The intertwined effect of lack of emotional warmth and child abuse and neglect on common mental disorders in adolescence

Living with parents, lifestyle pattern and common mental disorders in adolescents: a school-based study in Brazil

Background

Mental health conditions represent 16% of the global burden of disease and injury in adolescents. Promotion, protection, and restoring the mental health must be considered indispensable, especially in adolescence. This study aims to verify the association of lifestyle pattern, living with parents and the presence of Common Mental Disorders (CMD) in Brazilian adolescents.

Methods

Cross-sectional study that analyzed data from 71,553 adolescents aged 12–17 years, from the Study on Cardiovascular Risks in Adolescents (ERICA), between 2013 and 2014. Principal Component Analysis (PCA) was performed to identify lifestyle pattern, and Logistic Regression Models were performed to identify the associations between lifestyle pattern, living with parents, and presence of CMD.

Results

To construct the Common Mental Disorders (CMD) variable, the Goldberg General Health Questionnaire was used. The Pattern of Healthy Lifestyle Practices found was characterized by higher water consumption, lower consumption of ultra-processed foods, the habit of eating breakfast, less exposure time to screens, habit of physical activity, and longer mean sleep time in hours. Adolescents belonging to the second (OR: 0.73; 95% CI 0.65–0.82) and third (OR: 0.44; 95% CI 0.39–0.50) terciles of the pattern, that is, those who had higher belonging to the pattern had lower chances of having CMD. Adolescents who lived with neither parent (OR: 1.44; 95% CI 1.16–1.78) were associated with a higher chance to present CMD.

Conclusion

Living with parents can contribute to better mental health among adolescents. In addition, the adoption of a healthy lifestyle, encouraged by parents and the community, can reduce the chances of CMD in Brazilian adolescents.

Mediating effects of parent-child relationship on the association between childhood maltreatment and depressive symptoms among adolescents

BACKGROUND

Depressive symptoms are the most common mental disorder among adolescents, and its prevalence has been increasing in recent years. Although childhood maltreatment is a contributing factor to depressive symptoms among adolescents, the underlying mechanism of how this factor causes depressive symptoms is unclear.

OBJECTIVE

This study aimed to investigate the mediating effects of parent-child relationship on the association between childhood maltreatment and depressive symptoms among adolescents and to identify how sex and only child status affect this association.

METHODS

A total of 14,500 middle school students were randomly selected from four cities (Shenzhen, Zhengzhou, Nanchang, and Guiyang) in China. A survey questionnaire was administered to collect information on childhood maltreatment, parent-child relationship, and depressive symptoms. Pearson's correlation analysis was used in analyzing the relationship, Bootstrap method was used to test the mediating effects. A moderated mediation analysis has been used to determine the moderated mediation effect.

RESULTS

Childhood maltreatment significantly negatively correlated with parent-child relationship and positively correlated with depressive symptoms (P < 0.001). The indirect effect of parent-child relationship accounted for 20.60% of the total effect between childhood maltreatment and depressive symptoms in all respondents and differed by sex (boys, 17.00%; girls, 25.23%) and only child status (only child, 15.61%; child with siblings, 23.49%). Besides, the indirect effect of the mediation model was moderated by sex and only child status.

CONCLUSIONS

Childhood maltreatment increased the risk of depressive symptoms, and this relationship was partially mediated by parent-child relationship, sex and only child status have moderated the indirect relationship. These findings showed efforts aimed at enhancing the parent-child relationship may prevent or reduce the prevalence of depressive symptoms among adolescents, especially in girls and children with siblings.

Childhood Trauma and Mental Health in the Cape Town Adolescent Antiretroviral Cohort

This study aimed to assess the association of childhood trauma, stressful life events and HIV stigma with mental health in South African adolescents from the Cape Town Adolescent Antiretroviral Cohort (CTAAC). The Childhood Trauma Questionnaire, Life Events Questionnaire and the HIV Stigma Scale for South African Adolescents Living with HIV was used to assess childhood trauma, stressful life events and stigma in adolescents living with perinatally acquired HIV and healthy controls enrolled in the CTAAC. These measures were associated with mental health outcomes including the Beck-Youth Inventories, Child Behaviour Checklist, Columbian Impairment Scale, Childrens Motivation Scale, Conners Scale for Attention Deficit Hyperactivity Disorder using Pearson correlations and self-reported alcohol use, using Spearman-rank correlation. 63.7% of adolescents reported at least one childhood trauma on the CTQ. Significant associations were reported between CTQ measures and Beck-Youth Inventories. Emotional abuse was associated with anxiety, anger, depression and disruptive behaviour. Emotional neglect was associated with poor self-concept and disruptive behaviour. LEQ total score was significantly associated with Beck-Youth Inventories including anxiety, depression, anger and disruptive behaviour scales. HIV stigma was significantly associated with Beck-Youth Inventories including depression, anger and disruptive behaviour. Childhood trauma, stressful life events and HIV stigma in South African adolescents are associated with anxiety, depression, anger, disruptive-behaviour and poor self-concept. This study highlights the importance of enquiring about exposure to a variety of traumas, particularly those commonly experienced by South African adolescents. In addition, it is important to understand the impact of trauma exposure on each individuals mental health and functioning.

Childhood maltreatment and emotional distress: The role of beliefs about emotion and psychological inflexibility

The current study aimed to investigate the mediating role of negative beliefs about emotion and psychological inflexibility on the relationship between childhood maltreatment and emotional distress. A total of 519 participants completed the Childhood Trauma Questionnaire (CTQ), Depression Anxiety Stress Scale-21 (DASS-21), the Leahy Emotional Schema Scale II (LESS-II), and the Acceptance and Action Questionnaire-II (AAQ-II). All scales were significantly correlated. Two mediation analyses were tested. In the first model negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and emotional distress measured by DASS-21 total score. In the second model, negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and depression, anxiety, and stress measured by the subscales of DASS-21. Results suggest that maltreatment in childhood is associated with the individuals' approaches, plans and strategies in response to emotions, and psychological inflexibility which together further determine emotional distress.

Factors influencing the addiction characteristics of non-suicidal self-injurious behaviors in adolescents: A case-control study

BACKGROUND

Many studies have shown that in the context of public health emergencies, the incidence rate of adolescent non-suicidal self-injury (NSSI) patients increased dramatically. This paper aims to characterize the behavioral characteristics of adolescent NSSI and analyze the influencing factors of NSSI behavior addiction characteristics.

METHODS

Our research was a case-control study which included 84 adolescents with NSSI (female vs. male: 59 vs. 25) and 84 healthy controls (female vs. male: 53 vs. 31). All the participants enrolled were aged 12-18 years. The differences in the scores of the following five scales were compared between the case and control groups: Egna Minnen Barndoms Uppfostran (EMBU), Perceived Social Support Scale (PSSS), Perceived Stress Scale (PSS); Bergen Social Media Addiction Scale (BSMAS) and Video Game Dependence Scale (VDG-S). The characteristics of NSSI behavior of the study group were evaluated using the Ottawa Self Inventory Chinese Revised Edition (OSIC). And a binary logistic regression model was developed to analyze the factors that influence adolescent NSSI behavioral addiction characteristics.

RESULTS

In the study group, the emotional warmth scores in the father's and mother's rearing style scores in the EMBU were significantly lower than the controls. The BSMAS and VDG-S scores were significantly higher than those in the control group. 38 cases of NSSI with addiction characteristics accounted for 45.24% in the study group. The risk factors for NSSI addiction traits were as follows: female, single-child, high level of VDG-S scores, high scores of excessive interferences in father's rearing style, and high scores of punishments and excessive interferences in mother's rearing style score.

CONCLUSION

Female, only child, internet addiction, and negative parenting styles were predictors of NSSI behavioral addiction characteristics in adolescents. Targeted coping strategies should be developed to reduce the occurrence and development of self-injurious behavior, especially for female adolescents with Internet dependence in one-child families with negative parenting styles.

The role of family meal frequency in common mental disorders in children and adolescents over eight months of follow-up

OBJECTIVE

This study evaluated the influence of family meal frequency on the occurrence of common mental disorders (CMD) in children and adolescents over eight months of follow-up.

DESIGN

Data from this longitudinal study were derived from the PAAPAS-Parents, Students, Community Health Agents, and Teachers for Healthy Eating-community trial. CMD were evaluated using the General Health Questionnaire. Frequency of family meals (breakfast and dinner) was categorized as "breakfast and dinner regularly with the family", "at least breakfast or dinner regularly with the family", and "does not have any meal regularly with the family." The effect of family meal frequency on CMD was analyzed using generalized estimation equations with log-binomial models for repeated measures.

SETTING

This study was conducted in public schools (N = 18) of Duque de Caxias, Rio de Janeiro, Brazil, in 2016.

PARTICIPANTS

Children (aged 9-11 years) and adolescents (aged 12-17 years) from the fifth and sixth grades (N = 2,743).

RESULTS

These findings suggested that regular family meals were a protective factor for mental health. The adjusted relative risk of CMD was 0.75 (95% confidence interval = 0.69-0.83) for those who had two family meals regularly and 0.87 (95% confidence interval = 0.77-0.97) for those who had only one regular family meal, compared to students who had no regular family meals.

CONCLUSIONS

Potential strategies that educate and encourage families about the mental health benefits of eating regular meals together must be explored and implemented.

Childhood abuse and community violence: Risk factors for youth violence

OBJECTIVE

To investigate the joint effect of child abuse and neglect (CAN) and community violence (CV) on adolescents with peers that commit youth violence (YV).

METHODS

This is a school-based cross-sectional study of 699 students enrolled in four public and nine private schools in the municipality of Rio de Janeiro, Brazil. Participants were selected through a complex cluster sampling procedure. CAN was identified using the Childhood Trauma Questionnaire (CTQ). Exposure to CV was assessed by asking students if they have witnessed cases of lethal violence in the community. YV was measured indirectly through questions about having friends who have committed acts of crime. Multivariate logistic models were used to study the effects of emotional, physical, and sexual abuse and emotional and physical neglect in childhood on YV, controlled for confounders, according to different levels of CV.

RESULTS

Emotional abuse OR = 3.32 (CI 95%: 1.79-6.17), sexual abuse OR = 2.33 (CI 95%: 1.20-4.54), and physical neglect OR = 1.81 (CI 95%: 1.02-3.20) increased the odds of YV in adolescents, whether cooccurring with CV or not. Physical abuse OR = 3.95 (CI 95%: 2.29 - 6.80) and emotional neglect OR = 2.93 (CI 95%: 1.83-4.72) are only risk factors for YV involvement when associated with CV.

CONCLUSIONS

These findings highlight the relevance of CAN and CV as risk factors for YV and the potential increase in adolescents' vulnerability when exposed to both. Policies aiming at preventing and dealing with CAN are essential strategies to reduce YV, especially in areas with high levels of CV.