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Postpartum scarcity-adversity disrupts maternal behavior and induces a hypodopaminergic state in the rat dam and adult female offspring. Neuropsychopharmacology 2022; 47:488-496. [PMID: 34703012 PMCID: PMC8674224 DOI: 10.1038/s41386-021-01210-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/14/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023]
Abstract
Postpartum adversity is among the strongest predictors for the emergence of postpartum depression (PPD) in humans and a translational risk factor employed in rodent models. Parental care is disturbed under conditions of environmental adversity, including low resource environments, and in PPD. Nonetheless, the neural changes associated with these adversity-induced maladaptive behavioral states remain poorly understood. Postpartum scarcity-adversity can be modeled in rats by providing the dam with limited bedding and nesting (LBN) materials, which mimics the effects of a stressful low resource environment in potentiating maltreatment/neglect in humans. Indeed, LBN exposure from postpartum days (PD) 2-9 increased adverse maternal behaviors, impaired pup retrieval, and increased passive stress coping responses. Since mesolimbic dopamine (DA) activity is an important mechanism for motivated maternal behavior and is implicated in PPD, we assessed the impact of postpartum scarcity-adversity on in vivo electrophysiological properties of ventral tegmental area (VTA) DA neurons at two timepoints. We found reduced numbers of active VTA DA neurons in LBN dams at PD 9-10 but not PD-21, suggesting a transient impact on VTA population activity in LBN dams. Finally, we assessed the impact of early life scarcity-adversity on VTA DA function by conducting VTA recordings in adult female offspring and found a long-lasting attenuation in DA activity. These findings highlight a link between adversity-induced deficits in DA function and disrupted maternal behavior, suggesting the VTA/mesolimbic DA system as a potential mechanism by which postpartum scarcity-adversity drives aberrant maternal behavior, and early postnatal programming of adult VTA function in the offspring.
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Zhu Y, Wang MJ, Crawford KM, Ramírez-Tapia JC, Lussier AA, Davis KA, de Leeuw C, Takesian AE, Hensch TK, Smoller JW, Dunn EC. Sensitive period-regulating genetic pathways and exposure to adversity shape risk for depression. Neuropsychopharmacology 2022; 47:497-506. [PMID: 34689167 PMCID: PMC8674315 DOI: 10.1038/s41386-021-01172-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/23/2021] [Accepted: 08/30/2021] [Indexed: 01/03/2023]
Abstract
Animal and human studies have documented the existence of developmental windows (or sensitive periods) when experience can have lasting effects on brain structure or function, behavior, and disease. Although sensitive periods for depression likely arise through a complex interplay of genes and experience, this possibility has not yet been explored in humans. We examined the effect of genetic pathways regulating sensitive periods, alone and in interaction with common childhood adversities, on depression risk. Guided by a translational approach, we: (1) performed association analyses of three gene sets (60 genes) shown in animal studies to regulate sensitive periods using summary data from a genome-wide association study of depression (n = 807,553); (2) evaluated the developmental expression patterns of these genes using data from BrainSpan (n = 31), a transcriptional atlas of postmortem brain samples; and (3) tested gene-by-development interplay (dGxE) by analyzing the combined effect of common variants in sensitive period genes and time-varying exposure to two types of childhood adversity within a population-based birth cohort (n = 6254). The gene set regulating sensitive period opening associated with increased depression risk. Notably, 6 of the 15 genes in this set showed developmentally regulated gene-level expression. We also identified a statistical interaction between caregiver physical or emotional abuse during ages 1-5 years and genetic risk for depression conferred by the opening genes. Genes involved in regulating sensitive periods are differentially expressed across the life course and may be implicated in depression vulnerability. Our findings about gene-by-development interplay motivate further research in large, more diverse samples to further unravel the complexity of depression etiology through a sensitive period lens.
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Affiliation(s)
- Yiwen Zhu
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Min-Jung Wang
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | | | - Alexandre A Lussier
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Center for Brain Science, Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Kathryn A Davis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Christiaan de Leeuw
- Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Department of Complex Trait Genetics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anne E Takesian
- Eaton-Peabody Laboratories, Massachusetts Eye & Ear and Department of Otorhinolaryngology and Head/Neck Surgery, Harvard Medical School, Boston, MA, USA
| | - Takao K Hensch
- Center for Brain Science, Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jordan W Smoller
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Erin C Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Harvard Center on the Developing Child, Cambridge, MA, USA.
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53
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Halonen J, Hakko H, Riala K, Riipinen P. Familial Risk Factors in Relation to Recurrent Depression Among Former Adolescent Psychiatric Inpatients. Child Psychiatry Hum Dev 2022; 53:515-525. [PMID: 33651209 PMCID: PMC9107395 DOI: 10.1007/s10578-021-01146-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 02/02/2023]
Abstract
Treating recurrent depression is a challenge for clinical practitioners. We investigated which family environmental factors contribute to differences between recurrent and non-recurrent depression by the young adulthood of the former adolescent inpatients. The initial sample covered 237 adolescent psychiatric inpatients with depression, of which 35.4% had later diagnosed with recurrent depression. Recurrence in depression was associated to distant maternal relationships in both male (p = 0.022) and female patients (p = 0.042). In females, the likelihood for recurrent depression was also related to psychiatric problems of the father (p = 0.013) and siblings (OR = 3.7, p = 0.032), and having a grand multiparous mother (p = 0.005). Our results emphasise the need for effective family-centred approaches in treatment of adolescents with depression.
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Affiliation(s)
- Joonas Halonen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O.BOX 5000, 90014 Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029, Oulu, Finland.
| | - Kaisa Riala
- grid.412326.00000 0004 4685 4917Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029 Oulu, Finland
| | - Pirkko Riipinen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O.BOX 5000, 90014 Oulu, Finland ,grid.412326.00000 0004 4685 4917Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029 Oulu, Finland
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54
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Childhood poverty and mental health disorders in early adulthood: evidence from a Brazilian cohort study. Eur Child Adolesc Psychiatry 2021; 32:903-914. [PMID: 34853911 DOI: 10.1007/s00787-021-01923-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND We examined the association between childhood poverty and mental health disorders (MHD) in childhood and early adulthood. We also investigated whether the association between poverty in childhood and MHD is mediated by exposure to stressful life events (SLE). METHODS We used data from a prospective community cohort of young people assessed at baseline (M = 9.7 years, SD = 1.9), first (M = 13.5 years, SD = 1.9), and second (M = 18.2 years, SD = 2.0) follow-ups (N = 1,590) in Brazil. Poverty was assessed using a standardized classification. Exposure to 20 different SLE was measured using the Life History instrument. Psychiatric diagnoses were evaluated using the Development and Well-Being Assessment. Latent growth models investigated the association between poverty at baseline and the growth of any MHD, externalizing, and internalizing disorders. Mediation models evaluated whether the association between childhood poverty and MHD in early adulthood was mediated by exposure to SLE. RESULTS Poverty affected 11.4% of the sample at baseline and was associated with an increased propensity for presenting externalizing disorders in adolescence or early adulthood (standardized estimate = 0.27, p = 0.016). This association was not significant for any disorder or internalizing disorders. Childhood poverty increased the likelihood of externalizing disorders in early adulthood through higher exposure to SLE (OR = 1.07, 95 CI% 1.01-1.14). Results were only replicated among females in stratified analyses. CONCLUSIONS Childhood poverty had detrimental consequences on externalizing MHD in adolescence, especially among females. Poverty and SLE are preventable risk factors that need to be tackled to reduce the burden of externalizing disorders in young people.
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55
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Ramphal B, Pagliaccio D, Dworkin JD, Herbstman J, Noble KG, Margolis AE. Timing-specific associations between income-to-needs ratio and hippocampal and amygdala volumes in middle childhood: A preliminary study. Dev Psychobiol 2021; 63:e22153. [PMID: 34674248 DOI: 10.1002/dev.22153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 01/23/2023]
Abstract
It is well known that financial disadvantage is associated with alterations in brain development in regions critical to socioemotional well-being such as the hippocampus and the amygdala. Yet little is known about whether family income at different points in development is differentially associated with these structures. Furthermore, little is known about which environmental factors statistically mediate associations between income and subcortical structure. Using a longitudinal birth cohort and linear mixed-effects models, we identified associations between income-to-needs ratio (INR) at 6 timepoints throughout childhood and hippocampal and amygdala volumes at age 7-9 years (n = 41; 236 INR measurements; 41 brain measurements). Mediation analysis identified environmental sequelae of income that statistically accounted for INR-brain associations. Lower INR prior to age 4 was associated with smaller hippocampal volumes, whereas lower INR prior to age 2 was associated with smaller right amygdala volume. These associations were mediated by unmet basic needs (e.g., food, housing). These findings delineate the temporal specificity of associations between income and hippocampal and amygdala structures.
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Affiliation(s)
- Bruce Ramphal
- New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - David Pagliaccio
- New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jordan D Dworkin
- New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Kimberly G Noble
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Amy E Margolis
- New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
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56
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Ho TC, King LS. Mechanisms of neuroplasticity linking early adversity to depression: developmental considerations. Transl Psychiatry 2021; 11:517. [PMID: 34628465 PMCID: PMC8501358 DOI: 10.1038/s41398-021-01639-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/11/2021] [Accepted: 09/23/2021] [Indexed: 12/17/2022] Open
Abstract
Early exposure to psychosocial adversity is among the most potent predictors of depression. Because depression commonly emerges prior to adulthood, we must consider the fundamental principles of developmental neuroscience when examining how experiences of childhood adversity, including abuse and neglect, can lead to depression. Considering that both the environment and the brain are highly dynamic across the period spanning gestation through adolescence, the purpose of this review is to discuss and integrate stress-based models of depression that center developmental processes. We offer a general framework for understanding how psychosocial adversity in early life disrupts or calibrates the biobehavioral systems implicated in depression. Specifically, we propose that the sources and nature of the environmental input shaping the brain, and the mechanisms of neuroplasticity involved, change across development. We contend that the effects of adversity largely depend on the developmental stage of the organism. First, we summarize leading neurobiological models that focus on the effects of adversity on risk for mental disorders, including depression. In particular, we highlight models of allostatic load, acceleration maturation, dimensions of adversity, and sensitive or critical periods. Second, we expound on and review evidence for the formulation that distinct mechanisms of neuroplasticity are implicated depending on the timing of adverse experiences, and that inherent within certain windows of development are constraints on the sources and nature of these experiences. Finally, we consider other important facets of adverse experiences (e.g., environmental unpredictability, perceptions of one's experiences) before discussing promising research directions for the future of the field.
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Affiliation(s)
- Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Lucy S King
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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57
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Cox SML, Castellanos-Ryan N, Parent S, Benkelfat C, Vitaro F, Pihl RO, Boivin M, Tremblay RE, Leyton M, Séguin JR. Externalizing Risk Pathways for Adolescent Substance Use and Its Developmental Onset: A Canadian Birth Cohort Study: Trajectoires de comportements extériorisés et le risque pour l'initiation et l'usage de substances des adolescents : Une étude de cohorte de naissance canadienne. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:887-896. [PMID: 33530707 PMCID: PMC8573681 DOI: 10.1177/0706743720982429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Only a minority of drug and alcohol users develops a substance use disorder. Previous studies suggest that this differential vulnerability commonly reflects a developmental trajectory characterized by diverse externalizing behaviors. In this study, we examined the relation between child and adolescent externalizing behaviors and adolescent substance use in a prospectively followed Canadian birth cohort, accounting for the temporal sequence of a wide variety of contributing factors. METHODS Two hundred and forty-two adolescents followed since birth (date range: 1996 to 2012) were assessed on externalizing behavior (age 17 months to 16 years), alcohol and cannabis use at age 16, age of alcohol use onset, family history of substance use problems, family functioning (age 11 to 15), sensation seeking (age 16), prenatal substance exposure, socioeconomic status (age 1 to 9), and sex. RESULTS Age of alcohol use onset was predicted by a family history of substance use problems, externalizing traits from ages 6 to 10 and 11 to 16, sensation seeking at age 16, prenatal alcohol and tobacco exposure and family functioning at ages 11 to 15. High frequencies of alcohol and cannabis use at age 16 were both predicted by externalizing traits from ages 11 to 16, a family history of substance use problems and sensation seeking after controlling for other individual, environmental and familial variables. The association between familial substance use problems and substance use during adolescence was partially mediated by externalizing traits from age 11 to 16. CONCLUSIONS The present findings provide prospective evidence for a developmental risk pathway for adolescent substance use, potentially identifying those who could benefit from early interventions.
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Affiliation(s)
| | - Natalie Castellanos-Ryan
- School of Psychoeducation, 5622Université de Montréal, Québec, Canada.,CHU Ste-Justine Research Center, Montreal, Québec, Canada
| | - Sophie Parent
- School of Psychoeducation, 5622Université de Montréal, Québec, Canada
| | - Chawki Benkelfat
- Department of Psychiatry, 5620McGill University, Montreal, Québec, Canada
| | - Frank Vitaro
- School of Psychoeducation, 5622Université de Montréal, Québec, Canada.,CHU Ste-Justine Research Center, Montreal, Québec, Canada
| | - Robert O Pihl
- Department of Psychology, 5620McGill University, Montreal, Québec, Canada
| | - Michel Boivin
- Department of Psychology, Université Laval, Québec, Canada.,Institute of Genetic, Neurobiological and Social Foundations of Child Development, Tomsk State University, Russia
| | - Richard E Tremblay
- CHU Ste-Justine Research Center, Montreal, Québec, Canada.,Departments of Psychology and Pediatrics, 5622Université de Montréal, Québec, Canada.,School of Public Health and Sports Science, University College Dublin, Ireland.,INSERM, U669, Paris, France
| | - Marco Leyton
- Department of Psychiatry, 5620McGill University, Montreal, Québec, Canada.,Department of Psychology, 5620McGill University, Montreal, Québec, Canada
| | - Jean Richard Séguin
- CHU Ste-Justine Research Center, Montreal, Québec, Canada.,Department of Psychiatry and Addictology, 5622Université de Montréal, Québec, Canada
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58
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Li X, Guo W, Tang W, Lv Q, Zhang Y, Yu H, Wang Q, Deng W, Zhao L, Ma X, Meng Y, Li M, Wang H, Chen T, Liu YS, Tang Z, Du XD, Greenshaw AJ, Li T. The interactions between childhood adversities and recent stress were associated with early-adulthood depression among Chinese undergraduate students. Depress Anxiety 2021; 38:961-971. [PMID: 34293226 DOI: 10.1002/da.23201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/14/2021] [Accepted: 07/08/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is widely acknowledged that childhood adversities (CAs) and recent stress are potential risk factors for adult depression. However, the mechanism(s) by which interactions of CAs with recent stress affect adult depression remain unclear. AIMS To investigate the predictive association of the interaction among CAs and recent stress with early-adult depression. METHOD We conducted an annual survey of all freshmen for the period of 2016-2018 in a Chinese comprehensive university, with a sample size of 23,206. An online questionnaire including standardized self-report instruments was used to assess sociodemographic factors, childhood experiences of left-behind (CELB), and maltreatments (CEMTs) including beating (CEB), neglect (CEN), sexual abuse (CESA), recent stress, and current depression (measured by the 9-item Patient Health Questionnaire). RESULTS The correlation of Individual CAs and recent stress was significant. In addition to their significant independent/direct incremental effects, all surveyed CAs were associated with increased severity of early-adult depression, and increased frequency of clinically significant depression (CSD), through significant associations with recent stress (mediation effect). History of CEMTs including CEB, CEN, and CESA significantly increased the effects of recent stress on depression (moderation effect). CONCLUSIONS Chinese undergraduate students reported frequent history of exposure to CAs, which increased the likelihood of depression in early adulthood, not only directly but also through the increasing the likelihood (mediation effect) and impact (moderation effect) of recent stress on depression. These novel findings may help to extend our understanding of environmental determinants of depression, and to guide further research, clinical practice, and policy in this context.
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Affiliation(s)
- Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjun Guo
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjie Tang
- Centre for Psychological Educational and Consultation, Sichuan University, Chengdu, China
| | - Qiuyue Lv
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yamin Zhang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hua Yu
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaohong Ma
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Mingli Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huiyao Wang
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ting Chen
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yan-Song Liu
- Department of Clinical Psychology, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhen Tang
- Department of Clinical Psychology, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiang-Dong Du
- Department of Clinical Psychology, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Tao Li
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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59
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Su Y, D'Arcy C, Meng X. Research Review: Developmental origins of depression - a systematic review and meta-analysis. J Child Psychol Psychiatry 2021; 62:1050-1066. [PMID: 33259072 PMCID: PMC8451906 DOI: 10.1111/jcpp.13358] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many observational studies have found a direct association between adverse in utero, perinatal and postnatal exposures and offspring's depression. These findings are consistent with the 'developmental origins of disease hypothesis'. But no review has comprehensively summarized the roles of these exposures. This review aims to systematically scrutinize the strength of associations between individual prenatal, perinatal, and postnatal exposures and subsequent depression in offspring. METHODS We conducted a systematic review and meta-analysis to synthesize the literature from the EMBASE, HealthStar, PsychoInfo, and Medline databases since their inception to September 1, 2019. English language articles on population-based prospective cohort studies examining the associations between in utero, perinatal, and postnatal exposures and offspring's depression were searched. Random-effects models were used to calculate pooled estimates, and heterogeneity and sensitivity tests were conducted to explore potential confounders in the relationships of depression and early-life factors. Qualitative analysis was also conducted. RESULTS Sixty-four prospective cohort studies with 28 exposures studied in the relationships to offspring's depression met inclusion criteria. The meta-analysis found 12 prenatal, perinatal, and postnatal characteristics were associated with an increased risk of depression in offspring: low birth weight, premature birth, small gestational age, maternal education, socioeconomic status, having younger parents (<20 years), having older parents (≥35 years), maternal smoking, paternal smoking, maternal stress, maternal anxiety, and prenatal depression. Heterogeneity and sensitivity tests supported the findings. By and large, study characteristics had no effects on conclusions. Qualitative analyses generally supported the findings of meta-analysis and reported on additional risk factors. CONCLUSIONS This review provides a robust and comprehensive overview of the lasting psychopathological effects of in utero, perinatal, and postnatal exposures. The findings highlight the need for clinical and public health interventions focusing on the identified risk factors. Large prospective cohort studies are warranted to investigate the combined effects of multiple co-existing early-life exposures.
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Affiliation(s)
- Yingying Su
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
| | - Carl D'Arcy
- School of Public HealthUniversity of SaskatchewanSaskatoonSKCanada
- Department of PsychiatryCollege of MedicineUniversity of SaskatchewanSaskatoonSKCanada
| | - Xiangfei Meng
- Department of PsychiatryMcGill UniversityMontrealQCCanada
- Douglas Research CentreMontrealQCCanada
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60
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Society to cell: How child poverty gets “Under the Skin” to influence child development and lifelong health. DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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61
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Lee J, Lim H, Allen J, Choi G. Multiple Mediating Effects of Conflicts With Parents and Self-Esteem on the Relationship Between Economic Status and Depression Among Middle School Students Since COVID-19. Front Psychol 2021; 12:712219. [PMID: 34354651 PMCID: PMC8329029 DOI: 10.3389/fpsyg.2021.712219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022] Open
Abstract
This study explores associations between perceived economic status and depression among middle school students during COVID-19 in the context of conflict with parents and self-esteem. Data were collected in South Korea in the fall of 2020. A total of 328 middle school students were included, and a multiple mediator model was employed to examine the multiple mediating effects. Middle schoolers' household economic status was negatively associated with their conflict with parents. Conflict with parents was negatively related to middle school students' self-esteem. Indirect effects of perceived economic status via conflict with parents were significantly associated with depression. The indirect effect of perceived economic status via both conflict with parents and self-esteem was related to depression. Government subsidies should temporarily be expanded to improve households' economic status to potentially improve middle school students' depression and to enhance relationships between children and their parents during the COVID-19 pandemic. Further, extra financial support from the government should be focused on poor households with children in order to address family conflict, self-esteem, and depression among middle school students.
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Affiliation(s)
- Jaewon Lee
- Department of Social Welfare, Inha University, Incheon, South Korea
| | - Hyejung Lim
- School of Education, Korea University, Seoul, South Korea
| | - Jennifer Allen
- School of Social Work, Michigan State University, East Lansing, MI, United States
| | - Gyuhyun Choi
- Integrative Arts Therapy, Dongduk Women's University, Seoul, South Korea
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62
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Simanek AM, Meier HCS, D'Aloisio AA, Sandler DP. Objective and subjective childhood socioeconomic disadvantage and incident depression in adulthood: a longitudinal analysis in the Sister Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1201-1210. [PMID: 33881563 PMCID: PMC8580191 DOI: 10.1007/s00127-020-02013-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 12/08/2020] [Indexed: 01/04/2023]
Abstract
Understanding of the role of objective versus subjective childhood socioeconomic disadvantage (SD) in depression onset in adulthood among women, independent of later life SD, and across birth cohorts, is limited. We examined the association between objective (i.e., household education level) and subjective (i.e., rank of family income and report of not enough food to eat) SD during childhood and diagnosis of clinical depression after age 30 among 47,055 women in the Sister Study. We used Cox proportional hazard models adjusting for women's race/ethnicity, childhood household composition, mother's age at her birth adulthood educational attainment, and calendar year of birth. Analyses were repeated stratified by 10-year birth group. A total of 8036 (17.1%) women were diagnosed with clinical depression over a mean follow-up of 24.0 (± 9.9) years. Those reporting being poor (versus well-off) or not having enough food to eat in childhood had a 1.28 (95% confidence interval (CI) 1.13, 1.44) and 1.30 (95% CI 1.21, 1.41) times higher rate of depression diagnosis, respectively, with consistent associations observed across birth year groups. An inverse association between low household education level and incident depression was observed at baseline (i.e., age 30) becoming positive over time in the total sample but only among women born between 1935-1954 in analyses stratified by 10-year birth group. Our findings suggest that subjective SD in childhood is a largely consistent predictor of depression onset among women in adulthood whereas the effects of household education level in childhood may vary across women born into different birth cohorts, and for some, across the lifecourse.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA.
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA
| | | | - Dale P Sandler
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC, USA
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63
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Li J, Jia RX, Li JY, Qian S, Wang YQ, Xu Y. Meaning of socioeconomic status for mental health of adolescents in East China. PSYCHOL HEALTH MED 2021; 27:649-662. [PMID: 34190653 DOI: 10.1080/13548506.2021.1946105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There is limited evidence on the association between different dimensions of socioeconomic status and mental health on adolescents in developing nations. The aim of this study was to examine this association among adolescents in East China. A school-based study that recruited 6902 adolescents aged 13 to 18 years was conducted in Suzhou, Hefei and Hangzhou. Multiple of indicators of socioeconomic status and mental health in adolescents were examined. Results revealed that girls showed significantly higher score of the global severity index, obsessive-compulsive, depression, anxiety, hostility, and phobic anxiety symptoms than boys. As expected, there was a slightly negative correlation between different dimensions of socioeconomic status to different domains of mental health problems (r ranged from -0.044 to 0.124). Furthermore, we found that maternal education and occupation were significantly associated with mental health for both boys and girls, while subjective socioeconomic status only was significantly associated with girls. In conclusion, adolescents in families with socioeconomic disadvantage, in the form of lower educational level and occupational prestige of mothers, had greater risk of mental health problem. Meanwhile, higher subjective socioeconomic status positively affects the mental health of female adolescents.
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Affiliation(s)
- Jing Li
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Rui-Xia Jia
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Jia-Yu Li
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Sheng Qian
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China
| | - Ying-Quan Wang
- Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China
| | - Yong Xu
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, P.R. China.,Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, P.R. China
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64
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Socio-economic position as a moderator of cardiometabolic outcomes in patients receiving psychotropic treatment associated with weight gain: results from a prospective 12-month inception cohort study and a large population-based cohort. Transl Psychiatry 2021; 11:360. [PMID: 34226496 PMCID: PMC8257637 DOI: 10.1038/s41398-021-01482-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/17/2021] [Accepted: 06/07/2021] [Indexed: 01/21/2023] Open
Abstract
Weight gain and metabolic complications are major adverse effects of many psychotropic drugs. We aimed to understand how socio-economic status (SES), defined as the Swiss socio-economic position (SSEP), is associated with cardiometabolic parameters after initiation of psychotropic medications known to induce weight gain. Cardiometabolic parameters were collected in two Swiss cohorts following the prescription of psychotropic medications. The SSEP integrated neighborhood-based income, education, occupation, and housing condition. The results were then validated in an independent replication sample (UKBiobank), using educational attainment (EA) as a proxy for SES. Adult patients with a low SSEP had a higher risk of developing metabolic syndrome over one year versus patients with a high SSEP (Hazard ratio (95% CI) = 3.1 (1.5-6.5), n = 366). During the first 6 months of follow-up, a significant negative association between SSEP and body mass index (BMI), weight change, and waist circumference change was observed (25 ≤ age < 65, n = 526), which was particularly important in adults receiving medications with the highest risk of weight gain, with a BMI difference of 0.86 kg/m2 between patients with low versus high SSEP (95% CI: 0.03-1.70, n = 99). Eventually, a causal effect of EA on BMI was revealed using Mendelian randomization in the UKBiobank, which was notably strong in high-risk medication users (beta: -0.47 SD EA per 1 SD BMI; 95% CI: -0.46 to -0.27, n = 11,314). An additional aspect of personalized medicine was highlighted, suggesting the patients' SES represents a significant risk factor. Particular attention should be paid to patients with low SES when initiating high cardiometabolic risk psychotropic medications.
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65
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Qualitative approximations to causality: Non-randomizable factors in clinical psychology. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3873. [DOI: 10.32872/cpe.3873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Causal quests in non-randomized studies are unavoidable just because research questions are beyond doubt causal (e.g., aetiology). Large progress during the last decades has enriched the methodical toolbox.
Aims
Summary papers mainly focus on quantitative and highly formal methods. With examples from clinical psychology, we show how qualitative approaches can inform on the necessity and feasibility of quantitative analysis and may yet sometimes approximate causal answers.
Results
Qualitative use is hidden in some quantitative methods. For instance, it may yet suffice to know the direction of bias for a tentative causal conclusion. Counterfactuals clarify what causal effects of changeable factors are, unravel what is required for a causal answer, but do not cover immutable causes like gender. Directed acyclic graphs (DAGs) address causal effects in a broader sense, may give rise to quantitative estimation or indicate that this is premature.
Conclusion
No method is generally sufficient or necessary. Any causal analysis must ground on qualification and should balance the harms of a false positive and a false negative conclusion in a specific context.
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66
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Hanson JL, Nacewicz BM. Amygdala Allostasis and Early Life Adversity: Considering Excitotoxicity and Inescapability in the Sequelae of Stress. Front Hum Neurosci 2021; 15:624705. [PMID: 34140882 PMCID: PMC8203824 DOI: 10.3389/fnhum.2021.624705] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/23/2021] [Indexed: 12/19/2022] Open
Abstract
Early life adversity (ELA), such as child maltreatment or child poverty, engenders problems with emotional and behavioral regulation. In the quest to understand the neurobiological sequelae and mechanisms of risk, the amygdala has been of major focus. While the basic functions of this region make it a strong candidate for understanding the multiple mental health issues common after ELA, extant literature is marked by profound inconsistencies, with reports of larger, smaller, and no differences in regional volumes of this area. We believe integrative models of stress neurodevelopment, grounded in "allostatic load," will help resolve inconsistencies in the impact of ELA on the amygdala. In this review, we attempt to connect past research studies to new findings with animal models of cellular and neurotransmitter mediators of stress buffering to extreme fear generalization onto testable research and clinical concepts. Drawing on the greater impact of inescapability over unpredictability in animal models, we propose a mechanism by which ELA aggravates an exhaustive cycle of amygdala expansion and subsequent toxic-metabolic damage. We connect this neurobiological sequela to psychosocial mal/adaptation after ELA, bridging to behavioral studies of attachment, emotion processing, and social functioning. Lastly, we conclude this review by proposing a multitude of future directions in preclinical work and studies of humans that suffered ELA.
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Affiliation(s)
- Jamie L. Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brendon M. Nacewicz
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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67
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Bell KL, Purcell JB, Harnett NG, Goodman AM, Mrug S, Schuster MA, Elliott MN, Emery ST, Knight DC. White Matter Microstructure in the Young Adult Brain Varies with Neighborhood Disadvantage in Adolescence. Neuroscience 2021; 466:162-172. [PMID: 34004262 DOI: 10.1016/j.neuroscience.2021.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 01/20/2023]
Abstract
Neighborhood disadvantage and community violence are common in poor, urban communities and are risk factors for emotional dysfunction. Emotional processes are supported by neural circuitry that includes the prefrontal cortex (PFC), hippocampus, amygdala, and hypothalamus. These brain regions are connected by white matter pathways that include the cingulum bundle, uncinate fasciculus, stria terminalis, and fornix. Emotional function varies with the microstructure of these white matter pathways. However, it is not clear whether the microstructure of these pathways varies with risk factors for emotional dysfunction (e.g., neighborhood disadvantage and violence exposure). Therefore, determining the relationships between neighborhood disadvantage, violence exposure, and white matter microstructure may offer insight into the neural mechanisms by which adverse life experiences alter developing neural systems. The current study investigated the association that exposure to neighborhood disadvantage and violence have with the quantitative anisotropy (QA), a measure of the amount of directional water diffusion, of the cingulum bundle, uncinate fasciculus, stria terminalis, and fornix. Neighborhood disadvantage (Mage = 11.20) and violence exposure (MW1age = 11.20; MW2age = 13.05; MW3age = 16.20; MW4age = 19.25) were assessed during adolescence and participants returned for magnetic resonance imaging as young adults (N = 303; Mage = 20.25, SD = 1.55), during which diffusion weighted brain images were collected. The QA of the cingulum bundle, uncinate fasciculus, and stria terminalis/fornix varied negatively with neighborhood disadvantage such that the QA of these white matter tracts decreased as neighborhood disadvantage increased. Violence exposure was not related to QA in any tract (i.e., cingulum bundle, uncinate fasciculus, and stria terminalis/fornix) after correction for multiple comparisons. These results suggest that an adolescent's neighborhood may play an important role in the microstructure (i.e., QA) of white matter pathways that connect brain regions that support emotional function.
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Affiliation(s)
- Kristina L Bell
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Juliann B Purcell
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nathaniel G Harnett
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adam M Goodman
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mark A Schuster
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Susan Tortolero Emery
- School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
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68
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Heterogeneity and heterotypic continuity of emotional and behavioural profiles across development. Soc Psychiatry Psychiatr Epidemiol 2021; 56:807-819. [PMID: 32561937 DOI: 10.1007/s00127-020-01903-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/09/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE To identify emotional and behavioural symptoms profiles from early childhood to adolescence, their stability across development and associated factors. METHODS Our sample included 17,216 children assessed at ages 3, 5, 7, 11 and 14 years from the UK Millennium Cohort Study. We used latent profile and latent transition analysis to study their emotional and behavioural profiles from early childhood to adolescence. We included sociodemographic, family and parenting variables to study the effect on latent profile membership and transitions. RESULTS The number and specific profiles of emotional and behavioural symptoms changed with the developmental stage. We found a higher number of profiles for ages 3, 5, and 14, suggesting greater heterogeneity in the presentation of emotional and behavioural symptoms in early childhood and adolescence compared to late childhood. There was greater heterotypic continuity between ages 3 and 5, particularly in transitions from higher to lower severity profiles. Children exposed to socioeconomic disadvantages were more likely to belong or transition to any moderate or high emotional and behavioural symptoms profiles. Maternal psychological distress and harsh parenting were associated with internalizing and externalizing profiles, respectively. Higher levels of internalizing and externalizing symptoms across development were associated with lower mental wellbeing and higher rates of self-harm and substance use in adolescence. CONCLUSION Emotional and behavioural symptoms develop early in life, with levels of heterogeneity and heterotypic stability that change throughout development. These results call for interventions to prevent and treat paediatric mental illness that consider the heterogeneity and stability of symptoms across development.
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69
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Duarte CS, Canino GJ, Wall M, Ramos-Olazagasti M, Elkington KS, Bird H, Choi CJ, Adams C, Klotz J, Carliner H, Wainberg ML, Alegria M. Development, Psychopathology, and Ethnicity II: Psychiatric Disorders Among Young Adults. J Am Acad Child Adolesc Psychiatry 2021; 60:579-592. [PMID: 32171633 PMCID: PMC7945985 DOI: 10.1016/j.jaac.2020.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To estimate the prevalence of psychiatric disorders and their continuity since childhood among young adults from the same ethnic group living in 2 low-income contexts. METHOD Young adults (N = 2,004; ages 15-29) were followed (82.8% retention) as part of the Boricua Youth Study, a study of Puerto Rican youths recruited at ages 5-13 in the South Bronx (SBx), New York, and Puerto Rico (PR). We estimated prevalence (lifetime; past year) of major depressive (MDD), mania, hypomania, generalized anxiety (GAD), tobacco dependence, and any other substance use disorders (SUD). RESULTS The prevalence of every disorder was higher among young women from the SBx compared with those from PR (eg, 9.2% versus 4.1% past-year SUD; 14% versus 6.8% for MDD/GAD). Among SBx young men, tobacco dependence and illicit SUD were elevated. Across both contexts, men had higher adjusted odds of illicit SUD than women, while women had higher GAD than men. MDD did not differ by gender. Young adulthood disorders (except for alcohol use disorder and GAD) followed childhood disorders. For example, childhood externalizing disorders preceded both MDD (young men and women) and illicit SUD (young women only). CONCLUSION Young women raised in a context where adversities like ethnic discrimination concentrate are at high risk for psychiatric disorders. In certain high-poverty contexts, young men may present with MDD as often as women. Interventions to prevent psychiatric disorders may need to address gender-specific processes and childhood disorders. However, SUD prevention among young men may need to address other factors.
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Affiliation(s)
- Cristiane S. Duarte
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Glorisa J. Canino
- Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan
| | - Melanie Wall
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | | | - Katherine S. Elkington
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | | | | | | | | | - Hannah Carliner
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Milton L. Wainberg
- Columbia University, New York, NY,New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
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70
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Kawamoto T. Stability and Change in Psychological Distress and Early Adverse Environments in Japanese Adults. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09890-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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71
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Banks A. Black Adolescent Experiences with COVID-19 and Mental Health Services Utilization. J Racial Ethn Health Disparities 2021; 9:1097-1105. [PMID: 33909283 PMCID: PMC8080856 DOI: 10.1007/s40615-021-01049-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/01/2022]
Abstract
Background COVID-19 is disproportionately impacting communities of color. Black adolescents are among the most vulnerable to COVID-19, have high mental health service needs, and have low mental health services utilization. During this time of great physical threat due to COVID-19, it is equally important to understand and support the mental health of Black adolescents. Method This study collected open-ended survey item responses from adolescents (12–17 years old) that identified as Black, living in a city in the Southeastern United States (n = 33). Grounded theory was used to analyze the data, revealing details of the lived experience of these Black adolescents during the COVID-19 pandemic. Results Black adolescents reported that COVID-19 has been both positive and negative for them. Family is of utmost importance to them, as are their peers, whom they do not get to interact with due to changes in the operation of schools. Despite experiencing stress, adaptive responses to COVID-19 are reported. Black adolescents continue to cite issues with mental health services and providers. Financial issues were a common theme for these youth, blocking access to services and causing issues in the home environment. Conclusions Mental health service providers must address the service access and quality issues repeatedly reported by Black adolescents. Direct action must be taken to facilitate an increase in Black adolescents mental health services utilization and satisfaction. Changes are needed at the individual and macro levels to alter the experience of one of our most vulnerable groups. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01049-w.
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Affiliation(s)
- Andrae Banks
- Department of Social Work, North Carolina Central University, 1801 Fayetteville Street, Durham, NC, 27707, USA.
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72
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Beauvais MJS, Knoppers BM, Illes J. A marathon, not a sprint - neuroimaging, Open Science and ethics. Neuroimage 2021; 236:118041. [PMID: 33848622 DOI: 10.1016/j.neuroimage.2021.118041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 01/10/2023] Open
Abstract
Open Science is calling for a radical re-thinking of existing scientific practices. Within the neuroimaging community, Open Science practices are taking the form of open data repositories and open lab notebooks. The broad sharing of data that accompanies Open Science, however, raises some difficult ethical and legal issues. With neuroethics as a focusing lens, we explore eight central concerns posed by open data with regard to human brain imaging studies: respect for individuals and communities, concern for marginalized communities, consent, privacy protections, participatory research designs, contextual integrity, fusions of clinical and research goals, and incidental findings. Each consideration assists in bringing nuance to the potential benefits for open data sharing against associated challenges. We combine current understandings with forward-looking solutions to key issues. We conclude by underscoring the need for new policy tools to enhance the potential for responsible open data.
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Affiliation(s)
| | | | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Canada.
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73
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Mpairwe H, Mpango RS, Sembajjwe W, Webb EL, Elliott AM, Pearce N, Kinyanda E. Anxiety disorders and asthma among adolescents in Uganda: role of early-life exposures. ERJ Open Res 2021; 7:00749-2020. [PMID: 33898614 PMCID: PMC8053906 DOI: 10.1183/23120541.00749-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/05/2021] [Indexed: 02/07/2023] Open
Abstract
The reasons for the positive association between anxiety disorders and asthma are unknown. We investigated the possible role of shared exposures in early life. We conducted a case-control study among adolescents (age 12-17 years) with and without asthma in urban Uganda, as part of a larger asthma case-control study. Anxiety disorders were diagnosed by psychiatric clinical officers. We focused on generalised anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early-life exposures. The data were analysed using multiple logistic regression. We enrolled 162 adolescents; 73 of them had asthma. Adolescents with asthma were more likely to have any of the three anxiety disorders studied (46.6%) than adolescents without asthma (21.4%) (adjusted OR (aOR) 2.68, 95% CI 1.30-5.53). The association was strong for GAD (aOR 4.49, 95% CI 1.48-13.56) and panic disorder (aOR 5.43, 95% CI 2.11-14.02), but not for social anxiety disorder. The early-life risk factors associated with anxiety disorders among adolescents were similar to asthma risk factors previously published, including urban residence at birth (aOR 3.42, 95% CI 1.29-9.09) and during most of the first 5 years of life (aOR 2.87, 95% CI 1.07-7.66), father's tertiary education (aOR 2.09, 95% CI 1.00-4.37), and adolescent's history of other allergy-related diseases (aOR 4.64, 95% CI 1.66-13.00). We confirm a positive association between anxiety disorders and asthma among adolescents in urban Uganda. The early-life risk factors associated with anxiety disorders among adolescents were similar to those for asthma in the same age group, suggesting shared underlying environmental exposures.
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Affiliation(s)
- Harriet Mpairwe
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, London, UK
| | - Richard Stephen Mpango
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Wilber Sembajjwe
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Emily L Webb
- London School of Hygiene and Tropical Medicine, London, UK
| | - Alison M Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, London, UK
| | - Neil Pearce
- London School of Hygiene and Tropical Medicine, London, UK
| | - Eugene Kinyanda
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
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Lurie LA, Hagen MP, McLaughlin KA, Sheridan MA, Meltzoff AN, Rosen ML. Mechanisms linking socioeconomic status and academic achievement in early childhood: Cognitive stimulation and language. COGNITIVE DEVELOPMENT 2021; 58:101045. [PMID: 33986564 PMCID: PMC8112571 DOI: 10.1016/j.cogdev.2021.101045] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is a strong positive association between childhood socioeconomic status (SES) and academic achievement. This disparity may, in part, be explained by differences in early environmental experiences and language development. Cognitive stimulation-including language exposure, access to learning materials, caregiver involvement in children's learning, and variety of experiences-varies by SES and may link SES to language development. Childhood language development in turn is associated with academic achievement. In the current longitudinal study of 101 children (60-75 months), SES was positively associated with cognitive stimulation and performance on language measures. Cognitive stimulation mediated the association between SES and children's language. Furthermore, children's language mediated the association between SES and academic achievement 18 months later. In addition to addressing broader inequalities in access to resources that facilitate caregivers' abilities to provide cognitive stimulation, cognitive stimulation itself could be targeted in future interventions to mitigate SES-related disparities in language and academic achievement.
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Affiliation(s)
- Lucy A Lurie
- Department of Psychology, Harvard University
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill
| | | | | | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill
| | - Andrew N Meltzoff
- Department of Psychology and Institute for Learning and Brain Sciences, University of Washington
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Palacios-Barrios EE, Hanson JL, Barry KR, Albert WD, White SF, Skinner AT, Dodge KA, Lansford JE. Lower neural value signaling in the prefrontal cortex is related to childhood family income and depressive symptomatology during adolescence. Dev Cogn Neurosci 2021; 48:100920. [PMID: 33517111 PMCID: PMC7847970 DOI: 10.1016/j.dcn.2021.100920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/21/2022] Open
Abstract
Lower family income during childhood is related to increased rates of adolescent depression, though the underlying mechanisms are poorly understood. Evidence suggests that individuals with depression demonstrate hypoactivation in brain regions involved in reward learning and decision-making processes (e.g., portions of the prefrontal cortex). Separately, lower family income has been associated with neural alterations in similar regions. Motivated by this research, we examined associations between family income, depression, and brain activity during a reward learning and decision-making fMRI task in a sample of adolescents (full n = 94; usable n = 78; mean age = 15.2 years). We focused on brain activity for: 1) expected value (EV), the learned subjective value of an object, and 2) prediction error, the difference between EV and the actual outcome received. Regions of interest related to reward learning were examined in connection to childhood family income and parent-reported adolescent depressive symptoms. As hypothesized, lower activity in the subgenual anterior cingulate (sACC) for EV in response to approach stimuli was associated with lower childhood family income, as well as greater symptoms of depression measured one-year after the neuroimaging session. These results are consistent with the hypothesis that lower early family income leads to disruptions in reward and decision-making brain circuitry, contributing to adolescent depression.
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Affiliation(s)
| | - Jamie L Hanson
- University of Pittsburgh, Pittsburgh, PA, United States.
| | - Kelly R Barry
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Stuart F White
- Boys Town National Research Hospital, Boys Town, NE, United States
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Mal-Sarkar T, Keyes K, Koen N, Barnett W, Myer L, Rutherford C, Zar HJ, Stein DJ, Lund C. The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study. SSM Popul Health 2021; 14:100770. [PMID: 33855159 PMCID: PMC8025055 DOI: 10.1016/j.ssmph.2021.100770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 01/21/2023] Open
Abstract
Background Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes. Childhood trauma and low socioeconomic status (SES) independently predict antenatal depression among a cohort of expecting women. The relationship between childhood trauma, SES, and antenatal depression differed by clinical site. These differential relationships may have been due to neighborhood effects on social determinants of mental health.
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Affiliation(s)
- Tatini Mal-Sarkar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.,South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.,South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.,South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.,South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Crick Lund
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.,King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 18 de Crespigny Park, London, SE5 8AF, United Kingdom
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77
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Wirback T, Möller J, Larsson JO, Engström K. Social and sex differences in psychiatric comorbidity and psychosocial functioning among adolescents with depression. J Affect Disord 2021; 282:1132-1142. [PMID: 33601688 DOI: 10.1016/j.jad.2020.12.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 11/12/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND To determine social and sex differences in psychosocial functioning and psychiatric comorbidity among adolescents with depression. METHODS A cohort-based study in Stockholm, Sweden. Adolescents who turned 13 years during 2001-2007, were followed in registers until they turned 18 in 2005-2011, (n = 169,262). In the current study, those with depression at age 13-17 were included (n = 6,439). RESULTS Adolescents with parents with low (OR=1.5, CI 1.1-2.2) education were more likely to have low psychosocial functioning. Those with parents with low education and low household income were more likely to have comorbid internalizing (OR=1.3, CI 1.0-1.7/1.3, CI 1.0-1.7) and externalizing disorders (OR=2.5, CI 1.5-4.0/2.4, CI 1.4-4.2). Adolescents with parents born outside the Nordic countries were more likely to have comorbid externalizing disorders (OR=1.6, CI 1.1-2.4). No social differences were evident in relation to family receipt of unemployment benefits. Social differences were found for both girls and boys in relation to psychosocial functioning and comorbidity but the magnitude of social differences in depression with comorbidity was overall larger for boys than girls. LIMITATIONS The findings of the current study can only be generalized to adolescents that have sought care for and been diagnosed with depression, within a setting similar to this study, e.g. with free access to care. CONCLUSION Adolescents with depression and with more disadvantaged social circumstances in the childhood run a higher risk of psychiatric comorbidity and low psychosocial functioning, which can indicate a lengthy clinical course and poorer response to treatment. Both boys and girls follow this path but partly in different kinds of psychiatric comorbidity.
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Affiliation(s)
- Therese Wirback
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.
| | - Jette Möller
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Jan-Olov Larsson
- Department of Women's and Children's Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Karin Engström
- Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
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78
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Banks A, Fields L. Correlates of Incarceration of Fathers, Socioeconomic Influences, and Mental Illness. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:26-37. [PMID: 33252019 DOI: 10.1080/19371918.2020.1851842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The United States leads globally in incarceration. Incarceration can disrupt families in both immediate and long-term ways, including finances and mental illness. We examined the relationship between father incarceration during adolescence and the development of mental illness in adulthood as well as the relationship of household assets and debts in relation to the mental illness outcomes. Wave IV data of the National Longitudinal Study of Adolescent to Adult Health were used with a final analytic sample of 2129 participants. Data were analyzed using MANOVA in Stata 13.1. The findings indicated that biological father incarceration correlates with more adolescent mental illness. Enhanced model residuals were also significant for father incarceration, household assets, and household debts. Incarceration of biological fathers correlates with poorer mental health outcomes. Household assets and debts correlate with changes in adolescent outcomes as well, giving us more target areas for intervention development and testing. Clinically, assessing for adolescent experiences with father incarceration may be useful in supporting improved mental health over the life course. Policy work should give more attention to promotion of health and well-being of adolescents via reduction of the negative experience of fathers serving and/or having served time in prison. More discussion on family-level assets and debts is warranted to promote health and well-being for adolescents and adults.
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Affiliation(s)
- Andrae Banks
- Department of Social Work, North Carolina Central University, Durham, United States
| | - LaShawnda Fields
- Brown School of Social Work, Washington University in St. Louis, St Louis, United States
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79
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Minh A, Bültmann U, Reijneveld SA, van Zon SKR, McLeod CB. Childhood Socioeconomic Status and Depressive Symptom Trajectories in the Transition to Adulthood in the United States and Canada. J Adolesc Health 2021; 68:161-168. [PMID: 32680802 DOI: 10.1016/j.jadohealth.2020.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We examined whether young people in the U.S. and Canada exhibit similar depressive symptom trajectories in the transition to adulthood and compared the effect of childhood socioeconomic status on trajectory membership. METHODS We used the American National Longitudinal Survey of Youth 1979 Child/Young Adult (n = 6,315) and the Canadian National Longitudinal Survey of Children and Youth (n = 3,666). Depressive symptoms were measured using five items from the Center for Epidemiological Studies on Depression scale. Latent trajectories of depressive symptoms from ages 16-25 years were identified using growth mixture models. We estimated the effect of childhood family income, parental education, and parental unemployment on trajectory membership using multivariable Poisson regression models with robust variances. RESULTS We identified four similar trajectories in the two countries: (1) low stable; (2) mid-peak; (3) increasing; and (4) decreasing. Relatively more Americans were in the low-stable trajectory group than Canadians (77.6% vs. 64.9%), and fewer Americans were in the decreasing group (7.1% vs. 19.1%). In the U.S., childhood family income in the bottom two quartiles was related to higher rates of increasing trajectory membership compared with income in the top quartile (incidence rate ratios: 1.59-1.79, p < .05), but not in Canada. In the U.S., parental education at a high school level was associated with higher rates of decreasing trajectory membership compared with higher education (incidence rate ratio = 1.45, confidence interval: 1.10-1.91; p = .01), but not in Canada. CONCLUSIONS Depressive symptoms may take a similar course in the transition to adulthood within these two countries. Country differences may modify the degree to which childhood socioeconomic status determines trajectory membership.
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Affiliation(s)
- Anita Minh
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Ute Bültmann
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christopher B McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Institute for Work & Health, Toronto, Ontario, Canada
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80
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Al-Zawaadi A, Hesso I, Kayyali R. Mental Health Among School-Going Adolescents in Greater London: A Cross-Sectional Study. Front Psychiatry 2021; 12:592624. [PMID: 33815161 PMCID: PMC8017155 DOI: 10.3389/fpsyt.2021.592624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Mental health problems are among the leading causes of health-related disability among children and adolescents worldwide. However, there is still a global challenge in terms of gathering consistent epidemiological information about the issue. The present study was designed to describe various mental health issues and factors associated with negative feelings among adolescents in Greater London. Methods: This is a cross sectional study, using a self-administered questionnaire (Cronbach's alpha = 0.742). A convenience sampling strategy was used to recruit participants who were school/college-attending adolescents, aged 11-19. A minimum sample size of 199 was required (95% confidence interval, 5% margin of error, and 15.3% population proportion). The study was conducted between February and April 2016 in Greater London. Descriptive statistics and inferential statistics including chi square, Spearman correlation, and binary logistic regression were used to identify the key findings. Data analysis was performed using SPSS v21. Results: A total of 526 out of 1,920 surveys were collected across 18 secondary schools and two colleges, giving a response rate of 27.4%. More than half of the adolescents reported to be either neutral (41.4%), sad (7.8%), or very sad (2.8%), whereas 48% reported to be either happy (35%) or very happy (13%). Difficulties in relationships and hectic schedules were among the most stressful situations affecting adolescents' mental health. Discrimination was identified as the main predicting factor with five-fold increase in odds of having negative mental health symptomatology. Other significant risk factors identified were age, gender, smoking, and health comorbidities. Conclusion: Discrimination was identified as the most predictive factor influencing negative symptomatology among the study cohort. The study had several limitations, most notably the use of a non-validated surrogate measure for mental health, in addition to the exclusion of adolescents aged 10-11 years, school/college dropouts and non-school-going adolescents. A similar study on a national scale is highly recommended to determine the real magnitude of the problem, which would be the starting point toward proper tackling of mental health issues and associated complexities among the adolescent population across England.
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Affiliation(s)
- Asmaa Al-Zawaadi
- School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, United Kingdom
| | - Iman Hesso
- School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, United Kingdom
| | - Reem Kayyali
- School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, United Kingdom
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81
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Fares-Otero NE, Pfaltz MC, Rodriguez-Jimenez R, Schäfer I, Trautmann S. Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol. Eur J Psychotraumatol 2021; 12:1943872. [PMID: 36877473 PMCID: PMC10075514 DOI: 10.1080/20008198.2021.1943872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.
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Key Words
- abuso infantil, negligencia, cognicivón social, relaciones interpersonales, funcionamiento en la comunidad, psicosis, revisión sistemática
- child abuse, neglect, social cognitive skills, interpersonal relationships, community functioning, psychosis, systematic review
- 人际关系
- 儿童虐待
- 忽视
- 社会功能
- 社会认知技能
- 精神病
- 系统综述
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Affiliation(s)
- Natalia E Fares-Otero
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Madrid, Spain.,Universidad Internacional de la Rioja, Spain
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Faculty of Medicine, University Complutense de Madrid (UCM), Madrid, Spain, CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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82
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Adolph D, Margraf J, Schneider S. Your Fear is My Fear: The Relationship Between Parental and Offspring Anxieties. Child Psychiatry Hum Dev 2021; 52:772-781. [PMID: 32948972 PMCID: PMC8405516 DOI: 10.1007/s10578-020-01060-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 11/26/2022]
Abstract
Contrary to the well-documented link between parental and offspring clinical anxiety, little is known about the relationship between parental everyday-life anxieties (e.g., concerning family, finances, health) and offspring anxieties. To close this gap, we assessed the frequency of parental symptoms of DSM-IV anxiety disorders and everyday-life anxieties, as well as the frequency of offspring anxiety symptoms in a representative sample by self-report. Parents reported that 48.4% of the children were free of specific symptoms of DSM-IV anxiety disorders within the last 12 months, 39.2% showed low symptom load (1-3 symptoms) and 12.4% were moderately or severely strained (4-10 symptoms). Replicating previous studies, parental DSM-IV symptoms increased offspring risk for the same symptoms. In addition, parental everyday-life anxieties showed a positive relationship with offspring symptom severity. Demographic variables (female sex, low socioeconomic status and younger age) and parental anxiety markers explained 18% of variance in offspring symptom severity. The data are discussed in light of current models of familial transmission.
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Affiliation(s)
- Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany.
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
| | - Silvia Schneider
- Mental Health Research and Treatment Center, Ruhr-University Bochum, Massenbergstrasse 9-13, 44847, Bochum, Germany
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83
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Mills MS, Embury CM, Klanecky AK, Khanna MM, Calhoun VD, Stephen JM, Wang YP, Wilson TW, Badura-Brack AS. Traumatic Events Are Associated with Diverse Psychological Symptoms in Typically-Developing Children. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:381-388. [PMID: 33269038 PMCID: PMC7683694 DOI: 10.1007/s40653-019-00284-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Childhood traumatic events are significant risk factors for psychopathology according to adult retrospective research; however, few studies examine trauma exposure and psychological symptoms in pre-adolescent children. Typically-developing children, aged 9-12 years (N = 114), were recruited from the community and selected from the Developmental Chronnecto-Genomics (Dev-CoG) study examining child development. Children completed questionnaires about traumatic life events, posttraumatic stress, anxiety, depression, dissociation, anger, and internalizing and externalizing behaviors. Parents also completed internalizing and externalizing measures. The number of traumatic events significantly correlated with symptom severity across all child-report psychological measures, but surprisingly, trauma was not correlated with any parent-report scores. Follow-up analyses revealed a significant trauma effect for internalizing and externalizing behaviors according to child self-report, but not for parent-report measures. Results indicate that childhood trauma may be a non-specific risk factor for sub-clinical psychopathology in otherwise typically-developing children. Moreover, children appear to be the most appropriate reporters of their own psychological distress.
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Affiliation(s)
- Mackenzie S. Mills
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Christine M. Embury
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE USA
- Center for Magnetoencephalography, UNMC, Omaha, NE USA
- Department of Psychology, University of Nebraska at Omaha, Omaha, NE USA
| | - Alicia K. Klanecky
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Maya M. Khanna
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
| | - Vince D. Calhoun
- Department of Neurosciences, University of New Mexico (UNM), Albuquerque, NM USA
- Department of Electrical and Computer Engineering, UNM, Albuquerque, NM USA
- Department of Computer Science, UNM, Albuquerque, NM USA
- Department of Psychiatry, UNM, Albuquerque, NM USA
- The Mind Research Network, Albuquerque, NM USA
| | - Julia M. Stephen
- Department of Electrical and Computer Engineering, UNM, Albuquerque, NM USA
- Department of Computer Science, UNM, Albuquerque, NM USA
- Department of Psychiatry, UNM, Albuquerque, NM USA
- The Mind Research Network, Albuquerque, NM USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA USA
| | - Tony W. Wilson
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE USA
- Center for Magnetoencephalography, UNMC, Omaha, NE USA
| | - Amy S. Badura-Brack
- Department of Psychological Science, Creighton University, 2500 California Plaza, Omaha, NE 68178 USA
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84
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Hakulinen C, Mok PLH, Horsdal HT, Pedersen CB, Mortensen PB, Agerbo E, Webb RT. Parental income as a marker for socioeconomic position during childhood and later risk of developing a secondary care-diagnosed mental disorder examined across the full diagnostic spectrum: a national cohort study. BMC Med 2020; 18:323. [PMID: 33190641 PMCID: PMC7667856 DOI: 10.1186/s12916-020-01794-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Links between parental socioeconomic position during childhood and subsequent risks of developing mental disorders have rarely been examined across the diagnostic spectrum. We conducted a comprehensive analysis of parental income level, including income mobility, during childhood and risks for developing mental disorders diagnosed in secondary care in young adulthood. METHODS National cohort study of persons born in Denmark 1980-2000 (N = 1,051,265). Parental income was measured during birth year and at ages 5, 10 and 15. Follow-up began from 15th birthday until mental disorder diagnosis or 31 December 2016, whichever occurred first. Hazard ratios and cumulative incidence were estimated. RESULTS A quarter (25.2%; 95% CI 24.8-25.6%) of children born in the lowest income quintile families will have a secondary care-diagnosed mental disorder by age 37, versus 13.5% (13.2-13.9%) of those born in the highest income quintile. Longer time spent living in low-income families was associated with higher risks of developing mental disorders. Associations were strongest for substance misuse and personality disorders and weaker for mood disorders and anxiety/somatoform disorders. An exception was eating disorders, with low parental income being associated with attenuated risk. For all diagnostic categories examined except for eating disorders, downward socioeconomic mobility was linked with higher subsequent risk and upward socioeconomic mobility with lower subsequent risk of developing mental disorders. CONCLUSIONS Except for eating disorders, low parental income during childhood is associated with subsequent increased risk of mental disorders diagnosed in secondary care across the diagnostic spectrum. Early interventions to mitigate the disadvantages linked with low income, and better opportunities for upward socioeconomic mobility could reduce social and mental health inequalities.
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Affiliation(s)
- Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland.
| | - Pearl L H Mok
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Henriette Thisted Horsdal
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,NCRR National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark
| | - Carsten B Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,NCRR National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark.,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Preben B Mortensen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,NCRR National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark
| | - Esben Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,NCRR National Centre for Register-Based Research, School of Business and Social Sciences, Aarhus University, Aarhus V, Denmark.,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Roger T Webb
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
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85
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Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228440. [PMID: 33202649 PMCID: PMC7696437 DOI: 10.3390/ijerph17228440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 12/27/2022]
Abstract
The South African Mental Health Act of 2002 advocates the de-institutionalization of treatment of patients with mental disorders, so that the mental health care users or patients are treated in their communities. Although this approach is often used to discharge patients from hospital, no feasibility assessments are conducted to ascertain adequate care for these patients. The objective of the study was to explore the experiences of family members who provide home care for patients with serious mental disorders. A qualitative explorative design was used to interview 20 primary caregivers whose family members were readmitted to a public psychiatric hospital in Pretoria. Data were analysed using NVivo version 11. The findings are that caring for patients with serious mental illness at home is difficult, sometimes unbearable, because the families have to deal with violence perpetrated by the patients, safety concerns, financial difficulties and emotional turmoil, and wish that the patients would be kept in institutions. The absence of required skills and resources to care for the mentally ill at home exposes the patients and their families to emotional, financial and social difficulties, and results in unfavourable outcomes for both the patients and their families.
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86
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Little K, Hawkins MT, Sanson A, O'connor M, Toumbourou JW, Smart D, Vassallo S. Longitudinal Predictors of Alcohol‐Related Harms During the Transition to Adulthood. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00095.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Keriann Little
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Mary T Hawkins
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Ann Sanson
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - Meredith O'connor
- Department of Paediatrics, The University of Melbourne, Royal Children's Hospital,
| | - John W Toumbourou
- School of Psychology and Centre for Mental Health and Wellbeing Research, Deakin University,
- Centre for Adolescent Health, Murdoch Children's Research Institute,
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87
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Ramphal B, Whalen DJ, Kenley JK, Yu Q, Smyser CD, Rogers CE, Sylvester CM. Brain connectivity and socioeconomic status at birth and externalizing symptoms at age 2 years. Dev Cogn Neurosci 2020; 45:100811. [PMID: 32823180 PMCID: PMC7451824 DOI: 10.1016/j.dcn.2020.100811] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/20/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022] Open
Abstract
Low childhood socioeconomic status (SES) predisposes individuals to altered trajectories of brain development and increased rates of mental illness. Brain connectivity at birth is associated with psychiatric outcomes. We sought to investigate whether SES at birth is associated with neonatal brain connectivity and if these differences account for socioeconomic disparities in infant symptoms at age 2 years that are predictive of psychopathology. Resting state functional MRI was performed on 75 full-term and 37 term-equivalent preterm newborns (n = 112). SES was characterized by insurance type, the Area Deprivation Index, and a composite score. Seed-based voxelwise linear regression related SES to whole-brain functional connectivity of five brain regions representing functional networks implicated in psychiatric illnesses and affected by socioeconomic disadvantage: striatum, medial prefrontal cortex (mPFC), ventrolateral prefrontal cortex (vlPFC), and dorsal anterior cingulate cortex. Lower SES was associated with differences in striatum and vlPFC connectivity. Striatum connectivity with frontopolar and medial PFC mediated the relationship between SES and behavioral inhibition at age 2 measured by the Infant-Toddler Social Emotional Assessment (n = 46). Striatum-frontopolar connectivity mediated the relationship between SES and externalizing symptoms. These results, convergent across three SES metrics, suggest that neurodevelopmental trajectories linking SES and mental illness may begin as early as birth.
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Affiliation(s)
- Bruce Ramphal
- New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, NY, United States.
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Jeanette K Kenley
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Qiongru Yu
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Christopher D Smyser
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States; Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Chad M Sylvester
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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88
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Gholampour T, Noroozi M, Zavoshy R, Mohammadpoorasl A, Ezzeddin N. Relationship Between Household Food Insecurity and Growth Disorders in Children Aged 3 to 6 in Qazvin City, Iran. Pediatr Gastroenterol Hepatol Nutr 2020; 23:447-456. [PMID: 32953640 PMCID: PMC7481058 DOI: 10.5223/pghn.2020.23.5.447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Food insecurity, which is the inability to obtain food or inadequate food consumption in terms of quality and quantity, has physical and psychological consequences on children's health. This study aimed to investigate the relationship between children's growth disorders and food insecurity in Qazvin city, Iran. METHODS A case-control study was conducted on 177 cases and 355 controls of children aged 3 to 6 years, who were referred to health centers in Qazvin city. The case group consisted of children with growth disorders. Data were obtained with the 18-item US Department of Agriculture questionnaire, a household socioeconomic questionnaire, a and growth monitoring card. The data were analyzed with using IBM SPSS Version 22.0, by independent sample t-test, chi-square test, and logistic regression. RESULTS A significant relationship was found between children's growth disorders and household food insecurity with (p<0.05, odds ratio [OR]=17.0, confidence interval [CI]=5.9, 48.8) and without hunger (p<0.05, OR=2.69, CI=1.4, 4.9). There were also significant relationships between children's growth disorders and socioeconomic status (p<0.05, OR=3.4, CI=1.4, 8.5), the duration of breastfeeding (p<0.05, OR=0.94, CI=0.9, 0.98), and children's ages (p<0.05, OR=0.94, CI=0.92, 0.96). Sex and birth order, and the age of the parents was not found to be significantly related with growth disorders. CONCLUSION Lower socioeconomic status and household food insecurity were the important predictors of children's growth disorders. Policymakers should focus more on promoting steady employment and income among family members. Nutritional education for mothers is also recommended, in order to better meet the nutritional needs of the children.
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Affiliation(s)
- Tooba Gholampour
- Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mostafa Noroozi
- Children Growth Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rosa Zavoshy
- Department of Human Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Asghar Mohammadpoorasl
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Ezzeddin
- Department of Community Nutrition, Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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89
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Impact of earthquake exposure, family adversity and peer problems on anxiety-related emotional disorders in adolescent survivors three years after the Ya'an earthquake. J Affect Disord 2020; 273:215-222. [PMID: 32421606 DOI: 10.1016/j.jad.2020.04.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/28/2020] [Accepted: 04/26/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Traumatic experiences often give rise to an increased risk of anxiety problems in adolescents. This study investigated the anxiety prevalence in adolescent earthquake survivors and the effect of secondary stressors such as bullying, poverty, or being "left behind" by parents working in the cities. METHODS This cross-sectional study was conducted three years after the 2013 Ya'an (China) earthquake on 6,132 adolescents aged 9 to 18 years from 11 public schools in three severely earthquake affected counties. The participants completed self-report questionnaires that assessed anxiety, earthquake exposure, poverty level, left-behind duration and bullying. RESULTS Separation anxiety (38.7%) and panic symptoms (32.2%) were found to be the primary contributors to anxiety in this adolescent sample. The regression and structural equation modeling indicated that adolescents who had suffered from high earthquake exposure, peer bullying, being left-behind, or poverty were more likely to report problems in all anxiety subcategories, with females reporting more anxiety symptoms than males. The likelihood of all anxiety disorders except separation anxiety was found to increase with age. CONCLUSIONS This study highlighted the need for post-disaster interventions aimed at minimizing post-earthquake adversity such as peer bullying and specialized psychological services that target subgroups that might be more susceptible to anxiety-related emotional problems. The results could be used to identify possible markers for anxiety problems in children who had not experienced any major traumas.
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90
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Xia Z, Qi W, Xiaofeng G, Jiguang K, Hongfei H, Yuchen Z, Yihan Z, Yan W, Nannan L, Yiwei L, Hongsheng B, Xiaobai L. AMBMP activates WNT pathway and alleviates stress-induced behaviors in maternal separation and chronic stress models. Eur J Pharmacol 2020; 881:173192. [DOI: 10.1016/j.ejphar.2020.173192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
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91
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Investigation of the Trend in Adolescent Mental Health and its Related Social Factors: A Multi-Year Cross-Sectional Study For 13 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155405. [PMID: 32727147 PMCID: PMC7432642 DOI: 10.3390/ijerph17155405] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 01/16/2023]
Abstract
We aimed to investigate the mental health change and associated social correlates in adolescents in terms of depression, suicidal ideation, and suicidal attempt. In total, 978,079 students (12–18 years old, 7th–12th grade) participated in the survey for 13 years (2006–2018) by a multiple-year cross-sectional design (not a repeat measure for smaller group). Mental health outcome variables were assessed using self-report surveys with the independent variables of sex, age, economic status, school achievement, and parental educational level. Korean social indices of income inequality (Gini index, higher scores representing greater economic inequity with score range of 0–1), education (national proportion of tertiary education attainment), and actual suicides were investigated together as related social factors. The prevalence of depressive episodes, suicidal ideation, and suicidal attempt markedly dropped by 34.6%, 42.2%, and 48.3%, respectively. Moreover, the Gini index (from 0.314 in 2008 to 0.295 in 2015) and proportion of tertiary education (from 82.1% in 2006 to 69.7% in 2018) showed a decreasing tendency. These indices and adolescent mental health outcomes highly correlated with each other (Pearson’s r between Gini index and depressive episode = 0.789, suicidal ideation = 0.724, and suicidal attempt = 0.740; Pearson’s r between proportion of tertiary education and depressive episode = 0.930, suicidal ideation = 0.809, and suicidal attempt = 0.851). Adolescent mental health has improved in the last 13 years in Korea, and improvements in social inequality (decreased Gini index) and lessened burden of academic competition (decreased national proportion of tertiary education) were significantly associated with the improvement of adolescent’s mental health. However, the impact of parental educational level on children’s mental health was relatively minimal, compared with the impact of economic inequality and academic burden. Further studies are needed to reveal the underlying mechanism for the association between adolescent mental health and sociodemographic factors to save adolescents from psychological distress.
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92
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Schafer MH, Andersson MA. Looking homeward with the life course: Early origins of adult dwelling satisfaction? ADVANCES IN LIFE COURSE RESEARCH 2020; 44:100328. [PMID: 36726247 DOI: 10.1016/j.alcr.2020.100328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/01/2020] [Accepted: 02/20/2020] [Indexed: 06/18/2023]
Abstract
The long-term influence of childhood economic and social exposures on adult health and well-being is well-known. Most childhood circumstances transpire in or near the home, yet research has largely neglected how early exposures shape people's experience of their residential context in adulthood. To help address this gap, we use retrospective longitudinal data from the Midlife Development in the United States (MIDUS) study. Drawing on a life course framework, we test the potential mediating roles of adult social, economic, and mental health processes. Results suggest that childhood parental warmth and maltreatment have an enduring influence on people's satisfaction with their adult home, while there is little indication that childhood economic conditions shape adult dwelling satisfaction. Analyses of average controlled direct effects suggest that the effects of childhood parental warmth are mediated slightly by adult socioeconomic attainment and psychological adjustment but especially by supportive family relationships during adulthood. This pattern is consistent with an attachment-based interpretation of the importance of childhood conditions for adult relationships as well as home satisfaction. Taken together, our results suggest that parent-child bonds cast a long shadow over how people experience their residential context decades later, through a diffuse, multifaceted set of intervening pathways.
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93
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dosReis S, Zhang C, Qato DM, Camelo Castillo W, Reeves G. Family Adverse Experiences and Psychotropic Polypharmacy Among US Youth: 2009-2015. Pediatrics 2020; 145:peds.2019-2705. [PMID: 32430443 DOI: 10.1542/peds.2019-2705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine if adverse family factors are associated with a higher likelihood of psychotropic polypharmacy among US youth with a mental health condition. METHODS The 2009-2015 Medical Expenditure Panel Survey data were used to identify family characteristics of 5136 youth aged ≤18 years with an emotional or behavioral health condition. Family adversity was based on family size, number of parents in the household, parental education and income, and parent-reported physical and/or cognitive or mental health disability. Cluster analysis identified family adversity subgroups. Polypharmacy was defined as 3 or more psychotropic classes (eg, stimulants, antipsychotics, antidepressants, mood stabilizers, and sedatives) in at least 1 interview round in a calendar year. Weighted logistic regression evaluated associations between family adversity and psychotropic polypharmacy among youth. RESULTS Nearly half (47.8%) of youth lived with parents who had a disability. Parents in the least socioeconomically disadvantaged cluster mainly had a mental illness, and 94% of parents in the most socioeconomically disadvantaged cluster had a parent-reported physical and/or cognitive disability and mental illness. Among youth, mood disorder (24.2%; 95% confidence interval [CI]: 12.6%-16.0%), antidepressant use (16.0%; 95% CI: 10.6%-21.5%), and antipsychotic use (7.5%; 95% CI: 5.4%-9.6%) were higher in the most socioeconomically disadvantaged cluster relative to the other clusters. Approximately 3% of youth received psychotropic polypharmacy. The odds of psychotropic polypharmacy were 2.7 (95% CI: 1.1-6.4) times greater among youth in the most relative to the least socioeconomically disadvantaged cluster. CONCLUSIONS Higher use of psychotropic polypharmacy among youth with parents who have multiple disabilities raises concerns about oversight and monitoring of complex psychotropic treatment.
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Affiliation(s)
- Susan dosReis
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Chengchen Zhang
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Danya M Qato
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Wendy Camelo Castillo
- Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland
| | - Gloria Reeves
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, School of Medicine and
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94
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Torigoe-Lai TK, Mahrer NE, Klein MJ, Gold JI. A Secondary Analysis of Integrated Pediatric Chronic Pain Services Related to Cost Savings. J Clin Psychol Med Settings 2020; 28:374-383. [PMID: 32430736 DOI: 10.1007/s10880-020-09723-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Youth with chronic pain have high healthcare utilization and associated costs. Research supports integrated treatment; though, it's unclear which treatments are used and cost-effective. This study expands on work that found reduced service use and cost savings following participation in an outpatient integrated pediatric pain clinic. We explored which services were commonly used and which individual (psychotherapy, medication management, acupuncture, massage, biofeedback) and/or combinations of services were associated with service use reduction and cost savings. Medication management and psychotherapy were more common than complementary integrative medicine (CIM) services. Massage services were associated with reduced inpatient costs. There were trends of fewer emergency department visits for participants who received CIM services in addition to medication management and psychotherapy, and more visits for those with biofeedback. Findings suggest that a more detailed examination of service utilization is needed to better understand cost outcomes related to the integrated treatment of pediatric chronic pain.
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Affiliation(s)
- Tiffany K Torigoe-Lai
- University Center for Excellence in Developmental Disabilities, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Nicole E Mahrer
- Psychology Department, University of La Verne, La Verne, CA, USA
| | - Margaret J Klein
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Jeffrey I Gold
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, Keck School of Medicine, Los Angeles, CA, USA
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95
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Draisey J, Halldorsson B, Cooper P, Creswell C. Associations between family factors, childhood adversity, negative life events and child anxiety disorders: an exploratory study of diagnostic specificity. Behav Cogn Psychother 2020; 48:253-267. [PMID: 31727188 DOI: 10.1017/s1352465819000717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chronic childhood adversity, negative life events, and anxiogenic parenting behaviours have all been implicated in the development and maintenance of childhood anxiety disorders. However, few studies have addressed whether these factors are associated with particular types of childhood anxiety disorders. AIMS The aims of this study were to investigate whether specific associations were obtained between specific types of childhood anxiety disorder - namely, social anxiety disorder (SOC), separation anxiety disorder (SEP) and generalized anxiety disorder (GAD) - and the nature of particular forms of psycho-social risk - namely, chronic childhood adversity, negative life events, and particular forms of parenting behaviours. METHOD Two-hundred and ten children (aged 7-12 years) who met diagnostic criteria for SOC, SEP or GAD and their primary caregivers completed questionnaire measures on chronic childhood adversity and negative life events. In addition, dyads participated in two laboratory-based assessments of parent-child interactions. RESULTS We found little evidence for disorder specificity for chronic childhood adversity and negative life events, except in the case of separation anxiety disorder. Anxious children with separation anxiety were more likely than children with other forms of anxiety disorders to live with a single parent, experience more frequent parent arguments, and more negative life events. No group differences in observed parenting behaviours were found. CONCLUSIONS Childhood SEP may be particularly associated with family challenges which may need specific consideration to optimize prevention and/or treatment. Beyond this, there is limited evidence of specific associations between family and environmental factors and specific types of childhood anxiety disorders.
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Affiliation(s)
- Jenny Draisey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Brynjar Halldorsson
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychology, Reykjavik University, Iceland
| | - Peter Cooper
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
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96
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Keilow M, Wu C, Obel C. Cumulative social disadvantage and risk of attention deficit hyperactivity disorder: Results from a nationwide cohort study. SSM Popul Health 2020; 10:100548. [PMID: 32072007 PMCID: PMC7016018 DOI: 10.1016/j.ssmph.2020.100548] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/14/2020] [Accepted: 01/27/2020] [Indexed: 11/16/2022] Open
Abstract
Socioeconomic factors correlate with mental health and affect individual life chances. However, the influence of specific and cumulative social disadvantages on children's mental health problems has received little attention. Previous studies have primarily used global measures of mental health problems or aggregated indicators of socioeconomic status. We contribute to this research by including multiple indicators of parental social disadvantage to study independent and accumulative effects. The study focuses on the Attention Deficit/Hyperactivity Disorder (ADHD), which is known to affect children's educational and socioeconomic trajectories. ADHD is one of the most common child mental health problems and although heredity has been estimated to 76 percent, research suggests that a large social component remains in the prevalence. We exploit comprehensive high-quality registry data for the entire population of children born 1990-1999 in Denmark (N = 632,725). The ADHD prevalence is 3.68 percent. Estimates from linear probability models show that parental unemployment, relative income poverty, and low educational attainment increase children's risk of ADHD with 2.1 (95% CI 1.8-2.3), 2.3 (95% CI 2.1-2.5), and 3.5 percentage points (95% CI 3.3-3.7), respectively. Children who live with all three disadvantages face an increased risk of 4.9 percentage points.
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Affiliation(s)
- Maria Keilow
- VIVE – the Danish Center for Social Science Research, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Chunsen Wu
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Carsten Obel
- Department of Public Health, Aarhus University, Aarhus, Denmark
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97
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Kirby N, Wright B, Allgar V. Child mental health and resilience in the context of socioeconomic disadvantage: results from the Born in Bradford cohort study. Eur Child Adolesc Psychiatry 2020; 29:467-477. [PMID: 31243580 PMCID: PMC7103573 DOI: 10.1007/s00787-019-01348-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/03/2019] [Indexed: 01/05/2023]
Abstract
Socioeconomic disadvantage has been linked to mental health difficulties in children and adolescents, although many children appear to do well despite exposure to financial adversity in childhood. Our study looked at the effects of family financial difficulty on children's mental health outcomes (n = 636) at 4-5 years in a multi-ethnic UK cohort, the Born in Bradford cohort. We considered potential parent and child variables promoting resilience in this population. Univariate linear regression was used to identify associations between family financial difficulty measured antenatally and child mental health difficulties measured by teacher-rated Strengths and Difficulties (SDQ) scores at 4-5 years. Hierarchical multivariate regression was used to test for potential moderating effects of parent and child factors. Mothers completed the General Health Questionnaire-28, Kessler-6 Questionnaire and questions related to parenting warmth, hostility and confidence. Parent-rated Infant Characteristic Questionnaires and teacher-rated Early Years Foundation Stage scores provided information on child temperament, literacy and physical development as potential moderators. Financial difficulty was associated with worse mental health outcomes in children. High parent warmth, high child literacy scores and physical development scores were all associated with positive child mental health outcomes at 4-5 years. In terms of protective effects, only maternal warmth was found to significantly moderate the relationship between financial difficulty and child mental health difficulties. The current study demonstrates that family financial difficulty is associated with poorer child mental health outcomes in a UK cohort of mothers and their school-aged children. It provides evidence of the positive relationships between warm parenting, child literacy and child physical development with mental health in young children. The study supports the finding that warm parenting moderates the relationship between family financial difficulty and interventions supporting this aspect of parenting may therefore provide particular benefit to children growing up in this context.
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Affiliation(s)
- Natalie Kirby
- Hull York Medical School, University of York, York, UK.
- Tees Esk and Wear Valleys Foundation Trust, York, UK.
| | - Barry Wright
- Hull York Medical School, University of York, York, UK
- Leeds and York Partnership Foundation Trust, York, UK
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98
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Dodell-Feder D, Ressler KJ, Germine LT. Social cognition or social class and culture? On the interpretation of differences in social cognitive performance. Psychol Med 2020; 50:133-145. [PMID: 30616706 DOI: 10.1017/s003329171800404x] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The ability to understand others' mental states carries profound consequences for mental and physical health, making efforts at validly and reliably assessing mental state understanding (MSU) of utmost importance. However, the most widely used and current NIMH-recommended task for assessing MSU - the Reading the Mind in the Eyes Task (RMET) - suffers from potential assessment issues, including reliance on a participant's vocabulary/intelligence and the use of culturally biased stimuli. Here, we evaluate the impact of demographic and sociocultural factors (age, gender, education, ethnicity, race) on the RMET and other social and non-social cognitive tasks in an effort to determine the extent to which the RMET may be unduly influenced by participant characteristics. METHODS In total, 40 248 international, native-/primarily English-speaking participants between the ages of 10 and 70 completed one of five measures on TestMyBrain.org: RMET, a shortened version of RMET, a multiracial emotion identification task, an emotion discrimination task, and a non-social/non-verbal processing speed task (digit symbol matching). RESULTS Contrary to other tasks, performance on the RMET increased across the lifespan. Education, race, and ethnicity explained more variance in RMET performance than the other tasks, and differences between levels of education, race, and ethnicity were more pronounced for the RMET than the other tasks such that more highly educated, non-Hispanic, and White/Caucasian individuals performed best. CONCLUSIONS These data suggest that the RMET may be unduly influenced by social class and culture, posing a serious challenge to assessing MSU in clinical populations given shared variance between social status and psychiatric illness.
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Affiliation(s)
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
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99
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Hassiotis A, Brown E, Harris J, Helm D, Munir K, Salvador-Carulla L, Bertelli M, Baghdadli A, Wieland J, Novell-Alsina R, Cid J, Vergés L, Martínez-Leal R, Mutluer T, Ismayilov F, Emerson E. Association of Borderline Intellectual Functioning and Adverse Childhood Experience with adult psychiatric morbidity. Findings from a British birth cohort. BMC Psychiatry 2019; 19:387. [PMID: 31805899 PMCID: PMC6896708 DOI: 10.1186/s12888-019-2376-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/27/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND To examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity. METHODS We performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity. RESULTS Children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19; Mann-Whitney z = 31.74, p < 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104-0.141, all p < 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity. CONCLUSIONS The relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group.
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Affiliation(s)
- Angela Hassiotis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF UK
- Camden & Islington Foundation Trust, St Pancras Hospital, London, UK
| | - Emma Brown
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF UK
| | - James Harris
- Developmental Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Bloomberg Children’s Center, The Johns Hopkins Hospital, Baltimore, MD USA
| | - David Helm
- Institute for Community Inclusion, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Kerim Munir
- Institute for Community Inclusion, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA USA
- Developmental Medicine Center, Division of Developmental Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
| | | | - Marco Bertelli
- CREA, Research and Clinical Centre, San Sebastiano Foundation, Florence, Italy
| | - Amaria Baghdadli
- Child and Adolescent Psychiatry Department, Montpellier Hospital University, Montpellier, France
| | - Jannelien Wieland
- Kristal Centre for Psychiatry and Intellectual Disability, Rivierduinen, Leiden, The Netherlands
| | - Ramon Novell-Alsina
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Jordi Cid
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Laura Vergés
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Rafael Martínez-Leal
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koc University Hospital, Istanbul, Turkey
| | - Fuad Ismayilov
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | - Eric Emerson
- Centre for Disability Research & Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Cognitive Behavioural Therapy for Anxiety Disorders in Young Children: A Dutch Open Trial of the Fun FRIENDS Program. BEHAVIOUR CHANGE 2019. [DOI: 10.1017/bec.2019.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAnxiety disorders in young children are highly prevalent and increase the risk of social, school, and familial problems, and also of psychiatric disorders in adolescence and adulthood. Nevertheless, effective interventions for this age group are lacking. One of the few available interventions is the Fun FRIENDS program. We examined whether young children with anxiety disorders showed less anxiety after participating in Fun FRIENDS. Twenty-eight clinically anxious children (4–8 years old) participated in the cognitive behavioural Fun FRIENDS program. The program consists of 12 weekly 1.5-hour sessions and was provided in groups of 3 to 5 children. At preintervention and direct postintervention, parents completed the Anxiety Disorders Interview Schedule for Children and Child Behavior Checklist. Clinically and statistically significant decreases were found in number of anxiety disorders, symptom interference, emotional and behavioural problems, internalising problems, and anxiety problems. The decrease in anxious/depressed problems and externalising problems was not significant. Furthermore, higher preintervention anxiety levels predicted more treatment progress, whereas sex and age did not. The Dutch version of Fun FRIENDS is promising in treating anxiety disorders in young children. Randomised controlled trials are needed to draw definite conclusions on the effectiveness of Fun FRIENDS in a clinical setting.
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