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Borodovsky JT, Squeglia LM, Mewton L, Marsch LA. Longitudinal Use Patterns of Technology Subtypes During the Transition Into Early Adolescence: Results From the Adolescent Brain Cognitive Development Study. J Adolesc Health 2024:S1054-139X(24)00304-5. [PMID: 39140927 DOI: 10.1016/j.jadohealth.2024.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/15/2024] [Accepted: 06/17/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE Adolescents encounter a complex digital environment, yet existing data on youth technology use rarely differentiates technology subtypes. This study maps the evolution and intricacies of youth engagement with technology subtypes. METHODS N = 11,868 participants in the Adolescent Brain Cognitive Development study followed from ages ∼9/10 to ∼13/14. We examined youths' self-reported hours per day (hr/day) of technology subtypes: TV/Movies, video games, YouTube, social media, video chat, and texting. We used descriptive statistics and multilevel logistic regression to assess cross-sectional and longitudinal use patterns of technology subtypes, agreement between child and parent reports on the child's technology use, and associations between each technology subtype and sociodemographics (child's biological sex, parent education, income, and marital status). RESULTS At age 9/10, ∼75% of youth reported minimal (<30 min/day) social technology use (social media, video chat, texting) and up to ∼1.5 hr/day of TV, video games, and YouTube. By age 13/14, TV trajectories were converging to >2 hr/day, but social technology trajectories "fanned out" into a wide range of usage rates. Child and parent reports were weakly correlated (rs range: 0.13-0.29). Using child-reported hours of technology use, increases in the subject-specific odds of using a technology >2 hr/day ranged from 25% (YouTube; 95% CI: 1.16-1.35) to 234% (social media; 95% CI: 3.14-3.55). Compared with males, females had ∼100-200% greater odds of >2 hr/day of social technologies, but ∼40-80% reduced odds of >2 hr/day of video games and YouTube. Higher parent education and income predicted significantly lower odds of >2 hr/day of use - regardless of technology subtype. DISCUSSION Distributions of youths' self-reported technology engagement are highly contingent on technology subtype, age, and biological sex. Future research on youth development and technology may benefit from considering youths' varied digital experiences.
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Affiliation(s)
- Jacob T Borodovsky
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire.
| | - Lindsay M Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Louise Mewton
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Syndey, Australia
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire
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Jovanović V. The Depression Anxiety Stress Scales for Youth (DASS-Y): evidence of validity and cross-national and gender measurement invariance. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02561-0. [PMID: 39141105 DOI: 10.1007/s00787-024-02561-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
The Depression Anxiety Stress Scales for Youth (DASS-Y) is a recently developed measure of unpleasant emotional experiences for children and adolescents; however, the evidence for its validity is still limited. The present study evaluated the evidence for the structural, convergent, and incremental validity of the DASS-Y on a sample of Serbian adolescents aged 15-19 years (N = 421; 48% female, mean age = 16.86). Measurement invariance across gender and two countries (Serbia and Australia) was also tested. The findings supported the bifactor exploratory structural equation modeling (bifactor-ESEM) representation of the DASS-Y, which includes the General factor of negative affect/emotional distress, and three specific factors of Depression, Anxiety, and Stress. The DASS-Y factors showed evidence of incremental validity in predicting global externalizing symptoms and demonstrated convergent validity in relation to measures of global internalizing and externalizing symptoms as well as subjective well-being. The bifactor-ESEM model of the DASS-Y was found to be invariant across gender and two countries. The present study findings highlight the importance of distinguishing between general and specific components of unpleasant emotional states.
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Affiliation(s)
- Veljko Jovanović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, Novi Sad, 21 000, Serbia.
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Anderson RE, Johnson N, Jones SCT, Patterson A, Anyiwo N. Racial Socialization and Black Adolescent Mental Health and Developmental Outcomes: A Critical Review and Future Directions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-24. [PMID: 39137924 DOI: 10.1080/15374416.2024.2384025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
OBJECTIVE Black American adolescents are beleaguered with the most frequent and severe experiences of racial discrimination (RD) among their peers. To protect Black adolescents' mental health and developmental outcomes from the pernicious impact of discrimination, parents and other proximal adults and peers often utilize racial socialization (RS), or communications and behaviors emphasizing the importance of race and the harms of racism. While several recent RS reviews have been conducted across ethnicity, a modern review investigating RS practices related to and predictive of Black adolescent psychosocial outcomes is needed. METHOD To ground our critical systematic review of 45 articles, we first highlighted the ways RD impacts the lives of Black adolescents. Then, drawing from integrative models for Black youth development, we synthesized recent psychological, academic, and sociocultural literatures to describe the role of RS in Black adolescents' wellness. RESULTS The impact of various tenets of RS was seen most clearly as a protective factor against RD with respect to adolescents' mental health (e.g. depression), academic achievement (e.g. GPA), and sociocultural identity (e.g. public and private racial regard) development. Cultural socialization, a strategy related to extolling pride for one's race, was the most consistent RS protective factor, with novel RS constructs (e.g. parental competency) emerging as a method to buffer youth internalizing and externalizing problems. CONCLUSIONS Recommendations are made for future research on understudied components of RS and multiple methods and reporters to capture a more holistic depiction of RS practices. We emphasize preventative and intervening approaches to reduce the impetus for RS and its impact, including burgeoning clinical and community-level programs and the importance for provider training to yield positive mental health outcomes for Black adolescents.
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104
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Can B, Piskun V, Dunn A, Cartwright-Hatton S. The impact of treating parental bipolar disorder and schizophrenia on their children's mental health and wellbeing: an empty systematic review. Front Psychiatry 2024; 15:1425519. [PMID: 39193576 PMCID: PMC11347426 DOI: 10.3389/fpsyt.2024.1425519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024] Open
Abstract
Background Parental psychosis (bipolar disorder and schizophrenia) are major risk factors for mental health problems in offspring. Although interventions that focus on parenting and the family environment have shown effectiveness in mitigating this risk, no systematic review has examined the impact of simply treating adult bipolar disorder or schizophrenia on their dependent children's outcomes. Aims To systematically review the effects (in randomized controlled trials) of adult-based interventions for bipolar disorder and schizophrenia, on offspring mental health and wellbeing. Method Eligibility criteria included randomized controlled trials that examined the treatment of adults with bipolar disorder and schizophrenia that also included child mental health and wellbeing outcomes. PubMed, Scopus, PsycINFO, and PsychArticles databases were searched. Results 168,317 studies were reviewed; however, zero studies that met the inclusion criteria could be found. Conclusions The existing research aimed at treating adult bipolar disorder and schizophrenia has so far overlooked the potential advantages that these treatments could provide for their offspring. This is a missed opportunity to understand the mechanisms of intergenerational transmission. Researchers examining treatments for adults with bipolar disorder and schizophrenia should, where appropriate, consider including both adult and child mental health outcomes in their trials. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=431007, identifier CRD42023431007.
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Affiliation(s)
- Beril Can
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Victoria Piskun
- School of Psychology, University of Sussex, Falmer, Brighton, United Kingdom
| | - Abby Dunn
- School of Psychology, University of Surrey, Guilford, Surrey, United Kingdom
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105
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Mann O, Edin KJ, Shaefer HL. Understanding the relationship between intergenerational mobility and community violence. Proc Natl Acad Sci U S A 2024; 121:e2309066121. [PMID: 39102541 PMCID: PMC11331060 DOI: 10.1073/pnas.2309066121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/05/2024] [Indexed: 08/07/2024] Open
Abstract
Violence is a key mechanism in the reproduction of community disadvantage. The existing evidence indicates that violence in a community impacts the intergenerational mobility of its residents. The current study explores the possibility of a reverse relationship. This study provisionally tests the hypothesis that depressed intergenerational mobility in a community may also spark subsequent community violence. We deploy a county measure of intergenerational mobility captured during early adulthood for a cohort of youth born between 1980 and 1986 and raised in low-income families [R. Chetty, N. Hendren, Quart. J. Econom. 133, 1163-1228 (2018)]. We model the relationship between county mobility scores and two county-level outcomes: violent crime and homicide. We find that a county's level of intergenerational mobility as measured by the Chetty-Hendren data is a major predictor of its rate of violent crime and homicide in 2008, when the youth in Chetty's mobility cohort were young adults (the same age the mobility measure was captured). In fact, mobility is a significantly stronger and more consistent predictor of community violent crime and homicide rates than more commonly used factors like poverty, inequality, unemployment, and law enforcement presence.
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Affiliation(s)
- Olivia Mann
- Department of Sociology, Wallace Hall, Princeton University, Princeton, NJ08544
| | - Kathryn J. Edin
- Department of Sociology, Wallace Hall, Princeton University, Princeton, NJ08544
| | - H. Luke Shaefer
- Gerald R. Ford School of Public Policy, Joan and Sanford Weill Hall, University of Michigan, Ann Arbor, MI48109
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Usui Y, Ono M, Nibuya R, Kikkawa M, Ito S, Morishita C, Honyashiki M, Tamada Y, Inoue T, Masuya J. Effects of Inappropriate Nurturing Experiences, Depressive Rumination, and Trait Anxiety on Depressive Symptoms. Neuropsychiatr Dis Treat 2024; 20:1571-1581. [PMID: 39156034 PMCID: PMC11330240 DOI: 10.2147/ndt.s469417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024] Open
Abstract
Background Prior research has shown that inappropriate childhood nurturing experiences (low care and high overprotection), trait anxiety, and depressive rumination are risk factors for depression. However, no studies to date have analyzed the overall association between these factors and depressive symptoms. In the present study, we hypothesized that depressive rumination mediates the impacts of inappropriate childhood nurturing experiences on depressive symptoms, and that these mediating effects are moderated by trait anxiety, and tested these hypotheses in adult volunteers. Methods The subjects were adult volunteers who were investigated between April 2017 and April 2018. A self-report questionnaire on demographic data, childhood nurturing experiences, trait anxiety, depressive rumination, and depressive symptoms was distributed to conduct the survey, and written informed consent and valid responses were obtained from 585 subjects. Mediation and moderated-mediation analyses were performed by SPSS 28 and macro PROCESS 4.0 software. This study was approved by the Ethics Committee of Tokyo Medical University. Results Parental care showed a significant negative indirect effect on depressive symptoms via its effect on depressive rumination (p < 0.01), whereas parental overprotection showed the opposite effect (p < 0.01). Furthermore, the mediation effect of depressive rumination on depressive symptoms was increased by trait anxiety (p < 0.05). Conclusion Our present study demonstrated that the main factor affecting depressive symptoms is inappropriate childhood nurturing experiences, which indirectly enhance depression by intensifying depressive rumination, and that depressive rumination and trait anxiety mutually reinforce each other to enhance depressive symptoms. These findings may be useful for the prevention of depressive symptoms. Large-scale prospective studies are needed to confirm the causal associations among these factors in the future.
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Affiliation(s)
- Yunosuke Usui
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Miki Ono
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Rintaro Nibuya
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Masayuki Kikkawa
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Shunichiro Ito
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Chihiro Morishita
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Mina Honyashiki
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yu Tamada
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
- Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
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Becker KD, Wu EG, Westman JG, Boyd MR, Guan K, Lakind D, Chu W, Knudsen KS, Bradley WJ, Park AL, Kenworthy LaMarca T, Lang E, Chorpita BF. The Interrater Reliability of a Coding System for Measuring Mental Health Professionals' Decisions and Actions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-17. [PMID: 39137271 DOI: 10.1080/15374416.2024.2384027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
OBJECTIVE The clinical decisions and actions of evidence-based practice in psychology (EBPP) are largely underspecified and poorly understood, in part due to the lack of measurement methods. We tested the reliability of a behavioral coding system that characterizes a flow of interrelated activities that includes problem detection and prioritization, intervention selection and implementation, and review of intervention integrity and impact. METHOD The context included two publicly funded youth mental health service organizations located in geographically distinct and underresourced communities in the U.S. where service inequities are common. We sampled 84 digitally recorded and transcribed supervision events that included a sample of professionals who were mostly women (93.02%) and BIPOC (86.04%) whose self-reported race/ethnicity matched the youth populations they served. We coded these events for activities (e.g., considering) and their predicate content (i.e., problems or practices) and examined reliability of these codes applied to excerpts (i.e., small contiguous units of dialogue) as well as to complete events. RESULTS Interrater reliability estimates showed that, overall, coders reliably rated the occurrence and extensiveness of activities and content. Excerpt coding was generally more reliable than event coding. However, mathematical aggregation of excerpt coding offered a superior method for estimating event codes reliably, reducing individual subjectivity while providing event level synthesis of activities that are grounded in excerpt level details. CONCLUSIONS The assessment of clinical decisions and actions has the potential to unpack the black box of EBPP, with different methods best suited to different research questions and resource considerations.
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Affiliation(s)
| | - Eleanor G Wu
- Department of Psychology, University of South Carolina
| | | | | | - Karen Guan
- Department of Psychology, University of California
| | | | - Wendy Chu
- Department of Psychology, University of South Carolina
| | | | | | | | | | - Emily Lang
- Department of Psychology, University of California
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108
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Thomsen MK, Andersen M, Greve J. Transgender lives at the population level: Evidence from Danish administrative data. Soc Sci Med 2024; 358:117182. [PMID: 39168067 DOI: 10.1016/j.socscimed.2024.117182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 06/19/2024] [Accepted: 08/02/2024] [Indexed: 08/23/2024]
Abstract
This paper provides the first rigorous account of the diverse characteristics of transgender individuals at the population level, using data from Danish population registers. We observe three transgender subpopulations within the same national setting: all who changed thier legal sex (T-Legal, n = 1,995), all who have been assigned trans-related diagnostic codes (T-ICD, n = 1,594), and those who self-identified as transgender in a representative survey (T-Survey, n = 197, weighted n = 44,958). Results show significant differences in the subpopulations' backgrounds, family, education and labour market characteristics, and healthcare use. These differences extend beyond comparisons with the general population to great variations between each of the transgender subpopulations. Individuals with legal sex changes, and particularly those with trans-related diagnostic codes, face substantial disadvantages across various outcomes. Compared to the general population and the T-Survey subpopulation, the T-Legal subpopulation and the T-ICD subpopulation have significantly higher numbers of psychiatric hospital visits, lower educational attainment, lower annual earnings, and reduced employment rates, also when controlling for background characteristics. Earnings and employment rates remained significantly lower also when controlling for educational attainment. Our results show that the strategy chosen to identify trans individuals in population data has a great impact on the characteristics observed, and that trans individuals captured by surveys do not necessarily represent all transgender individuals, including those who seek to medically or legally transition. Furthermore, our results indicate that high numbers of trans individuals observed in surveys do not necessarily correspond to high demands for gender-affirming treatments or legal sex change. Finally, we show that transgender individuals who seek gender-affirming healthcare constitute a distinct and significantly disadvantaged group, also compared to other trans subpopulations.
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Affiliation(s)
- Morten Kjær Thomsen
- Department of Sociology, Leverhulme Centre for Demographic Science & Worcester College, University of Oxford, UK.
| | - Matvei Andersen
- VIVE - the Danish Center for Social Science Research, 1052, Copenhagen, Denmark
| | - Jane Greve
- VIVE - the Danish Center for Social Science Research, 1052, Copenhagen, Denmark
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109
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Zhang M, Nie Q, Ye W, Wang Y, Yang Z, Teng Z. Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents. J Youth Adolesc 2024:10.1007/s10964-024-02068-6. [PMID: 39133422 DOI: 10.1007/s10964-024-02068-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024]
Abstract
Although previous studies have shown a close relationship between gaming disorder and depressive symptoms, few have measured normal videogame use, symptoms of gaming disorder, and depressive symptoms concurrently. The longitudinal dynamics between these variables remain unclear. This study used two demographic cohorts to examine the longitudinal relationship between gaming and depressive symptoms: children (n = 1513, 46.9% girls, Mage ± SD = 9.63 ± 0.58 years) and adolescents (n = 1757, 48.5% girls, Mage ± SD = 12.55 ± 0.70 years). Random intercept cross-lagged panel models (RI-CLPMs) were employed to distinguish between within- and between-person levels of gaming and depressive symptoms. The RI-CLPM results showed a stable link between symptoms of gaming disorder and depression at the between-person level for both children and adolescents. At the within-person level, among children, depressive symptoms positively predicted subsequent gaming disorder symptoms, but gaming disorder symptoms were not a significant predictor of depressive symptoms at this level. Among adolescents, there was no significant cross-lagged effect between symptoms of gaming disorder and depression at the within-person level. Additionally, there was no significant cross-lagged effect between normal videogame use and depressive symptoms in either cohort. These results highlight the different effects of normal videogame use and gaming disorder symptoms associated with depressive symptoms. The different effects on children and adolescents underscore the importance of considering the different developmental stages in the study of gaming and mental health outcomes.
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Affiliation(s)
- Mengmeng Zhang
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Qian Nie
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Wenting Ye
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yifan Wang
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhiwei Yang
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhaojun Teng
- Research Center of Mental Health Education, Faculty of Psychology, Southwest University, Chongqing, China.
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110
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Tay J, Widger K, Steele R, Stremler R, Pole JD. Examining emotional and behavioural trajectories in siblings of children with life-limiting conditions. BMC Palliat Care 2024; 23:205. [PMID: 39129022 PMCID: PMC11318302 DOI: 10.1186/s12904-024-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Healthy siblings of children with life-limiting conditions often experience emotional and behavioural struggles over the course of the ill child's condition(s). Resources to support these siblings are limited due to a lack of understanding about their needs. Therefore, this study was designed to characterize the emotional and behavioural trajectories among siblings of children with progressive, life-limiting genetic, metabolic, or neurological conditions over a 12-month observation period. METHODS Seventy siblings were recruited from a large-survey based study (Charting the Territory) that examined the bio-psychosocial health outcomes of parents and siblings. Linear mixed effect models were used to assess the association between siblings' emotions and behaviour trajectories and selected demographic variables. Siblings' emotions and behaviour were measured with Child Behaviour Checklist (CBCL). RESULTS Siblings' mean age was 11.2 years at baseline and Internalizing, Externalizing, and Total Behaviour Problems mean scores were within normal ranges across time. However, 7-25% of siblings had scores within the clinical range. Brothers had higher levels of Internalizing Problems than sisters, whereas sisters had higher levels of Externalizing Problems than brothers. When treatment was first sought for the ill child less than a year prior to study participation, siblings had higher levels of Internalizing and Externalizing Problems compared with siblings who participated more than one year after treatment was sought. CONCLUSION Healthy siblings experience emotional and behavioural problems early in the child's disease trajectory. Although these problems improve with time, our findings show that brothers and sisters experience different types of challenges. Therefore, timely support for siblings is important as they navigate through the uncertainties and challenges.
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Affiliation(s)
- Joanne Tay
- Faculty of Nursing, University of Windsor, Room 317, Toldo Health Education Centre, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
| | - Kimberley Widger
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada
- Life Stage Program, ICES, Toronto, Canada
| | - Rose Steele
- School of Nursing, York University, Toronto, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Cancer Research Program, ICES, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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111
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D’Aiello B, Di Vara S, De Rossi P, Vicari S, Menghini D. The effect of a single dose of methylphenidate on attention in children and adolescents with ADHD and comorbid Oppositional Defiant Disorder. PLoS One 2024; 19:e0299449. [PMID: 39133690 PMCID: PMC11318934 DOI: 10.1371/journal.pone.0299449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/10/2024] [Indexed: 08/15/2024] Open
Abstract
The co-occurrence Oppositional Defiant Disorder (ODD) in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has been associated to difficulties in regulating adverse states, elevated functional impairment, deficits in Executive Functions and high risk for psychopathology. Recent studies have shown that ODD is a negative predictor of a positive response to methylphenidate (MPH) treatment for ADHD symptoms in children and adolescents and that patients with a diagnosis of comorbid ADHD and ODD are less likely to respond favorably to pharmacological treatment with MPH. We conducted a naturalistic study to understand the clinical characteristics of drug-naïve children and adolescents with ADHD that influence the response to MPH by measuring the effect on attention. Specifically, we investigated whether a single dose of MPH differently affects the performance of 53 children and adolescents with ADHD with or without ODD comorbidity. In addition, participant characteristics such as symptom severity, functional impairment, and associated behavioral and emotional symptoms at baseline were examined to better understand what aspects affect the response to MPH. We found that a single dose of MPH improved the attention of children and adolescents with ADHD without ODD more than those with comorbid ADHD and ODD, resulting in reduced reaction times. Our findings indicated that children and adolescents with comorbid ADHD and ODD and those with ADHD alone did not exhibit differences in measures of attention prior to taking MPH, nor in demographic variables (age, intelligence quotient, gender), clinical characteristics related to symptom severity, and adaptive behaviors. However, we observed differences between the two groups in certain behavioral aspects, including the Dysregulation Profile and disruptive behaviors. Assessing symptoms in combination with the presence of ADHD can be beneficial in determining which individuals would derive the greatest benefits from treatment.
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Affiliation(s)
- Barbara D’Aiello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Silvia Di Vara
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Pietro De Rossi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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112
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Aykut P, Kahveci G. The effect of conjoint behavioral consultation on achieving communication skills in children with autism spectrum disorder. Int J Dev Neurosci 2024. [PMID: 39129433 DOI: 10.1002/jdn.10368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 07/09/2024] [Accepted: 07/16/2024] [Indexed: 08/13/2024] Open
Abstract
This study, uniquely designed with tact and mand-modeling procedures presented through the Conjoint Behavioral Consultation (CBC) method, aims to evaluate the effects on the communication skills of preschool children with autism spectrum disorder (ASD) and the impact on disruptive behaviors (tantrums) at home. A pilot study with the families of three participants informed the adaptations for the main study, which was implemented with the families of nine participants. The research was conducted using an Embedded Mixed Methods Design, a distinctive approach that allowed for a comprehensive understanding of the outcomes. The primary research design was a single-subject research model with multiple probes across participants' designs, ensuring a thorough and individualized assessment. The study was carried out in both home and clinical settings, involving the participation of special education teachers and families. The findings indicate that the tact and mand-modeling procedures presented through the CBC method significantly improved the children's communication skills and led to substantial reductions in tantrum behaviors. All families indicated that the dependent variables held significant social importance. Significant enhancements were noted in the children's communication skills and social engagements after the intervention. The CBC intervention was determined to be feasible and feasible for families, with no additional expenses accrued. The long-term suitability and usefulness of the product in many environments increased its societal acceptance. This study revealed that the CBC approach had a favorable and reliable effect on academic and behavioral advancement.
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Affiliation(s)
- Pelin Aykut
- Department of Special Education, Faculty of Education, European University of Lefke, Lefka, Cyprus
| | - Gul Kahveci
- Department of Special Education, Faculty of Education, European University of Lefke, Lefka, Cyprus
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113
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Ver Hoeve ES, Psihogios AM, Torres TK, Jacquart J. Supporting a Young Adult with Social Anxiety Disorder and Improving Engagement in Cancer Care: A Case Report. J Adolesc Young Adult Oncol 2024. [PMID: 39133137 DOI: 10.1089/jayao.2024.0030] [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: 08/13/2024] Open
Abstract
Adolescent and young adult (AYA) patients with cancer often demonstrate suboptimal engagement in cancer care due to a host of logistical, developmental, and psychological factors. This clinical case study of a young adult (YA) with cancer highlights the multiple ways in which social anxiety disorder (SAD) impacted a YA's engagement in cancer care. The case study also details the use of an evidence-based treatment for SAD to support behavioral change. Identification and receipt of timely evidence-based psychological intervention for SAD have the potential to improve AYA well-being and enhance cancer care engagement.
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Affiliation(s)
- Elizabeth S Ver Hoeve
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Alexandra M Psihogios
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tara K Torres
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Jolene Jacquart
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
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114
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Klein M, Levy T, Shulman C, Lwow E, Silberg T. Exploring the link between parents' differentiation of self and children's externalizing behavior problems: the mediating role of need-supportive vs. need-frustrating parenting practices. Front Psychol 2024; 15:1387944. [PMID: 39188864 PMCID: PMC11346033 DOI: 10.3389/fpsyg.2024.1387944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/22/2024] [Indexed: 08/28/2024] Open
Abstract
Objective Externalizing behavior problems (EBPs) are common in children, with significant long-term impact on the child and family members. Parents, particularly mothers, of children with EBPs often experience heightened emotional distress. One crucial factor affecting parents' ability to manage this distress is their level of differentiation-of-self (DOS). Differentiated parents are more likely to engage in practices that meet their child's psychological needs, thus supporting the self-determination theory principles vital for a child's well-being. This study examined the impact of parental DOS on parenting practices and subsequently on the child's EBPs, exploring possible differences between mothers and fathers. Methods Thirty-two mother-father dyads with children aged 6-14, diagnosed with EBPs participated. Parents completed the Differentiation of Self Inventory-Short Form, the Revised Parents as a Social Context Questionnaire, and the Strengths and Difficulties Questionnaire to assess parental DOS, practices, and child's EBPs, respectively. Adjusted parallel mediation models examined the mediating role of parental practices in the relationship between parental DOS and a child's EBPs. Results While no direct link between parental DOS and child's symptoms was found, a complete mediation model indicated need-frustrating practices mediating between parental DOS and a child's EBPs, for both mothers and fathers. Additionally, fathers' need-supportive practices, but not mothers', were negatively associated with the child's symptoms. Discussion These findings highlight the interaction between parental traits, need-frustrating practices, and a child's psychopathology. Notably, fathers' supportive behaviors emerged as potential protective factors against child's EBPs, suggesting promising directions for future research and interventions targeting fathers.
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Affiliation(s)
- Michal Klein
- School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
- Behavior Regulation Service, Geha Mental Health Center, Petah Tikva, Israel
- Department of Social Work, Tel-Hai Academic College, Upper Galilee, Israel
| | - Tomer Levy
- Behavior Regulation Service, Geha Mental Health Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Cory Shulman
- School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Etan Lwow
- Ayeka-The Developmental Bond, Development and Parenting Center, Kfar Saba, Israel
| | - Tamar Silberg
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
- Department of Pediatric Rehabilitation, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
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115
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Davies J, O'Connor M, Halkett GKB, Kelada L, Gottardo NG. "I Don't Get to Play With My Mum Anymore": Experiences of Siblings Aged 8-12 of Children With Cancer: A Qualitative Study. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2024:27527530241267324. [PMID: 39129241 DOI: 10.1177/27527530241267324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Background: Siblings of children with cancer have been shown to experience disruption in multiple domains including family, school, and friendships. Existing literature on siblings' experiences focuses on older children or on a broad range of ages. Aim: To explore the experience of siblings aged 8-12 years when their brother or sister is diagnosed with cancer. Method: A qualitative design incorporating phenomenology as the theoretical framework was used. Participants were recruited from across Australia via notices on social media sites and by the distribution of flyers. We used thematic analysis to analyze the data. Data were collected via semistructured interviews conducted either in person or online. Findings: A total of 13 siblings (7 boys and 6 girls) aged between 8 and 12 years (M = 9.8, SD = 1.6) were interviewed. Seven main themes were identified. These were "It was really hard": Reactions to the cancer diagnosis; "I'm really angry": Emotional and Physical Responses to siblings' treatment; "I pretend teddy is real": Play as an outlet; "It was very lonely": Missing their siblings; "I missed out on a lot of fun": Disruption of activities: School, sports, playdates, and parties; Change and Transition and "Making a difficult situation worse": COVID-19 Pandemic. Discussion: Findings extend the current understanding showing that younger siblings' developmental and cognitive skills impact their experiences of childhood cancer. Younger siblings outlined the many losses they experienced which demonstrated a need for a comprehensive and tailored program to support young siblings aged under 12 of children with cancer.
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Affiliation(s)
- Jenny Davies
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
| | - Moira O'Connor
- Faculty of Health Sciences, School of Population Health, Curtin University, Perth, WA, Australia
- School of Population Health, Curtin Health Innovation Research Institute/enAble Institute for Health Science, Curtin University, Perth, WA, Australia
| | - Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
| | - Lauren Kelada
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Nicholas G Gottardo
- Department of Pediatric and Adolescent Oncology and Hematology, Perth Children's Hospital, Nedlands, Western Australia, Australia
- Brain Tumor Research Program, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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116
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Ai W, Cunningham WA, Lai MC. Camouflaging, internalized stigma, and mental health in the general population. Int J Soc Psychiatry 2024:207640241260020. [PMID: 39129337 DOI: 10.1177/00207640241260020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
BACKGROUND Camouflaging, the strategies that some autistic people use to hide their differences, has been hypothesized to trigger mental health ramifications. Camouflaging might reflect ubiquitous impression management experiences that are not unique to autistic people and similarly impact the mental health of non-autistic people. AIMS We first examined whether individuals in the general population camouflage and manage impressions while experiencing mental health repercussions, and how gender and neurodivergent traits modified these associations. We then assessed how camouflaging and impression management arose from internalized stigma, and their inter-relationships in shaping mental health outcomes. METHODS Data were collected from 972 adults from a representative U.S. general population sample, with measures pertaining to camouflaging, impression management, mental health, internalized stigma, and neurodivergent traits. Multivariate hierarchical regression and moderated mediation analyses were used to address the two research aims. RESULTS Both camouflaging and self-presentation (a key component of impression management) were associated with mental health presentations in the general population, which overlapped with those previously reported in autistic people. These associations were more pronounced in women compared with men and were of different directions for individuals with higher autistic traits versus higher ADHD traits. Internalized stigma might be a key stressor that could elicit camouflaging and impression management through social anxiety, which in turn might lead to adverse mental health outcomes. CONCLUSIONS These findings advance the conceptual clarity and clinical relevance of camouflaging and impression management across social and neurodiverse groups in the general population. The ramifications of camouflaging and impression management underscore the need to alleviate internalized stigma for better mental health across human groups.
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Affiliation(s)
- Wei Ai
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Meng-Chuan Lai
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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117
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Lee J, Lee SY. Primary and Secondary Callous-Unemotional Childhood Variants in a Korean Community Sample. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01747-6. [PMID: 39127968 DOI: 10.1007/s10578-024-01747-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2024] [Indexed: 08/12/2024]
Abstract
Despite the growing support for the multiple developmental pathways to phenotypic callous-unemotional (CU) traits (i.e., primary, and secondary CU variants), there remains limited research on childhood manifestations of CU variants in non-Western, community samples. Using a latent profile analysis with data sourced from the longitudinal, nationwide Korean sample (N = 1597, 48.7% girls), we discerned heterogeneous groups of children, based on externalizing problems, CU traits, and emotional reactivity level. The optimal five-profile solution identified distinct subgroups: low-risk, primary CU (characterized by low emotional reactivity and externalizing problem), reactive (low CU/moderate emotion reactivity and externalizing problem), and two secondary CU groups (i.e., secondary-high CU and secondary-moderate CU; both high in emotional reactivity and externalizing problems). The two secondary CU variants demonstrated differences from the primary CU variants, in that both are high in preschool externalizing problems (age 6) and school-age conduct problems (age 11). However, the secondary-moderate CU group displayed greater levels of anxiety at age 11 compared to secondary-high CU, indicating divergent developmental trajectories of secondary CU variants. These findings expand our understanding of CU variants among Korean preschoolers and highlight the role of emotional reactivity in distinguishing such subtypes and identifying their developmental outcomes across time.
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Affiliation(s)
- Jakyung Lee
- Department of Psychology, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, Republic of Korea
| | - Seung-Yeon Lee
- Department of Psychology, Ewha Womans University, 52, Ewhayeodae-Gil, Seodaemun-Gu, Seoul, Republic of Korea.
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118
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Jones M, Bosacki S, Talwar V. Interrelations Among Adolescents' Family Connections, Solitude Preferences, Theory of Mind and Perceptions of Academic and Work Competence. J Genet Psychol 2024:1-17. [PMID: 39126355 DOI: 10.1080/00221325.2024.2386016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 06/28/2024] [Indexed: 08/12/2024]
Abstract
This study explored the links among family connections, solitude preferences, perceptions of work (academic and job) competence, and Theory of Mind (ToM) in 73 Canadian adolescents aged 11-18 (M age = 13.1). Previous studies show significant connections among these factors, although little is known about how such associations may relate to one another, especially the role of young people's perceptions. To address these gaps in the literature, this study focused on adolescents' experiences and perceptions of their family relationships, solitude preferences, and competence in the school context and workplace. Participants completed a series of self-report measures, advanced ToM tasks and written explanation for perceived family emotional connections. Results revealed that adolescents with more positive family connections reported higher levels of self-perceived academic and job competence, embraced solitude positively, yet felt less desire to be alone. Girls showed a higher affinity for solitude than boys, and the presence of more siblings reduced the desire for solitude. Those youth who were proficient in ToM skills reported positive family connections and high levels of academic competence. Findings hold implications for future research and education in adolescent's social cognition and social and academic outcomes.
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Affiliation(s)
- Megan Jones
- Department of Psychology, University of Exeter, Exeter, UK
| | - Sandra Bosacki
- Department of Educational Studies, Brock University, St. Catharines, Canada
| | - Victoria Talwar
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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119
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Rhodes SM, McDougal E, Efthymiou C, Stewart TM, Booth JN. Co-production of the 'EPIC' multidimensional tool-kit to support neurodivergent children and young people at home and school: a feasibility and pilot study. Pilot Feasibility Stud 2024; 10:108. [PMID: 39127770 DOI: 10.1186/s40814-024-01530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/15/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Interventions focused on cognitive function in neurodivergent children typically focus on single functions, e.g. working memory training. They are often focused on 'deficit' models and lack an emphasis on understanding areas of individual strengths and difficulties as a prerequisite to appropriate support. The multidimensional nature and phenotypic variability of cognitive profiles in these children indicate a need for a multicomponent-tailored intervention programme focused on understanding and supporting an individual child's cognitive functioning. AIMS The 'EPIC' intervention (Edinburgh Psychoeducation Intervention for Children and Young People) is focused on improving cognition, learning and behaviour in neurodivergent children such as those with attention deficit hyperactivity disorder (ADHD) or who are autistic. Building on our previous co-production work, this study aimed to use a participatory methods approach to develop EPIC practices and materials in relation to our key principles which include psychoeducation, multicomponent, individualised approach, strengths and difficulties profiling and pairing of a child's individual strengths and difficulties with internal and external strategies. We also set out to assess the feasibility and acceptability of EPIC, and pilot this novel tool-kit intervention with neurodivergent children and their parents and teachers. METHODS The intervention practices, materials and strategies of EPIC were co-produced with neurodivergent children, their parents, teachers and clinicians taking a strengths and difficulties approach. Identification of psychoeducation activities and strategy practices (e.g. mind-maps, chunking), testing of feasibility and collection of pilot data were conducted over a bi-weekly 8-week programme. Eleven neurodivergent children aged 7 to 12 completed the 16-session individualised programme. Acceptability and feasibility were ascertained via qualitative reports elicited within child and teacher interviews and child ratings of enjoyment. Pilot evaluation data was collected pre- and post-intervention participation, and across cognitive assessments (CANTAB, BRIEF), educational attainment (WIAT) and parent and teacher questionnaires measuring clinical symptoms and behaviour (Conners, AQ, SDQ, self-perception). Data was compared with a matched neurodivergent treatment-as-usual control group (N = 9). RESULTS The co-produced EPIC intervention was both feasible to deliver and acceptable to children, parents and their teachers. Pilot data identified that the 8-week intervention improved cognition (short-term and working memory) and literacy (receptive vocabulary, oral word fluency, listening comprehension). Improvements in the intervention group were also found for parent-reported child behavioural difficulties and aggression, and teacher-reported scholastic competence. Effect sizes generated (Cohen's d) ranged from 0.65 to 2.83. Parents reported continuing to use EPIC strategies when interviewed over a year after participating in the programme. CONCLUSION The current study met our objectives fully. 'EPIC' (Edinburgh Psychoeducation Intervention for Children and Young People) is feasible in home and school contexts and improves a range of aspects of cognition, learning and behaviour in neurodivergent children. Our findings show EPIC is suitable to be assessed within a full-scale trial.
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Affiliation(s)
- Sinead M Rhodes
- Department of Child Life and Health, University of Edinburgh, Royal Hospital for Children and Young People, Little France, Edinburgh, EH16 4TJ, Scotland.
| | - Emily McDougal
- Evidence Based Practice Unit, Anna Freud and UCL, London, UK
| | - Christina Efthymiou
- Department of Child Life and Health, University of Edinburgh, Royal Hospital for Children and Young People, Little France, Edinburgh, EH16 4TJ, Scotland
| | - Tracy M Stewart
- Department of Child Life and Health, University of Edinburgh, Royal Hospital for Children and Young People, Little France, Edinburgh, EH16 4TJ, Scotland
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, EH8 8AQ, Scotland
| | - Josie N Booth
- Department of Child Life and Health, University of Edinburgh, Royal Hospital for Children and Young People, Little France, Edinburgh, EH16 4TJ, Scotland
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120
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Suzuki A, Tani Y, Isumi A, Ogawa T, Moriyama K, Fujiwara T. Frequent toothbrushing boosts resilience among children in poverty: results from a population-based longitudinal study. BMC Oral Health 2024; 24:927. [PMID: 39127655 DOI: 10.1186/s12903-024-04686-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Poverty negatively impacts beneficial aspects of mental development, such as resilience. Toothbrushing, an oral health behavior, has the potential to protect children's resilience through its anti-inflammatory and self-management effects and may be more effective for children, especially children in poverty. This study investigated whether toothbrushing boosts resilience among children, especially children under poverty, and modifies the association between poverty and resilience using a longitudinal population sample of school children. METHODS Data from the Adachi Child Health Impact of Living Difficulty (A-CHILD Study) were analyzed. A baseline study was conducted in 2015 in which the children were in first grade and followed through fourth grade (N = 3459, response rate: 80%, follow-up rate: 82%). Poverty was assessed by material deprivation (life-related deprivation and child-related deprivation) and annual household income at baseline. Children's toothbrushing frequency was assessed at baseline and classified into less than twice a day or twice or more a day. Children's resilience was assessed at baseline and follow-up using the Children's Resilient Coping Scale (range 0-100). RESULTS Children who brushed their teeth twice or more a day in first grade had 3.50 points greater resilience scores in fourth grade than those who brushed their teeth less than twice a day in first grade. After adjusting for confounders, including resilience in first grade, among underpoverty children, those who brushed their teeth twice or more a day in first grade had higher resilience scores [2.66 (95% CI = 0.53, 4.79)] than those who brushed their teeth less than twice a day. Among nonpoverished children, toothbrushing frequency in first grade did not significantly correlate with resilience in fourth grade. CONCLUSIONS The beneficial effect of toothbrushing twice or more a day on resilience was more significant among children in poverty than among those without poverty in elementary school in Japan. Health policy focused on frequent toothbrushing may contribute to boosting resilience among children living in poverty.
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Affiliation(s)
- Ayako Suzuki
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukako Tani
- Department of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Aya Isumi
- Department of Health Policy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuya Ogawa
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiji Moriyama
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
- Department of International Health, Johns Hopkins University, Baltimore, USA.
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121
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Raisamo S, Pasanen T, Hilli P, Ståhl T. Predictors of non-completion of upper secondary education in Finland based on register data. Scand J Public Health 2024:14034948241257564. [PMID: 39126218 DOI: 10.1177/14034948241257564] [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: 08/12/2024]
Abstract
AIMS School non-completion is a public health and educational concern in most countries. This study sought to identify the strongest predictors of the non-completion of upper secondary education based on register data. METHODS A cross-validated elastic net regression analysis was used to predict school non-completion in a population of 2696 students in the city of Jyväskylä, Finland. The register data included data from the primary social and healthcare register and the educational register. RESULTS The non-completion rate was 13.1% (13.4% for males, 12.8% for females). The non-completion of upper secondary education was best predicted by the following seven features (ordered from strongest to weakest): unauthorized absences (odds ratio (OR) = 2.27), out-of-home placement (OR = 2.23), average grade when leaving lower secondary education (OR = 0.73), an anxiety/depression diagnosis (OR = 1.43), visits to child guidance and family counselling centres (OR = 1.17), family poverty (OR = 1.11) and the grade point average in the 5th Grade (OR = 0.95). CONCLUSIONS Register data can be utilized to find the strongest predictors of school non-completion. Predictors support multidisciplinary actions preventing non-completion by providing both early signals to target actions more specifically and indicators for monitoring the impact of preventative actions.
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Affiliation(s)
- Susanna Raisamo
- Knowledge base for health and welfare management/Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tytti Pasanen
- Knowledge base for health and welfare management/Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Petri Hilli
- QSA Quantitative Solvency Analysts Ltd, Helsinki, Finland
| | - Timo Ståhl
- Knowledge base for health and welfare management/Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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122
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Hightower-Henson SR, Wymbs BT. Testing Parenting Self-Esteem as an Indicator of Mothers and Fathers Who Are at Risk for Aversive Responses to Disruptive Child Behavior. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01231-8. [PMID: 39120803 DOI: 10.1007/s10802-024-01231-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2024] [Indexed: 08/10/2024]
Abstract
Extensive literature demonstrates that parents of children with disruptive behaviors consistently report lower parenting self-esteem (i.e., satisfaction and efficacy) compared to parents of children without disruptive behaviors. However, little is known about whether having low parenting self-esteem results in negative parenting behavior while managing disruptive child behavior, and whether associations vary in strength depending on the clinical significance of the child's disruptive behavior. The current study examines 90 parent couples who were randomly assigned to interact with a 9- to 12-year-old confederate exhibiting either typical or disruptive behaviors. Parenting self-esteem moderated the association between disruptive child behavior and positive parenting behavior, such that mothers with low efficacy had a stronger positive association between disruptive child behavior and positive parenting behaviors. However, fathers with low efficacy had a stronger negative association between disruptive behaviors and positive parenting behavior. Exploratory analyses yielded mixed results. Specifically, mothers with low self-esteem and a child with ADHD had a stronger negative association between disruptive child behaviors and positive parenting compared to mothers who interacted with a confederate or did not have a child with ADHD. Results from the current study extend findings regarding the influence of parenting self-esteem on the association of disruptive child behavior and parenting behaviors, as moderating effects of parenting self-esteem was demonstrated for both mothers and fathers within the study.
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Affiliation(s)
| | - Brian T Wymbs
- Department of Psychology, Ohio University, Athens, OH, USA
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123
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Palmer L, Busuttil W, Simms A, Fear NT, Stevelink SAM. Holding and rupture: Describing post-traumatic stress among former UK Army and Royal Marine personnel deployed to Iraq and Afghanistan. PLoS One 2024; 19:e0308101. [PMID: 39121169 PMCID: PMC11315309 DOI: 10.1371/journal.pone.0308101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/13/2024] [Indexed: 08/11/2024] Open
Abstract
Former UK military personnel who were previously deployed to Iraq and Afghanistan in combat roles have exhibited elevated levels of Post-Traumatic Stress Disorder (PTSD) compared to other groups. The present qualitative analyses used semi-structured interviews and a framework analysis to compare the experiences of symptomatic (N=10) and asymptomatic (N=7) former Army and Royal Marine personnel who were exposed to combat. Participants were drawn from a large UK military health and wellbeing cohort study and were sampled based upon probable PTSD status using scores from the PTSD Checklist-Civilian Version (PCL-C). All symptomatic participants attributed the development of post-traumatic stress to deployment events, with one additionally ascribing symptoms to childhood events. Among the participants, post-traumatic stress was temporarily buffered, and held at bay, by the holding function of various military structures, including the military collective; cultural and ethical frameworks that helped to organise traumatic experiences; an operational necessity for psychological compartmentalisation and even the distraction of deployment itself. Leaving the military appeared to elicit a global rupture of these supports. As a result, the military-to-civilian transition led to an intensification of post-traumatic stress, including deployment-related memories, among the symptomatic participants. In contrast, asymptomatic participants tended to report continuity of their holding structures across the lifespan, especially across the military-to-civilian transition. The onset and maintenance of post-traumatic stress may thus be explained by an interplay between the capacity of holding structures and the magnitude of lifetime rupture. Overall, findings might provide an explanation for the widening discrepancies between those with enduring post-traumatic stress and those without and further research is required to determine the fit of our findings for other groups and contexts. This approach further illustrates the need to situate individual experiences of post-traumatic stress in wider structural, ecological, cultural and ethical contexts.
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Affiliation(s)
- Laura Palmer
- King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Walter Busuttil
- King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
| | - Amos Simms
- Academic Department of Military Mental Health, King’s College London, London, United Kingdom
| | - Nicola T. Fear
- King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
- Academic Department of Military Mental Health, King’s College London, London, United Kingdom
| | - Sharon A. M. Stevelink
- Department of Psychological Medicine, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, United Kingdom
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124
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Katz CC, Okpych N, Wall E, Shelton J, Courtney M. Characteristics of Transition-Age Youth Engaging in Suicidal Behavior. J Adolesc Health 2024:S1054-139X(24)00286-6. [PMID: 39127928 DOI: 10.1016/j.jadohealth.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE Suicide rates are markedly high among children with foster care involvement. Transition-age youth (TAY) who age-out of the foster care system are at particularly high risk. METHODS Analyzing data from the California Youth Transitions to Adulthood Study (n=727), this paper explores the descriptive characteristics of TAY who engage in suicidal behavior with the goals of better identifying, understanding, and supporting those at risk. We report rates of suicidal ideation and suicide attempt at four interview waves (ages 17, 19, 21, 23) and examine differences in rates by sociodemographic characteristics, past maltreatment, and behavioral health disorders. RESULTS At age 17, 42% of California Youth Transitions to Adulthood Study participants had thought of committing suicide and 24% had attempted suicide. Across ages, sexual minority youth reported significantly higher rates of suicidal ideation and behavior than their heterosexual peers. We also found that youth with (1) maltreatment experiences (both before and during foster care); (2) major depressive disorder, anxiety disorder or post-traumatic stress disorder; and (3) alcohol/substance abuse disorders were significantly more likely than their peers without these characteristics/diagnoses to engage in suicidal behavior at certain ages. Youth with comorbid psychiatric and substance use disorders were consistently at elevated risk. DISCUSSION Routine screening for suicidal behavior among TAY is important for child welfare service providers to consider. Youth at risk may benefit from more consistent assessment, mental health care, and targeted mental health intervention. Future research is needed to shed light on mechanisms linking certain sociodemographic, experiential, and behavioral health characteristics with suicidal behavior in TAY.
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Affiliation(s)
- Colleen C Katz
- Hunter College, City University of New York, New York, New York.
| | - Nathanael Okpych
- School of Social Work, The University of Connecticut, Hartford, Connecticut
| | - Eden Wall
- Hunter College, City University of New York, New York, New York
| | - Jama Shelton
- Hunter College, City University of New York, New York, New York
| | - Mark Courtney
- School of Social Welfare, University of California, Berkeley, California
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125
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Kerbage H, Elbejjani M, Bazzi O, El-Hage W, BouKhalil R, Corruble E, Purper-Ouakil D. 'We are all children of war': a qualitative inquiry into parenting following adolescents' recent traumatic exposure in a multiple crisis setting in Beirut, Lebanon. Eur J Psychotraumatol 2024; 15:2382650. [PMID: 39113651 PMCID: PMC11312994 DOI: 10.1080/20008066.2024.2382650] [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: 03/06/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 08/11/2024] Open
Abstract
Background: Strong familial bonds are crucial to building resilience among youth exposed to traumatic events in socially adverse environments. Exploring parental experiences in the aftermath of adolescents' traumatic exposure in these settings would help tailor early interventions.Objective: We qualitatively explored experiences and perceived needs among parents of teenagers aged 11-16 years who were exposed in the last three months to a potentially traumatic event in Beirut, Lebanon.Method: We purposively sampled 28 parents of 24 adolescents meeting the inclusion criteria. Semi-structured interviews were conducted, and thematic analysis was applied combined with a grounded theory approach.Results: The most frequent traumatic event was direct exposure to the violent clashes that happened in Beirut on 14 October 2021. Parents identified that the recent event exacerbated pre-existing mental health difficulties caused by cumulative stress. They were reminded of their own war experiences and tended to reject the 'sick role' associated with trauma. A majority of participants viewed resilience as a fixed trait characteristic of the Lebanese and avoided communication with their children about traumatic memories, while a significant minority criticised resilience as a myth that added pressure on them and had more open communication about trauma. Parenting styles oscillated between controlling behaviours, warmth, and avoidance, which impacted the family dynamic. Despite adversity, most parents tried to cope through social connectedness, humour, and living day by day.Conclusions: Our findings hold implications for contextual adaptations of early posttraumatic interventions aimed at strengthening family support, such as addressing parental mental health; increasing awareness among first-line responders on parents' potential representations of trauma and resilience; addressing the issue of controlling parenting; and including a component in psychoeducation on traumatic stress that validates the impact of daily stressors on mental health while avoiding direct labelling. Further research is needed to validate the impact of these domains.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP), Paris-Saclay University, Paris, France
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ola Bazzi
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Wissam El-Hage
- CHRU de Tours, Regional Trauma Center CRP-CVL, Tours, France
- UMR 1253, iBraiN, University of Tours, INSERM, Tours, France
| | - Rami BouKhalil
- Saint-Joseph University; Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Emmanuelle Corruble
- CESP, MOODS Team, INSERM U1018, School of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Diane Purper-Ouakil
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP), Paris-Saclay University, Paris, France
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126
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Siciliano RE, Anderson AS, Gruhn MA, Henry LM, Vreeland AJ, Watson KH, Ciriegio AE, Liu Q, Ebert J, Kuhn T, Cole DA, Compas BE. Momentary autonomic engagement during parent-adolescent conflict: Coping as a moderator of associations with emotions. Psychophysiology 2024:e14666. [PMID: 39118277 DOI: 10.1111/psyp.14666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024]
Abstract
Regulatory efforts are hypothesized to affect associations between emotions and physiology (i.e., concordance) to facilitate adaptive functioning. Assessing the role of coping on physiological-emotional concordance during ecologically relevant scenarios can elucidate whether concordance can serve as a biomarker of risk or resilience. The present study assessed self-reported coping as a moderator of minute-to-minute associations between autonomic nervous system activity and emotions (i.e., physiological-emotional concordance) in caregivers (N = 97) and adolescents (N = 97; ages 10-15) during a dyadic conflict task. Models included physiological variables (sympathetic, skin conductance level [SCL]; and parasympathetic, respiratory sinus arrhythmia [RSA]) and their interaction (SCL × RSA) as predictors of emotions, with coping variables as moderators. Caregivers' use of primary control coping (e.g., problem solving and emotional expression) and secondary control coping (e.g., cognitive reappraisal and acceptance) use in response to family stress predicted more positive emotional experiences during the laboratory conflict task. Adolescents' use of secondary control coping moderated the SCL-emotion association, such that increases in momentary SCL were associated with more positive emotion ratings for youth reporting higher secondary control coping. For youth who report more adaptive trait-level coping skills, momentary changes in SCL may reflect active engagement and attentiveness to facilitate more positive emotional experiences. Findings advance our understanding of the interrelationships between physiological responses and psychological experiences during relevant, interactive scenarios. Autonomic responses are differentially related to affective states depending on the coping strategies that adolescents employ, suggesting that concordance may be associated with intervention targets (i.e., coping skills).
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Affiliation(s)
- Rachel E Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allegra S Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Meredith A Gruhn
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Lauren M Henry
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allison J Vreeland
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kelly H Watson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Abagail E Ciriegio
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Qimin Liu
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Jon Ebert
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tarah Kuhn
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David A Cole
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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127
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Hart ER, Sperber JF, Troller-Renfree SV, Ortells-Faci P, Halpern-Meekin S, Sandre A, Noble KG. Mothers with low incomes view both individual and structural interventions as potentially helpful for supporting early child development. Sci Rep 2024; 14:18374. [PMID: 39112497 PMCID: PMC11306557 DOI: 10.1038/s41598-024-68762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/26/2024] [Indexed: 08/10/2024] Open
Abstract
Many developmental psychologists aspire to conduct research that informs interventions and policies to prevent income-related disparities in child development. Among growing researcher discussion about the value of interventions that target "structural" and resource-related correlates of income inequality and child development (e.g., housing, food, material goods, cash), rather than individual, person-centered correlates (e.g., parenting behaviors), the perspectives of mothers with low incomes may provide important context. 281 mothers with young children and low incomes rated various structural and individual interventions, framed as having minimal costs and entry barriers, for their perceived helpfulness. Analyses were pre-registered. Overall, mothers rated all interventions very highly, though they rated structural interventions as slightly more helpful than individual interventions. Mothers rated interventions they used in the past as less helpful than those they hadn't previously used. An exploratory qualitative analysis revealed mothers' desires for supports in other intervention domains beyond those addressed in our survey. Together, mothers' responses indicated that they did not see individual interventions as inherently unhelpful due to a focus on individual states, knowledge, and skills. Implications for developmental psychology and intervention science are discussed.
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Affiliation(s)
- Emma R Hart
- Teachers College, Columbia University, 525 W 120thSt., Box 54N, New York, NY, 10027, USA.
| | - Jessica F Sperber
- Teachers College, Columbia University, 525 W 120thSt., Box 54N, New York, NY, 10027, USA
| | | | | | | | - Aislinn Sandre
- Teachers College, Columbia University, 525 W 120thSt., Box 54N, New York, NY, 10027, USA
| | - Kimberly G Noble
- Teachers College, Columbia University, 525 W 120thSt., Box 54N, New York, NY, 10027, USA.
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128
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Luczejko AA, Werkmann NL, Hagelweide K, Stark R, Weigelt S, Christiansen H, Kieser M, Otto K, Reck C, Steinmayr R, Wirthwein L, Zietlow AL, Schwenck C. Transgenerational transmission of psychopathology: when are adaptive emotion regulation strategies protective in children? Child Adolesc Psychiatry Ment Health 2024; 18:96. [PMID: 39113085 PMCID: PMC11308581 DOI: 10.1186/s13034-024-00783-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER. METHODS Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4-16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires. RESULTS Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low. CONCLUSIONS The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms.
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Affiliation(s)
- Arleta A Luczejko
- Department of Clinical Child and Adolescent Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str. 10, 35394, Giessen, Giessen, Germany
| | - Naomi Leona Werkmann
- Department of Clinical Child and Adolescent Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str. 10, 35394, Giessen, Giessen, Germany.
| | - K Hagelweide
- Department of Rehabilitation Sciences, Technical University Dortmund, Dortmund, Germany
| | - R Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - S Weigelt
- Department of Rehabilitation Sciences, Technical University Dortmund, Dortmund, Germany
| | - H Christiansen
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - M Kieser
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - K Otto
- Department of Work and Organizational Psychology, Philipps-University Marburg, Marburg, Germany
| | - C Reck
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - R Steinmayr
- Department of Psychology, Technical University Dortmund, Dortmund, Germany
| | - L Wirthwein
- Department of Psychology, Technical University Dortmund, Dortmund, Germany
| | - A-L Zietlow
- Clinical Child and Adolescent Psychology, Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - C Schwenck
- Department of Clinical Child and Adolescent Psychology, Justus Liebig University Giessen, Otto-Behaghel-Str. 10, 35394, Giessen, Giessen, Germany
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129
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Blackburn MR, Hogg RC. #ForYou? the impact of pro-ana TikTok content on body image dissatisfaction and internalisation of societal beauty standards. PLoS One 2024; 19:e0307597. [PMID: 39110711 PMCID: PMC11305550 DOI: 10.1371/journal.pone.0307597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Videos glamourising disordered eating practices and body image concerns readily circulate on TikTok. Minimal empirical research has investigated the impact of TikTok content on body image and eating behaviour. The present study aimed to fill this gap in current research by examining the influence of pro-anorexia TikTok content on young women's body image and degree of internalisation of beauty standards, whilst also exploring the impact of daily time spent on TikTok and the development of disordered eating behaviours. An experimental and cross-sectional design was used to explore body image and internalisation of beauty standards in relation to pro-anorexia TikTok content. Time spent on TikTok was examined in relation to the risk of developing orthorexia nervosa. A sample of 273 female-identifying persons aged 18-28 years were exposed to either pro-anorexia or neutral TikTok content. Pre- and post-test measures of body image and internalisation of beauty standards were obtained. Participants were divided into four groups based on average daily time spent on TikTok. Women exposed to pro-anorexia content displayed the greatest decrease in body image satisfaction and an increase in internalisation of societal beauty standards. Women exposed to neutral content also reported a decrease in body image satisfaction. Participants categorised as high and extreme daily TikTok users reported greater average disordered eating behaviour on the EAT-26 than participants with low and moderate use, however this finding was not statistically significant in relation to orthorexic behaviours. This research has implications for the mental health of young female TikTok users, with exposure to pro-anorexia content having immediate consequences for internalisation and body image dissatisfaction, potentially increasing one's risk of developing disordered eating beliefs and behaviours.
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Affiliation(s)
- Madison R. Blackburn
- Faculty of Business, School of Psychology, Justice and Behavioural Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Rachel C. Hogg
- Faculty of Business, School of Psychology, Justice and Behavioural Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
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130
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Fjermestad KW, Wallin MH, Naujokat F, McLeod BD, Silverman WK, Öst LG, Lerner MD, Heiervang ER, Wergeland GJ. Group cohesion and alliance predict cognitive-behavioral group treatment outcomes for youth with anxiety disorders. Cogn Behav Ther 2024:1-19. [PMID: 39105346 DOI: 10.1080/16506073.2024.2385906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 07/24/2024] [Indexed: 08/07/2024]
Abstract
Knowledge about how to enhance group cognitive behavioral therapy (GCBT) outcomes is needed. In a randomized controlled effectiveness trial, we examined group cohesion (the bond between group members) and the alliance (the client-clinician bond) as predictors of GCBT outcomes. The sample was 88 youth (M age 11.7 years, SD = 2.1; 54.5% girls; 90.7% White) with anxiety disorders. Observers rated group cohesion and alliance in 32 sessions from 16 groups. We examined early group cohesion and alliance (r = .50, p < .001) and group cohesion and alliance change from early to late in treatment in relation to outcomes using generalized estimation equations accounting for nesting within groups (ICCs .31 to .55). The outcomes were diagnostic recovery, clinical severity, and parent- and youth-reported anxiety symptoms, each at post-treatment, 12-months, and 4-years follow-up. There were more significant associations with 4-years follow-up than earlier outcomes. Clinical severity and parent-reported anxiety symptoms were more frequently predicted than diagnostic recovery. Clinician- and parent-reported outcomes were far more frequently significantly predicted by cohesion and alliance than youth-rated outcomes. We conclude that group cohesion and alliance are related but distinct variables, both associated with some GCBT outcomes for as long as 4 years after treatment.
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Affiliation(s)
| | - Malin H Wallin
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Wendy K Silverman
- Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Lars-Göran Öst
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Einar R Heiervang
- Tynset Child and Adolescent Mental Health Clinic, Innlandet Hospital Trust, Lillehammer, Norway
| | - Gro Janne Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
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131
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Mueller ME, Graz MB, Truttmann AC, Schneider J, Duerden EG. Neonatal amygdala volumes, procedural pain and the association with social-emotional development in children born very preterm. Brain Struct Funct 2024:10.1007/s00429-024-02845-w. [PMID: 39103553 DOI: 10.1007/s00429-024-02845-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/19/2024] [Indexed: 08/07/2024]
Abstract
Very preterm birth (< 32 weeks' gestational age) is associated with later social and emotional impairments, which may result from enhanced vulnerability of the limbic system during this period of heightened vulnerability. Evidence suggests that early procedural pain may be a key moderator of early brain networks. In a prospective cohort study, neonates born very preterm (< 30 weeks' gestation) underwent MRI scanning at term-equivalent age (TEA) and clinical data were collected (mechanical ventilation, analgesics, sedatives). Procedural pain was operationalized as the number of skin breaking procedures. Amygdala volumes were automatically extracted. The Strengths and Difficulties questionnaire was used to assess social-emotional outcomes at 5 years of age (mean age 67.5 months). General linear models were employed to examine the association between neonatal amygdala volumes and social-emotional outcomes and the timing and amount of procedural pain exposure (early within the first weeks of life to TEA) as a moderator, adjusting for biological sex, gestational age, 5-year assessment age, days of mechanical ventilation and total cerebral volumes. A total of 42 preterm infants participated. Right amygdala volumes at TEA were associated with prosocial behaviour at age 5 (B = -0.010, p = 0.005). Procedural pain was found to moderate the relationship between right amygdala volumes in the neonatal period and conduct problems at 5 years, such that early skin breaking procedures experienced within the first few weeks of life strengthened the association between right amygdala volumes and conduct problems (B = 0.005, p = 0.047). Late skin breaking procedures, experienced near TEA, also strengthened the association between right amygdala volumes and conduct problems (B = 0.004, p = 0.048).
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Affiliation(s)
- Megan E Mueller
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Myriam Bickle Graz
- Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center, University of Lausanne, Lausanne, Switzerland
| | - Anita C Truttmann
- Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center, University of Lausanne, Lausanne, Switzerland
| | - Juliane Schneider
- Department of Woman-Mother-Child, Clinic of Neonatology, University Hospital Center, University of Lausanne, Lausanne, Switzerland
| | - Emma G Duerden
- Applied Psychology, Faculty of Education, Western University, 1137 Western Rd, London, ON, N6G 1G7, Canada.
- Departments of Pediatrics & Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Canada.
- Children's Health Research Institute, London, Canada.
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132
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Sharpe SL. A living experience proposal for the co-occurring diagnosis of avoidant/restrictive food intake disorder and other eating disorders. J Eat Disord 2024; 12:110. [PMID: 39103970 PMCID: PMC11299394 DOI: 10.1186/s40337-024-01073-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
The eating and feeding disorder section of the Diagnostic and Statistical Manual of Mental Disorders 5 Text Revision (DSM-5-TR) is organized by a diagnostic algorithm that limits the contemporaneous assignment of multiple eating disorder diagnoses. Avoidant/restrictive food intake disorder (ARFID) is a disturbance in food intake typically associated with lack of interest in food, food avoidance based on sensory characteristics, and/or fear of aversive consequences from eating. According to the DSM-5-TR, an ARFID diagnosis cannot be made when weight or shape disturbances are present, and ARFID cannot be co-diagnosed with other eating disorders characterized by these disturbances. However, emerging evidence from both clinical and lived experience contexts suggests that the co-occurrence of ARFID with multiple other types of eating disorders may be problematically invisibilized by this trumping scheme. The diagnostic criteria for ARFID can contribute to inappropriate diagnosis or exclusion from diagnosis due to excessive ambiguity and disqualification based on body image disturbance and other eating disorder pathology, even if unrelated to the food restriction or avoidance. This harmfully limits the ability of diagnostic codes to accurately describe an individual's eating disorder symptomatology, impacting access to specialized and appropriate eating disorder care. Therefore, revision of the DSM-5-TR criteria for ARFID and removal of limitations on the diagnosis of ARFID concurrent to other full-syndrome eating disorders stands to improve identification, diagnosis, and support of the full spectrum of ARFID presentations.
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Affiliation(s)
- Sam L Sharpe
- Department of Social Transformation Studies, Kansas State University, 003 Leasure Hall 1128 N. Martin Luther King Jr. Dr, Manhattan, KS, 66506, USA.
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133
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Chaparro-Moreno LJ, Villasanti HG, Justice LM, Sun J, Schmitt MB. Accuracy of Automatic Processing of Speech-Language Pathologist and Child Talk During School-Based Therapy Sessions. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2669-2684. [PMID: 39018260 DOI: 10.1044/2024_jslhr-23-00310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
PURPOSE This study examines the accuracy of Interaction Detection in Early Childhood Settings (IDEAS), a program that automatically transcribes audio files and estimates linguistic units relevant to speech-language therapy, including part-of-speech units that represent features of language complexity, such as adjectives and coordinating conjunctions. METHOD Forty-five video-recorded speech-language therapy sessions involving 27 speech-language pathologists (SLPs) and 56 children were used. The F measure determines the accuracy of IDEAS diarization (i.e., speech segmentation and speaker classification). Two additional evaluation metrics, namely, median absolute relative error and correlation, indicate the accuracy of IDEAS for the estimation of linguistic units as compared with two conditions, namely, Oracle (manual diarization) and Voice Type Classifier (existing diarizer with acceptable accuracy). RESULTS The high F measure for SLP talk data suggests high accuracy of IDEAS diarization for SLP talk but less so for child talk. These differences are reflected in the accuracy of IDEAS linguistic unit estimates. IDEAS median absolute relative error and correlation values for nine of the 10 SLP linguistic unit estimates meet the accuracy criteria, but none of the child linguistic unit estimates meet these criteria. The type of linguistic units also affects IDEAS accuracy. CONCLUSIONS IDEAS was tailored to educational settings to automatically convert audio recordings into text and to provide linguistic unit estimates in speech-language therapy sessions and classroom settings. Although not perfect, IDEAS is reliable in automatically capturing and returning linguistic units, especially in SLP talk, that are relevant in research and practice. The tool offers a way to automatically measure SLP talk in clinical settings, which will support research seeking to understand how SLP talk influences children's language growth.
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Affiliation(s)
| | | | - Laura M Justice
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus
| | - Jing Sun
- Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus
| | - Mary Beth Schmitt
- Department of Speech, Language, and Hearing Sciences, Moody College of Communication, The University of Texas at Austin
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134
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Willems L, Rasing SPA, Heijs DAM, Vermulst AA, Huvenaars MJ, Onrust SA, Creemers DHM. Mental health app boost my mood (BMM) as preventive early intervention for adolescents with (sub)clinical depressive symptoms. BMC Public Health 2024; 24:2118. [PMID: 39103796 DOI: 10.1186/s12889-024-19666-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 07/31/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Depression is a common mental disorder. Detecting (sub)clinical depressive symptoms in adolescents at an early stage and offering a low-threshold early intervention can minimize the risk of serious and/or long-term depression. As such, a digital intervention can be a low-threshold preventive and early intervention. This study aims to examine whether the Boost My Mood (BMM)-app is a suitable preventive early intervention for adolescents with (sub)clinical depressive symptoms. METHODS This naturalistic single-arm evaluation study (N = 50) was conducted in adolescents aged 16-21 with (sub)clinical depressive symptoms. Furthermore, the BMM-app was studied in relation to anxiety, worrying, stress, and sleeping problems. An exploratory objective was to determine whether positive expectations and social support are related to app use. RESULTS The study showed a significant decrease in not only depressive symptoms, but also anxiety, worrying and stress while using the BMM-app. Sleeping problems did not significantly decrease over time while using the BMM-app. The degree of use of the BMM-app and telling significant others about using the BMM-app were both not related to a decrease in depressive symptoms. The BMM-app was used significantly more when the adolescent had told relatives about their depressive symptoms. CONCLUSIONS A digital intervention, such as the BMM-app, can be a low-threshold preventive and early intervention for adolescents with (sub)clinical depressive symptoms. Beneficial effects of the BMM-app were reported on depressive symptoms as well as other aspects of quality of life, such as anxiety, worrying, and stress. Whereas several factors may have played a role in the current findings on depressive symptoms, there are reasons to assume that part of the reduction in symptoms could be attributed to the BMM-app. Although no causality can be assumed, this study is a first step in the implementation of preventive apps in mental health care.
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Affiliation(s)
- Linda Willems
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands.
| | - Sanne P A Rasing
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
- Behavioural Science Institute, Radboud University, P.O. Box 9104, Nijmegen, 6500 HE, The Netherlands
| | - Dewi A M Heijs
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
| | - Ad A Vermulst
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
| | | | - Simone A Onrust
- Trimbos-Instituut, P.O. Box 725, Utrecht, 3500 AS, The Netherlands
| | - Daan H M Creemers
- GGZ Oost Brabant, P.O. Box 3, Boekel, 5427 ZG, The Netherlands
- Behavioural Science Institute, Radboud University, P.O. Box 9104, Nijmegen, 6500 HE, The Netherlands
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Zhang M, Wu C, Lu S, Wang Y, Ma R, Du Y, Wang S, Fang J. Regional brain activity and connectivity associated with childhood trauma in drug-naive patients with obsessive-compulsive disorder. Sci Rep 2024; 14:18111. [PMID: 39103500 PMCID: PMC11300583 DOI: 10.1038/s41598-024-69122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y-BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = - 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y-BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c' = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.
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Affiliation(s)
- Manxue Zhang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Chujun Wu
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shihao Lu
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Yanrong Wang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Rui Ma
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Yunyun Du
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Shaoxia Wang
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China
| | - Jianqun Fang
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
- Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China.
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Dai W, Lv J, Wang H, Wei X. Cyber dating abuse perpetration and victimization among Chinese college students with a history of peer phubbing: psychological resilience moderates the indirect effect of rejection sensitivity. BMC Psychol 2024; 12:425. [PMID: 39103971 PMCID: PMC11299398 DOI: 10.1186/s40359-024-01924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 07/25/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND As emerging adults are increasingly reliant on instant messaging applications for communication with romantic partners, cyber dating abuse perpetration (CDAP) and victimization (CDAV) have proliferated. This has aroused the high attention of researchers. This study aimed to explore the mechanism of the influence of peer phubbing on CDAP and CDAV in Chinese context. METHODS 566 Chinese college students (average age of 19.31 years, 47.7% females) were investigated with the generic scale of being phubbed, rejection sensitivity questionnaire, Chinese version of resilience scale and cyber dating abuse questionnaire. The data were analyzed by using a moderated mediation model with SPSS and the PROCESS. RESULTS The results revealed that: (1) peer phubbing had a significant positive predictive effect on CDAP (β = .32, p < .001) and CDAV (β = .43, p < .001) respectively. (2) Rejection sensitivity played a partial mediating role both between peer phubbing and CDAP (indirect effect = .12, 95% CI = [.05, .18], accounting for 37.5%) and CDAV (indirect effect = .09, 95% CI = [.05, .14], accounting for 20.9%. (3) The first half (β = - .27, p < .001) of the indirect effect of peer phubbing on CDAP and CDAV are weakened by psychological resilience, and the direct paths were also weakened by psychological resilience(β = - .13, p < .001;β = - .16, p < .001). CONCLUSION These findings highlight the importance of discerning the mechanisms moderating the mediated paths linking peer phubbing to CDAP and CDAV. The results also underline the importance of implementing measures and interventions to use the protective role of psychological resilience on college students' CDAP and CDAV.
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Affiliation(s)
- Wenwu Dai
- School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Jiaojiao Lv
- Department of Psychology, Shanxi Datong University, Datong, China
| | - Hongxia Wang
- School of Humanities and Social Sciences, Beijing Forestry University, Beijing, China.
| | - Xiuchao Wei
- College of Education, Hebei Normal University, Shijiazhuang, China.
- Qinhuangdao No.1 High School, Qinhuangdao, China.
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Martin F, Dahmash D, Wicker S, Glover SL, Duncan C, Anastassiou A, Docherty L, Halligan S. Psychological well-being and needs of parents and carers of children and young people with mental health difficulties: a quantitative systematic review with meta-analyses. BMJ MENTAL HEALTH 2024; 27:e300971. [PMID: 39103177 PMCID: PMC11298743 DOI: 10.1136/bmjment-2023-300971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/26/2024] [Indexed: 08/07/2024]
Abstract
QUESTION For parents of children and young people (CYP) with diagnosed mental health difficulties, what are the levels of parents' well-being and psychological need? STUDY SELECTION AND ANALYSIS Medline, PsycINFO, EMBASE, AMED, CINAHL, Web of Science and Cochrane Library of Registered Trials were searched from inception to June 2023. INCLUSION CRITERIA parents of CYP aged 5-18 years with formal mental health diagnosis. Data were extracted from validated measures of well-being or psychological needs with established cut-off points or from a controlled study. FINDINGS 32 of the 73 310 records screened were included. Pooled means showed clinical range scores for one measure of depression, and all included measures of anxiety, parenting stress and general stress. Meta-analyses showed greater depression (g=0.24, 95% CI 0.11 to 0.38) and parenting stress (g=0.34, 95% CI 0.20 to 0.49) in parents of CYP with mental health difficulties versus those without. Mothers reported greater depression (g=0.42, 95% CI 0.18 to 0.66) and anxiety (g=0.73, 95% CI 0.27 to 1.18) than fathers. Narrative synthesis found no clear patterns in relation to CYP condition. Rates of parents with clinically relevant levels of distress varied. Typically, anxiety, parenting stress and general stress scored above clinical threshold. Quality appraisal revealed few studies with a clearly defined control group, or attempts to control for important variables such as parent gender. CONCLUSIONS The somewhat mixed results suggest clinical anxiety, parenting and general stress may be common, with sometimes high depression. Assessment and support for parents of CYP with mental health problems is required. Further controlled studies, with consideration of pre-existing parental mental health difficulties are required. PROSPERO REGISTRATION NUMBER CRD42022344453.
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Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Sarah Wicker
- School of Psychology, Cardiff University, Cardiff, UK
| | | | - Charlie Duncan
- British Association for Counselling and Psychotherapy, Lutterworth, UK
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Akagi T, Saijo Y, Yoshioka E, Sato Y, Nakanishi K, Kato Y, Nagaya K, Takahashi S, Ito Y, Iwata H, Yamaguchi T, Miyashita C, Ito S, Kishi R, Kamijima M, Yamazaki S, Ohya Y, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Nakayama T, Sobue T, Shima M, Kageyama S, Suganuma N, Ohga S, Katoh T. Association between maternal multimorbidity and neurodevelopment of offspring: a prospective birth cohort study from the Japan Environment and Children's Study. BMJ Open 2024; 14:e082585. [PMID: 39097305 PMCID: PMC11345530 DOI: 10.1136/bmjopen-2023-082585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024] Open
Abstract
OBJECTIVES To investigate the association between multimorbidity during pregnancy and neurodevelopmental delay in offspring using data from a Japanese nationwide birth cohort study. DESIGN This study was a prospective birth cohort study. SETTING This study population included 104 059 fetal records who participated in The Japan Environment and Children's Study from 2011 to 2014. PARTICIPANTS Pregnant women whose children had undergone developmental testing were included in this analysis. PRIMARY AND SECONDARY OUTCOME MEASURES Neurodevelopment of offspring was assessed using the Japanese version of the Ages and Stages Questionnaire, third edition, comprising five developmental domains. The number of comorbidities among the pregnant women was categorised as zero, single disease or multimorbidity (two or more diseases). Maternal chronic conditions included in multimorbidity were defined as conditions with high prevalence among women of reproductive age. A multivariate logistic regression analysis was conducted to examine the association between multimorbidity in pregnant women and offspring development. RESULTS Pregnant women with multimorbidity, single disease and no disease accounted for 3.6%, 30.6% and 65.8%, respectively. The ORs for neurodevelopmental impairment during the follow-up period were similar for infants of mothers with no disease comorbidity and those with a single disease comorbidity. However, the ORs for neurodevelopmental impairment were significantly higher for children born to mothers with multimorbidity compared with those born to healthy mothers. CONCLUSION An association was observed between the number of comorbidities in pregnant women and developmental delay in offspring. Multimorbidity in pregnant women may be associated with neurodevelopmental delay in their offspring. Further research is required in this regard in many other regions of the world.
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Affiliation(s)
- Takanobu Akagi
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Kentaro Nakanishi
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Yasuhito Kato
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
| | - Ken Nagaya
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Satoru Takahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Sachiko Ito
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - The Japan Environment and Children's Study group
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michihiro Kamijima
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Shin Yamazaki
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yukihiro Ohya
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Nobuo Yaegashi
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Koichi Hashimoto
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chisato Mori
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Shuichi Ito
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Zentaro Yamagata
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hidekuni Inadera
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takeo Nakayama
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomotaka Sobue
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masayuki Shima
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Seiji Kageyama
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Narufumi Suganuma
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Shoichi Ohga
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takahiko Katoh
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Japan
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Japan
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
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Spencer SD, Pinciotti CM, Murphy C, Hertz A, Wiese AD, Wood JJ, Kendall PC, Storch EA. Concurrent Validity of the Anxiety Disorders Section of the Anxiety Disorder Interview Schedule- Autism Spectrum Addendum (ADIS-ASA) in Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06496-y. [PMID: 39096461 DOI: 10.1007/s10803-024-06496-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 08/05/2024]
Abstract
PURPOSE Examine the concurrent validity of specific Anxiety Disorders Section of the Anxiety Disorder Interview Schedule for DSM-IV-Autism Spectrum Addendum (ADIS-ASA)-Parent Interview in a sample of 167 autistic youth who met diagnostic criteria for an anxiety-related disorder (Mage = 9.91; 78.4% male; 82% non-Hispanic; 77.67% White). METHODS Concurrent validity of Diagnostic and Statistical Manual (DSM)-defined ADIS-ASA anxiety disorder diagnostic caseness was examined via relations with (a) parent-reported dimensions of youth anxiety symptomology and (b) dimensional measures of youth anxiety-related functional impairment, respectively, using logistic regression models and point-biserial correlations. RESULTS Significant relations were found between separation anxiety disorder and social anxiety disorder (but not generalized anxiety disorder nor obsessive-compulsive disorder) caseness, respectively, and theoretically consistent facets of dimensional youth anxiety symptomology. Relations between ADIS-ASA diagnostic caseness and youth functional impairment-related variables revealed that only separation anxiety disorder demonstrated robust evidence of convergent validity. CONCLUSION Despite mixed findings concerning relations between ADIS-ASA anxiety disorder diagnostic caseness and dimensional measures of anxiety severity and anxiety-related impairment, the present findings provide further support for the status of the ADIS-ASA as a gold standard for assessment of anxiety in autistic youth. This work also highlights the importance of continuing to improve precision in measurement of anxiety symptomology in autistic youth, with implications for clinical assessment.
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Affiliation(s)
- Samuel D Spencer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Caitlin M Pinciotti
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Callie Murphy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alyssa Hertz
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey J Wood
- Department of Education, University of California, Los Angeles, USA
- Department of Psychiatry, University of California, Los Angeles, USA
| | - Philip C Kendall
- Department of Psychology and Neuroscience, Temple University, Philadelphia, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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140
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Edwards RC, Planalp EM, Bosquet Enlow M, Akshoomoff N, Bodison SC, Brennan MB, Ciciolla L, Eiden RD, Fillipi CA, Gustafsson HC, McKelvey LM, Morris AS, Peralta-Carcelén M, Poehlmann J, Wakschlag LS, Wilson S. Capturing the complexity of child behavior and caregiver-child interactions in the HEALthy Brain and Child Development (HBCD) Study using a rigorous and equitable approach. Dev Cogn Neurosci 2024; 69:101422. [PMID: 39126821 DOI: 10.1016/j.dcn.2024.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024] Open
Abstract
The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. This article outlines methodological considerations and the decision-making process for measurement selection for child behavior, parenting/caregiver-child interactions, and the family/home environment for HBCD. The decision-making process is detailed, including formation of a national workgroup (WG-BEH) that focused on developmentally appropriate measures that take a rigorous and equitable approach and aligned with HBCD objectives. Multi-level-observational and caregiver-report measures were deemed necessary for capturing the desired constructs across multiple contexts while balancing the nuance of observational data with pragmatic considerations. WG-BEH prioritized developmentally sensitive, validated assessments with psychometrics supporting use in diverse populations and focused on mechanistic linkages and prediction of desired constructs. Other considerations included participant burden and retention, staff training needs, and cultural sensitivity. Innovation was permitted when it was grounded in evidence and filled key gaps. Finally, this article describes the rationale for the selected constructs (e.g., temperament, social-emotional development, parenting behaviors, family organization) and corresponding measures chosen for HBCD visits from early infancy through 17 months of age.
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Affiliation(s)
- Renee C Edwards
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA.
| | - Elizabeth M Planalp
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Michelle Bosquet Enlow
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Natacha Akshoomoff
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Stefanie C Bodison
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Marianne B Brennan
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lucia Ciciolla
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Rina D Eiden
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Courtney A Fillipi
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Hanna C Gustafsson
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lorraine M McKelvey
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Amanda S Morris
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Myriam Peralta-Carcelén
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Julie Poehlmann
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Lauren S Wakschlag
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
| | - Sylia Wilson
- Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave, Suite 2400, Chicago, IL 60611, USA
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Lau AS, Lind T, Cox J, Motamedi M, Lui JHL, Chlebowski C, Flores A, Diaz D, Roesch S, Brookman-Frazee L. Validating a Pragmatic Measure of Evidence-Based Practice (EBP) Delivery: Therapist Reports of EBP Strategy Delivery and Associations with Child Outcome Trajectories. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01395-x. [PMID: 39096408 DOI: 10.1007/s10488-024-01395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 08/05/2024]
Abstract
Pragmatic measures of evidence-based practice (EBP) implementation can support and evaluate implementation efforts. We examined the predictive validity of therapist reports of EBP strategy delivery for children's mental health outcomes. Data were obtained from 1,380 sessions with 248 children delivered by 76 therapists in two county systems. Children (Mage=11.8 years, SD = 3.7) presented with internalizing (52%), externalizing (27%), trauma (16%), and other (5%) concerns. Therapists reported their delivery of EBP strategies on a revised version of the EBP Concordant Care Assessment (ECCA; Brookman-Frazee, et al., Administration and Policy in Mental Health and Mental Health Services Research, 48, 155-170, 2021) that included 25 content (e.g., parenting, cognitive behavioral) and 12 technique strategies (e.g., modeling, practice/role-play). On average, 5.6 ECCA session reports (SD = 2.3) were obtained for each client, and caregivers reported symptoms on the Brief Problem Checklist (Chorpita, et al., Journal of Consulting and Clinical Psychology, 78(4), 526-536, 2010) at baseline, weekly over two months, and again at four months. Multilevel models examined whether the mean extensiveness of each EBP strategy predicted trajectories of child outcomes. More individual technique (6 of 12) than content strategies (1 of 25) were associated with outcome trajectories. For techniques, more extensive use of Performance Feedback and Live Coaching and less extensive use of Addressing Barriers were associated with greater declines in total symptoms, and more extensive use of Establishing/Reviewing Goals, Tracking/Reviewing Progress, and Assigning/Reviewing Homework was associated with declines in externalizing symptoms. For content, more extensive use of Cognitive Restructuring was associated with declines in total symptoms. In addition, higher average extensiveness ratings of the top content strategy across sessions was associated with greater declines in total and externalizing symptoms. Therapist-reported delivery of some EBP strategies showed evidence of predictive validity and may hold utility in indexing quality of care.
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Affiliation(s)
- Anna S Lau
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Teresa Lind
- Department of Child and Family Development, San Diego State University, San Diego, CA, USA.
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA.
| | - Julia Cox
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Mojdeh Motamedi
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Joyce H L Lui
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Colby Chlebowski
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ashley Flores
- Department of Psychology, University of California-Los Angeles, Los Angeles, CA, USA
| | - Devynne Diaz
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Scott Roesch
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center (CASRC), San Diego, CA, USA
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
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142
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Long EE, Johnson MF, Carpenter LA. Autistic Characteristics, Cognitive Impairment, and Sex as Predictors of Anxiety and Depression among Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06406-2. [PMID: 39093544 DOI: 10.1007/s10803-024-06406-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 08/04/2024]
Abstract
Although it is well established that autistic youth are at high risk for anxiety and depression, factors associated with heightened risk within this population are poorly understood. The purpose of this study was to evaluate whether autistic characteristics and cognitive impairment interact to predict anxiety and depression symptoms, and whether the impacts of autistic characteristics and cognitive impairment on anxiety and depression differ for male and female children. Participants comprised 7989 youth (M = 11.23 years) enrolled in SPARK, a national cohort of autistic individuals. Autistic characteristics were assessed via the Social Communication Questionnaire. Anxiety and depression were assessed via the Child Behavior Checklist. Linear regressions were conducted to examine associations between autistic characteristics, cognitive impairment, and symptoms and to test for interactions. The effect of parent-reported autistic characteristics on anxiety was stronger for males than for females, while the effect of cognitive impairment on anxiety was stronger for females than for males. A different pattern was observed for depression. The effect of autistic characteristics on depression was the same for males and females, while cognitive impairment was not associated with depression per parent report. Findings indicate that both male and female children with high levels of autistic characteristics are susceptible to experiencing anxiety and depression, and that autistic female children with intact cognitive abilities are uniquely vulnerable to experiencing anxiety based on parent report. Results have implications for the prevention of internalizing problems in autistic youth, and highlight future directions for longitudinal work examining mechanisms of comorbidity.
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Affiliation(s)
- Erin E Long
- Department of Pediatrics, Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, 8915 W. Connell Ct, Milwaukee, WI, 53226, USA.
| | - Mary F Johnson
- Department of Neuroscience, Neuroscience Administration Research Team, Children's Hospital of Colorado, Aurora, CO, USA
| | - Laura A Carpenter
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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143
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Obegu P, Nicholls K, Alberti M. Operational Mechanisms of Peer Support Groups and Support for Caregivers of People Living with Serious Mental Illness. Community Ment Health J 2024:10.1007/s10597-024-01326-y. [PMID: 39093458 DOI: 10.1007/s10597-024-01326-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024]
Abstract
The challenges faced by caregivers of people living with serious mental illness in Canada are well documented in the literature including emotional distress, financial strain, social isolation, and concerns about their physical health following the impact of caregiving. Peer support programs (including peer support groups) emerged as a promising method to attempt to address these challenges. While there is evidence on the positive impacts of peer support groups in providing support for caregivers, the mechanisms by which peer support groups operate and influence support for caregivers of people living with serious mental illness are less understood. This qualitative study took on a co-designed participatory research approach. Fifteen adult caregivers of people living with serious mental illness across Canada were engaged through key informant interviews that lasted for 45 - 60 min each. A thematic analysis was carried out to help understand the operational mechanisms of peer support groups in influencing support for caregivers. The key informant interviews allowed for the identification and description of the following operational mechanisms that influenced the support caregivers received from peer support groups: (1) Group dynamics; (2) Messaging/content; (3) Equity and inclusion, (4) Group philosophy; and (5) Privacy concerns. Findings from this study showed that caregivers identified a number of operational mechanisms of peer support groups that explained how they felt supported when they participated in peer support groups. Among other operational mechanisms, group dynamics in terms of the gathering of caregivers of different age brackets and varying caregiving experience negatively influenced the peer support experience of caregivers. This pointed to the need for group dynamics that consider close age ranges and similar caregiving experience during group meetings to enhance support for caregivers. Caregivers also identified a gap in equity and inclusion in peer support groups that could have otherwise enriched their experience and enhanced the support they looked to receive from the group. Practical examples to enhance equity and inclusion include promoting active listening, using inclusive language, encouraging diverse representation and asking for feedback from peer support group members. While peer support groups in Canada exist independently of one another, it may help to consolidate evidence-based recommendations in the operational mechanisms of these groups, for the benefit of caregivers who turn to these groups for support, having been left on their own by an otherwise fractured mental health system.
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Affiliation(s)
- Pamela Obegu
- Canadian Institute for Advancements in Mental Health, Toronto, Canada.
| | - Kayla Nicholls
- Canadian Institute for Advancements in Mental Health, Toronto, Canada
| | - Mary Alberti
- Canadian Institute for Advancements in Mental Health, Toronto, Canada
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144
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Inci Izmir SB, Aktan ZD, Ercan ES. The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder. J Atten Disord 2024:10870547241267379. [PMID: 39092505 DOI: 10.1177/10870547241267379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVE The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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145
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Karl V, Engen H, Beck D, Norbom LB, Ferschmann L, Aksnes ER, Kjelkenes R, Voldsbekk I, Andreassen OA, Alnæs D, Ladouceur CD, Westlye LT, Tamnes CK. The role of functional emotion circuits in distinct dimensions of psychopathology in youth. Transl Psychiatry 2024; 14:317. [PMID: 39095355 PMCID: PMC11297301 DOI: 10.1038/s41398-024-03036-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
Several mental disorders emerge during childhood or adolescence and are often characterized by socioemotional difficulties, including alterations in emotion perception. Emotional facial expressions are processed in discrete functional brain modules whose connectivity patterns encode emotion categories, but the involvement of these neural circuits in psychopathology in youth is poorly understood. This study examined the associations between activation and functional connectivity patterns in emotion circuits and psychopathology during development. We used task-based fMRI data from the Philadelphia Neurodevelopmental Cohort (PNC, N = 1221, 8-23 years) and conducted generalized psycho-physiological interaction (gPPI) analyses. Measures of psychopathology were derived from an independent component analysis of questionnaire data. The results showed positive associations between identifying fearful, sad, and angry faces and depressive symptoms, and a negative relationship between sadness recognition and positive psychosis symptoms. We found a positive main effect of depressive symptoms on BOLD activation in regions overlapping with the default mode network, while individuals reporting higher levels of norm-violating behavior exhibited emotion-specific lower functional connectivity within regions of the salience network and between modules that overlapped with the salience and default mode network. Our findings illustrate the relevance of functional connectivity patterns underlying emotion processing for behavioral problems in children and adolescents.
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Affiliation(s)
- Valerie Karl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
| | - Haakon Engen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Institute of Military Psychiatry Norwegian Armed Forces Joint Medical Services, Oslo, Norway
| | - Dani Beck
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn B Norbom
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Lia Ferschmann
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Eira R Aksnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rikka Kjelkenes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Christian K Tamnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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146
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Gagnon E, Boivin M, Mimeau C, Feng B, Morneau-Vaillancourt G, Aubé S, Brendgen M, Vitaro F, Dionne G. The Intensity of Formal Child-Care Attendance Decreases the Shared Environment Contribution to School Readiness: A Twin Study. Child Psychiatry Hum Dev 2024; 55:882-892. [PMID: 36269520 PMCID: PMC11245436 DOI: 10.1007/s10578-022-01440-6] [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] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to explore if child-care intensity (hours/weeks) and age of onset could moderate genetic and environmental contributions to school readiness. A sample of 648 (85% Whites; 50% Females) pairs of twins was used to compute a GxE, CxE and ExE interaction analyses. The moderation model showed that shared environment explains 48% of individual differences in school readiness for children not attending formal child-care, and decreased gradually to a mere 3% for children attending formal child-care full time, e.g., 40 h per week. Age of onset exerted no moderation effect. The results support the hypothesis that child-care acts as a normalizing environment, possibly buffering negative effects from low-quality home environments on school readiness.
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Affiliation(s)
- Eloi Gagnon
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada.
| | - Michel Boivin
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada
| | - Catherine Mimeau
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada
| | - Bei Feng
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada
| | | | - Sophie Aubé
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada
| | - Mara Brendgen
- Department of Psychology, Quebec University in Montreal, Montreal, QC, Canada
| | - Frank Vitaro
- School of Psychoeducation, University of Montreal, Montreal, QC, Canada
| | - Ginette Dionne
- Department of Psychology, Laval University, 2325 Allée des Bibliothèques, Québec, QC, G1V 0A6, Canada.
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147
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Alon R. Emerging adults' emotions toward their siblings with down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 151:104791. [PMID: 38954913 DOI: 10.1016/j.ridd.2024.104791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Typically-developing siblings of individuals with Down Syndrome often experience complex emotions towards their sibling. This study explored how social support, personal resources (optimism, sense of coherence [SOC]), and individual variables (sex, religious affiliation, siblings' functionality) may impact emerging adult siblings' emotions toward their sibling with Down Syndrome. METHODS Participants were 292 siblings of individuals with DS ranging in age from 18-27 (M=21.54, SD=2.50). Participants completed self-report questionnaires exploring optimism, SOC, support, and acceptance. RESULTS Higher levels of support and optimism were positively associated with positive emotions, and higher SOC with lower levels of negative emotions. Siblings' functionality and religious affiliation interacted with variables to predict emotions. CONCLUSIONS This study contributes to a greater understanding of how emotions may play a role in sibling relations during the emerging adulthood stage. It also provides unique insight into how religious affiliation may be associated with more positive outcomes for siblings.
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Affiliation(s)
- Raaya Alon
- Michlalah Jerusalem College, Baruch Duvdevani 36, Jerusalem 9116002, Israel.
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148
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Blaess M, Eliot K. A Framework for RDN and SLP Collaboration: A Missing Piece in Autism Spectrum Disorder Treatment. J Acad Nutr Diet 2024; 124:939-946. [PMID: 38615995 DOI: 10.1016/j.jand.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Martha Blaess
- Department of Nutrition and Dietetics, Department of Speech, Language, and Hearing Sciences, Saint Louis University, Saint Louis, MO.
| | - Kathrin Eliot
- Department of Nutritional Sciences, The University of Oklahoma Health Sciences, Oklahoma City, OK
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149
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Lucas R, Geierstanger S, Soleimanpour S. Mental Health Needs, Barriers, and Receipt of Care Among Transgender and Nonbinary Adolescents. J Adolesc Health 2024; 75:267-274. [PMID: 38739056 DOI: 10.1016/j.jadohealth.2024.03.009] [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: 10/05/2023] [Revised: 02/02/2024] [Accepted: 03/19/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Transgender and nonbinary youth disproportionately experience adverse mental health outcomes compared to cisgender youth. This study examined differences in their mental health needs and supports, barriers to care, and receipt of mental health care. METHODS This study examined cross-sectional data from 43,339 adolescents who completed the California Healthy Kids Survey, 4% (n = 1,876) of whom identified as transgender and/or nonbinary. Chi-square test and t-test were used to compare mental health needs and supports, resilience, and barriers to and receipt of care experienced by transgender and nonbinary youth compared to cisgender youth. RESULTS Transgender and nonbinary youth were significantly more likely to experience chronic sadness/hopelessness (74% vs. 35%) and consider suicide (53% vs. 14%) and less likely to report resilience factors (school connectedness: mean score 3.12 vs. 3.52). Transgender and nonbinary youth were significantly less likely to be willing to talk to teachers/adults from school (12% vs. 18%) or parents/family members (21% vs. 43%), but more willing to talk to counselors (25% vs. 19%) regarding mental health concerns. Transgender and nonbinary youth were significantly more likely to select being afraid (48% vs. 20%), not knowing how to get help (44% vs. 30%), or concern their parents would find out (61% vs. 36%) as barriers to seeking mental health care, yet reported slightly higher odds of receiving care when needed (odds ratio: 1.2). DISCUSSION Transgender and nonbinary youth are more likely to report mental health concerns and barriers to seeking care than cisgender youth. Increasing access to care is critical for this population.
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Affiliation(s)
- Ruby Lucas
- Department of Epidemiology, University of Washington, Seattle, Washington; School of Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California.
| | - Sara Geierstanger
- School of Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California
| | - Samira Soleimanpour
- School of Medicine, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California
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150
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McGregor K, Rana V, McKenna JL, Williams CR, Vu A, Boskey ER. Understanding Family Support for Transgender Youth: Impact of Support on Psychosocial Functioning. J Adolesc Health 2024; 75:261-266. [PMID: 38842989 DOI: 10.1016/j.jadohealth.2024.04.006] [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: 10/20/2023] [Revised: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE This study investigated the association between positive and negative family support and psychosocial outcomes among transgender and gender diverse (TGD) youth. METHODS A retrospective analysis was performed using psychological data collected from 175 TGD youth (aged 13-18 years) at time of hormone readiness assessment within a multispecialty gender clinic between May 2021 and February 2023. As part of this assessment process, TGD youth provided responses to a variety of measures, including the Youth Self-Report and the Family Environment Scale. RESULTS Negative family support scales were more strongly associated with more outcomes than positive support scales. The exclusion and abuse, viewing gender expression as morally wrong, and trying to change gender scales were each associated with significantly higher Youth Self-Report T-scores for internalizing problems (βs = 6.86, 6.26, 5.56, all p < .01), externalizing problems (βs = 4.58, 4.42, 4.19, all p < .02), and total problems (βs = 6.70, 6.45, 5.34, all p < .02). The explicit care and support scale was associated with significantly lower T-scores for externalizing problems (β = -3.54 p = .02) and total problems (β = -3.35, p = .04). Overall support was also associated with higher T-scores in internalizing problems (b = -2.90, p = .02), externalizing problems (β = -2.40, p = .03), and total problems (β = -2.79, p = .03). DISCUSSION Family support plays a critical role in the psychosocial wellbeing of TGD youth. TGD youth reporting positive family support reported fewer mental health concerns, less experiences of nonaffirmation, and lower levels of internalized transphobia. TGD youth reporting negative family support were found to have an increased risk of suicidal ideation.
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Affiliation(s)
- Kerry McGregor
- Boston Children's Hospital, Division of Endocrinology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Vinisha Rana
- Boston Children's Hospital, Division of Endocrinology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - John L McKenna
- Boston Children's Hospital, Division of Endocrinology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Coleen R Williams
- Boston Children's Hospital, Division of Endocrinology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Ava Vu
- Boston Children's Hospital, Division of Endocrinology, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Elizabeth R Boskey
- Harvard Medical School, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Boston Children's Hospital, Division of Gynecology, Boston, Massachusetts
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