-olds: A repeat cross-sectional study in Wales, UK.

Background: Emotional problems among adolescents have increased substantially in recent years, and there is evidence that schoolwork pressures have also increased globally. We examine trends in perceived schoolwork pressure and emotional problems in Wales between 2002 and 2021, and associations between the two over this period. Methods: Repeat cross-sectional data were used from surveys conducted in secondary schools in Wales. Participants were 11-16-year-olds ( Results: The percentage of students reporting a lot of perceived schoolwork pressure increased from 21% in 2002, to 24% in 2004. Rates then declined until 2009, dropping to 13%, before increasing to nearly 26% by 2021. Students reporting the most pressure were females in older school years, with up to 57% of females in Year 11 reporting a lot of perceived pressure in 2021. Emotional problems followed a similar trend, decreasing between 2002 and 2009, and then increasing between 2009 and 2021. Between 2009 and 2019, estimates of the cohort difference in emotional problems reduced from 2.23 (95% CI = 2.12, 2.34) to 1.64 (95% CI = 1.54, 1.75) when adjusting for changes in schoolwork pressure. This is consistent with the hypothesis that schoolwork pressure may be driving some of the increase in emotional problems over time. Conclusions: Our findings showed a decline in perceived school pressure until 2009, followed by a rise until 2021. Increases were particularly apparent among female adolescents, mirroring trends in emotional problems. Although a range of competing causal explanations cannot be ruled out, overall increases in schoolwork pressure from the late 2000s may have contributed to the rise in adolescent emotional problems over this period.