1
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Disler ER, Steinwald P, Scott AR, Marston AP. Assessment of Psychosocial Impairment among Patients with Cleft Lip and/or Cleft Palate Using the Pediatric Symptom Checklist. Facial Plast Surg Aesthet Med 2024; 26:573-574. [PMID: 38738418 DOI: 10.1089/fpsam.2023.0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Affiliation(s)
- Emily R Disler
- Tufts University School of Medicine, Boston, Massachusetts USA
| | - Peter Steinwald
- Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts USA
| | - Andrew R Scott
- Tufts University School of Medicine, Boston, Massachusetts USA
- Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts USA
| | - Alexander P Marston
- Tufts University School of Medicine, Boston, Massachusetts USA
- Dr. Elie E. Rebeiz Department of Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts USA
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2
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Frueh L, Sharma R, Sheffield PE, Clougherty JE. Community violence and asthma: A review. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00453-8. [PMID: 39038705 DOI: 10.1016/j.anai.2024.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/28/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
Over the past 2 decades, epidemiologic studies have identified significant associations between exposure to violence, as a psychosocial stressor, and the incidence or exacerbation of asthma. Across diverse populations, study designs, and measures of community violence, researchers have consistently identified adverse associations. In this review, the published epidemiologic evidence is summarized with special attention to research published in the last 5 years and seminal papers. Hypothesized mechanisms for the direct effects of violence exposure and for how such exposure affects susceptibility to physical agents (eg, air pollution and extreme temperature) are discussed. These include stress-related pathways, behavioral mechanisms, and epigenetic mechanisms. Finally, clinical implications and recommendations are discussed.
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Affiliation(s)
- Lisa Frueh
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.
| | - Rachit Sharma
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Perry E Sheffield
- Departments of Environmental Medicine and Climate Science and Public Health and Pediatrics, Mount Sinai Icahn School of Medicine, New York, New York
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
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3
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Estrada-Prat X, Estrada E, Tor J, Mezzatesta M, Aranbarri A, Aizpitarte A, Butjosa A, Albiac N, Fabrega M, Haro JM, Pineda II, Alda JA, Virgili C, Camprodon E, Dolz M, Keating C, Via E. Caregiver-reported emotional-behavioral symptoms in Spanish youth during the COVID-19 pandemic: a longitudinal study. Pediatr Res 2024:10.1038/s41390-024-03364-4. [PMID: 38982168 DOI: 10.1038/s41390-024-03364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND COVID-19 pandemic stressors affected youth's mental health. This longitudinal study aims to explore these effects while considering predictive factors such as age and sex. METHODS An initial sample of 1502 caregivers answered a longitudinal survey evaluating their youths' (4-17 years of age) emotional/behavioral symptoms using the Pediatric Symptom Checklist (PSC) screening tool. First assessment in May-July 2020 included the prior year's retrospective (TR) and since-lockdown-start (T0) PSC, followed by monthly evaluations until February 2021. RESULTS A positive screening PSC (PSC+) was reported in 13.09% of cases at TR and 35.01% at T0, but the likelihood of PSC+ quickly decreased over time. At T0, a more pronounced impact was found on children (39.7%) compared to adolescents (25.4%); male children exhibited higher risk for a PSC+ at T0 and longitudinally than females. Adolescents presented a weaker effect of time-improvement. PSC+ at TR, experienced stressors, and caregiver's stress/depressive symptoms positively predicted PSC+ at T0 and longitudinally; adolescents' unproductive coping style predicted PSC+ at T0. CONCLUSION: The study shows a caregiver-reported increase in emotional/behavioral symptoms in youths during the COVID-19 pandemic, affecting predominantly younger children in the early stages and showing gradual improvement over time, albeit possibly slower in adolescents. IMPACT The results show the anticipated surge in emotional and behavioral symptoms during the COVID-19 lockdown in youth reported by caregivers, followed by subsequent amelioration. Of greater significance, the study reveals a heightened impact on young children initially, yet it suggests a slower improvement trajectory in adolescents. The study also identifies risk factors linked to emotional and behavioral symptoms within each age group. Alongside the longitudinal approach, the authors underscore the remarkable inclusion of a significant representation of young children, an unusual feature in such surveys.
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Affiliation(s)
- Xavier Estrada-Prat
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Eduardo Estrada
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
| | - Marcela Mezzatesta
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Aritz Aranbarri
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Alazne Aizpitarte
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Anna Butjosa
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Albiac
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Marina Fabrega
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Immaculada Insa Pineda
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
| | - Jose A Alda
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Carles Virgili
- Independent researcher in collaboration with the Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Ester Camprodon
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Charlotte Keating
- Independent researcher in collaboration with the Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950, Esplugues de Llobregat, Spain.
- Department of Child and Adolescent Mental Health. Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Spain.
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4
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Iris SL, Ivonne MK, Liat AH, Noa BM, Alon L, Hila S, Shira B, Silvana F. Screening for Emotional Problems in Pediatric Hospital Outpatient Clinics: Psychometric Traits of the Pediatric Symptom Checklist (Hebrew Version). J Clin Psychol Med Settings 2024; 31:432-443. [PMID: 38001395 DOI: 10.1007/s10880-023-09982-0] [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] [Accepted: 10/02/2023] [Indexed: 11/26/2023]
Abstract
This study assessed feasibility and psychometric properties of the Hebrew parent version of the Pediatric Symptom Checklist (PSC-17), aiming to improve treatment access for children and adolescents with behavioral and mental needs through early screening. The PSC-17 and the Strengths and Difficulties Questionnaire (SDQ) were filled in the waiting room, at three ambulatory clinics in a tertiary pediatric center, by 274 parents using a tablet or their cellphone. Demographic and clinical data were retrieved from patients' files. PSC results were compared to SDQ results and assessed vis-a-vis a psychiatric diagnosis, determined previously and independently by trained pediatric psychiatrists for 78 pediatric patients who attended these clinics. Construct and discriminant validity of the PSC-17 Hebrew version were good. Sensitivity, specificity, and positive and negative predictive values are presented. The PSC-17 (Hebrew version) was found to be a feasible tool for mental health screening at pediatric ambulatory care clinics.
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Affiliation(s)
| | | | | | - Benaroya-Milshtein Noa
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Liberman Alon
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Segal Hila
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Brik Shira
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Fennig Silvana
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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5
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Olson AE, Felt JM, Dunning ED, Zhang ZZ, Lombera MA, Moeckel C, Mustafa MU, Allen B, Frasier L, Shenk CE. Child Behavior Problems and Maltreatment Exposure. Pediatrics 2024; 153:e2023064625. [PMID: 38742313 PMCID: PMC11153321 DOI: 10.1542/peds.2023-064625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES Establish the longitudinal cross-lagged associations between maltreatment exposure and child behavior problems to promote screening and the type and timing of interventions needed. METHODS The Longitudinal Studies of Child Abuse and Neglect, a multiwave prospective cohort study of maltreatment exposure, enrolled children and caregivers (N = 1354) at approximately age 4 and followed them throughout childhood and adolescence. Families completed 7 waves of data collection with each wave occurring 2 years apart. Maltreatment was confirmed using official case records obtained from Child Protective Services. Six-month frequencies of behavior problems were assessed via caregiver-report. Two random-intercept, cross-lagged panel models tested the directional relations between maltreatment exposure and externalizing and internalizing behaviors. RESULTS Maltreatment exposure predicted increases in externalizing behaviors at ages 8 (b = 1.06; 95% confidence interval [CI] 0.14-1.98), 12 (b = 1.09; 95% CI 0.08-2.09), and 16 (b = 1.67; 95% CI 0.30-3.05) as well as internalizing behaviors at ages 6 (b = 0.66; 95% CI 0.03-1.29), 12 (b = 1.25; 95% CI 0.33-2.17), and 14 (b = 1.92; 95% CI 0.76-2.91). Increases in externalizing behaviors predicted maltreatment exposure at age 12 (odds ratio 1.02; 95% CI 1.00-1.05). CONCLUSIONS Maltreatment exposure is robustly associated with subsequent child behavior problems, strengthening inferences about the directionality of these relations. Early screening of externalizing behaviors in pediatric settings can identify children likely to benefit from intervention to reduce such behaviors as well as prevent maltreatment exposure at entry to adolescence.
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Affiliation(s)
| | | | | | - Zhenyu Z. Zhang
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania
| | - Metzli A. Lombera
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania
| | - Camille Moeckel
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Manal U. Mustafa
- The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Brian Allen
- Center for the Protection of Children, Department of Pediatrics
- Department of Psychiatry and Behavioral Health
| | - Lori Frasier
- Center for the Protection of Children, Department of Pediatrics
| | - Chad E. Shenk
- Department of Human Development and Family Studies
- Center for the Protection of Children, Department of Pediatrics
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6
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Williford DN, Jackson CB, Durkin K, Langholz A, Aballay A, Duncan CL. Utility of a Pediatric Psychosocial Screener in an Outpatient Burn Clinic. J Burn Care Res 2024; 45:630-637. [PMID: 38050330 PMCID: PMC11073576 DOI: 10.1093/jbcr/irad190] [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: 11/17/2022] [Indexed: 12/06/2023]
Abstract
Psychosocial concerns are common among youth who sustained a burn injury. Detecting psychosocial distress early is essential to ensure appropriate treatment and referrals. Thus far, research has focused largely on the long-term outcomes of pediatric burn survivors. The current quality improvement initiative details the implementation and outcomes of brief, pragmatic screening to assess psychosocial concerns among pediatric burn survivors in an outpatient setting. A primary caregiver completed an age-appropriate psychosocial screener for youth aged 4-10 years (n = 69), while patients aged 11-17 years (n = 72) completed a self-report screener. Total scores were used to categorize patients as acute risk (i.e., emotional concerns requiring immediate attention), moderate risk (i.e., elevated symptoms, but no immediate safety concerns), or low risk (i.e., endorsing few to no symptoms). Patients with acute risk were evaluated by medical staff to determine the need for immediate psychiatric intervention or social services referrals. Patients with moderate risk met with the on-site psychology team during their clinic visit or were contacted by telephone within 1 week. Patients in the low-risk category warranted no additional follow-up post-screening. Most patients scored in the low-risk category (n = 120; 85%), while 11% (n = 16) and 4% (n = 5) endorsed symptoms consistent with moderate and acute risk, respectively. Results demonstrate the utility of implementing pediatric psychosocial screening in an outpatient burn clinic, the importance of detecting psychosocial concerns in this context, and usage of referrals to address concerns. Findings also shed light on key caveats of psychosocial screening, barriers to accessing psychosocial support, and the potential benefits of embedded psychological support during medical visits.
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Affiliation(s)
- Desireé N Williford
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Carrie B Jackson
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Kristine Durkin
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Ariana Langholz
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Ariel Aballay
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
| | - Christina L Duncan
- Department of Psychology, West Virginia University, Morgantown, WV 26506, USA
- West Penn Hospital Burn Center, Allegheny Health Network, Pittsburgh, PA 15224, USA
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7
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Ahad MA, Parry YK, Willis E, Ullah S. Child maltreatment and psycho-social impairments among child laborers in rural Bangladesh. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02671-9. [PMID: 38684514 DOI: 10.1007/s00127-024-02671-9] [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: 02/03/2023] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE The current study focused on exploring the impact of maltreatment of child laborers on their psychosocial health condition from the views of their parents. METHODS A total of 100 parents of child laborers were recruited using snowball sampling. The structured questionnaire comprised two validated scales including ISPCAN Child Abuse Screening Tool (ICAST-P), and Paediatric Symptom Checklist (PSC) were used for the survey. Factor analysis and multivariable linear regression analysis were performed to examine the data using SPSS version 26, and Stata version 16.1. RESULTS A three-factor model consisting of internalizing, externalizing, and attention associated psycho-social impairments of child laborers were derived from the 35-item scale of PSC tool and represented a good fit to the data. A mean estimate of maltreatment indicates that a majority of child laborers are maltreated psychologically, followed by physical maltreatment and neglect. The factor analysis resulted that maltreated child laborers are highly prone to exhibit internalized psycho-social difficulties, followed by externalized and attention-associated emotional and behavioral difficulties among child laborers. The regression model further depicts that child laborers, who had been physically and psychologically maltreated, are significantly more likely to be affected by internalized and attention-related psycho-social impairments. CONCLUSIONS The study concluded that victimized child laborers exhibited significant internalized, as well as attention-related problems. These findings may be useful for future studies that examine emotional and behavioral problems among maltreated child laborers and, therefore, for developing prevention strategies.
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Affiliation(s)
- Md Abdul Ahad
- Department of Rural Sociology and Development, Sylhet Agricultural University, Sylhet, 3100, Bangladesh.
- College of Nursing and Health Sciences, Flinders University, SA, Australia.
| | - Yvonne Karen Parry
- College of Nursing and Health Sciences, Flinders University, SA, Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, SA, Australia
- Research Training Lead, School of Graduate Research, Central Queensland University, Queensland, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, SA, Australia
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Eapen V, Gerstl B, Ahinkorah BO, John JR, Hawker P, Nguyen TP, Brice F, Winata T, Bowden M. Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review. BJPsych Open 2024; 10:e78. [PMID: 38602192 PMCID: PMC11060074 DOI: 10.1192/bjo.2024.25] [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: 04/14/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. AIMS To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0-17 years) presenting with an acute mental health condition. METHOD A systematic literature search was conducted, and the studies' methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. RESULTS We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent-child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. CONCLUSIONS This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and School of Public Health, University of Technology Sydney, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Mental Health Team, School of Medicine, Western Sydney University, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Australia
| | - Michael Bowden
- Child and Youth Mental Health, New South Wales Ministry of Health, Australia; Sydney Medical School, University of Sydney, Australia; and Department of Psychological Medicine, Sydney Children's Hospitals Network, Australia
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9
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Brown FL, Yousef H, Bleile AC, Mansour H, Barrett A, Ghatasheh M, Puffer ES, Mansour Z, Hayef K, Kurdi S, Ali Q, Tol WA, El-Khani A, Calam R, Abu Hassan H, Jordans MJ. Nurturing families: A feasibility randomised controlled trial of a whole-family intervention with vulnerable families in Jordan. Glob Ment Health (Camb) 2024; 11:e51. [PMID: 38721483 PMCID: PMC11076925 DOI: 10.1017/gmh.2024.43] [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: 08/24/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 09/03/2024] Open
Abstract
Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α > 0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness.
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Affiliation(s)
- Felicity L. Brown
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Research and Development Department, War Child Alliance, Amman, Jordan
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Hind Yousef
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Alexandra C.E. Bleile
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Hadeel Mansour
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Anna Barrett
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
| | - Maha Ghatasheh
- Research and Development Department, War Child Alliance, Amman, Jordan
| | - Eve S. Puffer
- Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Zeinab Mansour
- Research and Development Department, War Child Alliance, Amman, Jordan
| | | | | | - Qaasim Ali
- Collateral Repair Project, Amman, Jordan
| | - Wietse A. Tol
- Section of Global Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
- Arq International, Diemen, The Netherlands
| | - Aala El-Khani
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Rachel Calam
- Division of Psychology and Mental Health, The University of Manchester, Manchester, UK
| | - Hana Abu Hassan
- University of California San Diego, San Diego, CA, USA
- Imperial College NHS Trust, London, UK
| | - Mark J.D. Jordans
- Research and Development Department, War Child Alliance, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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Adams WG, Gasman S, Beccia AL, Fuentes L. The Health Equity Explorer: An open-source resource for distributed health equity visualization and research across common data models. J Clin Transl Sci 2024; 8:e72. [PMID: 38690224 PMCID: PMC11058576 DOI: 10.1017/cts.2024.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction There is an urgent need to address pervasive inequities in health and healthcare in the USA. Many areas of health inequity are well known, but there remain important unexplored areas, and for many populations in the USA, accessing data to visualize and monitor health equity is difficult. Methods We describe the development and evaluation of an open-source, R-Shiny application, the "Health Equity Explorer (H2E)," designed to enable users to explore health equity data in a way that can be easily shared within and across common data models (CDMs). Results We have developed a novel, scalable informatics tool to explore a wide variety of drivers of health, including patient-reported Social Determinants of Health (SDoH), using data in an OMOP CDM research data repository in a way that can be easily shared. We describe our development process, data schema, potential use cases, and pilot data for 705,686 people who attended our health system at least once since 2016. For this group, 996,382 unique observations for questions related to food and housing security were available for 324,630 patients (at least one answer for all 46% of patients) with 65,152 (20.1% of patients with at least one visit and answer) reporting food or housing insecurity at least once. Conclusions H2E can be used to support dynamic and interactive explorations that include rich social and environmental data. The tool can support multiple CDMs and has the potential to support distributed health equity research and intervention on a national scale.
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Affiliation(s)
- William G. Adams
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
- Boston University Clinical and Translational Science Institute, Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Sarah Gasman
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Ariel L. Beccia
- Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Liza Fuentes
- Health Equity Accelerator, Boston Medical Center, Boston, MA, USA
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11
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Carroll AJ, Knapp AA, Villamar JA, Mohanty N, Coldren E, Hossain T, Limaye D, Mendoza D, Minier M, Sethi M, Hendricks Brown C, Franklin PD, Davis MM, Wakschlag LS, Smith JD. Engaging primary care clinicians in the selection of implementation strategies for toddler social-emotional health promotion in community health centers. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2024; 42:50-67. [PMID: 37956064 PMCID: PMC11090018 DOI: 10.1037/fsh0000852] [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] [Indexed: 11/15/2023]
Abstract
BACKGROUND Social-emotional risk for subsequent behavioral health problems can be identified at toddler age, a period where prevention has a heightened impact. This study aimed to meaningfully engage pediatric clinicians, given the emphasis on health promotion and broad reach of primary care, to prepare an Implementation Research Logic Model to guide the implementation of a screening and referral process for toddlers with elevated social-emotional risk. METHOD Using an adaptation of a previously published community partner engagement method, six pediatricians from community health centers (CHCs) comprised a Clinical Partner Work Group. The group was engaged in identifying determinants (barriers/facilitators), selecting and specifying strategies, strategy-determinant matching, a modified Delphi approach for strategy prioritization, and user-centered design methods. The data gathered from individual interviews, two group sessions, and a follow-up survey resulted in a completed Implementation Research Logic Model. RESULTS The Clinical Partner Work Group identified 16 determinants, including barriers (e.g., patient access to electronic devices) and facilitators (e.g., clinician buy-in). They then selected and specified 14 strategies, which were prioritized based on ratings of feasibility, effectiveness, and priority. The highest-rated strategies (e.g., integration of the screener into the electronic health record) provided coverage of all identified barriers and comprised the primary implementation strategy "package" to be used and tested. CONCLUSIONS Clinical partners provided important context and insights for implementation strategy selection and specification to support the implementation of social-emotional risk screening and referral in pediatric primary care. The methodology described herein can improve partner engagement in implementation efforts and increase the likelihood of success. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Allison J. Carroll
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | - Ashley A. Knapp
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | - Juan A. Villamar
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | | | | | | | | | | | - Mark Minier
- AllianceChicago, Chicago, Illinois, United States
| | | | - C. Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | - Patricia D. Franklin
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Matthew M. Davis
- Department of Pediatrics, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Justin D. Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
- Department of Population Health Sciences, Spencer Fox Eccles, School of Medicine, University of Utah
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12
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Scott VP, Rhee KE. Using the lens of trauma informed care to inform pediatric obesity management. Curr Opin Pediatr 2024; 36:49-56. [PMID: 37965895 DOI: 10.1097/mop.0000000000001314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
PURPOSE OF REVIEW Summarize the evolution of the trauma-informed care (TIC) approach in pediatrics, highlight the importance of using this lens in pediatric obesity management and treating the whole patient and family, and suggest recommendations for providers to incorporate TIC into their practice. RECENT FINDINGS Implementing TIC in pediatric obesity management is recommended and offers an approach to address trauma-related symptoms associated with obesity. The TIC framework creates a safe, nurturing space to have open conversations with patients and families to promote resilience and reduce stigma related to obesity without re-traumatization. Screening tools may expose symptoms related to trauma, but are limited. Provider training is available and development of TIC related skills may be improved through using the arts and humanities. Success of TIC requires a tailored, integrated healthcare system approach with commitment from all levels. SUMMARY The TIC approach offers providers skills to uncover trauma-related symptoms and address obesity-related health disparities while reducing stigma. Collaboration across all levels of the healthcare system and community partners is essential. Further research is warranted on the effectives of this approach in pediatric obesity prevention and management.
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Affiliation(s)
- Vanessa P Scott
- UC San Diego School of Medicine, Department of Pediatrics, UC San Diego Health, Academic General Pediatrics, La Jolla, California, USA
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13
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Ritfeld GJ, Wang M, Shapiro Z, Kable JA, Coles CD. Parenting by individuals with fetal alcohol spectrum disorders and neurobehavioral outcomes in their offspring. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:400-408. [PMID: 38149361 PMCID: PMC10922647 DOI: 10.1111/acer.15256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND The neurobehavioral health impairments associated with prenatal alcohol exposure are now known to persist through adulthood. However, little is known about how these impairments affect individuals' parenting abilities and the neurobehavioral health of their offspring. This study compares parents with fetal alcohol spectrum disorder (FASD) with socioeconomically matched, nonexposed parents on measures of parenting and family support and assesses the neurobehavioral health of the children in both groups. METHODS Forty-nine parent-child dyads were recruited from a longitudinal cohort of low socioeconomic status. Measures included the Parenting Styles and Dimensions Questionnaire, Family Support Scale, an in-depth psychosocial history, the Pediatric Symptom Checklist (PSC; parent and child reports), the Achenbach Child Behavior Checklist (CBCL), a screening psychiatric evaluation of the child, the NIH Toolbox Cognition Battery for Children, The Vineland Adaptive Behavior Scales-Third Edition caregiver rating form, and the Traumatic Events Screening Inventory (parent and child reports). RESULTS Cognitive functioning was impaired for both offspring of parents with FASD (x ¯ = 81.1, SD = 13.0) and control parents (x ¯ = 79.9, SD = 16.1), but despite similar impairments, children of parents with FASD were less likely to have an Individualized Education Plan than controls. Adaptive functioning was adequate for both groups (x ¯ = 92.1, SD = 15.4 in exposed vs.x ¯ = 94.3, SD = 12.3 in controls) and CBCL and PSC scores in both groups were within normal limits. Parents in both groups showed a predominantly authoritative parenting style. Despite a similar frequency of adverse childhood experiences in both groups, parents with FASD were less likely to recognize their child's adverse experiences. CONCLUSION Parents with FASD display notable strengths including a predominantly authoritative parenting style. However, parents with FASD underrecognize child trauma and underutilize developmental services compared to socioeconomically matched controls, despite similar neurocognitive impairments. Impairments in adaptive functioning in parents with FASD may translate into difficulties with child-parent communication and limit both insight into neurobehavioral problems and advocacy skills. There is a need to identify and support parents with FASD to optimize their parenting abilities in the context of their individual strengths and difficulties.
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Affiliation(s)
- Gaby J Ritfeld
- Barrow Neurological Institute at Phoenix Children's, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
- Department of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Psychiatry, Creighton University School of Medicine, Phoenix, Arizona, USA
| | - Michael Wang
- Department of Psychiatry, Creighton University School of Medicine, Phoenix, Arizona, USA
| | - Zvi Shapiro
- Department of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Julie A Kable
- Department of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Claire D Coles
- Department of Psychiatry and Behavioral Sciences and Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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14
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Jordans MJD, Brown FL, Kane J, Taha K, Steen F, Ali R, Elias J, Meksassi B, Aoun M, Greene CM, Malik A, Akhtar A, van Ommeren M, Sijbrandij M, Bryant R. Evaluation of the Early Adolescent Skills for Emotions (EASE) intervention in Lebanon: A randomized controlled trial. Compr Psychiatry 2023; 127:152424. [PMID: 37748283 PMCID: PMC11214135 DOI: 10.1016/j.comppsych.2023.152424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 07/21/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND There is a need for scalable evidence-based psychological interventions for young adolescents experiencing high levels of psychological distress in humanitarian settings and low- and middle-income countries. Poor mental health during adolescence presents a serious public health concern as it is a known predictor of persistent mental disorders in adulthood. This study evaluates the effectiveness of a new group-based intervention developed by the World Health Organization (Early Adolescent Skills for Emotions; EASE), implemented by non-specialists, to reduce young adolescents' psychological distress among mostly Syrian refugees in Lebanon. METHODS We conducted a two-arm, single-blind, individually randomized group treatment trial. Adolescents aged 10 to 14 years who screened positive for psychological distress using the Pediatric Symptom Checklist (PSC) were randomly allocated to EASE or enhanced treatment as usual (ETAU) (1:1.6). ETAU consisted of a single scripted psycho-education home-visit session with the adolescent and their caregivers. EASE consists of seven group sessions with adolescents and three sessions with caregivers. The primary outcome was adolescent-reported psychological distress as measured with the PSC (internalizing, externalizing, and attentional symptoms). Secondary outcomes included depression, posttraumatic stress, well-being, functioning, and caregivers' parenting and distress. All outcomes were assessed at baseline, endline, and 3 months (primary time point) and 12 months follow-up. RESULTS Due to the COVID-19 pandemic and other adversities in Lebanon at the time of this research, the study was prematurely terminated, resulting in an under-powered trial sample (n = 198 enrolled compared to n = 445 targeted). We screened 604 children for eligibility. The 198 enrolled adolescents were assigned to EASE (n = 80) and ETAU (n = 118), with retention rates between 76.1 and 88.4% across all timepoints. Intent-to-treat analyses demonstrated no between-group differences on any of the outcome measures between the EASE and ETAU. We did observe a significant improvement on the primary outcome equally in the EASE and ETAU groups (-0.90, 95% CI: -3.6, 1.8; p = .52), - a trend that was sustained at three months follow-up. Sub-group analyses, for those with higher depression symptoms at baseline, showed ETAU outperformed EASE on reducing depression symptoms (difference in mean change = 2.7, 95% CI: 0.1, 5.3; p = .04; d = 0.59) and internalizing problems (difference in mean change 1.0, 95% CI: 0.08, 1.9; p = .03; d = 0.56) . CONCLUSION No conclusions can be drawn about the comparative effectiveness of the intervention given that the sample was underpowered as a result of early termination. Both EASE and single session psycho-education home visits resulted in meaningful improvements in reducing psychological distress. We did not identify any indications in the data suggesting that EASE was more effective than a single session family intervention in the context of the COVID-19 pandemic and other crises in Lebanon. Fully powered research is needed to evaluate the effectiveness of EASE.
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Affiliation(s)
- Mark J D Jordans
- War Child, Research and Development Department, Amsterdam, the Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, the Netherlands.
| | - Felicity L Brown
- War Child, Research and Development Department, Amsterdam, the Netherlands; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, the Netherlands.
| | - Jeremy Kane
- Department of Epidemiology, Columbia University, New York, USA.
| | - Karine Taha
- War Child, Lebanon Country Office, Beirut, Lebanon
| | - Frederik Steen
- War Child, Research and Development Department, Amsterdam, the Netherlands.
| | - Rayane Ali
- War Child, Lebanon Country Office, Beirut, Lebanon.
| | - Joseph Elias
- War Child, Lebanon Country Office, Beirut, Lebanon.
| | | | - May Aoun
- War Child, Lebanon Country Office, Beirut, Lebanon.
| | - Claire M Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, USA.
| | | | - Aemal Akhtar
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Sweden; School of Psychology, University of New South Wales, Australia.
| | | | - Marit Sijbrandij
- VU University, Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam, the Netherlands.
| | - Richard Bryant
- School of Psychology, University of New South Wales, Australia.
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15
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Campbell F, Whear R, Rogers M, Sutton A, Barlow J, Booth A, Tattersall A, Wolstenholme L, Thompson‐Coon J. PROTOCOL: What is the effect of intergenerational activities on the wellbeing and mental health of children and young people? CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1347. [PMID: 37475878 PMCID: PMC10354504 DOI: 10.1002/cl2.1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: this systematic review will examine the impact of intergenerational interventions on the wellbeing and mental health in children and young people and will identify areas for future research as well as key messages for service commissioners.
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Affiliation(s)
- Fiona Campbell
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUnited KingdomUK
| | - Rebecca Whear
- NIHR CLAHRC South West Peninsula (PenCLAHRC)University of Exeter Medical SchoolExeterUK
| | - Morwenna Rogers
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical School, University of ExeterExeterUK
| | - Anthea Sutton
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUnited KingdomUK
| | - Jane Barlow
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
| | - Andrew Booth
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUnited KingdomUK
| | - Andrew Tattersall
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUnited KingdomUK
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16
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Karcher NR, Hicks R, Schiffman J, Asarnow JR, Calkins ME, Dauberman JL, Garrett CD, Koli RL, Larrauri CA, Loewy RL, McGough CA, Murphy JM, Niendam TA, Roaten K, Rodriguez J, Staglin BK, Wissow L, Woodberry KA, Young JF, Gur RE, Bearden CE, Barch DM. Youth Mental Health Screening and Linkage to Care. Psychiatr Serv 2023; 74:727-736. [PMID: 36695011 PMCID: PMC10329990 DOI: 10.1176/appi.ps.202200008] [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] [Indexed: 01/26/2023]
Abstract
One Mind, in partnership with Meadows Mental Health Policy Institute, convened several virtual meetings of mental health researchers, clinicians, and other stakeholders in 2020 to identify first steps toward creating an initiative for early screening and linkage to care for youths (individuals in early adolescence through early adulthood, ages 10-24 years) with mental health difficulties, including serious mental illness, in the United States. This article synthesizes and builds on discussions from those meetings by outlining and recommending potential steps and considerations for the development and integration of a novel measurement-based screening process in youth-facing school and medical settings to increase early identification of mental health needs and linkage to evidence-based care. Meeting attendees agreed on an initiative incorporating a staged assessment process that includes a first-stage brief screener for several domains of psychopathology. Individuals who meet threshold criteria on the first-stage screener would then complete an interview, a second-stage in-depth screening, or both. Screening must be followed by recommendations and linkage to an appropriate level of evidence-based care based on acuity of symptoms endorsed during the staged assessment. Meeting attendees proposed steps and discussed additional considerations for creating the first nationwide initiative for screening and linkage to care, an initiative that could transform access of youths to mental health screening and care.
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Affiliation(s)
- Nicole R. Karcher
- Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, MO
| | | | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, CA
| | - Joan R. Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Judith L. Dauberman
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Chantel D. Garrett
- Department of Health Services, Strong 365, University of Washington, Seattle, WA
| | - Roshni L. Koli
- Department of Psychiatry, University of Texas at Austin, Dell Medical School, Austin, TX, USA
| | | | - Rachel L. Loewy
- Department of Psychiatry, University of California, San Francisco, CA
| | | | - J. Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Tara A. Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA
| | - Kimberly Roaten
- Department of Psychiatry, Meadows Mental Health Policy Institute, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jacqueline Rodriguez
- Student Support & Health Services, Sacramento City Unified School District, Sacramento, CA
| | | | - Lawrence Wissow
- Department of Psychiatry, University of Washington, Seattle, WA
| | - Kristen A. Woodberry
- Center for Psychiatric Research, Maine Medical Center Research Institute, Scarborough, ME
- Department of Psychiatry, Tufts School of Medicine, Boston, MA
| | - Jami F. Young
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, PA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA
| | - Deanna M. Barch
- Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, MO
- Departments of Psychological & Brain Sciences and Radiology, Washington University in St. Louis, St. Louis, MO
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17
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Levante A, Martis C, Bianco F, Castelli I, Petrocchi S, Lecciso F. Internalizing and externalizing symptoms in children during the COVID-19 pandemic: a systematic mixed studies review. Front Psychol 2023; 14:1182309. [PMID: 37397311 PMCID: PMC10313408 DOI: 10.3389/fpsyg.2023.1182309] [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: 03/08/2023] [Accepted: 05/02/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Given the vulnerability of children during the COVID-19 pandemic, paying close attention to their wellbeing at the time is warranted. The present protocol-based systematic mixed-studies review examines papers published during 2020-2022, focusing on the impact of the COVID-19 pandemic on children's internalizing/externalizing symptoms and the determinants thereof. Method PROSPERO: CRD42022385284. Five databases were searched and the PRISMA diagram was applied. The inclusion criteria were: papers published in English in peer-reviewed journals; papers published between January 2020 and October 2022 involving children aged 5-13 years; qualitative, quantitative, and mixed studies. The standardized Mixed Method Appraisal Tool protocol was used to appraise the quality of the studies. Results Thirty-four studies involving 40,976 participants in total were analyzed. Their principal characteristics were tabulated. The results showed that children's internalizing/externalizing symptoms increased during the pandemic, largely as a result of disengagement from play activities and excessive use of the internet. Girls showed more internalizing symptoms and boys more externalizing symptoms. Distress was the strongest parental factor mediating children's internalizing/externalizing symptoms. The quality of the studies was appraised as low (n = 12), medium (n = 12), and high (n = 10). Conclusion Gender-based interventions should be designed for children and parents. The studies reviewed were cross-sectional, so long-term patterns and outcomes could not be predicted. Future researchers might consider a longitudinal approach to determine the long-term effects of the pandemic on children's internalizing and externalizing symptoms. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385284, identifier: CRD42022385284.
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Affiliation(s)
- Annalisa Levante
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Chiara Martis
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Federica Bianco
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Ilaria Castelli
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Serena Petrocchi
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Flavia Lecciso
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Lab of Applied Psychology, Department of Human and Social Sciences, University of Salento, Lecce, Italy
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18
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Rodríguez-Jiménez T, Vidal-Arenas V, Falcó R, Moreno-Amador B, Marzo JC, Piqueras JA. Assessing Emotional Distress in Adolescents: Psychometrics of the Spanish Version of the Social Emotional Distress Scale-Secondary. CHILD & YOUTH CARE FORUM 2023:1-21. [PMID: 37360761 PMCID: PMC10239276 DOI: 10.1007/s10566-023-09758-5] [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: 05/19/2023] [Indexed: 06/28/2023]
Abstract
Background The Social Emotional Distress Scale-Secondary (SEDS-S) is a short measure designed for comprehensive school-based mental health screening, particularly for using very brief self-reported measures of well-being and distress. Whereas prior studies have shown validity and reliability evidence for the English version, there is a lack of literature about its psychometric properties for Spanish-speaking youths. Objective To examine the psychometric properties of the SEDS-S in a large sample of Spanish adolescents, providing evidence of its reliability, structure, convergent and discriminant validity, longitudinal and gender measurement invariance, and normative data. Methods Participants were 5550 adolescents aged 12-18 years old. Test-retest reliability was examined using Cronbach's alpha and McDonald's omega coefficients, and evidence for convergent and discriminant validity was measured using Pearson's correlation. Confirmatory factor analysis (CFA) was used to examine structure validity, while multigroup and longitudinal measurement invariance analysis was conducted for longitudinal and gender latent structure stability. Results The CFA supported a unidimensional latent structure, which was also observed to be invariant between gender groups and over time. The scale showed evidence of reliability, with coefficients above .85. In addition, the SEDS-S score was positively related to measures assessing distress and negatively related to measures assessing well-being, thereby providing convergent/discriminant validity of the total scores. Conclusion This study provides the first evidence of the reliability and validity of the Spanish version of the SEDS-S for assessing emotional distress among adolescents, cross-sectionally and longitudinally. Furthermore, findings indicated that SEDS-S could be a suitable assessment tool for screening and program evaluation purposes at different contexts beyond the school setting.
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Affiliation(s)
| | - Verónica Vidal-Arenas
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | - Raquel Falcó
- Department of Health Psychology, Miguel Hernández University of Elche, Alicante, Spain
| | - Beatriz Moreno-Amador
- Department of Health Psychology, Miguel Hernández University of Elche, Alicante, Spain
| | - Juan C. Marzo
- Department of Health Psychology, Miguel Hernández University of Elche, Alicante, Spain
| | - José A. Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche, Alicante, Spain
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19
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Avittan H, Kustovs D. Cognition and Mental Health in Pediatric Patients Following COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5061. [PMID: 36981968 PMCID: PMC10049312 DOI: 10.3390/ijerph20065061] [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: 01/06/2023] [Revised: 02/28/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
The global coronavirus pandemic has significantly impacted public health and has been a research subject since its emergence in 2019. The acute phase of the disease leads to pulmonary and non-pulmonary manifestations, which in some individuals may progress to long-lasting symptoms. In this article, we conducted a narrative review of the current literature to summarize current knowledge regarding long COVID syndrome in children, focusing on cognitive symptoms. The review included a search of three databases (PubMed, Embase, and Web of Science) using the key phrases "post COVID-19 cognitive pediatric", "long COVID pediatric", "mental health long COVID children", and "COVID-19 cognitive symptoms". A total of 102 studies were included. The review revealed that the main long-term cognitive symptoms following COVID-19 were memory and concentration deficits, sleep disturbances, and psychiatric states such as anxiety and stress. In addition to the direct physiological effects of a viral infection, there are psychological, behavioral, and social factors contributing to cognitive impairment, which should be addressed regarding the pediatric population. The high prevalence of neurocognitive symptoms in children following COVID-19 emphasizes the importance of understanding the mechanisms of nervous system involvement.
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Affiliation(s)
- Hadar Avittan
- Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, LV 1007 Riga, Latvia
| | - Dmitrijs Kustovs
- Department of pharmacology, Riga Stradins University, Dzirciema Street 16, LV 1007 Riga, Latvia;
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Hall A, West X, Brown M, Hall E, Kim E, Leib A, Mergaman P, Salih Z, Aronoff S. Association of Adverse Childhood Experiences and Resilience With Obesity, High Blood Pressure, and Parental Report of Behavioral Health Symptoms in Children: A Cross Sectional Study. Glob Pediatr Health 2023; 10:2333794X231159518. [PMID: 36911753 PMCID: PMC9996718 DOI: 10.1177/2333794x231159518] [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: 01/26/2023] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
The interplay between Adverse Childhood Experiences (ACEs) and resilience on health in children is not well understood. Parents completed 3 questionnaires: ACEs, Child and Youth Resilience Measure (CYRM), and the Pediatric Symptom Checklist-17(PSC-17). BMI and blood pressure were measured. 19.8% of children had 4 or more ACEs, resilience ranged from 25 to 51, 14.3% had a positive PSC-17 score, 25.6% were obese, 3.1% had systolic hypertension, and 1.2% had diastolic hypertension. Higher ACEs (ACE OR: 1.398, 95% CI = 1.044-1.893, P = .026) and lower resilience (Resilience OR: 0.740, 95% CI 0.668-0.812; P = 1.13 × 10-9) were predictive of increased reports of behavioral health symptoms, but not obesity or hypertension. The personal resilience subscale was a predictor of positive PSC-17 score (OR 0.646, 95% CI = 0.546-0.749, P = 3.18 × 10-8); relationship subscale was not. Cultivating resilience, especially personal aspects, may provide an effective intervention for behavioral health symptoms in children.
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Affiliation(s)
- Ashleigh Hall
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Xandria West
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Marilyn Brown
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Erin Hall
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,Seattle Children's Hospital 4800 Sand Point Way NE Seattle, WA, USA
| | - Ella Kim
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Alexa Leib
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,West Chester Medical Center, Valhalla, NY, USA
| | - Paige Mergaman
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zanaib Salih
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Stephen Aronoff
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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21
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Twelve-month follow-up of a randomised clinical trial of a brief group psychological intervention for common mental disorders in Syrian refugees in Jordan. Epidemiol Psychiatr Sci 2022; 31:e81. [PMID: 36377410 PMCID: PMC9677446 DOI: 10.1017/s2045796022000658] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIMS There is increasing evidence that brief psychological interventions delivered by lay providers can reduce common mental disorders in the short-term. This study evaluates the longer-term impact of a brief, lay provider delivered group psychological intervention (Group Problem Management Plus; gPM+) on the mental health of refugees and their children's mental health. METHODS This single-blind, parallel, controlled trial randomised 410 adult Syrians in Azraq Refugee Camp in Jordan who screened positive for distress and impaired functioning to either five sessions of gPM+ or enhanced usual care (EUC). Primary outcomes were scores on the Hopkins Symptom Checklist-25 (HSCL-25; depression and anxiety scales) assessed at baseline, 6 weeks, 3 months and 12 months Secondary outcomes included disability, posttraumatic stress, personally identified problems, prolonged grief, prodromal psychotic symptoms, parenting behaviour and children's mental health. RESULTS Between 15 October 2019 and 2 March 2020, 204 participants were assigned to gPM + and 206 to EUC, and 307 (74.9%) were retained at 12 months. Intent-to-treat analyses indicated that although participants in gPM + had greater reductions in depression at 3 months, at 12 months there were no significant differences between treatment arms on depression (mean difference -0.9, 95% CI -3.2 to 1.3; p = 0.39) or anxiety (mean difference -1.7, 95% CI -4.8 to -1.3; p = 0.06). There were no significant differences between conditions for secondary outcomes except that participants in gPM + had greater increases in positive parenting. CONCLUSIONS The short-term benefits of a brief, psychological programme delivered by lay providers may not be sustained over longer time periods, and there is a need for sustainable programmes that can prolong benefits gained through gPM + .
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22
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Crandal BR, Hazen AL, Dickson KS, Tsai CYK, Trask EV, Aarons GA. Mental health symptoms of youth initiating psychiatric care at different phases of the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2022; 16:77. [PMID: 36180887 PMCID: PMC9524341 DOI: 10.1186/s13034-022-00511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine differences in caregiver and youth reported mental health symptoms for youth initiating mental health treatment through phases of the Coronavirus Disease (COVID-19) pandemic, compared with symptomology reported the prior year. STUDY DESIGN This retrospective study analyzes group differences in mental health symptoms (Pediatric Symptom Checklist; PSC-35) based on 7874 youth seeking treatment in publicly funded mental health treatment programs during California's Stay-At-Home order (March-May, 2020) and the prolonged pandemic (May-December, 2020) phases of the COVID-19 pandemic as compared with matching groups in 2019. RESULTS Youth entering mental health treatment services, and their caregivers, reported significantly increased internalizing, externalizing, and attention-related symptoms during the prolonged pandemic phase, but not during the acute stay-at-home phase of the COVID-19 pandemic, and with small effect sizes. Group comparison analyses did not detect a significantly larger effect for Sexual and Gender Diverse (SGD) youth who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex, and Black, Indigenous, People of Color (BIPOC). CONCLUSIONS A large-scale comparison of youth mental health symptoms before and during the COVID-19 pandemic suggests that mental health was disrupted for youth seeking treatment as the pandemic prolonged throughout 2020.
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Affiliation(s)
- Brent R. Crandal
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093 USA ,grid.286440.c0000 0004 0383 2910Behavioral Health Services, Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA 92123 USA
| | - Andrea L. Hazen
- grid.286440.c0000 0004 0383 2910Chadwick Center for Children & Families, Rady Children’s Hospital, 3020 Children’s Way, San Diego, CA 92123 USA ,grid.266100.30000 0001 2107 4242Child and Adolescent Services Research Center, 3665 Kearny Villa Road, Suite 200N, San Diego, CA 92123 USA
| | - Kelsey S. Dickson
- grid.266100.30000 0001 2107 4242Child and Adolescent Services Research Center, 3665 Kearny Villa Road, Suite 200N, San Diego, CA 92123 USA ,grid.263081.e0000 0001 0790 1491Department of Child and Family Development, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182 USA
| | - Chia-Yu Kathryn Tsai
- grid.514026.40000 0004 6484 7120California University of Science and Medicine, 1501 Violet Street, Colton, CA 92324 USA
| | - Emily Velazquez Trask
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093 USA ,grid.427930.b0000 0004 4903 9942Behavioral Health Services Department, Health and Human Services, County of San Diego, 3255 Camino del Rio South, San Diego, CA 92108 USA
| | - Gregory A. Aarons
- grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093 USA ,grid.266100.30000 0001 2107 4242Child and Adolescent Services Research Center, 3665 Kearny Villa Road, Suite 200N, San Diego, CA 92123 USA ,grid.427930.b0000 0004 4903 9942Behavioral Health Services Department, Health and Human Services, County of San Diego, 3255 Camino del Rio South, San Diego, CA 92108 USA
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23
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Costenaro P, Di Chiara C, Boscolo V, Barbieri A, Tomasello A, Cantarutti A, Cozzani S, Liberati C, Oletto S, Giaquinto C, Donà D. Perceived Psychological Impact on Children and Parents of Experiencing COVID-19 Infection in One or More Family Members. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1370. [PMID: 36138679 PMCID: PMC9498072 DOI: 10.3390/children9091370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022]
Abstract
SARS-CoV-2 infection may impair behavior and mental health; we explored the psychological impact on parents and children who experienced COVID-19 within their families. A cross-sectional web-based survey was conducted on families attending the COVID-19 Follow-up Clinic at the Department for Women’s and Children’s Health, Padua (Italy). From April 2020 to August 2021, 75 surveys were collected from 66 families (97 parents and 129 children); almost 70% of participants had COVID-19, mostly asymptomatic/mildly symptomatic, and the median time from infection to survey compilation was 164.7 days (SD 56). Most parents (>87%) reported positive relationships with family members either before, during, or after COVID-19. More than one-third of children and adolescents were unable to adapt to isolation. Among 31 pre-school children with a median age of 3 (SD 1.7), a change of one or more functions was reported for 74.2% of cases irrespective of COVID-19 status, particularly a change in circadian rhythm (25%), in relationship with parents (42.8%), and poor emotional control (36%). Among 74 children with a median age of 10.9 years (SD 2.7), 8.1% had a score indicating a disease; however, significant impairment in attention was reported for 16.7%, along with anxiety/depression and problems with conduct in 5.6% and 6.5% of cases, respectively.
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Affiliation(s)
- Paola Costenaro
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Costanza Di Chiara
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Valentina Boscolo
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Alessia Barbieri
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Alice Tomasello
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Anna Cantarutti
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Sandra Cozzani
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Cecilia Liberati
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Serenella Oletto
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Carlo Giaquinto
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
| | - Daniele Donà
- Division of Pediatric Infectious Diseases, Department for Women’s and Children’s Health, University of Padua, 35128 Padua, Italy
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Moreno-Amador B, Cervin M, Falcó R, Marzo JC, Piqueras JA. Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in a large sample of adolescents. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03477-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractFew studies have investigated body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in adolescents and how they relate to mental health, quality of life, suicide attempts, and non-suicidal self-harm. We used a quota sampling procedure and contacted 100 secondary centres in the Southeast of Spain, of which 34 participated in the study. A sample of 5,345 adolescents (12–18 years) completed dimensional measures of body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms. The proportion of adolescents with clinically significant symptoms within each symptom type was estimated and associations with other indicators of mental health examined. Clinically significant body-dysmorphic symptoms were reported by 3.7%, hoarding by 0.9%, hair-pulling by 0.7%, and skin-picking by 1.8%. Body-dysmorphic symptoms were more common in girls and in those over 14 years of age. Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were moderately to strongly associated with obsessive-compulsive symptoms, internalizing symptoms, externalizing symptoms, and poor quality of life. Those with significant body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were much more likely to have attempted suicide and engaged in non-suicidal self-harm during the last twelve months than those without such symptoms. Body-dysmorphic symptoms showed the strongest associations with internalizing symptoms and poor quality of life. Limitations are the sole use of self-report and a sample from only two regions in Spain, but findings suggest that body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms are common and impairing during adolescence.
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25
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Brown FL, Bosqui T, Elias J, Farah S, Mayya A, Abo Nakkoul D, Walsh B, Chreif S, Einein A, Meksassi B, Abi Saad R, Naal H, Ghossainy ME, Donnelly M, Betancourt TS, Carr A, Puffer E, El Chammay R, Jordans MJD. Family systemic psychosocial support for at-risk adolescents in Lebanon: study protocol for a multi-site randomised controlled trial. Trials 2022; 23:327. [PMID: 35436976 PMCID: PMC9014280 DOI: 10.1186/s13063-022-06284-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents growing up in communities characterised by adversity face multiple risk factors for poor mental health and wellbeing. There is currently a scarcity of research on effective approaches for preventing and treating psychological distress in this population, particularly in humanitarian settings. The powerful impact of the home environment and family support is well known; however, approaches targeting the family are seldom developed or evaluated in such settings. We developed a brief family systemic psychosocial support intervention to be delivered through existing child protection systems with non-specialist facilitators. This paper outlines the study protocol for a randomised controlled trial of the intervention in Lebanon. METHODS We will conduct a single-blind hybrid effectiveness-implementation multi-site RCT comparing the locally developed systemic family intervention to a waitlist control group for families residing in vulnerable regions in North Lebanon and Beqaa governorates (including families of Syrian, Palestinian, and Lebanese backgrounds). Outcomes on a range of family, adolescent, and caregiver measures will be assessed at baseline (T0) and post-intervention (T1), and at a 3-month follow-up for the treatment arm (T2). Families will be eligible for the trial if they are identified by implementing organisations as being medium-to-high risk for child protection concerns and have one or more adolescent aged 12-17 who demonstrates significant psychological distress on a self-report brief screening tool. Families will be randomly assigned to a treatment or a waitlist control condition. Families in the waitlist condition will receive a group version of the programme after completion of the study, to allow us to assess feasibility, acceptability, and preliminary indications of intervention effects of this modality. The primary outcome is reduction in overall adolescent-reported psychological distress over time, with post-intervention (T1) as the primary endpoint. Secondary adolescent-reported outcomes include family functioning, psychosocial wellbeing, and emotional regulation difficulties. Secondary caregiver-reported outcomes include parenting style, family functioning, psychological distress, and emotional regulation difficulties. DISCUSSION This trial will provide the first assessment of the effectiveness of the family systemic psychosocial support intervention for use in Lebanon, with important implications for the use of systemic, low-cost, non-specialist interventions for this age range. TRIAL REGISTRATION Local registry: National Mental Health Program, Ministry of Public Health, Lebanese Republic. Registered on 19 October 2021 Lebanese Clinical Trial Registry LBCTR2021104870 . Registered on 13 October 2021 Global registry: ISRCTN ISRCTN13751677 . Registered on 1 November 2021.
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Affiliation(s)
- Felicity L. Brown
- Research and Development Department, War Child Holland, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania Bosqui
- Department of Psychology, American University of Beirut, Beirut, Lebanon
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Republic of Ireland
| | | | - Sally Farah
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | - Anas Mayya
- Department of Psychology, American University of Beirut, Beirut, Lebanon
| | | | | | | | | | | | - Roula Abi Saad
- Child Protection Department, United Nations Children’s fund (UNICEF), Lebanon, Beirut, Lebanon
| | - Hady Naal
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Maliki E. Ghossainy
- Wheelock College of Education and Human Development, Boston University, Boston, MA USA
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Queen’s University Belfast, Belfast, Northern Ireland
| | | | - Alan Carr
- School of Psychology, University College Dublin, Belfield, Dublin, Republic of Ireland
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC USA
| | - Rabih El Chammay
- Ministry of Public Health, Beirut, Lebanon
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Mark J. D. Jordans
- Research and Development Department, War Child Holland, Amsterdam, The Netherlands
- Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
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26
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Systematic review and meta-analysis: relationships between attention-deficit/hyperactivity disorder and urinary symptoms in children. Eur Child Adolesc Psychiatry 2022; 31:663-670. [PMID: 33635440 DOI: 10.1007/s00787-021-01736-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
Lower urinary tract symptoms (LUTS), e.g., urinary frequency, pressure, urgency, and overactive bladder syndrome, are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD). Understanding the co-occurrence of these conditions has implications regarding clinical approaches, treatments, and improved quality of life. We conducted a systematic review and meta-analysis to examine the relationships between LUTS and ADHD in children. We searched for articles published between January 1990 and July 2019, in PubMed, CENTRAL, and PsycNet. Two authors independently screened all articles and extracted data. We performed random-effect meta-analyses for ADHD with pooled outcomes for LUTS. We identified 119 relevant articles in the literature and 18 articles fulfilled the inclusion criteria for the systematic review, of which, 5 articles had sufficient data for meta-analysis. Examining ADHD among individuals with LUTS, the odds ratio was 2.99 (95% CI 1.13, 7.88, p < 0.001), compared to controls. In multiple studies, the mean overall score for LUTS, using a standardized measure, was significantly higher in patients with ADHD in comparison to controls, and the severity of ADHD was positively associated with the severity of LUTS. Younger age in children was correlated with a higher LUTS score. Different subtypes of urinary incontinence demonstrated differences in behavioral problems and psychiatric comorbidity. Sex differences in LUTS were not consistent across articles. Our results indicate clinically significant associations between ADHD and LUTS in children. Because LUTS and ADHD are common disorders in children, clinicians should be aware of these associations as they inform optimal assessment and treatment strategies.
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27
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Sheldrick RC, Bair-Merritt MH, Durham MP, Rosenberg J, Tamene M, Bonacci C, Daftary G, Tang MH, Sengupta N, Morris A, Feinberg E. Integrating Pediatric Universal Behavioral Health Care at Federally Qualified Health Centers. Pediatrics 2022; 149:185679. [PMID: 35347338 DOI: 10.1542/peds.2021-051822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Research supports integrated pediatric behavioral health (BH), but evidence gaps remain in ensuring equitable care for children of all ages. In response, an interdisciplinary team codeveloped a stepped care model that expands BH services at 3 federally qualified health centers (FQHCs). METHODS FQHCs reported monthly electronic medical record data regarding detection of BH issues, receipt of services, and psychotropic medications. Study staff reviewed charts of children with attention-deficit/hyperactivity disorder (ADHD) before and after implementation. RESULTS Across 47 437 well-child visits, >80% included a complete BH screen, significantly higher than the state's long-term average (67.5%; P < .001). Primary care providers identified >30% of children as having BH issues. Of these, 11.2% of children <5 years, 53.8% of 5-12 years, and 74.6% >12 years were referred for care. Children seen by BH staff on the day of referral (ie, "warm hand-off") were more likely to complete an additional BH visit than children seen later (hazard ratio = 1.37; P < .0001). There was no change in the proportion of children prescribed psychotropic medications, but polypharmacy declined (from 9.5% to 5.7%; P < .001). After implementation, diagnostic rates for ADHD more than doubled compared with baseline, follow-up with a clinician within 30 days of diagnosis increased (62.9% before vs 78.3% after; P = .03) and prescriptions for psychotropic medication decreased (61.4% before vs 43.9% after; P = .03). CONCLUSIONS Adding to a growing literature, results demonstrate that integrated BH care can improve services for children of all ages in FQHCs that predominantly serve marginalized populations.
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Affiliation(s)
| | | | - Michelle P Durham
- Psychiatry, Boston University School of Medicine, Boston, Massachusetts.,Psychiatry, Boston Medical Center, Boston, Massachusetts
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28
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Bryant RA, Bawaneh A, Awwad M, Al-Hayek H, Giardinelli L, Whitney C, Jordans MJD, Cuijpers P, Sijbrandij M, Ventevogel P, Dawson K, Akhtar A. Effectiveness of a brief group behavioral intervention for common mental disorders in Syrian refugees in Jordan: A randomized controlled trial. PLoS Med 2022; 19:e1003949. [PMID: 35298469 PMCID: PMC8929659 DOI: 10.1371/journal.pmed.1003949] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/16/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Common mental disorders are frequently experienced by refugees. This study evaluates the impact of a brief, lay provider delivered group-based psychological intervention [Group Problem Management Plus (gPM+)] on the mental health of refugees in a camp, as well as on parenting behavior and children's mental health. METHODS AND FINDINGS In this single-blind, parallel, randomized controlled trial, 410 adult Syrian refugees (300 females, 110 males) in Azraq Refugee Camp (Jordan) were identified through screening of psychological distress (≥16 on the Kessler Psychological Distress Scale) and impaired functioning (≥17 on the WHO Disability Assessment Schedule). Participants were randomly allocated to gPM+ or enhanced usual care (EUC) involving referral information for psychosocial services on a 1:1 ratio. Participants were aware of treatment allocation, but assessors were blinded to treatment condition. Primary outcomes were scores on the Hopkins Symptom Checklist-25 (HSCL; depression and anxiety scales) assessed at baseline, 6 weeks, and 3 months follow-up as the primary outcome time point. It was hypothesized that gPM+ would result in greater reductions of scores on the HSCL than EUC. Secondary outcomes were disability, posttraumatic stress, personally identified problems, prolonged grief, prodromal psychotic symptoms, parenting behavior, and children's mental health. Between October 15, 2019 and March 2, 2020, 624 refugees were screened for eligibility, 462 (74.0%) screened positive, of whom 204 were assigned to gPM+ and 206 to EUC. There were 168 (82.4%) participants in gPM+ and 189 (91.7%) in EUC assessed at follow-up. Intent-to-treat analyses indicated that at follow-up, participants in gPM+ showed greater reduction on HSCL depression scale than those receiving EUC (mean difference, 3.69 [95% CI 1.90 to 5.48], p = .001; effect size, 0.40). There was no difference between conditions in anxiety (mean difference -0.56, 95% CI -2.09 to 0.96; p = .47; effect size, -0.03). Relative to EUC, participants in gPM+ had greater reductions in severity of personally identified problems (mean difference 0.88, 95% CI 0.07 to 1.69; p = .03), and inconsistent disciplinary parenting (mean difference 1.54, 95% CI 1.03 to 2.05; p < .001). There were no significant differences between conditions for changes in PTSD, disability, grief, prodromal symptoms, or childhood mental health outcomes. Mediation analysis indicated the change in inconsistent disciplinary parenting was associated with reduced attentional (β = 0.11, SE .07; 95% CI .003 to .274) and internalizing (β = 0.08, SE .05; 95% CI .003 to 0.19) problems in children. No adverse events were attributable to the interventions or the trial. Major limitations included only one-quarter of participants being male, and measures of personally identified problems, grief, prodromal psychotic symptoms, inconsistent parenting behavior, and children's mental health have not been validated with Syrians. CONCLUSIONS In camp-based Syrian refugees, a brief group behavioral intervention led to reduced depressive symptoms, personally identified problems, and disciplinary parenting compared to usual care, and this may have indirect benefits for refugees' children. The limited capacity of the intervention to reduce PTSD, disability, or children's psychological problems points to the need for development of more effective treatments for refugees in camp settings. TRIAL REGISTRATION Prospectively registered at Australian and New Zealand Clinical Trials Registry: ACTRN12619001386123.
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Affiliation(s)
- Richard A. Bryant
- University of New South Wales, Sydney, Australia
- Westmead Institute of Medical Research, Sydney, Australia
| | - Ahmad Bawaneh
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | - Manar Awwad
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | - Hadeel Al-Hayek
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | | | - Claire Whitney
- International Medical Corps, Washington DC, United States of America
| | - Mark J. D. Jordans
- War Child, Amsterdam, the Netherlands
- University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Peter Ventevogel
- United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Katie Dawson
- University of New South Wales, Sydney, Australia
| | - Aemal Akhtar
- University of New South Wales, Sydney, Australia
- Vrije Universiteit, Amsterdam, the Netherlands
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29
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Schumm JA, O’Farrell TJ. A comparison of psychosocial adjustment among children of women who received behavioral couples therapy versus individually based therapy for substance use disorder. J Subst Abuse Treat 2022; 133:108560. [PMID: 34246515 PMCID: PMC8733047 DOI: 10.1016/j.jsat.2021.108560] [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: 10/08/2020] [Revised: 06/08/2021] [Accepted: 06/28/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Children of women with substance use disorder (SUD) exhibit elevated risk for psychosocial adjustment problems. However, little research has examined whether women's SUD treatment is beneficial for their children. In comparison to individually based therapy (IBT), behavioral couples therapy (BCT) is superior for reducing women's SUD problems and improving their intimate partner relationships. The current study sought to examine whether BCT is more efficacious than 12-step-oriented IBT for reducing psychosocial adjustment problems among the children of women with SUD. METHODS The study obtained the data from two larger randomized clinical trials, both of which compared BCT plus IBT versus IBT alone for women with SUD. Participants were women (N = 75) and their male partners who had an identified target child between the ages of 6 and 16 years old (M = 10.63). Most (62%) were the biological child of both partners, and 92% lived with the couple. Both partners completed the Child Behavior Checklist (CBCL) in relation to the target child at baseline, post-treatment, and 6-month follow-up. RESULTS Comparisons of CBCL scores from baseline to following treatment mostly showed significant improvement in BCT + IBT but not IBT. Generalized estimating equations, which controlled for baseline CBCL, showed better retainment of treatment gains for mother-reported internalizing CBCL scores in BCT + IBT, but the study found no other between treatment differences. CONCLUSION These findings suggest that BCT + IBT produces more consistent improvements for children of women with SUD versus IBT.
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Affiliation(s)
- Jeremiah A. Schumm
- School of Professional Psychology, Wright State University,Samaritan Behavioral Health, Inc.,OneFifteen, Inc
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Sikov J, Baul TD, Garg A, Loubeau K, Murphy JM, Spencer AE. Linguistic Inequities in ADHD Diagnosis among School-age Children Screened for Attention Problems in Primary Care. J Health Care Poor Underserved 2022; 33:1632-1649. [PMID: 36245185 PMCID: PMC9873475 DOI: 10.1353/hpu.2022.0089] [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: 01/26/2023]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) remains underidentified among racial/ethnic minoritized populations. We examined whether parent reported screening questionnaires for attention problems in primary care mitigated these ADHD diagnostic inequities and identified contributing sociodemographic and clinical factors. METHODS We conducted a cross-sectional electronic medical record (EMR) study in an urban, hospital-based primary care pediatric clinic of school age children (N=2212) with a completed Pediatric Symptom Checklist (PSC-17). We examined differences between children with vs. without ADHD diagnoses, adjusting for positive PSC-17 attention score. RESULTS Adjusting for positive PSC attention score, children had higher odds of an ADHD diagnosis if they were English-speaking and had a documented Vanderbilt ADHD Diagnostic Rating Scale in their medical record. CONCLUSION Multilingual, parent-report screening for attention problems in pediatric primary care does not mitigate linguistic inequities in ADHD diagnosis.
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Affiliation(s)
| | - Tithi D. Baul
- Department of Psychiatry at the Boston Medical Center
| | - Arvin Garg
- Department of Pediatrics at the University of Massachusetts Medical School
| | | | | | - Andrea E. Spencer
- Department of Psychiatry at the Boston Medical Center and the Boston University School of Medicine
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31
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Taylor EK, Dopp AR, Lounsbury K, Thompson Y, Miller M, Jorgensen A, Silovsky JF. Enhancing Early Engagement (E3) in mental health services training for children's advocacy center's victim advocates: feasibility protocol for a randomized controlled trial. Pilot Feasibility Stud 2021; 7:212. [PMID: 34872619 PMCID: PMC8645678 DOI: 10.1186/s40814-021-00949-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Child maltreatment is a major public issue in the United States, yet most children affected by abuse or neglect never engage in evidence-based practices (EBP) for child mental health. Children’s Advocacy Centers (CACs’) are uniquely situated to serve as Family Navigators who connect children impacted by maltreatment to appropriate EBPs. In fact, the CAC position of Victim Advocate mirrors the Mental Health Family Navigator national initiative. Methods The feasibility study protocol is to develop, implement, and evaluate web-based and consultative training for Victim Advocates to enhance early engagement in services (E3 training). The interactive web-based training embeds key targets of knowledge and skills related to family engagement, trauma, and EBP services. Participating CACs were randomized to E3 webinar-based training, E3 webinar plus consultation, or delayed training. The project will test the E3 training’s impact on key mechanisms of change (e.g., knowledge, skills) to improve rates of screening, referral, and access to EBP services. The feasibility of implementing the training program and differential impact and costs by level of training will be examined. Discussion The overarching goal of this project is to test the feasibility of training that is readily implemented through CACs and examine the mechanisms for improving early engagement and, ultimately, child, and adolescent mental health outcomes. Results and cost findings will be used to plan a large-scale comprehensive, mixed-methods hybrid type II effectiveness-implementation and cost-effectiveness trial of family navigator E3 training. If outcomes are positive, considerable infrastructure exists to support the scale-up and sustainability of E3 training nationwide, by embedding the training in national CAC training protocols. Trial registration NCT04221633 Date and version identifier March 25, 2021; Vers. 1.0 (original); September 11, 2021; Vers 2.0 (revision); October 29, 2021; Vers. 3.0 (revision)
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Affiliation(s)
- Erin K Taylor
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA.
| | - Alex R Dopp
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA
| | - Kaitlin Lounsbury
- National Children's Alliance, 516 C St NE #100, Washington, DC, 20002, USA
| | - Yutian Thompson
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA
| | - Michelle Miller
- National Children's Alliance, 516 C St NE #100, Washington, DC, 20002, USA
| | - Ashley Jorgensen
- HumRRO, 700 North Hurstbourne Parkway, Suite 100, Louisville, KY, 40222, USA
| | - Jane F Silovsky
- Center on Child Abuse and Neglect, Department of Pediatrics, University of Oklahoma Health Sciences Center, 940 NE 13th St #4900, Oklahoma City, OK, 73104, USA
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Epstein LH, Schechtman KB, Kilanowski C, Ramel M, Moursi NA, Quattrin T, Cook SR, Eneli IU, Pratt C, Geller N, Campo R, Lew D, Wilfley DE. Implementing family-based behavioral treatment in the pediatric primary care setting: Design of the PLAN study. Contemp Clin Trials 2021; 109:106497. [PMID: 34389519 PMCID: PMC9664376 DOI: 10.1016/j.cct.2021.106497] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/20/2021] [Accepted: 06/27/2021] [Indexed: 12/11/2022]
Abstract
Family-based behavioral treatment (FBT) is an evidence-based treatment for pediatric obesity. FBT has primarily been implemented in specialty clinics, with highly trained interventionists. The goal of this study is to assess effectiveness of FBT implemented in pediatric primary care settings using newly trained interventionists who might implement FBT in pediatric practices. The goal is to randomize 528 families with a child with overweight/obesity (≥85th BMI percentile) and parent with overweight/obesity (BMI ≥ 25) across four sites (Buffalo and Rochester, New York; Columbus, Ohio; St. Louis, Missouri) to FBT or usual care and obtain assessments at 6-month intervals over 24 months of treatment. FBT is implemented using a mastery model, which provides quantity of treatment tailored to family progress and following the United States Preventive Services Task Force recommendations for effective dose and duration of treatment. The primary outcome of the trial is change in relative weight for children, and secondarily, for parents and siblings who are overweight/obese. Between group differences in the tendency to prefer small immediate rewards over larger, delayed rewards (delay discounting) and how this is related to treatment outcome is also evaluated. Challenges in translation of group-based interventions to individualized treatments in primary care settings, and in study implementation that arose due to the COVID-19 pandemic are discussed. It is hypothesized that the FBT intervention will be associated with better changes in relative weight for children, parents, and siblings than usual care. The results of this study can inform future dissemination and implementation of FBT into primary care settings.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
| | - Kenneth B Schechtman
- Department of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Colleen Kilanowski
- Department of Pediatrics, Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Melissa Ramel
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nasreen A Moursi
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Teresa Quattrin
- Department of Pediatrics, Jacobs School of Medicine, and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Steven R Cook
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Ihouma U Eneli
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Charlotte Pratt
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nancy Geller
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rebecca Campo
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Daphne Lew
- Department of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
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Bandi R, Lathiya R, Lingappa L, Konanki R. Herbal Medicine-Induced Seizures in Children: Single-Center Experience Over 18 Months. Indian Pediatr 2021. [PMID: 33452778 PMCID: PMC7840423 DOI: 10.1007/s13312-021-2099-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ramya Bandi
- Department of Neurology, Rainbow Children's Hospital, Banjara Hills, Hyderabad 500 034, Andhra Pradesh, India
| | - Rini Lathiya
- Department of Genetics, Rainbow Children's Hospital, Banjara Hills, Hyderabad 500 034, Andhra Pradesh, India
| | - Lokesh Lingappa
- Department of Neurology, Rainbow Children's Hospital, Banjara Hills, Hyderabad 500 034, Andhra Pradesh, India
| | - Ramesh Konanki
- Department of Neurology, Rainbow Children's Hospital, Banjara Hills, Hyderabad 500 034, Andhra Pradesh, India.
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Abstract
Most children will experience some type of trauma during childhood, and many children suffer from significant adversities. Research in genetics, neuroscience, and epidemiology all provide evidence that these experiences have effects at the molecular, cellular, and organ level, with consequences on physical, emotional, developmental, and behavioral health across the life span. Trauma-informed care translates that science to inform and improve pediatric care and outcomes. To practically address trauma and promote resilience, pediatric clinicians need tools to assess childhood trauma and adversity experiences as well as practical guidance, resources, and interventions. In this clinical report, we summarize current, practical advice for rendering trauma-informed care across varied medical settings.
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Affiliation(s)
- Heather Forkey
- Department of Pediatrics, University of Massachusetts, Worcester, Massachusetts
| | - Moira Szilagyi
- Divisions of General and Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Erin T Kelly
- Ambulatory Health Services, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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Bate J, Pham PT, Borelli JL. Be My Safe Haven: Parent-Child Relationships and Emotional Health During COVID-19. J Pediatr Psychol 2021; 46:624-634. [PMID: 34283892 PMCID: PMC8344797 DOI: 10.1093/jpepsy/jsab046] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 04/07/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Since March 2020, millions of children have been confined to their homes and restricted from in-person activities, radically changing the dynamics of parent-child relationships. This study examines the association between coronavirus disease 2019 (COVID-19) impact and the mental health of parents and school-aged children; specifically, whether qualities of the parent-child relationship moderated the relationship between parents' emotional health (EH) and children's emotional and behavioral health (EBH). METHODS Data from this Internet-based study of a community sample were collected in March-May 2020. Parents (N = 158, 92.4% White, 96.2% female) reported on COVID-19 impacts, their own EH, perceptions of their relationship with their eldest child between 6 and 12 years-old, and the EBH of that child. RESULTS Responses to questions about COVID-19 impact were assigned weighted values and used to create a COVID-19 impact scale. Hierarchical linear regressions revealed that greater COVID-19 impact was associated with greater parents' EH issues only, and parents' EH was a significant positive predictor of children's EBH. Positive qualities and conflict in the parent-child relationship moderated the link between parents' and children's EH. At higher levels of relationship conflict and lower levels of positivity, there were stronger positive associations between parents' and children's EH. Parent-child relationship quality did not moderate the association between parents' EH and children's behavioral health (BH). CONCLUSIONS These cross-sectional study results suggest that beyond focusing on symptom management, families may benefit from supports targeting the parent-child relationship. Insights and implications for practitioners are discussed.
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Affiliation(s)
- Jordan Bate
- Ferkauf Graduate School of Psychology, Yeshiva University
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Roby E, Da Rosa Piccolo L, Gutierrez J, Kesoglides N, Raak CD, Mendelsohn AL, Canfield CF. Father involvement in infancy predicts behavior and response to chronic stress in middle childhood in a low-income Latinx sample. Dev Psychobiol 2021; 63:1449-1465. [PMID: 33398881 PMCID: PMC8254829 DOI: 10.1002/dev.22081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 11/06/2022]
Abstract
Fathers' involvement in early childhood is important for children's physical, emotional, and cognitive development, particularly in low-income families. However, little is known about the longitudinal relations between early father involvement and children's later physiological responses to chronic stress and behaviors impacted by stress in the context of poverty. These issues are particularly important among Latinx immigrant families who face significant psychosocial and poverty-related risk. In the current study, we examined the relationship between father involvement in infancy and physiological chronic stress in the middle childhood period, as measured through hair cortisol concentration (HCC), and several behavioral measures (attention problems, working memory) in a Latinx immigrant sample with low income. Father involvement in infancy predicted children's later HCC, and working memory in second to third grade. Father involvement also moderated the effect of HCC on working memory, such that increased HCC predicted better working memory when fathers were not involved. These findings suggest that the fathers' involvement in infancy has lasting impacts on health and behavior and that associations between physiological and behavioral measures of stress may be moderated by differences in early father involvement.
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Affiliation(s)
- Erin Roby
- Department of Pediatrics, NYU Grossman School of Medicine
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Petts RA, Gaynor ST. Behavioral Health in Primary Care: Brief Screening and Intervention Strategies for Pediatric Clinicians. Pediatr Clin North Am 2021; 68:583-606. [PMID: 34044987 DOI: 10.1016/j.pcl.2021.02.010] [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: 11/30/2022]
Abstract
Despite the high prevalence of behavioral health concerns presenting in pediatric primary care and the growing support for integrating behavioral health services into this setting, a majority of primary care providers do not have access to on-site behavioral health specialists. Fortunately, primary care providers can implement some services typically provided by behavioral health clinicians. This article outlines screening, brief intervention, and referral guidelines for prominent behavioral health problems seen in primary care. The evidence-based approaches have the potential to supplement typical management of behavioral health problems in primary care and provide a foundation for future integrated behavioral health practice.
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Affiliation(s)
- Rachel A Petts
- Department of Psychology, Wichita State University, 1845 Fairmount Street, Wichita, KS 67260, USA.
| | - Scott T Gaynor
- Department of Psychology, Western Michigan University, 1903 West Michigan Avenue, Kalamazoo, MI 49008, USA
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38
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Hamersma S, Ye J. The effect of public health insurance expansions on the mental and behavioral health of girls and boys. Soc Sci Med 2021; 280:113998. [PMID: 34022585 DOI: 10.1016/j.socscimed.2021.113998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/21/2021] [Accepted: 05/02/2021] [Indexed: 12/23/2022]
Abstract
This paper examines the effects of public health insurance expansions on the mental health care utilization and mental and behavioral health of children 6-17 years old. We leverage major expansions in public health insurance eligibility for children and adolescents under Medicaid and the State Children's Health Insurance Program during 1997-2002 to examine mental health care utilization and outcomes for children in the National Survey of America's Families. The study examines these dynamics by gender of children due to their distinct mental health care patterns and risks. The expansions are associated with an estimated 30% reduction in mental health care utilization for girls, but no measurable effect for boys, which may partly be accounted for by increased well-child visits for girls. Mental health improves only for teenagers; boys in particular have an estimated 22 percent increase in their probability of the highest level of health. Parents experience spillovers of lower insurance coverage for themselves - likely from dropping private family coverage for public child-only coverage - but slightly better mental health.
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Affiliation(s)
- Sarah Hamersma
- Department of Public Administration and International Affairs, Syracuse University, Center for Policy Research, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244-1020, USA.
| | - Jinqi Ye
- School of Economics, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 430074, China.
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Murphy JM, Stepanian S, Riobueno-Naylor A, Holcomb JM, Haile H, Dutta A, Giuliano CP, Bernstein SC, Joseph B, Shui AM, Jellinek MS. Implementation of an Electronic Approach to Psychosocial Screening in a Network of Pediatric Practices. Acad Pediatr 2021; 21:702-709. [PMID: 33285307 DOI: 10.1016/j.acap.2020.11.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE A network of 18 pediatric practice locations serving predominantly commercially insured patients implemented the electronic administration of the Pediatric Symptom Checklist-17 parent-report (PSC-17P) for all 5.50- to 17.99-year-old children seen for well child visits (WCVs) and wrote up the results as a quality improvement project. The current study investigated this screening over 2 years to assess its implementation and risk rates over time. METHODS Parents completed the PSC-17P electronically before the visit and the scored data were immediately available in the patient's chart. Using billing and screening data, the study tracked rates of overall and positive screening during the first-year baseline (4 months) and full implementation phases of the project in the first (8 months) and second (12 months) year. RESULTS A total of 35,237 patients completed a WCV in the first year. There was a significant improvement in PSC-17P screening rates from the first-year baseline (26.3%) to full implementation (89.3%; P < .001) phases. In the second year, a total of 40,969 patients completed a WCV and 77.9% (n = 31,901) were screened, including 18,024 patients with screens in both years. PSC-17P screening rates varied significantly across the 18 locations and rates of PSC-17P risk differed significantly by practice, insurance type, sex, and age. CONCLUSIONS The current study demonstrated the feasibility of routine psychosocial screening over 2 years using the electronically administered PSC-17P in a network of pediatric practices. This study also corroborated past reports that PSC-17 risk rates differed significantly by insurance type (Medicaid vs commercial), sex, and age group.
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Affiliation(s)
- J Michael Murphy
- Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass; Department of Psychiatry (JM Murphy, MS Jellinek), Harvard Medical School, Boston, Mass.
| | - Salpi Stepanian
- Department of Clinical and Quality Programs (S Stepanian, CP Giuliano, SC Bernstein), Affiliated Pediatric Practices, Dedham, Mass
| | - Alexa Riobueno-Naylor
- Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass
| | - Juliana M Holcomb
- Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass
| | - Haregnesh Haile
- Department of Psychology (H Haile), The Catholic University of America, Washington, DC
| | - Anamika Dutta
- Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass
| | - Christopher P Giuliano
- Department of Clinical and Quality Programs (S Stepanian, CP Giuliano, SC Bernstein), Affiliated Pediatric Practices, Dedham, Mass
| | - Shelly C Bernstein
- Department of Clinical and Quality Programs (S Stepanian, CP Giuliano, SC Bernstein), Affiliated Pediatric Practices, Dedham, Mass; Department of Pediatrics (SC Bernstein, MS Jellinek), Harvard Medical School, Boston, Mass
| | | | - Amy M Shui
- Biostatistics Center (AM Shui), Massachusetts General Hospital, Boston, Mass
| | - Michael S Jellinek
- Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass; Department of Psychiatry (JM Murphy, MS Jellinek), Harvard Medical School, Boston, Mass; Department of Pediatrics (SC Bernstein, MS Jellinek), Harvard Medical School, Boston, Mass
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Delgado JR, Diaz LD, LaHuffman-Jackson R, Quion N, Walts K. Community-Based Trauma-Informed Care Following Immigrant Family Reunification: A Narrative Review. Acad Pediatr 2021; 21:600-604. [PMID: 33582311 DOI: 10.1016/j.acap.2021.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
Many immigrant families made the decision to separate from their children and migrate to the United States (US) hoping to reunite when able. Contrary to what is envisioned, the ultimate reunification can be a challenging transition. Reestablishing the parent-child relationship can be hindered by the anger, distress, vulnerability, and abuse the child may have experienced during the separation leading to behavioral concerns and depressive symptoms. The culmination of trauma and adverse childhood events prior to and following reunification is associated with an increased risk of anxiety, depression, behavioral disorders, and toxic stress. Unaddressed, these issues can lead to poor adult psychiatric health and limit a child's educational success and potential lifetime earnings. Trauma-informed programming has been an effective tool in addressing the mental health needs of refugee and immigrant children and may benefit this particular group of reunified families when held in a community setting alongside peer support. Familias Reunidas and Family Reunification and Resiliency Training (FUERTE) are 2 community-based programs that successfully guided recently reunified families through the process of reconnecting. Review of these programs suggests there is significance in the collaboration of health care providers, education specialists, and community liaisons in program creation, cultivation of a supportive group environment, incorporation of trauma-informed principles, and partnership with a community establishment. These components can lead to a reunification program that provides access to mental health services in order to work toward eliminating the health disparities affecting these families. Brief Summary: Family reunification can be a challenging transition for recently immigrated children whose parent(s) immigrated to the US years before them. Community programming could provide access to trauma-informed care to overcome the emotional distress reunification can cause within families.
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Affiliation(s)
| | - Ligia D Diaz
- University of Pittsburgh (LD Diaz), Department of Psychology, Pittsburgh, Pa
| | - Renée LaHuffman-Jackson
- Fairfax County Public Schools, Office of Family & School Partnerships (R LaHuffman-Jackson), Falls Church, Va
| | - Nathalie Quion
- Children's National Hospital, Children's Health Center Northwest (N Quion), Washington, DC
| | - Kathleen Walts
- Fairfax County Public Schools, Office of Professional Learning and Family Engagement (K Walts), Falls Church, Va
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Klages KL, Berlin KS, Cook JL, Keenan ME, Semenkovich K, Banks GG, Rybak TM, Ankney RL, Decker KM, Whitworth JR, Corkins MR. Examining Risk Factors of Health-Related Quality of Life Impairments Among Adolescents with Inflammatory Bowel Disease. Behav Med 2021; 47:140-150. [PMID: 34048329 DOI: 10.1080/08964289.2019.1676193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Inflammatory Bowel Disease (IBD) is a chronic, costly, and burdensome disease that is typically diagnosed during adolescence. Despite the use of effective treatments, rates of relapse and intestinal inflammation remain high and put patients at risk for long term physical and psychosocial health complications. Given the costs associated with IBD, it is critical to examine potential risk factors of poor health-related quality of life (HRQoL) among patients for the enhancement and further development of interventions. As such, the aim of the current study was to examine how sociodemographic and disease characteristics, psychosocial problems, and adherence behaviors impact HRQoL among a sample of youth with IBD. 107 adolescents with IBD and their caregiver completed self- and parent-report measures as part of a psychosocial screening service. Medical records were reviewed to obtain information regarding diagnosis, insurance, medication use, illness severity, and disease activity. Results revealed lower HRQoL scores among adolescents with more psychosocial problems (Est. = -3.08; p < .001), greater disease severity (Est. = -.40; p = .001), and those who identified as Black (Est. = -.38; p < .05). Greater disease severity (Est. = .13 p = .004), use of nonpublic insurance (Est. = .32 p = .004), and fewer psychosocial problems (Est. = -.13 p = .04) were associated with greater adherence behaviors. These findings suggest that implementing individually tailored, evidence-based psychological interventions focused on coping with psychosocial problems and symptoms may be important in enhancing adherence behaviors and HRQoL among adolescents with IBD.
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Affiliation(s)
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis.,Department of Pediatrics, University of Tennessee Health Sciences Center
| | | | | | | | | | | | | | | | - John R Whitworth
- Department of Pediatrics, University of Tennessee Health Sciences Center
| | - Mark R Corkins
- Department of Pediatrics, University of Tennessee Health Sciences Center
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Barnett M, Sheldrick RC, Liu SR, Kia-Keating M, Negriff S. Implications of adverse childhood experiences screening on behavioral health services: A scoping review and systems modeling analysis. AMERICAN PSYCHOLOGIST 2021; 76:364-378. [PMID: 33734801 PMCID: PMC8161946 DOI: 10.1037/amp0000756] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Widespread implementation of adverse childhood experiences (ACEs) screening is occurring in the United States in response to policies and practice recommendations. However, limited research has established how these screening efforts impact the health care system and ultimately health outcomes. This article examines the current knowledge base on screening in medical settings. A scoping review of articles reporting on ACEs screening and prevalence in the United States was conducted. Of the 1,643 unique studies across two decades, 12 articles meeting criteria included nine on routine screening in medical settings and three on population-based surveys. A Monte Carlo simulation model was designed to synthesize evidence, identify key areas of uncertainty, and explore service system implications. Results indicated significant heterogeneity in the proportion of respondents who reported ACEs, with 6% to 64% of patients reporting 1+ ACEs and .01% to 40.7% reporting 4+ ACEs. Gaps in the literature were identified regarding cut-scores for referrals and referral completion rates. Three scenarios, modeled based on these data and past research on behavioral health screenings in pediatric primary care, demonstrated how ACEs screening may differentially impact behavioral health care systems. Priorities for future research were highlighted to refine estimates of the likely impact of ACEs screening on health care delivery. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Miya Barnett
- University of California, Santa Barbara, Department of Counseling, Clinical, and School Psychology
| | | | - Sabrina R. Liu
- University of California, Santa Barbara, Department of Counseling, Clinical, and School Psychology
| | - Maryam Kia-Keating
- University of California, Santa Barbara, Department of Counseling, Clinical, and School Psychology
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Abstract
This study evaluated whether children with higher adverse childhood experiences (ACE) scores had alterations in immune cell gene expression profiles. RNA sequencing was conducted on dried blood spot samples from 37 generally healthy English-speaking children (age 5-11) who were recruited from well-child visits at a university-affiliated pediatric practice. The Whole Child Assessment was used to assess ACE exposure. Primary analyses examined an a priori-specified composite of 19 pro-inflammatory gene transcripts. Secondary analyses examined a 34-gene composite assessing Type I interferon response, and used Transcript Origin Analyses to identify cellular mechanisms. After controlling for age, body mass index percentile, sex, race/ethnicity, current insurance status, and household smoking exposure, pro-inflammatory gene expression was elevated by 0.094 log2 RNA expression units with each Child-ACE total score point (p = .019). Type I interferon gene expression was similarly upregulated (0.103; p = .008). Transcript origin analyses implicated CD8+ T cell as the primary sources of gene transcripts upregulated, and nonclassical (CD16+) monocytes as sources of downregulated transcripts. These preliminary analyses suggest that parent-reported ACE exposures are associated with increased expression of both inflammatory and interferon gene transcripts in children's circulating blood cells.
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Bandi R, Lathiya R, Lingappa L, Konanki R, Kimiya T, Shinjoh M, Miyata A, Takahashi T, Shah S, Kaul A, Shah R, Maddipoti S. Herbal Medicine-Induced Seizures in Children: Single-Center Experience Over 18 Months. Indian Pediatr 2021; 58:71-73. [PMID: 33452778 PMCID: PMC7840423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2024]
Abstract
Many common household herbal preparations may have seizurogenic ingredients. We report 15 children with seizures following exposure to such compounds: oral ingestion of liquid preparation in 13, and local application of balm and Eucalyptus oil ingestion in one each. All children, except one, had generalized seizures. This study highlights the need to address this history during evaluation of first seizure, and increase awareness of seizurogenic potential of such preparations.
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Affiliation(s)
- Ramya Bandi
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Rini Lathiya
- Department of Genetics, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Lokesh Lingappa
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Ramesh Konanki
- Department of Neurology, Rainbow Children’s Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, 500 034 India
| | - Takahisa Kimiya
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan
| | - Masayoshi Shinjoh
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Akiko Miyata
- Saiwai Pediatric Clinic, Tachikawa-shi, Tokyo, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Sachin Shah
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Amita Kaul
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Rima Shah
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
| | - Sankeerth Maddipoti
- Surya Mother and Child Superspecialty Hospital, Pune, Maharashtra, 411 057 India
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Akhtar A, Giardinelli L, Bawaneh A, Awwad M, Al-Hayek H, Whitney C, Jordans MJD, Sijbrandij M, Cuijpers P, Dawson K, Bryant R. Feasibility trial of a scalable transdiagnostic group psychological intervention for Syrians residing in a refugee camp. Eur J Psychotraumatol 2021; 12:1932295. [PMID: 34262668 PMCID: PMC8253196 DOI: 10.1080/20008198.2021.1932295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Approximately 10% of Syrian refugees currently reside in camp settings, which can impose additional post-migration stressors. With elevated rates of psychological distress and few available resources, task-shifting psychosocial programmes are necessary to provide adequate care. One such programme developed by the World Health Organization (WHO) is Group Problem Management Plus (GroupPM+). Objective: This study aimed to test the safety and acceptability of GroupPM+ in a refugee camp and to identify areas for adaptation in preparation for a definitive RCT. Method: A feasibility randomized controlled trial (RCT) was conducted in Azraq refugee camp in Jordan. Inclusion criteria were: (1) Syrian adults aged ≥18 years, (2) parent of a child aged 10-16 years, (3) experiencing psychological distress as defined by a score of ≥16 on the Kessler Distress Scale, and (4) ≥17 on the WHO Disability Assessment Schedule 2.0. Following baseline assessments, participants were randomized to receive GroupPM+ or enhanced treatment-as-usual. Post-assessments were conducted one week following the last GroupPM+ session. Primary outcomes were feasibility and acceptance of GroupPM+; symptoms of anxiety, depression, PTSD, prodromal psychosis, grief, and child's self-reported psychological distress were also assessed. Results: Of the 207 persons screened, 64 (31%) screened positive for psychological distress. Of the 35 randomized into the GroupPM+ intervention, 24 (69%) completed the intervention. No adverse events were reported throughout the trial. Children whose parents received GroupPM+ had greater reductions in internalizing and externalizing symptoms at posttreatment. 55 (86%) participants completed the post-assessment follow-up. These results demonstrate both the feasibility of conducting the trial in a camp and acceptance of the GroupPM+ intervention by Syrian refugees. Conclusions: Following the feasibility trial, both the implementation procedures and intervention were safe and culturally acceptable. The results support the readiness for a definitive RCT to determine the effectiveness and cost-effectiveness of the intervention in camp settings.
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Affiliation(s)
- Aemal Akhtar
- School of Psychology, University of New South Wales, Sydney, Australia.,Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Ahmad Bawaneh
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | - Manar Awwad
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | - Hadeel Al-Hayek
- Jordan Country Office, International Medical Corps, Amman, Jordan
| | - Claire Whitney
- Technical Unit, International Medical Corps, Washington, DC, USA
| | - Mark J D Jordans
- Research and Development Department, War Child, Amsterdam, The Netherlands.,Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Katie Dawson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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Akhtar A, Malik A, Ghatasheh M, Aqel IS, Habashneh R, Dawson KS, Watts S, Jordans MJD, Brown F, Sijbrandij M, Cuijpers P, Bryant R. Feasibility trial of a brief scalable psychological intervention for Syrian refugee adolescents in Jordan. Eur J Psychotraumatol 2021; 12:1901408. [PMID: 34868475 PMCID: PMC8635577 DOI: 10.1080/20008198.2021.1901408] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Most refugees are less than 18 years and at heightened risk of common mental disorders (CMDs) relative to other youth. Limited evidence exists for psychosocial programsfor youth in low-resource settings. Early Adolescent Skills for Emotions (EASE) was developed by the World Health Organization to address this gap. OBJECTIVES This study tested the safety, feasibility, and trial procedures of the EASE intervention among Syrian refugee youth in preparation for a definitive randomized controlled trial (RCT). METHODS A feasibility RCT was conducted in Amman, Jordan with Syrian children aged 10-14 years who reported psychological distress. Following community screening, youth and their caregivers were randomized to receive either the EASE intervention or enhanced treatment as usual (ETAU). EASE comprised seven group sessions teaching children coping skills, and caregivers received three group sessions to augment the youth sessions. Assessments were conducted at baseline and 1 week following the last EASE session (8 weeks following baseline). Following the trial, a qualitative process evaluation with staff and beneficiaries took place. Primary outcomes were safety and feasibility indicators, and distress was measured by the Paediatric Symptom Checklist. RESULTS In November 2018, 179 children were screened; 61 (33%) met criteria for distress (34.1%), two were excluded for suicidal risk, and 59 were randomized (EASE = 33, ETAU = 26). Of those who received EASE, 26 children (79%) completed the intervention. Group attendance was high and no adverse events were reported in either arm. Psychological distress did not show signs of abating in either group over time. CONCLUSION This feasibility trial demonstrated the safety and acceptability of the intervention. Important lessons were learnt regarding entry criteria into the study and engagement of caregivers in the intervention. A fully powered randomized controlled trial will be conducted to evaluate the efficacy of EASE.
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Affiliation(s)
- Aemal Akhtar
- Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands.,School of Psychology, University of New South Wales, Sydney, Australia
| | - Aiysha Malik
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Maha Ghatasheh
- Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | | | - Rand Habashneh
- Institute for Family Health, King Hussein Foundation, Amman, Jordan
| | - Katie S Dawson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Sarah Watts
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Mark J D Jordans
- Research and Development Department, War Child Holland, Amsterdam, The Netherlands.,Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Felicity Brown
- Research and Development Department, War Child Holland, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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Skelton JA, Van Fossen C, Harry O, Pratt KJ. Family Dynamics and Pediatric Weight Management: Putting the Family into Family-Based Treatment. Curr Obes Rep 2020; 9:424-441. [PMID: 33108634 DOI: 10.1007/s13679-020-00407-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW The treatment of pediatric obesity entails working with entire families. However, aside from parenting and family health behaviors, family dynamics and relationships are not often incorporated in clinical treatment of obesity. RECENT FINDINGS Evidence across several studies suggest a relationship between family dynamics and child weight, with impaired family dynamics associated with higher weight status in children. Evidence is mixed if child age and family function are associated. Unfortunately, there is little evidence that addressing family dynamics (i.e., relationships and overall family system) will improve weight in children with obesity. Notably, few studies target family dynamics specifically. There are several validated measures of family dynamics available for researchers to explore the family system as it relates to child health and behaviors. A deeper understanding of family dynamics and relationships may provide new avenues to address issues of weight in children; accounting for the family, and their underlying functioning, may benefit the clinician and child engaged in weight management.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Catherine Van Fossen
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Onengiya Harry
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Keeley J Pratt
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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48
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Abright AR, Grudnikoff E. Measurement-Based Care in the Treatment of Adolescent Depression. Child Adolesc Psychiatr Clin N Am 2020; 29:631-643. [PMID: 32891366 DOI: 10.1016/j.chc.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Measurement-based care is a helpful adjunct to clinical assessment in improving outcomes in depression in adults and adolescents. Measurement-based care principles are incorporated in current regulatory requirements for use of standardized instruments in efforts to improve care and prevent suicide. Challenges for child and adolescent psychiatrists and other clinicians in implementing measurement-based care include concerns about time and expense involved in administration and interpretation of results from rating scales and other instruments. Implementation can be facilitated by selection of instruments that are brief, easy to administer and score, compatible with electronic health record systems, and available in the public domain.
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Affiliation(s)
- Arthur Reese Abright
- New York City Health + Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, 79-01 Broadway, Elmhurst, NY 11373, USA.
| | - Eugene Grudnikoff
- New York City Health + Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, 79-01 Broadway, Elmhurst, NY 11373, USA; South Oaks Hospital, 400 Sunrise Highway, Amityville, NY 11701, USA
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49
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Hostutler CA, Ramtekkar U. Using Measurement-Based Care Data in Population Health Management. Child Adolesc Psychiatr Clin N Am 2020; 29:733-741. [PMID: 32891372 DOI: 10.1016/j.chc.2020.06.010] [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: 11/28/2022]
Abstract
Although screening can significantly improve the identification of youth with mental health needs in primary care, there is no evidence that screening improves outcomes. Measurement-based care using clinical mental health registries has been shown to improve screening outcomes in adult primary care populations and pediatric physical health needs; however, there is limited attention to pediatric mental health registries in primary care. This article describes clinical mental health registries, discusses the barriers to implementation with youth, and describes next steps in expanding the use of pediatric mental health registries in primary care.
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Affiliation(s)
- Cody A Hostutler
- Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital; Department of Pediatrics, The Ohio State University
| | - Ujjwal Ramtekkar
- Department of Child and Adolescent Psychiatry, Nationwide Children's Hospital; Department of Psychiatry, The Ohio State University.
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Patil S, Patil N, Joglekar C, Yadav A, Nilawar A, Banavali U, Bhat R, Dombale V, Warpe B, Mohite R, Joshi K. a Dolescent and pr Econception health pe Rspecti Ve of Adult Non-communicable diseases ( DERVAN): protocol for rural prospective adolescent girls cohort study in Ratnagiri district of Konkan region of India (DERVAN-1). BMJ Open 2020; 10:e035926. [PMID: 32895267 PMCID: PMC7476477 DOI: 10.1136/bmjopen-2019-035926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Precise impact of nutritional insufficiencies in adolescence as a risk factor for non-communicable diseases (NCD) in later life as adults remains largely unknown.We are conducting research into the effects of nutrition on adolescent girls of Ratnagiri district by a prospective cohort study (aDolescent and prEconception health peRspectiVe of Adult Non-communicable diseases cohort). Our study focuses on the physical health, nutritional parameters and cognitive profiles of adolescent girls, during the prenatal and postnatal period and we aim to follow this cohort and their offspring for 20 years. METHODS AND ANALYSIS Cohort recruitment began in June 2019. Our aim is to recruit more than 1500 adolescent girls, age 16-18 years, over a period of 3 years. The recruit's cognition, diet and physical activity will be recorded. The following investigations will be performed: body composition by anthropometry and bioimpedence, and blood pressure, fasting blood sample to measure glucose, insulin, lipids, micronutrients and hormones, abdominal ultrasonography to measure liver, pancreas and kidneys.A biorepository has been created for long-term storage of blood, urine and saliva samples for future analysis. By this longitudinal study, we aim to identify the effects of malnutrition on the behavioural and biological measures in adolescent subjects and evaluate if these are associated with the onset of NCDs in adulthood. ETHICS AND DISSEMINATION Institutional Ethic Committee (IEC) of BKL Walawalkar Rural Medical College and Hospital has granted the permission to carry out the study. IEC is registered with Government of India. Its registration code is EC/755/INST/MH/2015/RR-18. It is not a clinical trial but as required we have also registered the study on Clinical Trial Registry of India (CTRI). The registration code is CTRI/2019/04/018453.Appropriate written informed consent and assent are obtained from the parents and the adolescent girls, respectively. We plan to publish our results in peer-reviewed journals.
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Affiliation(s)
- Suvarna Patil
- Department of Medicine, BKL Walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Netaji Patil
- Department of Radiology, BKL Walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Charudatta Joglekar
- Centre for Adolescent Health and Nutrition, BKL Walawalkar Hospital & Rural Medical College, Sawarde, India
| | - Arvind Yadav
- Department of Biochemistry, BKL Walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Anup Nilawar
- Department of Biochemistry, BKL Walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Ulka Banavali
- Centre for Adolescent Health and Nutrition, BKL Walawalkar Hospital & Rural Medical College, Sawarde, India
| | - Rohit Bhat
- Centre for Adolescent Health and Nutrition, BKL Walawalkar Hospital & Rural Medical College, Sawarde, India
| | - Vijay Dombale
- Department of Pathology, BKL walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Bhushan Warpe
- Department of Pathology, BKL walawalkar Hospital & Rural Medical College, Sawarde, Maharashtra, India
| | - Rachana Mohite
- Centre for Adolescent Health and Nutrition, BKL Walawalkar Hospital & Rural Medical College, Sawarde, India
| | - Kiran Joshi
- Department of Obstetrics and Gynaecology, BKL walawalkar Hospital & Rural medical College, Sawarde, Maharashtra, India
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