Over the past year, Dr. Luthar has engaged with Wilton High School (WHS) in a research-based collaboration to determine the most promising directions for future interventions that will maximize youth well-being in our community.
In November 2017, over 1,200 WHS students participated in an extensive survey conducted by Dr. Luthar at no cost to WHS (about an 80-85% participation rate, depending on the measure). Among the topics examined were:
student adjustment outcomes which included depression, anxiety and somatic symptoms (internalizing symptoms), and rule breaking and aggression (externalizing symptoms);
use of alcohol and other drugs;
positive attributes such as empathy, compassion, and altruism (prosocial behavior).
Dr. Luthar uses instruments and measures that are scientifically rigorous and used by scientists in peer-reviewed research publications.
On March 5, 2018, Dr. Luthar presented her findings to parents and concerned members of the community. Speaker fees were provided by a grant that the Wilton Youth Council received from the Wilton Woman's Club and funding from the WHS PTSA. Dr. Luthar did not charge a fee for data collection or analysis.
“I am a mom myself… I have anxiety about all these issues myself. I have lived it.”
Dr. Luthar speaks from the point of view of a mother and a researcher.
Her presentation addressed three sets of questions:
Where do Wilton students fall, on average, relative to other high achieving schools, not just on aspects of personal adjustment but also on risks and protective factors that will affect their well-being?
Of the risk and protective factors that were assessed, which are especially salient or important? Dr. Luthar studies resilience, which is doing well in the face of adversity. Researchers are often criticized for giving a laundry list of things that matter, but that is not helpful for people who want to make a difference. While there may be 25 important variables, when Dr. Luthar’s lab assesses a community, they try to distill the top 2, 3, or 4 things that community should focus for intervention, based on their assessment.
Based on the findings, what future directions should be pursued to make a difference that is based in research?
“Be reassured that we are working toward getting, not solutions, but certainly good directions for what we can do to make a difference, that are based in research, that are not based on impressions.”
“In high achieving schools with good standardized tests, high SATs, lots of extracurriculars… in every single school we see the same thing. There are elevations in one or more significant areas of adjustment… This is not unique to you.”
The instrument used is from the Monitoring the Future study, for which there are excellent national norms by students’ age and by the year of assessments.
Rates of substance use in Wilton are elevated compared to national norms but similar to other high achieving schools. Almost no Wilton students reported smoking cigarettes in the last year. Around 50% reported using alcohol during that time, and approximately 35% reported having been drunk. About 25% reported using marijuana.
Nearly 25% of 9th and 10th graders and 45% of 11th and 12th graders reported using an e-cigarette or JUUL in the last month. This is substantially elevated compared to norms. “Kids might think they are harmless, but we need to help them understand that we do not know what it is in them yet.”
Internalizing Symptoms (anxious-depressed, withdrawn depressed, somatic symptoms) and Externalizing Symptoms (rule breaking, aggression)
The instrument used is the Youth Self Report, which is a published, copyrighted measure, also with excellent national norms. It assesses both internalizing and externalizing symptoms. Internalizing symptoms are inward directed – anxious, depressed, and also somatic symptoms like unexplained headaches or stomachaches. Externalizing symptoms are outward directed – rule-breaking, aggressive behaviors, etc. This measure gives not just average levels, but allows researchers to measure the level at which symptoms become clinically significant.
About 30% of Wilton students have “above average” levels of internalizing symptoms (clinically significant levels), compared to a national norm of 7%. Almost 20% have “much above average” levels, compared to a national norm of 2%. The most pronounced problem is anxious-depressed; next are withdrawn-depressed and somatic symptoms. Levels of externalizing symptoms are also elevated, although to a lesser extent.
Levels of these symptoms are worrisome and motivated Dr. Luthar to look carefully at the data to try to understand this. However, Dr. Luthar assured the audience that this is common in high achieving schools.
“You are not unique… some kind of symptoms are elevated everywhere, the question is which kind, and how much, and what we can do about it. But please do not think of yourselves as unique on this front.”
A lot of people are concerned about hooking up. The good news here is that most Wilton students do not view hooking up favorably; about 80% girls and 70% boys do not view it positively.
We want to be able to encourage things like empathy and prosocial behaviors (helping others), so in recent years, Dr. Luthar has begun to look more at these positive attributes.
With regard to empathy, prosocial reputations (altruism), and intrinsic life goals (commitment to personal growth, relationships, and community vs. image, fame and wealth), students’ responses here are similar to other high achieving schools she has studied.
What factors influence children’s adjustment outcomes?
“If you consider aspects of kids’ relationships with primary adults in their lives, that is always going to have more predictive power on their adjustment levels than any number of extracurricular activities or anything else.”
Relationships with Parents
Parents are among the most important influences on their child’s development. In assessing risks and protective factors, Dr. Luthar measures different aspects of how children see their relationships with both parents.
With regard to parent attachment – feelings of trust, communication, alienation, perceived criticism and expectations - responses are similar to other high achieving schools.
Dr. Luthar looked for associations between parent attachment and outcomes. When attachment to parents is high for Wilton students, internalizing (anxious, depressed, somatic) and externalizing (rule-breaking, aggression) symptoms are low. The strength of associations with outcomes is stronger for alienation. Wilton students who feel alienated from their parents have higher levels of symptoms.
“The bottom line is, when our kids have a low sense of alienation from us, and feel close to and trusting of us, their symptom levels are low.”
Dr. Luthar emphasized that in any relationship, associations are stronger for negative things, by as much as a factor of three, than for positive ones.
“Harshness always hurts more than kindness helps, so we want to avoid harshness.”
For boys, high parent attachment is linked not only with low symptoms but also with high positive prosocial reputation (altruism) and somewhat with empathy.
There are some challenges for parents in communities like ours that are unique as compared to other subcultures. One is parents’ perceived laxness, or what kids perceive will be the repercussions of breaking the rules. Therefore, parent containment of errant behaviors (rudeness, bullying, delinquency, cheating, academic indolence and substance use) was examined. In general, in high achieving schools, kids perceive that repercussions for substance will be less than for some other behaviors.
Parents need to understand that their anticipated repercussions do matter – especially for low substance use and high positive behaviors and values. Wilton students’ actions and values are influenced by their perception of their parents’ values and how they believe their parents will respond to their behavior.
When it comes to alcohol and other drugs, sometime parents say, “everybody does it.” In fact, not everybody does, but also, it’s very important to note that kids respond to parents’ repercussions. Do not be draconian, because that can backfire. But within the context of a loving relationship, parents must be vigilant. Rules about substance use should be discussed clearly between parents and children, and mutually agreed upon consequences must be enforced.
In other longitudinal research Dr. Luthar has found that not only is parent containment associated with high school students’ use of alcohol and other drugs, but it is associated with psychiatric diagnoses of addiction many years later, at the age of 28. Rates of addiction at 28 for graduates of high achieving schools were twice as high as national norms.
“I don’t say all this to scare you… but to say that if you pick up on drug and alcohol use, or depression and anxiety, I implore you to take it seriously.”
Relationships with Peers
Social media use was measured along with peer relationships. Responses to questions on social media use and relationships with peers were similar to those of comparison schools.
As with parent relationships, “bad is stronger than good” holds true in peer relationships. In general, links with adjustment problems are stronger for peer victimization, bullying and sexual harassment than for support from peers.
Social media comparisons are concerning. Like adults, students compare themselves to others on social media. Kids who tend to feel that others’ lives are better than theirs are most prone to depression and anxiety, and this association is especially strong for girls.
For parents of daughters, it is important to understand that the expectations of girls today across so many domains are exceptionally high. They are expected to be successful in academics and extracurriculars, and also be sweet, kind, and attractive. “Girls are getting crushed under this pressure.” This is true for sons as well, but parents of daughters need to be especially vigilant for perfectionism. Dr. Luthar recommends the book Enough as She Is by Rachel Simmons.
In the last couple of years, Dr. Luthar has begun focusing intensively on dimensions of school climate, because they are generally modifiable by school administrators. “Intervening at the school level is a very expedient way to get at a lot of issues.”
The approach involves examining about a dozen major dimensions of school climate and identifying what proportion of kids feel positively about each one, and what proportion feel negatively. More importantly, sophisticated analyses help to disentangle the importance of each for kids’ adjustment in this particular community. The question here is, when considering 10-12 aspects of school climate, which ones have the most unique significance, and therefore should be prioritized in interventions in this school?
Based on associations with symptoms, of greatest concern in Wilton are the school’s perceived intolerance of bullying, alienation from teachers, students’ belief that there is an adult at school who cares about them, and parent / community involvement. Teacher academic support is also significant for boys.
For the dimension “Caring Adult at School”, 51% of girls and 60% of boys had favorable responses (e.g. believe that if they were absent, an adult at school would miss them). Responses were negative for 49% of girls and 40% of boys.
Dr. Luthar emphasized that it is important not to engage in “teacher-bashing.” Teachers have an exceptional workload and the burnout rate is high, much more so in public schools than in smaller independent schools. The purpose here is not to cast aspersions, but to report what the kids are saying, to determine where there is room for improvement.
Parent and community involvement is also of concern. In Wilton, students who perceive that collaboration is low between the school and the parents are the most troubled. Dr. Luthar was puzzled by this, so she looked more closely at the data. This situation is analogous to conflict between two parents in the household. Kids feel that the adults are not “on the same team,” and they feel caught in the middle. “These are the kids who are feeling the most pressure and unhappiness.”
This is an important area for intervention both on the part of the parents and of the school. The community should consider how the parents and administrators can work together with kindness and respect to try to understand why the kids are feeling so much tension on this front.
How should Wilton parents approach interventions?
Interventions must be multi-pronged and collaborative, focusing on parents, schools and peer groups. With this in mind, Dr. Luthar had shared her findings separately with high school faculty before her presentation for parents. She had also spoken personally with a group of Wilton high school students, and the following day, had a meeting with senior administrators from the district and the high school to discuss useful directions for the future.
“Students’ beliefs about parents and schools each have unique associations with adjustment, so it’s not just one or the other. It’s not just parents or just schools… Everything we do as grown-ups matters to our kids.”
With honest conversations, without blaming, with compassion and kindness, communities can address the issues that are identified for intervention and see improved results.
Messages for Parents
Key messages for parents center around five themes:
Foster good, open communication: “I tell my mother about my problems and troubles.”
Avoid what may be seen as criticism (especially with girls): “I never feel like I can meet my mother’s expectations.”
Be vigilant for distress among youth. Check in frequently and sincerely, even when you are brushed off. “If kids are doing well in terms of academics and extracurriculars, parents think, ‘he couldn’t be depressed, or she couldn’t be drinking that much or cutting herself.’ This happens behind that very successful exterior sometimes.”
Strive for appropriate, consistent limit-setting. Anticipated repercussions for substance use, rudeness, bullying, rule-breaking, and cheating are linked with low substance use and high prosocial behaviors.
Be a good role model. Family values of kindness, decency, and integrity are particularly important in hyper-competitive subcultures.
Well-being of Caretaker
Also, parents must focus on their own well-being. The single most potent influence in fostering resilience is the well-being of the caretaker. If parents do not receive care for themselves, they cannot “run on empty” as they try to provide ongoing care for others.
“Eighty years of research on resilience comes up with this one take-home message: Resilience rests, fundamentally, on relationships. And this thing – which is unconditional acceptance - “I feel seen and loved for the person I am at my core” – is critical for kids. And guess what. It’s critical for us.”
Teachers, counselors and other adults at school are also at risk for burnout and need support.
Dr. Luthar is now offering an intervention called Authentic Connections. Learn more at www.authenticconnectionsgroups.org. Authentic Connections are small groups that can be focused on moms, teachers, other professionals, or students. They can be offered in person or remotely.
Parents should be concerned about excessive focus on achievements.
“If your sense of self-worth is dependent on the splendor of your accomplishments, that’s a very slippery slope.”
This is true for kids and also for parents. Kids need to see that parents themselves feel valued and loved for the people who they are, rather than for their “status”, careers, or material possessions.
Kids will say that they want to take the intense pressure off themselves, but that parents are often too focused doing whatever is need to get into a small number of “top” colleges.
“This panic about college… we adults need to look at that and say, is it worth it?”
When Dr. Luthar met with kids at Wilton High School, they also admitted that they themselves can pressure each other. For example, after a test they ask each other about grades. They compare themselves constantly. So, why do they do this? As a community, we will have to find a way to take the focus off this at all levels.
“Let us aim high, let us even aim very high, but there is a point at which we come together and say, ‘stop.’”
Dr. Luthar also recommended that Wilton bring together a community civility committee to address the fracture between parents and the school.
Adults must think about how they behave on social media. The kids are watching and listening. We need to think about what we role model on Facebook. “This is about the fifth time that I’ve heard about 412. I have no idea what it is, but I know that it is not good.” Children should not be involved in adults’ disagreements.
“This is a community that is very forward thinking and open to hearing about issues… a lot of schools are very afraid to do this kind of thing. I applaud you sincerely for this. And I look forward to working collaboratively to foster the well-being of children and families in this town."
Summary compiled by Genevieve Eason