Associations of problematic teacher–pupil relationships with child mental health, psychiatric disorders and neurodevelopmental conditions as reported by parents and children: cross-sectional analysis
Abstract
Background Problematic teacher–pupil relationships (TPR) affect children’s educational outcomes and mental health, particularly for children with psychiatric disorders and neurodevelopmental conditions, yet few population-based studies have explored this association. Aims To estimate the association between problematic TPRs and psychiatric disorder classifications including neurodevelopmental conditions and poor mental health, and whether this varied by informant. Method A cross-sectional analysis of the Mental Health in Children and Young People 2017 survey (n = 6634) was performed. Mental health was assessed using the Strengths and Difficulties Questionnaire, whereas classification of psychiatric disorders, including neurodevelopmental conditions, was assessed using the Development and Well-Being Assessment. TPR quality was evaluated through reports from parents and children (aged >11 years). Bivariable and multivariable regression analyses were stratified by age (5–10 years, n = 3509; 11–16 years, n = 3010), controlling for covariates. Multiple imputation was used to address missing data. Data-set information: NatCen Social Research (2024), Mental Health in Children and Young People 2017, UK Data Service, SN 8467. Results Problematic TPRs were associated with increased odds of any psychiatric disorder in children aged 5–10 years (adjusted odds ratio = 4.80, 95% CI: 2.74–8.40) and 11–16 years (adjusted odds ratio = 4.07, 95% CI: 2.76–6.01). Strengths and Difficulties Questionnaire total difficulties scores were higher by 4.26 points (95% CI: 3.09–5.42) and 3.93 points (95% CI: 3.04–4.83) for children aged 5–10 and 11–16 years, respectively. Problematic TPRs were also associated with attention-deficit hyperactivity disorder, with no significant differences between informant types. Teacher recognition of poor mental health did not moderate these associations. Conclusions These findings support the importance of TPRs in school policy and of supporting teachers to foster positive relationships in schools.