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Ndetei DM, Mutiso V, Nyamai P, Musyimi C. The correlations on psychopathology in children self-rating, psychopathology in children as related by their parents and psychopathology in parents self-rating in a Kenyan school setting: towards an inclusive family-centered approach. BMC Psychiatry 2024; 24:535. [PMID: 39054489 PMCID: PMC11270966 DOI: 10.1186/s12888-024-05971-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
Several studies have reported on the association between parental and childhood psychopathologies. Despite this, little is known about the psychopathologies between parents and children in a non-clinical population. We present such a study, the first in a Kenyan setting in an attempt to fill this gap. The objective of this study was to determine the association between self-rating psychopathology in children, parent-rating psychopathology in their children and self-rating psychopathology in parents in a non-clinical population of children attending schools in Kenya. We identified 113 participants, comprising children and their parents in 10 randomly sampled primary schools in South East Kenya. The children completed the Youth Self-Report (YSR) scale and parents completed the Child Behavior Check List (CBCL) on their children and the Adult Self-Reports (ASR) on themselves. These instruments are part of the Achenbach System of Empirically Based Assessment (ASEBA), developed in the USA for a comprehensive approach to assessing adaptation and maladaptive behavior in children and adolescents. There was back and forth translation of the instruments from English to Swahili and the local dialect, Kamba. Every revision of the English translation was sent to the instrument author who sent back comments until the revised version was in sync with the version developed by the author. We used the ASEBA in-built algorithm for scoring to determine cut-off points for problematic and non-problematic behavior. Correlations, linear regression and independent sample t-test were used to explore these associations. The mean age of the children was 12.7. While there was no significant association between child problems as measured by YSR (self-reported) and parent problems as measured by ASR and CBCL in the overall correlations, there was a significant association when examining specific groups (clinical range vs. non-clinical). Moreover, significant association existed between total problems on YSR and ASR internalizing problems (t=-2.3,p = 0.023), with clinical range having a higher mean than the normal range. In addition, a significant relationship (p < 0.05) was found between psychopathology in children as reported by both parents (CBCL) and psychopathology in parents as self-reported (ASR).Mothers were more likely to report lower syndrome scores of their children as compared to fathers. Our findings indicate discrepancies between children self-rating and parent ratings, suggesting that one cannot manage psychopathology in children without reference to psychopathology in their parents. We suggest broad-based psycho-education to include children and parents to enhance shared awareness of psychopathology and uptake of treatment.
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Affiliation(s)
- David M Ndetei
- Africa Institute of Mental and Brain Health (Formerly Africa Mental Health Research and Training Foundation), Nairobi, Kenya.
- Department of Psychiatry, Kenya and Founding Director of Africa Institute of Mental and Brain Health (Formerly Africa Mental Health Research and Training Foundation (AMHRTF)), University of Nairobi, Mawensi Road, Off Elgon Road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya.
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
| | - Victoria Mutiso
- Africa Institute of Mental and Brain Health (Formerly Africa Mental Health Research and Training Foundation), Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Pascalyne Nyamai
- Africa Institute of Mental and Brain Health (Formerly Africa Mental Health Research and Training Foundation), Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Christine Musyimi
- Africa Institute of Mental and Brain Health (Formerly Africa Mental Health Research and Training Foundation), Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
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2
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Rettew DC, Biel MG. Widening Our Lane: How Child and Adolescent Psychiatrists Can Embrace the Full Spectrum of Mental Health. Child Adolesc Psychiatr Clin N Am 2024; 33:293-306. [PMID: 38823804 DOI: 10.1016/j.chc.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
The majority of a psychiatrist's training and clinical attention is devoted to mental illness rather than mental health. This article suggests a broader understanding and application of mental well-being that can benefit both those already struggling with mental health challenges and those trying to stay well. Recommendations for being a well-being-oriented psychiatrist include increasing one's knowledge about well-being and health promotion and adjusting one's practice to incorporate these principles. Recommendations at the level of the field of psychiatry include revising the definition of a psychiatrist, increasing research on well-being and health promotion, improving financial incentives, expanding efforts in schools and community settings, and providing additional training.
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Affiliation(s)
- David C Rettew
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA; Lane County Behavioral Health, Eugene, OR, USA.
| | - Matthew G Biel
- MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA
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3
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Özbek MM, Sevinçok D, Aksu H. Perceived Social Support and Parental Emotional Temperament Among Children with Attention Deficit and Hyperactivity Disorder. PSYCHIAT CLIN PSYCH 2023; 33:203-210. [PMID: 38765306 PMCID: PMC11082631 DOI: 10.5152/pcp.2023.22527] [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: 10/01/2022] [Accepted: 04/01/2023] [Indexed: 05/22/2024] Open
Abstract
Background This research examined how the emotional temperaments of parents of children with attention deficit and hyperactivity disorder correlated with their perceptions of their children's social support from friends, teachers, and families. Additionally, the parents' emotional temperaments in terms of their association with children's low and high perceptions of family support were examined. Methods The study included 50 children with attention deficit and hyperactivity disorder, 40 neurotypical control subjects, and their parents. The Symptom Checklist-90-R was used to analyze the parents' psychopathology. The parents' affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto questionnaire version. The children's perceptions of their support from their families, peers, and teachers were evaluated using the Social Support Appraisal Scale. Results Mothers' depressive (r = -0.419, P = .002) and anxious temperaments (r = -0.338, P = .016) were inversely correlated with perceived social support from parents among children with attention deficit and hyperactivity disorder. Mothers' hyperthymic (r = 0.443, P = .001) and cyclothymic temperaments (r = 0.310, P = .029) and fathers' hyperthymic temperament (r = 0.371, P = .008) were positively correlated with perceived social support from parents. Regression analyses revealed that perceived social support from friends was predicted by paternal low cyclothymic and high anxious temperament. They also showed that inattention and mother's general psychopathology predicted perceived social support from family. Perceived social support from teacher was predicted by hyperactivity, maternal low cyclothymic temperament, and paternal high anxious temperament. Conclusion While parents' depressive and anxious temperaments were associated with low perceived social support from family, hyperthymic and cyclothymic temperaments were associated with increased perceived social support from the family among children with attention deficit and hyperactivity disorder.
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Affiliation(s)
- Mutlu Muhammed Özbek
- Department of Child and Adolescent Psychiatry, Kars Harakani State Hospital, Kars, Turkey
| | - Doğa Sevinçok
- Department of Child and Adolescent Psychiatry, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Hatice Aksu
- Department of Child and Adolescent Psychiatry, Aydın Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
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Monnier M, Moulin F, Bailhache M, Thierry X, Vandentorren S, Côté S, Falissard B, Simeon T, Geay B, Marchand-Martin L, Dufourg MN, Charles MA, Ancel PY, Melchior M, Rouquette A, Galera C. Parents' depression and anxiety associated with hyperactivity-inattention and emotional symptoms in children during school closure due to COVID-19 in France. Sci Rep 2023; 13:4863. [PMID: 36964194 PMCID: PMC10038697 DOI: 10.1038/s41598-023-31985-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/21/2023] [Indexed: 03/26/2023] Open
Abstract
Several risk factors of children's mental health issues have been identified during the pandemic of COronaVIrus Disease first appeared in 2019 (COVID-19). This study aims to fill the knowledge gap regarding the association between parents' and children's mental health issues during the COVID-19 school closure in France. We conducted a cross-sectional analysis of data collected in the SAPRIS-ELFE study during the COVID-19 pandemic in France. Using multinomial logistic regressions, we estimated associations between parents' and children's mental health issues. Symptoms of anxiety were assessed by the General Anxiety Disorder-7 (GAD-7) and depression by the Patient Health Questionnaire-9 (PHQ-9) for the parents. Hyperactivity/inattention and emotional symptoms in children were assessed by the Strengths and Difficulties Questionnaire (SDQ). The sample included 3496 children aged 8 to 9 years, of whom 50.0% were girls. During the school closure, 7.1% of responding parents had moderate to severe levels of anxiety and 6.7% had moderate to severe levels of depression. A total of 11.8% of the children had an abnormal hyperactivity/inattention score and 6.6% had an abnormal emotional symptoms score. In multivariate regression models, parental moderate to severe level of anxiety and moderate to severe level of depression were associated with abnormal hyperactivity-inattention score (adjusted Odds Ratio (aOR) 3.31; 95% Confidence Interval (CI) 2.33-4.70 and aOR 4.65; 95% CI 3.27-6.59, respectively) and abnormal emotional symptoms score in children (aOR 3.58; 95% CI 2.33-5.49 and aOR 3.78; 95 CI 2.47-5.78 respectively). Children whose parents have symptoms of anxiety and/or depression have an increased likelihood of symptoms of hyperactivity/inattention and emotional symptoms during school closures in France due to COVID-19. Our findings suggest that public health initiatives should target parents and children to limit the impact of such crises on their mental health issues.
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Affiliation(s)
- Maëva Monnier
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France.
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France.
| | - Flore Moulin
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France
| | - Marion Bailhache
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France
- Pole de Pédiatrie, CHU de Bordeaux, Place Amélie Raba Léon, 33000, Bordeaux, France
| | - Xavier Thierry
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France
- Inserm, Paris, France
- Etablissement Français du Sang (EFS), Paris, France
| | - Stéphanie Vandentorren
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France
- Santé Publique France, French National Public Health Agency, 94415, Saint-Maurice, France
| | - Sylvana Côté
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
| | - Bruno Falissard
- Inserm, UVSQ, CESP, Fac. de Médecine - Université Paris-Sud, INSERM 1018, Paris-Saclay University, DevPsy, Villejuif, France
- Public Health and Epidemiology Department, AP-HP Paris-Saclay, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Thierry Simeon
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France
- Inserm, Paris, France
- Etablissement Français du Sang (EFS), Paris, France
| | - Bertrand Geay
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France
- Inserm, Paris, France
- Etablissement Français du Sang (EFS), Paris, France
| | - Laetitia Marchand-Martin
- Inserm, Paris, France
- Université Paris Cité, Paris, France
- Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Paris, France
| | - Marie-Noelle Dufourg
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France
- Inserm, Paris, France
- Etablissement Français du Sang (EFS), Paris, France
| | - Marie-Aline Charles
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France
- Inserm, Paris, France
- Etablissement Français du Sang (EFS), Paris, France
- Université Paris Cité, Paris, France
- Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Pierre-Yves Ancel
- Inserm, Paris, France
- Université Paris Cité, Paris, France
- Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Institut national de recherche pour l'agriculture, l'alimentation et l'environnement (INRAE), Paris, France
| | - Maria Melchior
- Faculté de Médecine St Antoine, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Épidémiologie Sociale (ERES), Sorbonne Université, Paris, France
| | - Alexandra Rouquette
- Inserm, UVSQ, CESP, Fac. de Médecine - Université Paris-Sud, INSERM 1018, Paris-Saclay University, DevPsy, Villejuif, France
- Public Health and Epidemiology Department, AP-HP Paris-Saclay, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Cédric Galera
- Bordeaux Population Health Research Center, Institut National de la Santé et de la Recherche Médicale (INSERM) U 1219, 146 Rue Léo Saignat, 33077, Bordeaux Cedex, France.
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France.
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada.
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Cardenas A, Esser K, Wright E, Netten K, Edwards A, Rose J, Vigod S, Cohen E, Orkin J. Caring for the Caregiver (C4C): An Integrated Stepped Care Model for Caregivers of Children With Medical Complexity. Acad Pediatr 2023; 23:236-243. [PMID: 35680082 DOI: 10.1016/j.acap.2022.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/19/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Children with medical complexity (CMC) are a medically fragile subset of children who rely on parental caregivers for substantial care needs. Caregivers of CMC often experience adverse health outcomes such as depression and anxiety, sleep deprivation, financial hardships, and social isolation. Caregivers of CMC are at risk of premature mortality, which is thought to be mediated by chronic and elevated stress, as well as psychiatric morbidity risk. Access to mental health care, where the needs of both the caregiver and child are considered, can enable caregivers to meet high caregiving demands and improve both child and caregiver outcomes. We describe the Caring for the Caregiver (C4C) model, a novel integrated stepped care model consisting of collaboration between a psychiatrist and a pediatric complex care program. This model provides support in 3 steps: 1) early identification of distress, 2) social work assessment, intervention and psychotherapy, and 3) psychiatric care, including diagnosis or medication initiation, for caregivers of CMC. This innovative model will be the first to embed support for the mental health needs of caregivers of CMC within a pediatric team, facilitating access to psychiatric care and serving as a foundation for future integrated stepped care models.
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Affiliation(s)
- Analyssa Cardenas
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada
| | - Kayla Esser
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada
| | - Elisabeth Wright
- Department of Psychiatry (E Wright, S Vigod), Women's College Hospital, Toronto, ON, Canada; Department of Psychiatry (E Wright, S Vigod), University of Toronto, Toronto, ON, Canada
| | - Kathy Netten
- Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada
| | - Ashley Edwards
- Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada
| | - Julie Rose
- SickKids Family Advisory Network (J Rose), The Hospital for Sick Children, Toronto, ON, Canada
| | - Simone Vigod
- Department of Psychiatry (E Wright, S Vigod), Women's College Hospital, Toronto, ON, Canada; Department of Psychiatry (E Wright, S Vigod), University of Toronto, Toronto, ON, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada; Department of Pediatrics (E Cohen, J Orkin), University of Toronto, Toronto, ON, Canada; Edwin S.H. Leong Centre for Healthy Children (E Cohen), University of Toronto, Toronto, ON, Canada
| | - Julia Orkin
- Child Health Evaluative Sciences (A Cardenas, K Esser, E Cohen, and J Orkin), The Hospital for Sick Children, Toronto, ON, Canada; Division of Pediatric Medicine (K Netten, A Edwards, E Cohen, and J Orkin), The Hospital for Sick Children, , Toronto, ON, Canada; Department of Pediatrics (E Cohen, J Orkin), University of Toronto, Toronto, ON, Canada.
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Engelhard C, Hishinuma E, Rehuher D. The impact of maternal depression on child mental health treatment and models for integrating care: a systematic review. Arch Womens Ment Health 2022; 25:1041-1065. [PMID: 36327004 DOI: 10.1007/s00737-022-01272-2] [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: 08/04/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Maternal depression negatively impacts child mental health and is a well-known risk factor for child psychopathology. However, maternal depression treatment and child mental health treatment are rarely integrated. The purpose of this review was to assess the impact of maternal depression on child mental health treatment, including (1) how treatment of maternal depression affects child mental health outcomes, (2) the impact of maternal depression on children receiving mental health care, and (3) emerging models that address maternal depression in primary-care pediatrics and child mental health settings. A systematic literature review was conducted using PubMed and PsycInfo. Initial search yielded 224 records, and after exclusion, 29 papers were reviewed. Effective treatment of maternal depression is associated with a significant decrease in child psychiatric symptoms. Maternal depression negatively affects child mental health treatment in that there is a high rate of untreated mental illness among mothers of psychiatrically ill children, and maternal depression impedes effective child mental health treatment. Current models to address maternal depression in child settings include screening in pediatric primary care, psychotherapy for depressed mothers of psychiatrically ill children, and emerging models that integrate maternal and child mental health treatment. Effective treatment of maternal depression significantly improves child mental health and should be better integrated into child treatment. Opportunities to improve care include more robust screening for parental mental illness, supports to refer parents to psychiatric care, and on-site services for parents. Such interventions hold promise, but require significant support from a multidisciplinary team.
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Affiliation(s)
- Caitlin Engelhard
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA.
| | - Earl Hishinuma
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA
| | - Davis Rehuher
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA
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7
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McGinnis EW, Copeland W, Shanahan L, Egger HL. Parental perception of mental health needs in young children. Child Adolesc Ment Health 2022; 27:328-334. [PMID: 34653306 PMCID: PMC9010484 DOI: 10.1111/camh.12515] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is evidence of unmet psychiatric needs in children under 6. These young children are dependent on their parents to identify their mental health needs. This study tested child and parent associations with parent perception of young child mental health need. METHOD Parents of 917 children (aged 2-6 years) completed a diagnostic interview about their child assessing depression, anxiety, ODD/CD, ADHD, and impairment. Parents were surveyed about their own depression, anxiety, and asked about their psychiatric impairment. Parents were also asked whether they perceived their child as having a mental health need. RESULTS Only 38.8% of children who met criteria for a diagnosis were perceived by their parents as having a need, similar to previously studied rates in school-aged children. Perception of need was associated with higher levels of symptoms and impairment. Thresholds for at least half of parents perceiving their child as having a need were relatively high: 19 or more symptoms, or 4 or more impairments. There was evidence of specificity: children with depressive disorders were more likely to be perceived as in need compared with other disorders. In terms of parent factors, more parental depressive symptoms were associated with higher perception of child need when the child had a diagnosis. Parental psychological impairment was associated with higher perception of need when the child had no diagnosis. CONCLUSIONS Most preschool children that meet criteria for a psychiatric disorder are not perceived as needing help by their parents, which is dependent on both child and parent factors.
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Affiliation(s)
| | | | - Lilly Shanahan
- Psychology & Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Helen L Egger
- Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA
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8
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Ndetei DM, Mutiso VN, Musyimi CW, Alietsi RK, Shanley JR, Bhui KS. The feasibility of using life skills training in primary schools to improve mental health and academic performance: a pilot study in Kenya. BMC Psychiatry 2022; 22:131. [PMID: 35177007 PMCID: PMC8855590 DOI: 10.1186/s12888-022-03781-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/14/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There is no Kenyan evidence on the relationship between mental illness and academic performance. We aimed to determine the effect of life skills training on mental health and academic performance. METHODS We administered to 1848 primary school children a researcher designed socio-demographic questionnaire, and the Youth Self Report (YSR) and Child Behavior Checklist (CBCL) to their parents, followed by eight sessions of life skills training. We extracted data from the individual records of each child on overall performance pre and post training separated by one year. We conducted descriptive statistics, paired sample t-tests, multivariate linear regression analysis and linear mixed model analysis to assess changing patterns of academic performance and any predictive characteristics. RESULTS There was significant (p < 0.05) improvement in overall academic performance (aggregate marks and all individual subjects) for both lower primary and upper primary classes after the life-skills training intervention. For lower classes (2-4 grades) increase in academic performance was significantly associated with fathers and mothers education levels, region and class. For upper classes, (5-7 grades) increase in academic performance was associated with region, class and age. CONCLUSIONS Life skills training is recommended as it could improve academic performance, but predicted by socio-demographic factors.
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Affiliation(s)
- David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya. .,Department of Psychiatry, University of Nairobi, Nairobi, Kenya. .,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Christine W Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Rita K Alietsi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Jenelle R Shanley
- School of Graduate Psychology, Pacific University, Forest Grove, USA
| | - Kamaldeep S Bhui
- Department of Psychiatry, University of Oxford, Oxford, England.,World Psychiatric Association Collaborating Centre for Research and Training, London, UK
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9
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Hare MM, Dick AS, Graziano PA. Adverse childhood experiences predict neurite density differences in young children with and without attention deficit hyperactivity disorder. Dev Psychobiol 2022; 64:e22234. [PMID: 35050509 PMCID: PMC8827844 DOI: 10.1002/dev.22234] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/09/2021] [Accepted: 11/28/2021] [Indexed: 01/03/2023]
Abstract
Adverse childhood experiences (ACEs) put millions of children at risk for later health problems. As childhood represents a critical developmental period, it is important to understand how ACEs impact brain development in young children. In addition, children with attention-deficit/hyperactivity disorder (ADHD) are more likely than typically developing (TD) peers to experience ACEs. Therefore, the current study examined the impact of ACEs on early brain development, using a cumulative risk approach, in a large sample of children with and without ADHD. We examined 198 young children (Mage = 5.45, 82.3% Hispanic/Latino; 52.5% ADHD) across measures of brain volume, cortical thickness, neurite density index (NDI), and orientation dispersion index (ODI). For the NDI measure, there was a significant interaction between group and cumulative risk (ß = .18, p = .048), such that for children with ADHD, but not TD children, greater cumulate risk was associated with increased NDI in corpus callosum. No other interactions were detected. Additionally, when examining across groups, greater cumulative risk was associated with reduced ODI and volume in the cerebellum, although these findings did not survive a correction for multiple comparisons. Our results highlight the role early cumulative ACEs play in brain development across TD and children with ADHD.
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Affiliation(s)
- Megan M. Hare
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199, USA
| | - Anthony Steven Dick
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199, USA
| | - Paulo A. Graziano
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL 33199, USA
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10
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A Systematic Review Focusing on Psychotherapeutic Interventions that Impact Parental Psychopathology, Child Psychopathology and Parenting Behavior. Clin Child Fam Psychol Rev 2021; 24:579-598. [PMID: 34254219 DOI: 10.1007/s10567-021-00355-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2021] [Indexed: 10/20/2022]
Abstract
Given the high rates of co-occurrence of psychopathology within families, it is important to identify and characterize interventions that simultaneously reduce both parent and child symptoms, and improve parenting quality. This is needed as intervention development is increasingly moving toward integrated interventions that target some combination of parent and child mental health, and parenting behavior. Even so, much remains unknown regarding which treatment components provide maximum benefit for parent symptoms, child symptoms, and parenting behavior. This systematic review identified and characterized psychotherapeutic interventions that report improvements in each of three outcomes: parent symptoms, child symptoms and parenting behavior. Fifty-six unique interventions were eligible for review, of which 25 reported improvements in all three outcomes. All 25 of these interventions directly intervened on parenting behavior, often as the sole target of the intervention. Few interventions improved all three outcomes in samples in which parents, children or both met clinical-level thresholds of psychopathology. Additional research is needed to better understand the bi-directional and transactional influences of treatment on family members, and to better inform the development of interventions for dually disordered parent-child dyads across a range of diagnostic profiles.
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11
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Abstract
Objective: The objective of this study was to examine the association between parent mental health (ADHD and depression) and offspring performance on neurocognitive tasks in children with ADHD. Method: The clinical sample consisted of 570 children (85% males, mean age: 10.77 years) with ADHD who completed neurocognitive tasks measuring working memory, attention set-shifting, and motivational deficits. Questionnaire measures were used to assess ADHD and depression symptom presence in parents. Results: Controlling for ADHD severity, children of parents with ADHD had poorer working memory (B = -0.25, 95% confidence interval [CI] [-0.45, -0.07], p = .01) and increased errors on the extra dimensional shift stage of the set-shifting task (B = 0.26 95% CI [0.02, 0.50], p = .04). Parent depression was not associated with offspring performance on any of the assessed neurocognitive tasks. Conclusion: Children with ADHD who have a parent with ADHD symptom presence are a subgroup of children who may have additional neurocognitive impairments that have potential implications when implementing interventions that target cognition and learning.
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Affiliation(s)
| | | | | | - Kate Langley
- Cardiff University, UK,Kate Langley, School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff CF10 3AT, UK.
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Gao Y, Liu Y, Wang P, An X, Xu S, Yu F, Chen Q, Li Y, Wang S, Lv J, Pan G, Wang P. Resemblance and clustering of mother's and father's psychopathology levels among Chinese parents of schoolchildren with psychiatric disorders. Eur Psychiatry 2020; 63:e100. [PMID: 33109292 PMCID: PMC7737180 DOI: 10.1192/j.eurpsy.2020.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have assessed the characteristics of spousal psychopathologies among parents of schoolchildren with and without psychological disorders (PD) in China. Methods Parental symptoms were measured using the General Health Questionnaire (GHQ) in 275 mothers and 278 fathers of 298 schoolchildren with PDs diagnosed in a population survey and in 825 mothers and 834 fathers of 894 schoolchildren without PDs as a 1:3 matched comparison group. Spousal GHQ scores were compared. Childhood PD type, presence of childhood comorbidities, and multiple parental and family characteristics were examined as predictors for parental GHQ scores by multiple linear regression analyses. Results The GHQ scores were significantly higher among mothers and fathers of children with any PD. Maternal GHQ scores were higher than paternal scores and significantly correlated with paternal GHQ scores in both groups. Spousal GHQ, personal PD history, and childhood PD comorbidity were significant independent predictors of both parents’ GHQ scores. There were also significant associations among parental chronic disease, low family income, and paternal and maternal GHQ score, as well as among low maternal education, less common disorder (LCD) prevalence in children and maternal GHQ score. The rate of GHQ score ≥3 for both parents was significantly higher in the study group than the control group (15.1 vs.7.0%). Conclusions Parents of children with any PD type demonstrate significantly elevated psychopathologies, and psychopathology tends to occur concomitantly and resemble that of the other spouse. Screening and treatment of parental psychiatric symptoms will benefit all family members.
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Affiliation(s)
- Yuan Gao
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Yunyong Liu
- Department of Psychiatry, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Ping Wang
- Institute of Chronic Disease, Shenyang Municipal Center for Disease Control and Prevention, Shenyang, People's Republic of China
| | - Xiaoxia An
- Institute of Chronic Disease, Benxi Municipal Center for Disease Control and Prevention, Benxi, People's Republic of China
| | - Shaohe Xu
- Institute of Chronic Disease, Anshan Municipal Center for Disease Control and Prevention, Anshan, People's Republic of China
| | - Fei Yu
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Qian Chen
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Yuying Li
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Shuangling Wang
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Jianda Lv
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Guowei Pan
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
| | - Ping Wang
- Research Center for Universal Health, School of Public Health, China Medical University, Shenyang110122, People's Republic of China
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Wesselhoeft R, Davidsen K, Sibbersen C, Kyhl H, Talati A, Andersen MS, Bilenberg N. Maternal prenatal stress and postnatal depressive symptoms: discrepancy between mother and teacher reports of toddler psychological problems. Soc Psychiatry Psychiatr Epidemiol 2020; 56:559-570. [PMID: 32995941 PMCID: PMC8005495 DOI: 10.1007/s00127-020-01964-z] [Citation(s) in RCA: 8] [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: 09/08/2019] [Accepted: 09/23/2020] [Indexed: 01/30/2023]
Abstract
PURPOSE Maternal prenatal stress and postnatal depression are reported to increase the risk for early offspring psychological problems. We examined whether these two stressors predicted toddler emotional or behavioral problems based on the mother and teacher reports, respectively. METHODS A longitudinal study within the Odense Child Cohort (OCC). Prenatal stress was assessed (gestation week 28) using Cohen's Perceived Stress Scale (PSS). Depressive symptoms were assessed (3 months after birth) using the Edinburgh Postnatal Depression Scale (EPDS). Behavioral and emotional problems were assessed by mothers using the preschool version of Child Behaviour Checklist (CBCL) and by teachers using the caregiver-teacher report form (CTR-F). RESULTS N = 1302 mother-child dyads were included. CBCL (N = 1302) was collected at 29 months (SD 5.3) and C-TRF (N = 989) at 32.6 months (SD 6.9). N = 70 mothers (5.4%) were at high risk for postnatal depression (EPDS score > 12). Generalized additive models showed that prenatal stress (increase of + 1 on PSS-10 total score) predicted an increase in CBCL (+ 0.011) and C-TRF (+ 0.015) total scores. Postnatal depressive symptoms (increase of + 1 on EPDS total score) only predicted an increase in CBCL total score (+ 0.026). CONCLUSION Prenatal maternal stress was a significant predictor of both mother and teacher reported toddler emotional and behavioral problems, although effect sizes were small. Postnatal depressive symptoms were associated with increased maternal (but not teacher) reporting of toddler problems. Mothers reported more toddler psychological problems than teachers, and the mother-teacher discrepancy was positively correlated to maternal postnatal depressive symptoms.
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Affiliation(s)
- R Wesselhoeft
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark.
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - K Davidsen
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - C Sibbersen
- Research Unit of E-Mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - H Kyhl
- Hans Christian Andersen Children's Hospital, University of Southern Denmark and Odense Patient Data Explorative Network (OPEN), Odense, Denmark
| | - A Talati
- Division of Epidemiology, Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - M S Andersen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - N Bilenberg
- Research Unit of Child and Adolescent Mental Health, Institute for Clinical Research, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
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McTate E, Szulczewski L, Joffe NE, Chan SF, Pai ALH. Implementation of the Psychosocial Standards for Caregiver Mental Health Within a Pediatric Hematology/Oncology Program. J Clin Psychol Med Settings 2020; 28:323-330. [PMID: 32328955 DOI: 10.1007/s10880-020-09719-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The assessment of mental health needs and access to appropriate interventions for parents and caregivers is one of 15 evidence-based standards for the psychosocial care of children with cancer and their families. The objectives of this paper are to describe one program's approach to meeting this standard in oncologic, hematologic, and immunologic populations and outline key ethical, regulatory, and logistical considerations in providing mental health services to caregivers in a pediatric medical setting. A description of the Caregiver Mental Health Program (CMHP) is provided along with a case example to illustrate key considerations, including multiple family members needing care, access to psychiatric services, scope of treatment, confidentiality and privacy, and logistics. Challenges in the development of the CMHP as well as the program's benefits are discussed. Implementation of this standard of care will vary across institutions depending on various factors, such as staffing and programmatic resources and institutional culture.
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Affiliation(s)
- Emily McTate
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lauren Szulczewski
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA. .,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Naomi E Joffe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sherilynn F Chan
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229, USA.,Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Achenbach TM. International findings with the Achenbach System of Empirically Based Assessment (ASEBA): applications to clinical services, research, and training. Child Adolesc Psychiatry Ment Health 2019; 13:30. [PMID: 31312253 PMCID: PMC6610912 DOI: 10.1186/s13034-019-0291-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/24/2019] [Indexed: 12/15/2022] Open
Abstract
The purpose of this invited article is to present multicultural norms and related international findings obtained with the Achenbach System of Empirically Based Assessment (ASEBA) by indigenous researchers in over 50 societies. The article describes ASEBA instruments for which multicultural norms are available, plus procedures for constructing the multicultural norms. It presents applications to clinical services, including use of multi-informant data for assessing children and their parents. The Multicultural Family Assessment Module (MFAM) enables mental health providers to view side-by-side bar graphs of child and parent scores on syndromes, DSM-oriented scales, Internalizing, Externalizing, and Total Problems. Evidence-based assessment of progress and outcomes is facilitated by the Progress & Outcomes App (P&O App). Research applications are outlined, including longitudinal and outcomes research. Applications to training mental health providers include having trainees study standardized multi-informant assessment data prior to interviewing children and their parents. Trainees can also sharpen their clinical skills by completing assessment forms to describe children and their parents, and then using ASEBA software to compare their ratings with ratings by children, parents, and other informants. Practical evidence-based assessment instruments with multicultural norms enable mental health providers, researchers, and trainees to perform intake, progress, and outcome assessments of children and their parents in terms of a standardized international clinical data language.
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Affiliation(s)
- Thomas M. Achenbach
- Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401 USA
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16
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Popov N, Phoenix M, King G. To screen or not to screen? Exploring the value of parent mental health screening in children's rehabilitation services. Disabil Rehabil 2019; 43:739-745. [PMID: 31258016 DOI: 10.1080/09638288.2019.1635657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Parents of children with disabilities are at increased risk of mental health challenges, yet it is unclear whether parent mental health screening should be considered in the context of children's rehabilitation. METHODS A nonsystematic narrative review was conducted guided by a framework for assessing the effectiveness of proposed health screening programs. Screening for the purpose of recommending further assessments and/or psychosocial supports and services was considered. The potential harms and benefits of mental health screening for parents of children with disability were examined considering relevant contextual factors. RESULTS AND CONCLUSIONS While best evidence in the form of a randomized controlled trial in this population does not yet exist, there was evidence to suggest that parent mental health is an important factor in promoting child and family health and well-being and deserves consideration in the practice of family-centered care. If appropriate referral pathways and resources are developed, children's rehabilitation service providers may be in an advantageous position to provide parent mental health screening.IMPLICATIONS FOR REHABILITATIONParents of children with disabilities are at increased risk for depression, stress, and anxiety.Service providers may be well placed to identify mental health concerns through screening.Contextual factors to consider before initiating screening include level of evidence for screening, whether screening would reach target clients, and whether additional supports are available.Children's rehabilitation service providers can be family-centered by attending to parent mental health needs, with the potential to improve the health, development, and well-being of the whole family.
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Affiliation(s)
| | - Michelle Phoenix
- Bloorview Research Institute, Toronto, Canada.,CanChild, McMaster University, Hamilton, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Gillian King
- Bloorview Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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17
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Molitor SJ, Dvorsky MR. Ethical Considerations for Assessing Parent Mental Health during Child Assessment Services. ETHICS & BEHAVIOR 2019; 29:87-100. [PMID: 34168418 DOI: 10.1080/10508422.2018.1482746] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Parents play an integral role in the mental health service provision of children and adolescents, and they can have significant effects on the outcomes of youth. A growing body of research has linked parents' own mental health status to numerous outcomes for their children, and recent guidelines have emerged recommending the assessment of parent psychopathology when treating child patients. However, these recommendations present a range of ethical considerations. Mental health professionals must determine if the assessment of a parent is empirically supported and that an assessment procedure appropriate for parents can be feasibly implemented. They must also respect the autonomy and confidentiality of parents while ensuring that assessment findings can be translated to meaningful benefits for child patients. This article details and discusses each of these concerns within the context of the relevant principles and standards of the 2016 American Psychological Association's Code of Ethics. Further, it provides guidelines, relevant clinical examples, and an applied model for mental health professionals to consider the ethical implications of assessing parent mental health when serving child patients.
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Risk factors for parental psychopathology: a study in families with children or adolescents with psychopathology. Eur Child Adolesc Psychiatry 2018; 27:1575-1584. [PMID: 29644474 PMCID: PMC6245117 DOI: 10.1007/s00787-018-1156-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/05/2018] [Indexed: 01/02/2023]
Abstract
The parents of children with psychopathology are at increased risk for psychiatric symptoms. To investigate which parents are mostly at risk, we assessed in a clinical sample of families with children with psychopathology, whether parental symptom scores can be predicted by offspring psychiatric diagnoses and other child, parent and family characteristics. Parental depressive, anxiety, avoidant personality, attention-deficit/hyperactivity (ADHD), and antisocial personality symptoms were measured with the Adult Self Report in 1805 mothers and 1361 fathers of 1866 children with a psychiatric diagnosis as assessed in a child and adolescent psychiatric outpatient clinic. In a multivariate model, including all parental symptom scores as outcome variables, all offspring psychiatric diagnoses, offspring comorbidity and age, parental age, parental educational attainment, employment, and relationship status were simultaneously tested as predictors. Both 35.7% of mothers and 32.8% of fathers scored (sub)clinical for at least one symptom domain, mainly depressive symptoms, ADHD symptoms or, only in fathers, avoidant personality symptoms. Parental psychiatric symptoms were predicted by unemployment. Parental depressive and ADHD symptoms were further predicted by offspring depression and offspring ADHD, respectively, as well as by not living together with the other parent. Finally, parental avoidant personality symptoms were also predicted by offspring autism spectrum disorders. In families with children referred to child and adolescent psychiatric outpatient clinics, parental symptom scores are associated with adverse circumstances and with similar psychopathology in their offspring. This signifies, without implying causality, that some families are particularly vulnerable, with multiple family members affected and living in adverse circumstances.
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Agha SS, Zammit S, Thapar A, Langley K. Maternal psychopathology and offspring clinical outcome: a four-year follow-up of boys with ADHD. Eur Child Adolesc Psychiatry 2017; 26:253-262. [PMID: 27376657 PMCID: PMC5306178 DOI: 10.1007/s00787-016-0873-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 05/25/2016] [Indexed: 11/12/2022]
Abstract
Previous cross-sectional research has shown that parents of children with attention deficit hyperactivity disorder (ADHD) have high rates of psychopathology, especially ADHD and depression. However, it is not clear whether different types of parent psychopathology contribute to the course and persistence of ADHD in the child over time. The aim of this two wave study was to investigate if mother self-reported ADHD and depression influence persistence of offspring ADHD and conduct disorder symptom severity in adolescents diagnosed with ADHD in childhood. A sample of 143 males with a confirmed diagnosis of ADHD participated in this study. ADHD and conduct disorder symptoms were assessed at baseline and reassessed 4 years later. The boys in this sample had a mean age of 10.7 years at Time 1 (SD 2.14, range 6-15 years) and 13.73 years at Time 2 (SD 1.74, range 10-17 years). Questionnaire measures were used to assess ADHD and depression symptoms in mothers at Time 1. Mother self-reported ADHD was not associated with a change in child ADHD or conduct symptom severity over time. Mother self-reported depression was found to predict an increase in child conduct disorder symptoms, but did not contribute to ADHD symptom levels. This study provides the first evidence that concurrent depression in mothers may be a predictor of worsening conduct disorder symptoms in adolescents with ADHD. It may, therefore, be important to screen for depression in mothers of children with ADHD in clinical practice to tailor interventions accordingly.
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Affiliation(s)
- Sharifah Shameem Agha
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, UK.
- Child and Adolescent Mental Health Services Network (CAMHS), Cwm Taf Health Board, Cardiff, Wales, UK.
| | - Stanley Zammit
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, Wales, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Anita Thapar
- Child and Adolescent Psychiatry Section, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, Wales, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Kate Langley
- MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, Wales, UK.
- School of Psychology, Cardiff University, Cardiff, Wales, UK.
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Achenbach TM. Future Directions for Clinical Research, Services, and Training: Evidence-Based Assessment Across Informants, Cultures, and Dimensional Hierarchies. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 46:159-169. [DOI: 10.1080/15374416.2016.1220315] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Swartz HA, Cyranowski JM, Cheng Y, Zuckoff A, Brent DA, Markowitz JC, Martin S, Amole MC, Ritchey F, Frank E. Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children. J Am Acad Child Adolesc Psychiatry 2016; 55:495-503.e2. [PMID: 27238068 PMCID: PMC4886238 DOI: 10.1016/j.jaac.2016.04.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/04/2016] [Accepted: 04/01/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families. METHOD Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year. RESULTS Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. CONCLUSION IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed Mothers of Psychiatrically Ill Children; http://clinicaltrials.gov/; NCT00919594.
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Affiliation(s)
- Holly A Swartz
- University of Pittsburgh School of Medicine, Pittsburgh.
| | | | | | | | - David A Brent
- University of Pittsburgh School of Medicine, Pittsburgh
| | - John C Markowitz
- New York State Psychiatric Institute and College of Physicians and Surgeons, Columbia University, New York
| | - Stacy Martin
- University of Pittsburgh School of Medicine, Pittsburgh
| | | | - Fiona Ritchey
- University of Pittsburgh School of Medicine, Pittsburgh
| | - Ellen Frank
- University of Pittsburgh School of Medicine, Pittsburgh
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Wesseldijk LW, Dieleman GC, Lindauer RJL, Bartels M, Willemsen G, Hudziak JJ, Boomsma DI, Middeldorp CM. Spousal resemblance in psychopathology: A comparison of parents of children with and without psychopathology. Eur Psychiatry 2016; 34:49-55. [PMID: 26928346 DOI: 10.1016/j.eurpsy.2016.01.2423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/20/2016] [Accepted: 01/20/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Spouses resemble each other for psychopathology, but data regarding spousal resemblance in externalizing psychopathology, and data regarding spousal resemblance across different syndromes (e.g. anxiety in wives and attention deficit/hyperactivity disorder [ADHD] in husbands) are limited. Moreover, knowledge is lacking regarding spousal resemblance in parents of children with psychiatric disorders. We investigated and compared spousal resemblance within and across internalizing and externalizing symptom domains in parents of children with and without psychopathology. METHODS Symptoms of depression, anxiety, avoidant personality, ADHD, and antisocial personality were assessed with the Adult Self Report in 728 mothers and 544 fathers of 778 children seen in child and adolescent psychiatric outpatient clinics and in 2075 mothers and 1623 fathers of 2784 children from a population-based sample. Differences in symptom scores and spousal correlations between the samples were tested. RESULTS Parents in the clinical sample had higher symptom scores than in the population-based sample. In both samples, correlations within and across internalizing and externalizing domains of psychopathology were significant. Importantly, correlations were significantly higher in the clinical sample (P=0.03). Correlations, within and across symptoms, ranged from 0.14 to 0.30 in the clinical sample and from 0.05 to 0.23 in the population-based sample. CONCLUSIONS This large study shows that spousal resemblance is not only present within but also across symptom domains. Especially in the clinical sample, ADHD symptoms in fathers and antisocial personality symptoms in mothers were correlated with a range of psychiatric symptoms in their spouses. Clinicians need to be alert of these multiple affected families.
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Affiliation(s)
- L W Wesseldijk
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - M Bartels
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - G Willemsen
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J J Hudziak
- Department of Psychiatry and Medicine (Division of Human Genetics), Center for Children, Youth and Families, University of Vermont, B229 Given B, Burlington, VT 05405, USA
| | - D I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - C M Middeldorp
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, The Netherlands
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Middeldorp CM, Wesseldijk LW, Hudziak JJ, Verhulst FC, Lindauer RJL, Dieleman GC. Parents of children with psychopathology: psychiatric problems and the association with their child's problems. Eur Child Adolesc Psychiatry 2016; 25:919-27. [PMID: 26757722 PMCID: PMC4967089 DOI: 10.1007/s00787-015-0813-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/15/2015] [Indexed: 11/27/2022]
Abstract
Knowledge is lacking regarding current psychopathology in parents whose children are evaluated in a psychiatric outpatient clinic. This especially accounts for fathers. We provide insight into the prevalence rates of parental psychopathology and the association with their offspring psychopathology by analyzing data on psychiatric problems collected in 701 mothers and 530 fathers of 757 referred children. Prevalence rates of parental psychopathology were based on (sub)clinical scores on the adult self report. Parent-offspring associations were investigated in multivariate analyses taking into account co-morbidity. Around 20 % of the parents had a (sub)clinical score on internalizing problems and around 10 % on attention deficit hyperactivity (ADH) problems. Prevalence rates did not differ between mothers and fathers. Parent-offspring associations did not differ between girls and boys. Maternal anxiety was associated with all offspring problem scores. In addition, maternal ADH problems were associated with offspring ADH problems. Paternal anxiety and ADH problems scores were specifically associated with offspring internalizing and externalizing problem scores, respectively. Associations with offspring psychopathology were of similar magnitude for mothers and fathers and were not influenced by spousal resemblance. Our study shows that both fathers and mothers are at increased risk for psychiatric problems at the time of a child's evaluation and that their problems are equally associated with their offspring problems. The results emphasize the need to screen mothers as well as fathers for psychiatric problems. Specific treatment programs should be developed for these families in especially high need.
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Affiliation(s)
- Christel M Middeldorp
- Department of Biological Psychology, Neuroscience Campus Amsterdam, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
- Department of Child and Adolescent Psychiatry, GGZ inGeest/VU University Medical Center, Overschiestraat 57, 1062 HN, Amsterdam, The Netherlands.
| | - Laura W Wesseldijk
- Department of Biological Psychology, EMGO+ Institute for Health and Care Research, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
| | - James J Hudziak
- Division of Human Genetics, Department of Psychiatry and Medicine, Center for Children, Youth and Families, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT, 05401, USA
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Ramon J L Lindauer
- Department of Child and Adolescent Psychiatry, De Bascule, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ, Amsterdam ZO, The Netherlands
| | - Gwen C Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center Rotterdam, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
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Maternal psychiatric history is associated with the symptom severity of ADHD in offspring. Psychiatry Res 2015; 226:507-12. [PMID: 25747683 DOI: 10.1016/j.psychres.2015.02.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 01/22/2015] [Accepted: 02/14/2015] [Indexed: 11/24/2022]
Abstract
Controversy exists about the role of parent psychopathology in persistence and severity of attention deficit hyperactivity disorder (ADHD) symptoms in their children. Here we aimed to analyse the potential association between the severity of ADHD symptoms in children and the presence of psychiatric and ADHD symptoms in their biological parents. Seventy-three triads of children and their parents who were in active treatment for their diagnosed ADHD were evaluated in our Child and Adolescent Mental Health Centers. The mental health of the parents was also assessed. The general psychopathology of the parents was evaluated using the Symptom Checklist-90-R (SCL-90-R), and symptoms of hyperactivity were examined using the Adult ADHD Self-Report Scale (ASRS v.1.1). The severity of symptoms in children was assessed using the ADHD Rating Scale-IV (ADHD-RS-IV). Variables that could have affected the clinical development of ADHD such as sex, evolution time, age, academic level and the presence of comorbidities were controlled. The severity of the symptoms in children with ADHD was significantly related to the psychiatric history of their mother, the younger age of the child and the presence of a comorbid conduct disorder in the child. We discussed the importance of screening for parental psychopathology in clinical practice.
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Carmody KA, Haskett ME, Loehman J, Rose RA. Physically Abused Children's Adjustment at the Transition to School: Child, Parent, and Family Factors. JOURNAL OF CHILD AND FAMILY STUDIES 2015; 24:957-969. [PMID: 26401095 PMCID: PMC4577240 DOI: 10.1007/s10826-014-9906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Childhood physical abuse predicts emotional/behavioral, self-regulatory, and social problems. Yet factors from multiple ecological levels contribute to children's adjustment. The purpose of this study was to examine the degree to which the social-emotional adjustment of physically abused children in first grade would be predicted by a set of child-, parent-, and family-level predictors in kindergarten. Drawing on a short-term longitudinal study of 92 physically abused children and their primary caregivers, the current study used linear regression to examine early childhood child (i.e., gender, IQ, child perceptions of maternal acceptance), parent (i.e., parental mental health), and family relationship (i.e., sensitive parenting, hostile parenting, family conflict) factors as predictors of first grade internalizing and externalizing symptomatology, emotion dysregulation, and negative peer interactions. We used a multi-method, multi-informant approach to measuring predictors and children's adjustment. Internalizing symptomatology was significantly predicted by child IQ, parental mental health, and family conflict. Externalizing symptomatology and emotion dysregulation were predicted by child IQ. Although a large proportion of variance in measures of adjustment was accounted for by the set of predictors, few individual variables were unique predictors of child adjustment. Variability in the predictors of adjustment for physically abused children underscores the need for individualized treatment approaches.
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Affiliation(s)
- Karen Appleyard Carmody
- Department of Psychiatry and Behavioral Medicine, Duke University School of Medicine; Center for Child & Family Health, 411 West Chapel Hill Street, Suite 908, Durham, NC 27701
| | - Mary E Haskett
- Department of Psychology, North Carolina State University, Raleigh, NC
| | - Jessisca Loehman
- Department of Psychology, North Carolina State University, Raleigh, NC
| | - Roderick A Rose
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Lifetime prevalence of psychiatric disorders among parents of children with bipolar I disorder: parental difference. ScientificWorldJournal 2014; 2014:256584. [PMID: 25431782 PMCID: PMC4241319 DOI: 10.1155/2014/256584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/06/2014] [Indexed: 11/23/2022] Open
Abstract
Background. Evaluation of family system is an important area in the context of child and adolescent mental health. This study aimed to estimate psychiatric disorders in parents of children and adolescents with bipolar I disorder (BID). Methods and Materials. In this cross-sectional study, during 2012-2013, all of the children and adolescents diagnosed with BID based on Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version were included. All of the parents (both mother and father) were evaluated by Structured Clinical Interview for DSM-IV-TR. Statistical Analysis. Prevalence rates are reported and independent-sample t-test and chi-square test were used when appropriate. Results. A total of 108 families were interviewed. 25% of mothers and 33% of fathers met the criteria for at least one psychiatric disorder, with major depressive disorder, BMD, and cluster B personality disorder being more prevalent. Fathers were more likely to receive a dual psychiatric diagnosis. Cluster B personality disorder and substance dependence were more prevalent among fathers while major depressive disorder was more prevalent among mothers. Conclusion. This study confirmed a higher prevalence of psychiatric disorders in parents of children with BID and emphasizes parental evolution.
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Kim Y, Kim B, Chang JS, Kim BN, Cho SC, Hwang JW. Parental quality of life and depressive mood following methylphenidate treatment of children with attention-deficit hyperactivity disorder. Psychiatry Clin Neurosci 2014; 68:506-14. [PMID: 24417707 DOI: 10.1111/pcn.12155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 12/05/2013] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
AIM This naturalistic study investigated the associations between quality of life and depressive mood in parents and symptom changes in attention-deficit hyperactivity disorder (ADHD) children. METHODS At baseline and at weeks 4 and 8, the parents evaluated their children, who were receiving treatment with osmotic-release oral system methylphenidate (mean dosage 36.3 ± 15.5 mg/day), using the Swanson, Nolan, and Pelham - Fourth Edition (SNAP-IV-18) scale. The parents evaluated themselves using the Beck Depression Inventory (BDI) and the World Health Organization Quality of Life Assessment, Brief Version (WHOQOL-BREF). RESULTS A significant reduction in SNAP-IV-18 scores and improvements in parental BDI scores and parental WHOQOL-BREF scores were observed. The decrease in BDI scores from baseline to 8 weeks was significantly associated with increases in WHOQOL-BREF sub-domain scores from baseline to 8 weeks, with a greater decrease at 4 weeks and after. The decrease in the SNAP-IV-18 hyperactivity-impulsivity score was significantly associated with increases in WHOQOL social sub-domain scores from baseline to 8 weeks. For those patients who showed a 25% or greater decrease in the SNAP-IV-18 total scores from baseline to 8 weeks, the decreases in the SNAP-IV-18 total score and in the inattention and hyperactivity-impulsivity scores were significantly associated with a decrease in BDI scores from baseline to 8 weeks. CONCLUSION Methylphenidate treatment for ADHD was associated with both symptom alleviation in children with ADHD and improvement in parental depressive mood and quality of life, suggesting that the effects of treatment could go beyond symptom improvement in ADHD.
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Affiliation(s)
- Yeni Kim
- Department of Child Psychiatry, Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Korea
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Guedeney A, Matthey S, Puura K. SOCIAL WITHDRAWAL BEHAVIOR IN INFANCY: A HISTORY OF THE CONCEPT AND A REVIEW OF PUBLISHED STUDIES USING THE ALARM DISTRESS BABY SCALE. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21412] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Margari F, Craig F, Petruzzelli MG, Lamanna A, Matera E, Margari L. Parents psychopathology of children with Attention Deficit Hyperactivity Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1036-1043. [PMID: 23291521 DOI: 10.1016/j.ridd.2012.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/04/2012] [Accepted: 12/04/2012] [Indexed: 06/01/2023]
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a disorder with extremely complex etiology, not yet well defined but certainly multi-factorial. This study investigated the possible etiopathogenetic role of ADHD symptoms and psychopathology disorders in parents of children with ADHD. We present a case-control study of parents of 50 children affected by ADHD and of 45 healthy children, matched to age and gender. Parents of ADHD children reported higher levels of ADHD symptoms, depressive disorders and Depressive Personality Disorders than parents of healthy children. Mothers displayed greater presence of depression, while fathers showed problems concerning alcohol use. The occurrence of ADHD symptoms, psychopathology and personality disorders in parents highlights the importance to integrate the treatment programs in the ADHD children with the screening and treatment for psychopathological symptoms of the parents.
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Affiliation(s)
- Francesco Margari
- Department of Neuroscience and Sense Organs, University of Aldo Moro Bari, Piazza Giulio Cesare 1, Italy
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Vidair HB, Fichter CN, Kunkle KL, Boccia AS. Targeting parental psychopathology in child anxiety. Child Adolesc Psychiatr Clin N Am 2012; 21:669-89. [PMID: 22801001 DOI: 10.1016/j.chc.2012.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The increased risk of anxiety in children of parents with psychopathology is a significant public health problem, as early-onset is associated with a variety of difficulties later in life. The aim of this article is to determine if treating parents is associated with improvements in child anxiety through the review of both top-down (parent identified for treatment) and family-focused child anxiety treatment studies. The authors present conclusions based on the state of the current literature, discuss implications for research and clinical practice, and propose utilizing a family-based model for treating parental psychopathology, parental behavior, and child anxiety.
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Affiliation(s)
- Hilary B Vidair
- Clinical Psychology Doctoral Program, Long Island University, Post Campus, 720 Northern Boulevard, Brookville, NY 11548, USA.
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31
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Berg-Nielsen TS, Wichström L. The mental health of preschoolers in a Norwegian population-based study when their parents have symptoms of borderline, antisocial, and narcissistic personality disorders: at the mercy of unpredictability. Child Adolesc Psychiatry Ment Health 2012; 6:19. [PMID: 22607915 PMCID: PMC3464890 DOI: 10.1186/1753-2000-6-19] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 05/20/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Clinical studies have shown that children of parents with mental health problems are most likely to develop psychiatric problems themselves when their parents have a Personality Disorder characterized by hostility. The Personality Disorders that appear most associated with hostility, with the potential to affect children, are Borderline Personality Disorder, Antisocial Personality Disorder and Narcissistic Personality Disorder. The question addressed in this study is whether the risk to children's mental health extends to the normal population of parents who have subclinical symptomlevels of these disorders. METHODS This inquiry used data from a Trondheim, Norway community sample of 922 preschoolers and one parent for each child. The mean age of the children was 53 months (SD 2.1). Parents reported symptoms of Borderline, Antisocial and Narcissistic Personality Disorders on the DSM-IV ICD-10 Personality Questionnaire, and the children's symptoms of DSM-IV behavioral and emotional diagnoses were measured with the Preschool Age Psychiatric Assessment, a comprehensive interview. Multigroup Structural Equation Modeling was used to assess the effect of parents' symptoms on their preschoolers' behavioral and emotional problems. RESULTS The analyses yielded strongly significant values for the effect of parents' Personality Disorder symptoms on child problems, explaining 13.2% of the variance of the children's behavioral symptoms and 2.9% of the variance of internalizing symptoms. Biological parents' cohabitation status, i.e., whether they were living together, emerged as a strong moderator on the associations between parental variables and child emotional symptoms; when parents were not cohabiting, the variance of the children's emotional problems explained by the parents' Personality Disorder symptoms increased from 2.9% to 19.1%. CONCLUSIONS For the first time, it is documented that parents' self-reported symptoms of Borderline, Antisocial, and Narcissistic Personality Disorders at a predominantly subclinical level had a strong effect on their children's psychiatric symptoms, especially when the biological parents were not living together. Child service providers need to be aware of these specific symptoms of parental Personality Disorders, which may represent a possible risk to children.
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Affiliation(s)
- Turid Suzanne Berg-Nielsen
- Regional Centre for Child and Adolescent Mental Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Lars Wichström
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway,NTNU Social Science, Trondheim, Norway,Child and Adolescent Psychiatric Clinic, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway
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Siegenthaler E, Munder T, Egger M. Effect of preventive interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2012; 51:8-17.e8. [PMID: 22176935 DOI: 10.1016/j.jaac.2011.10.018] [Citation(s) in RCA: 236] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 10/26/2011] [Accepted: 10/28/2011] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Mental illness in parents affects the mental health of their children. A systematic review and a meta-analysis of the effectiveness of interventions to prevent mental disorders or psychological symptoms in the offspring were performed. METHOD The Cochrane, MEDLINE, EMBASE, and PsycINFO databases were searched for randomized controlled trials of interventions in parents with mental disorders. Outcomes in the child included incident mental disorders of the same nature and internalizing (negative emotions, depressive symptoms, anxiety) or externalizing (hyperactivity, aggressiveness, behavioral problems) symptoms. Relative risks and standardized mean differences in symptom scores were combined in random-effects meta-analysis. RESULTS Thirteen trials including 1,490 children were analyzed. Interventions included cognitive, behavioral, or psychoeducational components. Seven trials assessed the incidence of mental disorders and seven trials assessed symptoms. In total 161 new diagnoses of mental illness were recorded, with interventions decreasing the risk by 40% (combined relative risk 0.60, 95% CI 0.45-0.79). Symptom scores were lower in the intervention groups: standardized mean differences were -0.22 (95% CI -0.37 to -0.08) for internalizing symptoms (p = .003) and -0.16 (95% confidence interval -0.36 to 0.04) for externalizing symptoms (p = .12). CONCLUSIONS Interventions to prevent mental disorders and psychological symptoms in the offspring of parents with mental disorders appear to be effective.
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Reiss D. Parents and children: linked by psychopathology but not by clinical care. J Am Acad Child Adolesc Psychiatry 2011; 50:431-4. [PMID: 21515190 DOI: 10.1016/j.jaac.2011.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 02/10/2011] [Indexed: 11/20/2022]
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