Perceived academic pressure and mental health in adolescents: a cross-sectional study examining individual vulnerabilities and school climate

Abstract

Background

Concerns have been raised about the impact of academic pressure on adolescents’ mental health. Growing evidence suggests that perceived academic pressure reflects the interaction between contextual demands and individual vulnerabilities, conceptualized as the convergence of biological, psychological, and environmental factors. Furthermore, the impact of achievement goals and school climate on perceived pressure has been highlighted. This study examined the association between perceived academic pressure and individual vulnerabilities, and the role of school climate and achievement goals.

Methods

This was a cross-sectional study. At nine schools in Piedmont, Italy, participation was proposed to all the students from the first year of middle school to the fourth year of high school (aged 10-17 years). Students completed self-reported questionnaires assessing perceived academic stress (10-point Likert scale), individual vulnerabilities (Strengths and Difficulties Questionnaire, SDQ), school climate (Multidimensional School Climate Questionnaire, MSCQ), achievement goals (Achievement Goal Questionnaire-Revised, AGQ-R), and reported the number of school evaluations in the previous month as an indicator of objective academic pressure. Linear mixed-effect models examined the association between individual vulnerabilities and perceived academic stress, accounting for classroom clustering and adjusting for age, gender, school climate, and monthly evaluation number. Mediation analysis tested whether school climate represented a significant indirect path in this association. Linear regressions tested associations between achievement goals and stress, and between vulnerabilities and school climate.

Results

A total of 889 students participated (58.7% female). Higher individual vulnerability (SDQ score) was associated with higher perceived academic stress (standardized β 0.24, p<.001) and poorer perceived school climate (standardized β 0.26, p<.001). The association between perceived pressure and vulnerabilities was stronger than that between perceived and objective pressure and school climate partially accounted for this association (average causal mediation effect 0.11, p<.0001). Perceived academic pressure was negatively associated with mastery-approach (standardized β -0.07, p=.033) and positively with performance-avoidance (standardized β 0.14, p=.002).

Conclusions

Perceived academic pressure is more strongly associated with individual vulnerabilities than with objective pressure, and co-varies with perceptions of school climate. Achievement goal orientations are differentially linked to this experience, with performance-avoidance and low mastery-approach representing potential risk factors. School-based interventions should address emotional vulnerabilities, motivational processes, and school climate to promote student well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13034-026-01051-2.

Introduction

In recent years, there has been a growing concern about the impact of academic pressure on adolescents’ mental health. The WHO has emphasized the urgent need to address academic pressure in the debate on the health and psychological well-being of young people [1]. Perceived academic pressure (or stress) is a broad and multifaceted concept for which there is no widely used definition or single measurement tool. Stress is generally defined as the feeling of being unable to cope with environmental demands. Academic stress, in particular, is a student’s perception of receiving unwelcome and unpleasant pressure within an educational setting [2]. A recent systematic review conceptualizes academic pressure as chronic stress related to workload, examinations, fear of failure, concerns about the future, expectations from parents, teachers, or oneself, as well as competition with peers or siblings [3]. In order to understand the relationship between perceived academic pressure and mental health, it is important to distinguish between objective academic pressure, referring to the measurable demands of the school system, and subjective academic pressure, referring to how students personally feel about these demands in relation to their coping resources.

Evidence indicates that adolescents’ perception of academic pressure has increased in recent years, especially during the transition from late childhood to adolescence, when academic expectations intensify and school transitions occur [4–6] with a potential negative impact on educational engagement [7, 8].

This trend is particularly relevant within the Italian educational system, which is organized into primary school (ages 6–10), lower secondary school (ages 11–13), and upper secondary school (ages 14–19). Students face two major transitions at ages 11 and 14, involving new peer groups, increased academic expectations and more structured evaluation procedures, and formal grading begins early. The early introduction of curricular differentiation and the requirement to choose between academic and vocational tracks at age 14 contributes to a progressively stronger emphasis on performance and future orientation.

In this context, increasing academic pressure could be a significant school-related stressor that intersects with broader changes in adolescents’ psychosocial well-being. Indeed, this rise in perceived academic pressure appears to occur alongside wider shifts in youth well-being. A growing body of international evidence reports a marked deterioration in adolescent mental health since the early 2010s, including increasing rates of anxiety, depression, psychological distress, and suicide [9], especially among girls and partially exacerbated by the COVID-19 pandemic [10, 11]. Survey data from different countries consistently identify school demands as a primary source of stress: in a large UK sample of adolescents aged 13–19, most respondents identified school as their main stressor [12], while Italian HBSC (Health Behaviour in School-aged Children) data show that a majority of 15-year-olds report feeling stressed by school responsibilities, particularly girls [13]. Academic stress also appears among the leading antecedents to suicide, along with family history of mental illness, bereavement, childhood abuse or neglect, bullying and physical health issues [14]. Meta-analytic evidence supports the link between academic pressure and various mental health outcomes, including anxiety, depressive symptoms, loneliness, low self-esteem, psychosomatic symptoms and emotional difficulties [3, 15]. Suicidal ideation has been linked to concerns over grades [3], dissatisfaction with chosen courses and poor academic performance [16]. These data align with findings across various geographic regions, where connections between academic workload and depressive symptoms, psychological distress, self-harm, and problem behaviors have been consistently reported [4, 17–20]. Moreover, seasonal fluctuations in psychiatric emergency visits and suicide mirror the school calendar in adolescents, with peaks during school months and declines during holidays [3, 11, 21]. Quite the opposite, in the adult population, severe mental illness hospital admissions increase in spring and summer [22].

While an association between school pressure and mental health has frequently been reported in the last years, the mechanisms shaping this relationship and contributing to the subjective experience of school pressure are less well understood. Evidence suggests that adolescents do not experience demands uniformly and that individual characteristics play a central role in shaping how expectations are experienced as pressure: difficulties in emotion regulation and maladaptive coping strategies are associated with higher levels of perceived stress and greater emotional distress in adolescence [23], while lower academic self-efficacy amplifies the subjective impact of school demands partially mediating the association between academic stress and psychological distress [24].

These individual processes unfold within a broader school context that can either exacerbate or mitigate perceived pressure. According to the transactional model of stress [25], stress does not result from demands themselves, but from how individuals appraise those demands in relation to their perceived coping resources. In this perspective, the school environment becomes a central determinant of whether academic demands are experienced as manageable or overwhelming. School climate, defined as the quality and character of school life based on people’s experiences of school norms, values, interpersonal relationships, teaching and learning practices, organizational structures [26], represents a key lens through which academic demands are interpreted and has a substantial impact on students’ mental health [27]. A supportive school climate characterized by positive teacher-student relationships stimulates engagement, encourages goal-setting and foster resilience [28]; peer support reduces feelings of helplessness, and school connectedness represents a protective factor, reducing the risk of suicide attempts and suicidal ideation [29, 30]. Conversely, climates perceived as unsupportive, non-inclusive, emotionally unresponsive, or excessively evaluative are linked to increased emotional distress and disengagement [31]. Recent evidence shows that classroom environments that emphasize avoiding failure and demonstrating skills rather than acquiring them are associated with higher levels of stress related to school performance, especially when combined with low perceived teacher support [32]: a negative school environment can actively amplify students’ stress reactions by influencing how academic needs are assessed.

This role of the educational context in which academic pressure arises is particularly relevant in light of reports that, in recent decades, the education system has been perceived as increasingly focused on academic performance. Institutional efforts have been made to promote a holistic approach in education that values not only academic performance but also psychological and social well-being. Since 2015, large-scale international assessments, such as the Programme for International Student Assessment (PISA) of the Organization for Economic Co-operation and Development (OECD), have incorporated indicators of students’ well-being, motivation and life satisfaction alongside academic performance [33], and international organizations such as UNESCO and UNICEF have emphasized the role of schools in promoting health, psychosocial well-being, and inclusive and supportive learning environments [34]. Despite these initiatives, however, there remains a perception of assessment methods that place greater emphasis on memorization and results, as well as a significant investment by families in their children’s academic achievements [1].

Within this contextual and institutional framework, students’ motivational models are a key mechanism through which academic pressure can be observed. Achievement goal theory describes how students define success and guide their learning behavior. According to the goal orientation model of depression vulnerability, students focused on outperforming peers or avoiding failure are more vulnerable to depressive symptoms, as self-worth becomes contingent on external standards and social comparison [35, 36]. On the contrary, mastery orientation encourages students to see challenges and failures as moments of personal growth and learning, rather than as personal defeats. This helps to develop better coping strategies, reducing vulnerability to depression [37, 38].

Taken together, this body of evidence suggests that perceived academic pressure does not arise from academic demands alone, but from their interaction with individual vulnerabilities, motivational orientations, and the school environment in which they are embedded. In line with the biopsychosocial model, individual vulnerabilities are conceptualized as the convergence of biological, psychological, and environmental factors that influence emotional and behavioral functioning, evaluated in the present study with the Strength and Difficulty Questionnaire. While each of these domains has been shown to relate to adolescent well-being, the specific nature of the relationship remains unresolved. In the present study, we therefore focus on the interplay between individual vulnerabilities, school climate, and perceived academic pressure. Specifically, we examine whether it is the objective demands of school workload (objective pressure) that leads to an increase of adolescents’ vulnerabilities (that can be an indicator of poor mental health), or whether increased vulnerabilities lead to the perception of excessive school stress. In this sense, two alternative interpretations frame the question. (A) Academic pressure as a driver of stress. Together with the worsening of mental health observed over the past decade, the rise in academic pressure may reflect a broader change toward a performance-focused society. Factors such as competitiveness, meritocracy and growing individualism, paired with rising parental expectations, may have contributed to the perception among young people that the social environment is overly demanding [39, 40]. High demands and expectations increase vulnerability to mental health problems [41]. (B) Academic pressure perception as a marker of fragility to stress. Excessive academic stress can exacerbate pre-existing fragilities, amplifying the risk of psychological distress. We further propose that school climate represents a key mechanism in this process. Vulnerable students may be particularly sensitive to contextual cues: competitive or emotionally unsupportive environments may amplify feelings of overload and inadequacy, whereas supportive environments may buffer stress and reduce the subjective burden of academic demands. In addition, student achievement goals may influence how academic demands are interpreted and experienced, as they encourage either performance-based evaluation or learning-oriented engagement. Despite the theoretical plausibility of this pathway, empirical research examining school climate as a mediator between individual vulnerability and perceived academic pressure remains limited.

The present study

This study aims to evaluate the following hypotheses:

1. Self-reported academic pressure (subjective perception) is more strongly associated with individual vulnerabilities than with the demands of school workload (objective pressure).

Although academic demands constitute a potential stressor, prior evidence suggests that students differ markedly in how these demands are appraised. Individual vulnerabilities, such as emotional regulation difficulties and internalizing symptoms, are expected to play a stronger role than objective workload in shaping the subjective experience of academic pressure.

• 2.Perceived school climate and learning approaches influence perceived academic pressure: the former mediates the association between individual vulnerability and perceived pressure, while the latter is associated with greater perceived stress.

Vulnerable students may be particularly sensitive to contextual cues: competitive or emotionally unsupportive environments may amplify feelings of overload and inadequacy, while learning approaches focused on external evaluation and fear of failure are expected to increase sensitivity to pressure.

Methods

Participants and recruitment procedures

This cross-sectional observational study was conducted on a sample of students aged 10–17 years from middle and high schools in Piedmont, northern Italy. Participation was proposed to 28 schools (13 middle schools and 15 high schools), both in urban and rural areas, through an e-mail to the principal explaining the rationale and purpose of the research. Subsequently, a video call or an in-person meeting was organized with the headmaster or delegated reference staff of schools interested in the research project to detail the study purpose, design and possible involvement. Nine schools, including 4 middle schools and 5 high schools, declared their interest in participating and were therefore enrolled, as shown in Fig. 1. Among the 5 high schools, 3 are lyceums (Italian secondary schools with a strong academic curriculum, preparing for university), one is made up of both technical and vocational institute classes, and one is a vocational training school. Of the 3 lyceums, one specializes in scientific tracks (including sports and applied sciences), one focuses on linguistic and human sciences, and the third offers tracks in scientific, linguistic, and human sciences.

Fig. 1.

School and student recruitment process

Participation was proposed to all the students from the first year of middle school to the fourth year of high school. Fifth-year high school students were a priori excluded due to the age criterion, as they comprised students aged 18 and over. School recruitment occurred between September and October 2024, while data collection took place between October and November 2024. A total of 1718 students were invited to participate in the study. They and their parents were provided with written explanations of the background, purpose and aims of the study before completing the questionnaires. Participation in the study was voluntary; all enrolled students gave their assent to participate, and all their parents signed a written informed consent form. Students were excluded if their parents did not give consent for their participation or if the consent form was not completed correctly (see Fig. 1). A total of 889 students were involved, who filled out the questionnaires in class during school hours.

No financial incentive was offered for participation. The study was designed in accordance with the principles of the Declaration of Helsinki of the World Medical Association (modified in 2013, Fortaleza, Brasil). Ethical approval was granted by the Ethics Committee of the University of Turin (protocol no. 0565208 of 27/9/2024).

Measurements

Sociodemographic and school variables

Age and gender identity, grade level currently attended, section, school type and name.

Perceived academic pressure and positive aspects

The impact of school on students’ lives both in terms of perceived stress and positive aspects was measured using a 10-point Likert scale (from 0 = not at all to 10 = a lot) answering two close questions (respectively, “How much does school contribute to your daily stress?” and “How much do the positive aspects of school (friends, growth path, constructive relationship with teachers) influence your well-being?“).

Objective academic pressure

Objective pressure was assessed asking students to report the number of previous month’s evaluations.

Individual vulnerabilities

Individual vulnerabilities were assessed with the Strengths and Difficulties Questionnaire (SDQ), which is a screening tool designed to assess emotional and behavioral difficulties in children and adolescents [42]. It consists of 25 items measuring psychological attributes across five scales: emotional symptoms, hyperactivity/inattention, conduct problems, hyperactivity/inattention, peer relationship problems (which combine to produce internalizing, externalizing and total difficulties scores) and prosocial behavior. Based on the 3-band classification, scores are categorized into low, medium or high levels of emotional or behavioral difficulties, internalizing or externalizing problems and total difficulties [43]. An additional impact supplement assesses the presence of difficulties and, if identified, further explores their chronicity, associated distress, social impairment, and the burden they impose on others. The self-report version was used in this study. The Italian adaptation of the SDQ showed strong reliability, as evidenced by Cronbach’s alpha coefficients spanning from 0.73 to 0.89 [44].

Perceived school climate

School climate was measured with the Multidimensional School Climate Questionnaire (MSCQ), which consists of 49 self-report items divided in two main sections, Classroom practices and School atmosphere [45]. The Classroom practices section covers six dimensions reflecting daily classroom activities (Rules, Student Support, Student Involvement, Positive Teaching, Encouragement, Class Management). The School atmosphere section includes five dimensions referring to abstract features of the school environment (Student Relations, Student-Teacher Relations, Educational Climate, Sense of Belonging, Interpersonal Justice). Participants answered on a scale from 1 (completely agree) to 6 (completely disagree), with lower scores indicating more positive perceptions of school climate. Subscale scores were calculated by averaging the items. An adapted and validated Italian version was employed, showing adequate internal consistency, with Cronbach’s alpha values above 0.70 across all factors [45].

Achievement goals

Achievement goals were assessed using the Achievement Goal Questionnaire Revised (AGQ-R) by Elliot and Murayama [46]. This is a widely used instrument for assessing students’ achievement goals. It was developed and validated using data from undergraduate psychology students in the USA. The 12-item self-report scale is based on the two-by-two achievement goal theory and includes four subscales, each consisting of three items, which capture distinct goals: mastery-approach, mastery-avoidance, performance-approach and performance-avoidance. The factor and dimensional structure of the AGQ-R have been confirmed by standard confirmatory factor analysis, which involved comparing the proposed four-factor model with a series of alternative models. Internal consistency has been shown to be high for all subscales: mastery-approach goals (Cronbach’s alpha = 0.84), mastery-avoidance goals (Cronbach’s alpha = 0.88), performance-approach goals (Cronbach’s alpha = 0.92), and performance-avoidance goals (Cronbach’s alpha = 0.94) [46].

Participants rated each item on a scale from 1 (strongly disagree) to 5 (strongly agree). Items were averaged in the subscale indexes, with higher scores reflecting higher levels of the corresponding achievement goal.

Data analysis

Statistical analyses were performed using the statistical programming language R (version 4.2.1) (R Core Team, 2021). Descriptive analyses of sociodemographic variables were conducted by reporting number and percentage (frequencies) for categorical variables, and mean values with standard deviations for numerical variables.

To assess the association between individual vulnerabilities (self-reported difficulties: SDQ) and the selected outcome (school stress) we performed regression analyses, accounting for potential variables influencing this relationship, such as academic workload (measured as the number of school tests per month), age, gender, school climate (MSCQ) at both the individual and group level. In particular, we employed linear mixed-effects models with a random intercept for the classroom to assess climate effects on outcomes at both the individual and classroom levels. In total, 73 classes were included, with class sizes ranging from a minimum of three participating students to a maximum of 34 (median = 11). We modeled linear mixed effect models using the lme4 package in R [47]. By including, for each variable, both the individual deviation from the classroom mean and the classroom mean, we accounted for within- and between-classroom effects and estimated the contribution of each term. To assess whether individual vulnerabilities influence school climate perception a linear regression analysis was performed, using individual school climate as the outcome variable. We accounted for the same confounding variables as above. A linear regression analysis was also employed to evaluate the association between the four achievement goal models (AGQR) and school stress. For each independent variable, standardized beta coefficients, 95% confidence intervals, standard error and p-values were calculated and reported in tables.

We compared fixed-effect coefficients using Wald z-tests based on linear contrasts of parameter estimates and their model-based covariance matrix.

For students from two schools where tests were administered off-site, we could not confidently determine classroom membership, and classroom climate was measured at the school level. To ensure this did not introduce confounding, we repeated all analyses excluding these students as a sensitivity analysis. The results supported the same conclusions, with similar effect sizes (data not shown).

To dissect the total effect of self-reported difficulties (SDQ) on the outcome stress into direct and indirect effect we performed a mediation analysis [48] (R mediation package [48]) with quasi-Bayesian confidence intervals, with school climate (MSCQ) as the mediating variable. Specifically, mediation analysis breaks down the total effect of an independent variable on a dependent variable into direct effects (influences that do not involve the mediator) and indirect effects (influences that occur through the mediator). It is used to examine the mediators of an association, In the context of the present study, given the cross-sectional design, these results should be interpreted as tests of indirect associations rather than confirmed causal pathways.

All continuous variables (including Likert-type scale scores treated as approximately continuous) were transformed to z-scores (mean = 0, SD = 1) prior to model fitting. Specifically, predictors (e.g., SDQ, climate, number of tests, age) and the mediator were standardized, and to obtain fully standardized effects the outcome variable was also standardized before fitting the outcome model. Categorical variables (e.g., gender) were entered as factors and were not standardized. Mixed-effects models included a random intercept for SEC. Consequently, fixed-effect coefficients and mediation effects are interpreted in standard deviation units: they represent the expected change in the outcome (in SD units) associated with a 1 SD increase in the predictor (or mediator), adjusted for covariates and conditional on the SEC random intercept. For categorical predictors, coefficients represent standardized mean differences relative to the reference category.

Results

A total of 889 students were involved, 58.7% (522) of whom were female, with a mean age of 14.8 years (SD 1.9, range 10–17). See Table 1 for the demographic and school characteristics of the cohort.

Table 1.

Student demographics and schools’ characteristics

Total cohort	N = 889
Gender identity: male	n (%) 360 (40.5)
Female	522 (58.7)
Non-binary	7 (0.8)
Age, yrs, mean (SD)	14.0 (1.9)
Middle school	436 (49.0)
Grade level I year	53 (6.0)
II year	199 (22.4)
III year	184 (20.7)
High school	452 (50.8)
Grade level I year	105 (11.8)
II year	100 (11.2)
III year	160 (18.0)
IV year	88 (9.9)
Lyceum	329 (37.0)
n % of 329
Human sciences 143 43.5
Scientific 59 17.9
Linguistic 58 17.6
Sports science 42 12.8
Applied science 27 8.2
Technical institute	92 (10.3)
Vocational institute	17 (1.9)
Vocational training	15 (1.7)

With regard to the psychometric characteristics of the sample (see Table 2), the mean SDQ total score was in the “normal” range of the original 3-band classification. The subscale with the highest values was the emotional symptoms scale (Table 2), although all subscales were within the normal range. Of the AGQ-R subscales, mean scores were highest for mastery-approach and lowest for mastery-avoidance (Table 2). On the MSCQ, mean scores were highest for involvement and lowest for rules, indicating low levels of student participation and constructive engagement with school norms (Table 2).

Table 2.

Psychometric characteristics of the student cohort

Total cohort	N = 889
	mean (SD)
School stress 1–10	7.3 (2.4)
School positives aspects 1–10	7.0 (2.2)
Monthly evaluations number	13.6 (6.5)
SDQ emotional difficulties 0–10	4.3 (2.8)
Conduct difficulties 0–10	1.8 (1.7)
Hyperactivity 0–10	2.2 (1.7)
Peer difficulties 0–10	1.4 (1.5)
Prosocial 0–10	7.4 (2.1)
Internalizing 0–20	5.7 (3.6)
Externalizing 0–20	4.0 (2.9)
Total difficulties 0–40	9.8 (5.7)
AGQ-R Mastery approach 1–5	3.9 (0.9)
Mastery avoidance 1–5	2.9 (1.1)
Performance approach 1–5	3.1 (1.1)
Performance avoidance 1–5	3.2 (1.1)
MSCQ rules 1–6	2.4 (0.9)
Student support 1–6	2.9 (1.2)
Involvement 1–6	3.3 (1.2)
Positive teaching 1–6	2.8 (1.2)
Encouragement 1–6	2.5 (0.9)
Class management 1–6	2.5 (1.2)
Students’ relations 1–6	2.6 (1.1)
Student-teacher relations 1–6	3.0 (1.2)
Educational climate 1–6	2.5 (0.9)
Sense of belonging 1–6	3.1 (0.9)
Interpersonal justice 1–6	2.7 (1.2)
Classroom level MSCQ rules 1–6	2.41 (0.46)
Student support 1–6	3.43 (0.66)
Involvement 1–6	2.87 (0.56)
Positive teaching 1–6	3.35 (0.59)
Encouragement 1–6	2.82 (0.63)
Class management 1–6	2.55 (0.56)
Students’ relations 1–6	2.66 (0.57)
Student-teacher relations 1–6	3.01 (0.67)
Educational climate 1–6	2.49 (0.52)
Sense of belonging 1–6	3.08 (0.49)
Interpersonal justice 1–6	2.70 (0.67)

Association between individual vulnerabilities and school stress

In the hypothesis testing analysis, we considered the average SDQ at the class level (SDQ between) and the individual deviation from the classroom mean SDQ (SDQ within). The same was done for school climate (climate between and within). Controlling for school climate, higher individual SDQ scores were associated with greater perceived school stress (standardized β 0.24, CI 95% 0.18–0.30). Specifically, for every unit increase in the total SDQ score, perceived school stress was associated with a 0.24 SD increase (Table 3). Older age was also associated with a higher perception of school stress (standardized β 0.25, CI 95% 0.15–0.34) (Table 3). Additionally, higher individual scores of school climate as measured by the MSCQ (within the classroom), were positively associated with perceived school pressure (standardized β 0.21, CI 95% 0.14–0.27), (Table 3). The average number of monthly evaluations per classroom had a small but significant correlation with perceived stress (standardized β 0.08, CI 95% 0.00–0.16). Notably, neither the average classroom fragility (SDQ between, standardized β 0.06, CI 95% – 0.03–0.14) nor the average classroom climate (Climate between, standardized β 0.001, CI 95% – 0.09–0.11) correlated with the individually perceived level of stress.

Table 3.

Associations of SDQ and school stress and individual school climate

School stress					Climate within*
Predictors	Standardized β	CI (95%)	SE	P	Standardized β	CI (95%)	SE	P
(Intercept)	0.00	0.00–0.00	0.00	< 0.001	– 0.00	– 0.00-0.00	0.00	0.237
SDQ within*	0.24	0.18–0.30	0.03	< 0.001	0.26	0.19–0.33	0.03	< 0.001
SDQ between**	0.06	– 0.03–0.14	0.05	0.214	– 0.03	– 0.11–0.04	0.04	0.396
Evaluations within*	0.001	– 0.05–0.07	0.03	0.771	0.18	0.12–0.25	0.03	< 0.001
Evaluations between**	0.08	0.00–0.16	0.04	0.042	0.01	– 0.05-0.08	0.03	0.669
Age	0.25	0.15–0.34	0.03	< 0.001	0.02	– 0.05-0.10	0.04	0.531
Female gender	0.16	0.03–0.29	0.05	0.014	0.09	– 0.04-0.23	0.07	0.183
Non-binary gender	0.18	– 0.53–0.90	0.05	0.618	0.86	0.09–1.63	0.39	0.028
Climate within*	0.21	0.14–0.27	0.07	< 0.001	–	–	–	–
Climate between**	0.001	– 0.09–0.11	0.37	0.847	–	–	–	–
N = 816	conditionalR2: 0.283	ICC: 0.06 §	σ2  = 0.72	Tau = 0.05	Conditional R2: 0.120	ICC: ~0 §	σ2  = 0.88	Tau = 0.00

* individual deviation from the classroom mean

** average class level

^§fully adjusted intra-class correlation coefficient

σ² indicates residuals variance; bold font indicates statistical significance

A Wald z-test comparing the standardized within-person coefficients indicated that the SDQ effect differed significantly from the within-person workload effect (Z = 5.37; p < .001).

Association between individual vulnerabilities and school climate

When using individual school climate as the outcome variable (climate within), the analysis indicated that individual SDQ (SDQ within) was positively associated (p<.001), even after accounting for the number of evaluations, age and gender (Table 3). In contrast to perceived stress, students’ deviation from their classroom’s mean monthly number of evaluations (standardized β 0.18, CI 95% 0.12–0.25), but not the classroom average workload (standardized β 0.01, CI 95% -0.05–0.08), was associated with school climate.

Relationship between individual vulnerabilities, school climate and school stress

The mediation analysis suggested that SDQ has both a direct (ADE, average direct note:* the term “effect” is used in keeping with the original terminology of mediation analysis, the cross-sectional nature of the study only allows to evaluate associations standardized β 0.49, CI 95% 0.36–0.62) and indirect effect (average indirect "effect" standardized β 0.11, CI 95% 0.07–0.15) mediated by school climate on academic stress (proportion mediated, β 0.18, CI 95% 0.11–0.27) (Table 4; Fig. 2).

Table 4.

Direct and indirect effect of SDQ on school stress

School stress
Predictors	Standardized β	95% CI lower	95% CI upper	SE	p
Indirect effect	0.11	0.07	0.15	0.02	< 0.0001
Direct effect	0.49	0.36	0.62	0.06	< 0.0001
Total effect	0.60	0.47	0.73	0.06	< 0.0001
Prop. mediated	0.18	0.11	0.27	0.04	< 0.0001

bold font indicates statistical significance

Fig. 2.

Visual representation of direct and indirect effect of SDQ on school stress

Association between achievement goals on school stress

With regard to achievement goals, statistical analyses showed that academic pressure is negatively associated with the mastery-approach (standardized β – 0.07, CI 95% – 0.14 to – 0.01) and positively associated with performance-avoidance (standardized β 0.14, CI 95% 0.05–0.23) (Table 5): lower levels of mastery-approach and higher levels of performance-avoidance are associated with higher perceived pressure.

Table 5.

Association between AGQ-R and school stress

School stress
Predictors	Standardized β	CI (95%)	SE	p
(Intercept)	0.00	0.00–0.00	0.00	0.007
Age	0.26	0.19–0.34	0.04	< 0.001
Female gender	0.28	0.15–0.41	0.07	< 0.001
Non-binary gender	0.45	– 0.26–1.15	0.26	0.216
AGQR Mastery approach	– 0.07	– 0.14 – – 0.01	0.04	0.033
AGQR Mastery avoidance	0.001	– 0.06–0.08	0.04	0.790
AGQR Performance approach	– 0.04	– 0.12–0.05	0.04	0.429
AGQR Performance avoidance	0.14	0.05–0.23	0.05	0.002
N = 887	Conditional R2: 0.156	ICC = 0.04§	σ2  = 0.84	Tau = 0.04

^§fully adjusted intra-class correlation coefficient

σ² indicates residuals variance (after fixed and random effects); bold font indicates statistical significance

Discussion

Perceived academic stress and individual vulnerabilities

In this study, we analyzed the association between perceived academic pressure and mental health among middle and high school adolescents in school settings of northern Italy and we found that perceived academic pressure was more strongly associated with the individual’s self-reported level of vulnerability than with objective school pressure (workload).

Greater emotional fragilities, which may increase the predisposition to psychopathological issues, enhance stress sensitivity, resulting in a heightened perception of stress. These results align with numerous previous studies which found an association between academic pressure and mental health outcomes, especially anxiety and depression [37, 49–51]. In our sample, adolescents reported more problems in the emotional symptoms’ domain with respect to other domains, such as externalizing symptoms (e.g., conduct problems, hyperactivity) and peer relationship issues. According to the mediation analysis, individual vulnerabilities correlated with perceived academic stress both directly and indirectly through school climate. These results suggest that students with more severe individual difficulties are also more vulnerable to challenges within their environment, such as dysfunctional peer relationships, rules, control, organization, teacher expectations and the judgment of significant adults. This, in turn, may contribute to the school environment being perceived as less supportive and more demanding, which is associated with higher perceived stress. This finding is consistent with other studies, reporting that students’ academic well-being is strongly influenced by perceived school climate, particularly self-engagement and teacher behavior, which in turn is strongly associated with self-rated health [27, 28].

The cross-sectional nature of the study prevents us from establishing the direction of the association between individual vulnerabilities and school pressure through school climate. However, the analyses revealed significant heterogeneity in students’ subjective perceptions of school climate even within the same class, where students are exposed to comparable academic demands and evaluation procedures, and thus to a similar level of objective academic pressure. This suggests that individual vulnerabilities may play a relevant role in shaping how the school environment and academic demands are experienced. Even within the same class, students may experience different levels of subjective pressure due to individual factors previously described, which influence their sensitivity to competition and social comparison, their relationships with teachers, as well as external influences such as parental expectations and perceived family pressure. In particular, parental expectations are a relevant factor in shaping the associations under study [52], although, unfortunately, it was not possible to assess them directly in the present study. Nonetheless, it is noteworthy that differences in individual vulnerability relative to the class average, rather than the class average level of vulnerability itself, were consistently associated with perceived academic pressure and school climate, whereas objective indicators such as the number of assessments, representing objective academic pressure, were not always associated with perceived stress and climate, and this association was not always at the same level (individual or class). Indeed, the analyses showed that individual vulnerabilities have a stronger association with stress than objective pressure. This pattern suggests that the subjective experience of pressure is more closely linked to individual fragility than to shared contextual demands. Evidence for a potential causal relationship between academic pressure and mental well-being comes from longitudinal studies in which academic pressure and subsequent mental health outcomes were examined while adjusting for baseline mental health [53–55]. These studies found an association between academic pressure and poor mental health at follow-up, providing support for a directional effect of academic pressure on later psychological distress.

However, this relationship may be more complex and should be interpreted within the broader context of the general rise in psychopathology among children and adolescents described in high income countries and the huge societal changes we are living through [9]. A higher perception of academic pressure could represent a consequence of a more demanding and competitive society [22], or less effective coping strategies or changing attitudes towards psychopathology [56].

School climate and perceived academic pressure

The effect of school climate on perceived academic stress is widely known and well-documented in the literature [32], and theoretical models suggest that the school environment plays a key role in shaping how academic demands are interpreted and experienced by students. In line with the framework outlined in the introduction, supportive climates are expected to buffer perceived pressure, whereas emotionally unsupportive or overly evaluative contexts may amplify feelings of overload and inadequacy [28–30]. In our sample, according to the results of the MSCQ subscales, students reported little involvement in school functioning and felt that their opinions were not sufficiently taken into account. They also reported a lack of trust and closeness with teachers, perceiving limited emotional support and rarely turning to adults in the school for help with personal difficulties. This pattern is consistent with previous findings showing that school climate and student well-being are strongly influenced by opportunities for participation and by teacher behavior, and that positive teacher-student relationships foster engagement and perceived competence, while peer support reduces feelings of isolation [27, 28]. At the same time, students in our study perceived teachers as effective in enforcing rules. In addition, adolescents felt that teachers asked them to do their best. While this attitude may value abilities, competence and academic engagement of young people, they may also reinforce high performance expectations and, consequently, contribute to increased perceived academic pressure, particularly among more vulnerable students. This interpretation aligns with the idea, discussed in the introduction, that school environments may simultaneously promote achievement and inadvertently intensify pressure, depending on how expectations and support are balanced [32].

These findings are also relevant in light of recent international efforts to integrate student well-being into educational policy and practice. Since 2015, large-scale assessments such as PISA have included indicators of students’ well-being, motivation, and life satisfaction alongside academic performance, reflecting a growing recognition that learning and well-being are deeply interconnected [33]. Our results suggest that such initiatives may be most effective when they address not only individual outcomes but also relational and organizational aspects of school climate, particularly students’ sense of voice, emotional support, and the balance between encouragement and pressure, which appear to be closely linked to perceived academic stress.

Achievement goal orientations and perceived academic pressure

In this study higher levels of performance-avoidance and lower levels of mastery-approach were significantly associated with higher perceived pressure. When learning is driven by comparison with others or fear of failure, students experience higher levels of stress and depressive symptoms, according to Stare et al. [37]. As outlined by the goal orientation model of depression vulnerability [35, 36], students whose self-worth is shaped by outperforming their peers tend to depend on external standards of success, causing them to perceive failures as reflections of personal inadequacy. In contrast, a mastery orientation encourages students to view challenges and setbacks as opportunities for development and personal growth.

Age and perceived academic pressure

Finally, as expected, we found a relationship between perceived stress and age: as children get older, they experience more academic pressure. A study analyzing cross-national trends from 1994 to 2010 showed similar patterns, particularly after the transition to high school [6]. From a developmental perspective, this period is characterized by increased cognitive capacity for future-oriented thinking, greater awareness of social comparison and evaluation, and heightened sensitivity to performance feedback, all of which may contribute to the intensification of perceived academic demands. Students also become more focused on future academic and career paths [57]. At the same time, adolescents’ growing need for autonomy, self-identity and close relationships, may increasingly clash with school environments that emphasize external evaluation and standardized performance, as described by the stage-environment fit model [58].

These developmental processes unfold within a specific educational context. In Italy, the increase in perceived academic pressure may be further influenced by the structure of the school system, which involves two significant transitions: from primary to lower secondary school at around age 11, and from lower to upper secondary school at around age 14. These transitions are often accompanied by changes in peer groups, teaching methods, and assessment procedures. The early introduction of formal grading and curricular differentiation, as well as the requirement to choose between academic and vocational tracks at age 14, may make academic demands seem more significant as students grow older. This type of educational process, involving two phases at critical stages of development, can exacerbate the perception of increased pressure.

The results of this study have relevant implications for future school-based interventions aimed at reducing perceived academic pressure and promoting adolescent well-being. Consistent with previous evidence showing that supportive school climates and positive teacher–student relationships are associated with lower distress [27, 28], our findings suggest that interventions should address not only academic demands but also students’ emotional vulnerabilities and their subjective experience of the school environment. In practice, this points to the importance of educational practices that foster emotional regulation, students’ sense of voice and belonging, and warm, responsive relationships with teachers, while avoiding overly evaluative or competitive classroom climate. From a motivational perspective, our results suggest that educational intervention should emphasize learning, effort, and improvement rather than social comparison and fear of failure, in line with research showing that mastery-oriented learning is associated with lower stress and greater well-being [31–33]. In accordance with recent initiatives such as the PISA study, which has integrated indicators of student well-being alongside academic performance, this study supports the need for systemic approaches that balance achievement and well-being within schools. These implications extend beyond schools to families, suggesting that parental communication styles that emphasize support, realistic expectations, and the value of learning over performance may help buffer adolescents’ experience of academic pressure.

Study limitations

Several limitations must be considered when interpreting these results. First, the cross-sectional design of the study prevents direct causal inferences regarding the direction of associations, as academic pressure may have preceded and driven the emergence of individual vulnerabilities. Second, the study lacked comprehensive control for potential confounding variables influencing the relationship between academic pressure and mental health. Factors such as individual traits like perfectionism, school emphasis on academic success, socio-economic status, teacher expectations and socially oriented achievement motivation were not fully accounted for. In particular, we were unable to control parental pressure and expectations, both of which are shown by literature to be major sources of stress for adolescents. Third, the sample was drawn from a specific geographic area using a convenience sampling method, resulting in unequal representation of school types. Technical and professional schools were underrepresented compared to high schools, reflecting differences in willingness to participate and accessibility. Fourth, potential biases may arise from the self-reported nature of the measures, as they only reflect individual perceptions and not objective evaluations. Fifth, participation was limited to students whose parents provided informed consent, introducing the possibility of selection bias. Finally, although not central to the main hypothesis, one of the instruments used (the AGQ-R) has been validated in English but not in the Italian translation adopted in the present study. Sixth, it should be noted that the causal interpretation of mediation effects relies on the sequential ignorability assumption, which is unlikely to be fully satisfied in a cross-sectional design; accordingly, the indirect effect estimates should be considered descriptive rather than confirmatory of causal pathways.

Conclusions

The study provides evidence for the association between perceived academic pressure and adolescent mental health in a large cohort of students. Individual vulnerabilities stand out as a predominant factor throughout the cohort, with both direct and indirect associations, the latter operating through school climate.

Various aspects of the school environment, particularly teacher-student relations and involvement, are identified as key factors positively or negatively influencing mental health. Additionally, performance-avoidance achievement goals are linked to increased emotional difficulties. Prevention efforts should be implemented targeting these elements in the school setting, which is well known to be crucial to potentially reach all adolescents. Therefore, more research is needed, particularly with longitudinal studies, in order to better shape effective preventive interventions.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

ACME

Average causal mediation effect

ADE

Average direct effect

AGQ-R

Achievement Goal Questionnaire Revised

HBSC

Health behavior in school-aged children

MSCQ

Multidimensional School Climate Questionnaire

SDQ

Strengths and difficulties questionnaire

WHO

World Health Organization

PISA

Programme for International Student Assessment

OECD

Organization for Economic Co-operation and Development

Author contributions

CD and DM conceptualized the study and selected the methodology. MB selected the sample of schools and collected the data. DM selected the software and conducted the formal data analysis. CD, DM, MB contributed to the conception and drafting of the first version of the manuscript. AM, BV, FA and FSR reviewed and edited the manuscript under the supervision of BV, CD and DM. All authors read and approved the final version of the manuscript.

Funding

This research received no external funding.

Data availability

Research data are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the University of Turin (protocol no. 0565208 of 27/9/2024) and designed in accordance with the principles of the Declaration of Helsinki of the World Medical Association. Students and their parents were provided with written explanations of the background, purpose and aims of the study. All parents signed a written informed consent, and all minors gave their assent to participate.

Competing interests

In the last 2 years, BV has received consultant fees or honoraria from Medice, Menarini, Angelini (Ethos), and Alkermes Pharmaceuticals.