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Children and Youth Services Review 42 (2014) 28–33

Contents lists available at ScienceDirect

Children and Youth Services Review


journal homepage: www.elsevier.com/locate/childyouth

Burnout among high school students: A literature review


Vera Walburg
Unité de Recherche Interdisciplinaire OCTOGONE E.A. 4156, Centre d'Etudes et de Recherche en Psychopathologie (CERPP) (Center for Research and Study of Psychopathology),
Université de Toulouse II–Le Mirail, 5 allées Antonio Machado, F-31058 Toulouse Cedex, France
Faculté libre des lettres et des Sciences Humaines, Institut Catholique de Toulouse (ICT), 31 rue de la Fonderie, BP 7012, F-31068 Toulouse-Cedex 7, France

a r t i c l e i n f o a b s t r a c t

Article history: Burnout among adults in professional situations is well-known and widely described (Maslach, Schaufeli & Leiter
Received 1 September 2013 2001). According to Schauffeli et al. (2002) burnout syndrome is also found among university students. More
Received in revised form 29 January 2014 recently, burnout has also been identified in high school student populations. The aim of this study is to explore
Accepted 25 March 2014
current research concerning school-related burnout among high school students. Sixteen studies concerning
Available online 2 April 2014
school-related burnout and academic stress among high school students were reviewed. The review of these
Keywords:
publications has highlighted a number of risk factors and mental health consequences concerning burnout in
Burnout an adolescent population. Gaps regarding research in this field have also emerged, in particular the need for
High school screening scales and repercussions on mental health. Implications for future studies include developing preven-
Adolescence tion with attention to feelings of self-efficacy and solution-oriented coping.
Risk factors © 2014 Elsevier Ltd. All rights reserved.
Mental health

1. Introduction consequences already identified in the current research about academic stress and
school-related burnout; and secondly to highlight gaps of knowledge in this field. The
procedural modalities for literature research will be presented followed by the review it-
Several previous studies have been carried out concerning burnout among adults in
self grouped according to three categories: 1) results providing a definition of school re-
stressful work situations. According to Schaufeli, Martinez, Pinto, Salanova, and Backer
lated stress and burnout, 2) research concerning risk factors, and 3) mental health
(2002) burnout was originally assumed to occur only in professions but recently it has
consequences. The concluding section of the article will provide a synthesis as well as
been extended to all activity domains. Burnout is defined as a three-dimensional con-
highlight considerations for further research.
struct including exhaustion, cynicism or depersonalization, and inefficacy or reduced per-
sonal accomplishment (Maslach, Shaufeli, & Leiter, 2001). More precisely, exhaustion
involves feelings of strain and chronic fatigue. Cynicism consists of an indifferent or dis- 2. Method
tant attitude toward work, losing interest in one's work, or not seeing work as meaning-
ful. And lack of professional efficacy refers to reduced feelings of competence,
achievement, and accomplishment. According to the results of these studies it should
2.1. Literature search strategy
be noted that burnout has important consequences on mental health among adults in
professional situations, such as higher risk for depression (Mutkins, Brown, & A computerized research of the literature through the EBSCO search
Thosteinsson, 2011), low self-esteem (Eriksson, Engström, Starring, & Janson, 2011), engine including the Pubmed, PsychINFO and Science Direct databases
and a higher suicide risk (Pompili et al., 2010). The concept of burnout was extended
was performed between June 2011 and December 2013 using the
to university students, indeed Schaufeli et al. (2002) showed in their study, carried out
among 1661 undergraduate students from Spain, Portugal, and Netherlands that burnout term “burnout”, “academic stress”, “adolescents” and “high schools”.
is inversely correlated to university engagement and performances, independent of coun- Reference lists of all identified publications were checked to retrieve
try of origin. Recently, some research was published exploring burnout among secondary other relevant publications not identified by means of the computerized
and high school students (Salmela-Aro, Kiuru, & Nurmi, 2008; Salmela-Aro, Kiuru, search.
Pietikïnen, & Jokela, 2008; Silvar, 2001). As previously mentioned, burnout in adults in-
creases the risk of mental disorders such as depression, low self-esteem and a higher
risk of suicide; these disorders are also particularly highly prevalent in adolescents 2.2. Selection criteria
(Costello, Erkanli, & Angold, 2006; Jiang, Perry, & Hesser, 2010; Orth, Robins, & Roberts,
2008). Given the importance of these disorders in adolescents it appears useful to exam-
Studies that met the following criteria were included; 1) study ob-
ine the impact of burnout in a population of high school students. The purpose of this re-
view is firstly to synthesize existing research concerning risk factors and mental health jectives included describing burnout or academic stress among adoles-
cents, 2) publication was an original research article, 3) publication in
peer-reviewed journals, and 4) publication was written in English. The
described inclusion criteria were applied to the initial 80 hits. Sixteen
studies were selected for the review. The 64 studies not retained for
E-mail address: vera.walburg@gmail.com. this review were excluded for the following reasons: 1) the publication

http://dx.doi.org/10.1016/j.childyouth.2014.03.020
0190-7409/© 2014 Elsevier Ltd. All rights reserved.
V. Walburg / Children and Youth Services Review 42 (2014) 28–33 29

was not about school related stress or burnout 2) the publication con- the evolution of burnout during the transition from comprehensive
cerned other aspects of school maladjustments and 3) the publication school to senior high schools (vocational or academic-oriented). The
was a literature review. These studies were conducted between 2001 results show that adolescents in senior high schools (academic track)
and 2013. experienced more exhaustion than those in vocational schools (profes-
sional track). Similarly, scores of cynicism and feelings of inadequacy in-
3. Research concerning burnout among high school students creased after transitioning to high school for adolescents on academic
tracks whereas these scores decreased especially for boys on vocational
3.1. Definition of burnout and academic stress in the literature tracks. Girls experienced a higher level of all three burnout components
(exhaustion, cynicism and inadequacy) than boys.
Referring to the transactional model (Lazarus & Folkman, 1984) In the same vein the study of Bask and Salmela-Aro (2013) focused
stress represents a physical and emotional state of being exhausted on the link between school burnout and school dropout rates. This lon-
and overwhelmed during which the demands exceed the internal gitudinal study focused on the transition to post-comprehensive school
and external resources of an individual to cope with the situation. as for the previous study. A total of 878 ninth-grade Finnish students
Therefore, academic or school related stress refers to stress states participated in the study and data collection was done in 2004, 2005,
among students based on student statute or academic demands. Burn- 2006, and 2009. The average age of participants was, respectively, 16,
out concerns an emotional state of exhaustion, cynicism and deper- 17, 18 and 21. The results of this study indicated that all the components
sonalization engendered by an exposure to a high level of chronic of burnout tend to increase over time. It was especially the cynical as-
stress. pects which best predicted school dropout.
Ang and Huan (2006) in their study carried out in Singapore with Also related to this transition period from secondary school to
1108 adolescents (596 boys and 508 girls) aged from 12 to 18 with upper-secondary school, the study done by Salmela-Aro & Tynkkynen
mean age 14.33 (SD = 0.93), defined academic stress as chronic stress (2012) focused specifically on the effect of gender on school-related
feelings among students with high academic self-expectations or high burnout during this transition. The study took place in four steps and
academic expectations from others such as parents and teachers. A mul- the overall sample was 954 participants: time 1 occurred at the begin-
tiple regression analysis in four steps showed that depression was a par- ning of the ninth grade which is the last secondary school class, includ-
tial mediator between academic stress and suicidal ideations among ing 687 participants (327 girls, 360 boys; response rate 72%); time 2 at
adolescents. Indeed, by including depressed mood in the model a previ- the end of the ninth grade included 642 participates (317 girls, 325
ously established significant relationship between academic stress and boys, response rate 67%); time 3 took place six months after the transi-
suicidal ideations was significantly reduced. tion where 818 participated (396 girls, 422 boys; response rate 86%). Fi-
For Salmela-Aro, Kiuru, Leskinen, and Nurmi (2009) school-related nally, time 4 was one year later and included 749 participants (368 girls,
burnout is described as being composed of exhaustion due to school de- 381 boys, response rate 79%). The results demonstrated an increase of
mands, cynical and detached attitudes toward school, and feelings of in- all three school burnout components among high school boys and an in-
adequacy as a student. The same author also described burnout as a crease in school-related burnout among high school girls, particularly
continuous phenomenon of academic stress to major burnout. This concerning feelings of inadequacy. For students on the vocational
study was conducted with a total of 1418 participants (709 girls, 709 track no changes were observed; cynical aspects tended to decrease
boys) from 13 post-comprehensive schools (6 upper secondary high overall among girls.
schools; 7 vocational schools), the mean age of participants was Another study carried out by Salmela-Aro, Kiuru, Pietikïnen, Jokela
16 years (SD = 1.73). The aim of this study was the goodness-of-fit of (2008) was collected from two samples in Finland. In sample 1, partici-
the three-factor model: exhaustion at school, cynicism toward the pants were 58,657 students from 431 schools, aged from 14.3 to 16.2,
meaning of school, and sense of inadequacy. The results indicate that including 29,420 boys and 29,237 girls. In sample 2 responders were
school burnout was best described by three positively correlating fac- 29,515 students from 228 schools, aged from 16.3 to 18 years, 12,903
tors encountered in the school setting including: exhaustion, cynicism, boys and 16,612 girls. The major findings in this study were that
and inadequacy. Depression was associated with all three factors of negative school climate was positively related to school-related burn-
school burnout. Lower academic achievement and lower school en- out, whereas support from school and positive motivation received
gagement encouraged more cynicism toward school and a sense of from teachers was related to a low level of school-related burnout.
inadequacy. Concerning background variables, girls and those with a lower grade
Additional studies provided some indications for academic stress point average experienced more school-related burnout. Nevertheless,
and school-related burnout such as Yusoff (2010) who described aca- socio-economic status and family structure were not related to school-
demic stress as result of inappropriate workloads or assignments, exam- related burnout.
inations, and inappropriate treatment by teachers; or Kiuru, Aunola, A study carried out by Silvar (2001) in Slovenia was carried out on
Nurmi, Leskinen, and Salmela-Aro (2008) who proposed that school- 1868 Slovene high school students aged from 15 to 18 years, 58.3% girls
related burnout is caused by a lack of fit between student's internal re- and 41.7% boys. This study highlighted the fact that school-related burn-
sources, school workload, personal expectations of school results, or out is related to poor family relationships and emotionally-oriented cop-
expectations held by teachers or parents. Silvar (2001) defined school- ing. Moreover, girls indicated higher academic stress, which was related
related burnout as a consequence of excessive school demands, lack of to anxiety and 6.8% of the participants in this study experienced a high
control, lack of recompenses for high achievement, lack of interpersonal level of school-related burnout.
relationships, and high expectations from significant others like teachers The study conducted by Yusoff (2010) involved 100 secondary
and family members. school students from a Malaysian government secondary school located
Thus, the literature provided a specific definition of academic stress in Kota Bharu. The authors found a high prevalence (26.1%) of school-
and school-related burnout placed in the in the context of school envi- related stress among their students. School stress factors concerned ac-
ronment, differing sensibly from the adult context. ademic matters (university admission, school subjects, and workload).
The most frequent coping strategies found in this study were positive
3.2. Risk factors coping strategies (religious, active coping, positive reinterpretation,
planning, and use of instrumental support).
Some studies aimed to describe risk factors for burnout and academ- A study carried out in Turkey in ten high schools in Eskisehir
ic stress. The longitudinal study conducted by Salmela-Aro, Kiuru, and by Aypay (2011) included 691 students (371 girls and 360 boys).
Nurmi (2008) with 773 participants (297 girls and 314 boys) observed Among these participants, 261 (38%) were in the 6th grade, 236
30 V. Walburg / Children and Youth Services Review 42 (2014) 28–33

(34%) were in the 7th grade and 194 (28%) were in the 8th grade. The (Salmela-Aro, Savolainen, & Holopainen, 2009) including 611 partici-
results showed that burnout was induced by academic matters like pants (297 girls, 314 boys) from eight Finnish comprehensive schools,
school activities, feelings of inadequacy, lack of interest, and family found moderate stability of depression and school-related burnout
concerns. symptoms over time during adolescence, and underscores the fact that
The study conducted by Murberg and Bru (2003) among 531 stu- school-related burnout predicts depressive symptoms more strongly
dents aged from 13 to 16 from two secondary schools in Norway (284 than vice versa. Symptomatic evolution based on gender or choice of
girls and 247 boys), identified four dimensions of school-related stress: studies (academic or vocational track) has not been found.
difficulties with peers at school, parent and/or teacher conflicts, worries Another longitudinal study carried out by Murberg and Bru (2006)
about school achievement, and school pressure. Girls reported more explored the role of neuroticism and school-related stress in somatic
academic stress related to “worries about achievement and school re- symptoms. The study was conducted among 535 participants (376
sults”. They also reported more psychosomatic symptoms than boys. girls, 237 boys) in Norway. The major finding was that school related
Boys in turn reported more academic stress relative to conflicts with stress and neuroticism are risk factors for somatic symptoms.
teachers and parents. There was no evidence, however, of a link be- Finally, a third longitudinal study provided by Tuominen-Soini and
tween higher psychosomatic symptoms and higher academic stress Salmela-Aro (2013) had as its main goal, to explore school-related
among girls. The results indicate also that 18.1% of participants present burnout and school engagement profiles among high school students;
a high level of school-related stress and were affected by at least one a secondary objective was to examine the stability of profiles six years
psychosomatic symptom. later in young adulthood. At time 1 the study took place in six high
The study conducted by Kiuru et al. (2008) explored the role of peer schools in one Finnish town. 979 students were involved in the study
influence on school-related burnout. The study involved 517 partici- (587 girls and 392 boys) and mean age was 18.11 years (SD = 1.11).
pants (265 girls, 252 boys) from eight Finnish schools; median age Six years later 68% of the original sample participated (663 participants;
was 15 (SD = 0.34). The results of this study showed that the members 426 girls and 237 boys). Cluster analysis indicated four profiles: en-
of adolescent peer groups were somewhat similar in terms of their gaged, engaged-exhausted, cynical, and burned-out. Moreover, results
school burnout. Evidence for peer influence in school-related burnout indicated that these profiles were rather stable over time from late ad-
was found, but no evidence was found for the effect of peer group selec- olescence to young adulthood.
tion. The results showed that belonging to a high-achieving peer group As a result, it can be noted that some research underlines conse-
protected group members against an increase in school-related burnout quences of school-related burnout on depression, somatic symptoms,
and peer groups characterized by low academic achievement promoted and academic trajectories with a higher risk of school dropout but many
an increase in school-related burnout. aspects of maladjustment and high-risk behavior remains unknown.
The study accomplished by Parker and Salmela-Aro (2011) tested Table 1 summarizes the research reviewed in this article alphabeti-
four theoretical frameworks explaining the development of burnout. A cally presented according to author name, publication date, main objec-
model provided by Golembiewski (1989), which stipulates that burnout tive, method used and the main result. Of the sixteen articles reviewed,
develops in phases resulting in clusters representing progressively more three intended to test development models or validate measures, six
maladaptive states. A model provided by Leiter (1989) indicates a link were cross-sectional studies, and seven were longitudinal studies. The
between emotional exhaustion and cynicism. A model provided by average number of participants was 4428.81 but with substantial vari-
Lee and Ashford (1993), according to which emotional exhaustion pre- ability between studies with one study featuring 100 participants and
dicts both cynicism and feelings of inadequacy. And finally a model from another 58,657 participants.
Taris, Le Blanc, Schaufeli, and Schreurs (2005) indicates that emotional
exhaustion has both direct and indirect effects on feelings of inadequacy
via cynicism. Participants were 852 Finnish high-school students; the 4. Discussion
sample contained 444 girls and 408 boys and average age was 16. The
major findings indicated that the theoretical framework provided by The different studies reviewed in this paper were conducted at var-
Taris et al. (2005) fitted the data best and that school-related burnout ious geographical locations (Northern Europe, Eastern Europe, Asia,
is rather consistent over time as is cynicism which in turn predicts feel- Turkey, Malaysia) suggesting that the phenomenon is not geographical-
ings of inadequacy. ly or culturally restricted but could be found among students with dif-
A study provided by Vasalampi, Salmela-Aro, and Nurmi (2009) ex- ferent school organizations and academic policies. The results of these
plored the role of self-concordant achievement-related goal in school studies revealed the marked incidence of school-related burnout on ad-
engagement, adjustment and school-related burnout scores. Partici- olescent school life. Indeed, these studies indicate that school-related
pants were 614 (376 girls, 237 boys) high school students from a burnout increases the risk for internalized problems like anxiety (Silvar,
medium-sized town in central Finland. Mean age was 17 years (SD = 2001) and depression (Salmela-Aro, Savolainen, et al., 2009) as well as so-
0.28). Globally the results indicate that the pursuit of achievement- matic symptoms (Murberg & Bru, 2003; Murberg & Bru, 2007). Higher
related goals for internal reasons was related to a high level of goal effort risks for suicidal ideation were also found (Ang & Huan, 2006). School-
and goal progress, which in turn predicts school adjustment. Moreover, related burnout and academic stress also affect academic achievement
the results showed that goal progress in their achievement-related goal by increasing the risk for school dropout (Bask & Salmela-Aro,
was related to a low level of school-related burnout among girls, but it 2013; Silvar, 2001) and for lower school engagement and achieve-
did not produce the same effect for boys. ment (Tuominen-Soini & Salmela-Aro, 2013; Vasalampi et al., 2009).
Hence, many risk factors for academic stress and school-related burn- In addition, students on academic tracks appeared consistently to be
out have been identified related to school context like school pressure, more at risk than those on vocational or professional tracks
peer groups, school engagement as well as adjustment and academic (Salmela-Aro, Kiuru, & Nurmi, 2008; Salmela-Aro & Tynkkynen, 2012;
track. Nevertheless, internal aspects like personality traits, cognitive dis- Bask & Salmela-Aro, 2013), implying that this finding merits further
crepancies and core beliefs which may impact vulnerability have not yet study.
been widely explored. All studies found higher school-related burnout and school related
stress scores among girls than boys which is consistent with previous
3.3. Consequences for mental health research stipulating that girls experienced higher levels of internalized
problems (Pomeranz, Altermatt, & Saxon, 2002).
Three studies highlighted some implications of school-related burn- Certain studies indicate some protective factors like problem resolu-
out in adolescent mental health: The longitudinal study conducted by tion coping strategies (Yusoff, 2010), high-achieving peer groups (Kiuru
V. Walburg / Children and Youth Services Review 42 (2014) 28–33 31

Table 1
School-related burnout research synthesis.

Author and publication year Country Research method, main purpose and sample size Major findings and conclusion

Salmela-Aro, Kiuru, et al. (2009) Finland Testing the goodness-of-fit of the three-factor model: exhaustion School burnout was best described by three positively
at school, cynicism toward the meaning of school, and sense of correlating factors: exhaustion at school, cynicism toward
inadequacy. school, and inadequacy at school.
Sample size: 1108
Salmela-Aro, Kiuru, and Nurmi Finland Evolution of school-related burnout during the transition from Adolescents in senior high schools (academic track)
(2008) secondary school to upper secondary school (academic track) or experienced more exhaustion than those in vocational schools
vocational school (vocational track) and the role of gender (vocational track).
during this transition. Girls experienced more school-related burnout than boys.
Longitudinal study
Sample size: 773
Salmela-Aro, Kiuru, Pietikïnen, Finland The effect of school related variables like negative school Negative school climate was related to high school burnout.
et al. (2008) climate, positive motivation received from teachers, support Support from school and positive motivation received from
from school and background variables like gender, GPA, SES, and teachers was related to a low level of school burnout.
family structure on school-related burnout scores. Girls with lower GPA experienced more burnout.
Cross-sectional study SES and family structure were not related to school-related
Sample size: 58,657 burnout.
Kiuru et al. (2008) Finland Do the members of adolescents' peer groups show similar levels Members of adolescent peer groups were similar in terms of
of school-related burnout? their school-related burnout.
Do academic achievement and gender predict school burnout Belonging to a high-achieving peer group protected group
and evolution over time? members against the increase in school-related burnout.
Longitudinal study Peer groups characterized by low academic achievement
Sample size: 517 promoted an increase in school-related burnout.
Ang and Huan (2006) Singapore The role of depression as a mediator between academic stress Depression was a partial mediator between academic stress and
and suicidal ideation. suicidal ideation among adolescents.
Cross-sectional study
Sample size: 1108
Silvar (2001) Slovenia Incidence of school-related burnout among secondary school The study revealed that school-related burnout was linked to
students related to gender, school performance, number of high anxiety scores and low self-esteem, poor family
students, absenteeism, and self-esteem. relationships, emotionally oriented coping, and absenteeism.
Cross-sectional study
Sample size: 1868
Yusoff (2010) Malaysian Prevalence of academic stress, stressors and coping strategies High prevalence of academic stress.
among secondary school students in Malaysia. Stress factors concerned academic matters.
Cross-sectional study The most frequent coping strategies used in this study were
Sample size: 100 “positive coping strategies”.
Aypay (2011) Turkey The validity and reliability of a scale measuring school-related Four factors were identified by an explanatory and confirmatory
burnout among high school students in Turkey. factor analysis: burnout from school activities, burnout from
Sample size: 697 family, and feeling of insufficiency in school and lack of interest
toward school.
Parker and Salmela-Aro (2011) Finland Testing the development of school-related burnout models The major findings indicated that the theoretical framework
linked to four framework models. provided by Taris et al. (2005) fitted the data best.
Sample size: 852
Salmela-Aro, Savolainen, et al. Finland Evolution of depression and school-related burnout symptoms A moderate stability of depression and burnout symptoms over
(2009) between middle and late adolescence. time during adolescence, and that burnout predicts depressive
Cross-sectional study symptoms more strongly than vice versa.
Sample size: 611
Murberg and Bru (2003) Norway The relationship between academic stress, psychosomatic For dimensions of school related stress: difficulties with peers at
symptoms, and gender differences. school, parent and/or teacher conflicts, worries about school
Cross-sectional study achievement and school pressure.
Sample size: 531 Girls reported more academic stress and more psychosomatic
symptoms than boys.
Murberg and Bru (2007) Norway The role of neuroticism and school related stress in somatic The results indicate that school related stress and neuroticism
symptoms. are risk factors for somatic symptoms.
Longitudinal study
Sample size: 535
Vasalampi et al. (2009) Finland The role of self-concordant achievement-related goal in school The pursuit of achievement-related goals for internal reasons
engagement, adjustment and school-related burnout scores. was related to a high level of goal effort and goal progress.
Cross-sectional study. Goal progress in their achievement-related goal was related to a
Sample size: 614 low level of school-related burnout among girls.
Bask and Salmela-Aro (2013) Finland The link between school burnout and school dropout during the All the components of burnout tend to increase over time.
transition to upper-secondary school. Cynical traits predict school dropout best.
Longitudinal study
Sample size: 878
Salmela-Aro and Tynkkynen (2012) Finland Gender effect on school-related burnout during transition to School-related burnout increases among students in high school
upper-secondary schools. for both genders.
Longitudinal study
Sample size: 954
Tuominen-Soini and Salmela-Aro Finland School-related burnout and school engagement profiles among Four typical profiles were found: engaged, engaged-exhausted,
(2013) high school students; examination of profiles for stability six cynical and burned-out.
years later. Profiles are rather stable over time from adolescence to young
Longitudinal study adulthood.
Sample size: 979
32 V. Walburg / Children and Youth Services Review 42 (2014) 28–33

et al., 2008) and pursuit of achievement-related goals (Vasalampi et al., school-related burnout among students and would hence be relevant
2009). for future research in the field of protective factors.
The study provided by Agliata and Renk (2009) indicates that discrep-
4.1. Limitation of the study ancies between parental expectations and perceived self-performance by
the student induced internal disorder (anxiety, depression, distress).
While one limitation could be that this review examined studies From this perspective an approach focused on parents as preventions,
about both academic stress and school-related burnout it is suggested perhaps deserves to be investigated.
that these two concepts are particularly close and interconnected as de-
scribed by Salmela-Aro, Kiuru, and Nurmi (2008); this author describes
5. Conclusion
these two concepts as a continuous phenomenon, sharing the same risk
factors. Similarly, the fact that some studies reviewed in this paper deal
Burnout is a well-known concept among adults in professional situ-
with adolescents on a vocational track while the primary purpose of this
ations; over the last decade this concept has also been studied in the
article is the school burnout among students in high school can lend it-
school context. Research in this area has shown the importance of the
self to confusion. However, data from adolescents on vocational tracks
phenomenon in adolescents affecting their mental health and academic
are presented in contrast to the data of those who continue on academic
performance. More research is needed for a better understanding of risk
tracks.
factors and implications on mental health but also for developing scales
Since, school-related burnout is rather a recent problem studied
measuring prevalence and potential protective factors. Interventions on
among high school students the number of studies so far is perhaps a
self-efficacy, coping strategies or cognitive beliefs about academic com-
bit limited for a review of the literature. Nevertheless, it seems worth-
petence are also interesting possibilities to explore in the future.
while to present the current research in this area to get a first insight
of risk factors and psychopathologic consequences of this disorder, to
provide possible indications for prevention, and, above all, encourage References
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