Do changes in parent mental health explain trends in youth emotional problems?

Internet access during COVID-19 and depressive symptoms in middle-aged and older adults: Evidence from a quasi-experimental study in China

BACKGROUND

Amid the COVID-19 pandemic, the mental health of middle-aged and older adults has become an increasing concern, and the role of the internet in addressing this public health crisis has drawn the attention of researchers. This study evaluated the impact of internet access during COVID-19 on depressive symptoms among middle-aged and older adults.

METHODS

Data were derived from China Health and Retirement Longitudinal Study (CHARLS) 2018 and 2020. Difference-in-differences analysis was performed to compare changes in depressive symptoms between the internet users during COVID-19 and those who didn't have access to the internet before and during the pandemic.

RESULTS

We found that internet access during COVID-19 pandemic significantly reduced middle-aged and older adults' depressive symptoms. Further investigation identified the underlying mechanisms through which internet access helps in alleviating depressive symptoms by reducing the likelihood of experiencing negative emotions about COVID-19. Heterogeneity analyses showed that rural residents and middle-aged individuals benefited more from internet access during the pandemic.

CONCLUSIONS

Since internet access can alleviate middle-aged and older adults' depressive symptoms amidst public health crisis, policy makers should focus on enhancing their access to the internet.

Adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in children and adolescents: A longitudinal study

BACKGROUND

Adverse childhood experiences (ACEs) have a profound impact on individuals, shaping their long-term health and life opportunities. This study delves into the complex ties between ACEs and the socioemotional development of Australian children and youth by examining the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors.

METHODS

This study utilized data from the Longitudinal Study of Australian Children and employed the generalized estimating equation method to investigate the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in Australian children and adolescents.

RESULTS

Adverse childhood experiences such as physical punishment, hostile parenting, parental conflicts, separation, financial strain, and parental mental health issues increased the risk of externalizing and internalizing behaviors while reducing prosocial behaviors. The risk increases with the number of ACEs, as evidenced by the incidence ratio (IR); for example, for externalizing behaviors, an ACEs score of one leads to IR = 1.69, while an ACEs score of 4 results in IR = 3.34. Similar trends were observed for internalizing and prosocial behaviors.

LIMITATIONS

The presence of imbalanced longitudinal data, arising from variations in the number of observations across different time points, challenges robust inferences. Furthermore, this study investigates the relationship between ACEs and behavioral problems, without establishing causality. Consequently, the results should be interpreted with caution.

CONCLUSIONS

The findings of this study highlight that adverse childhood experiences significantly influence behavioral outcomes in children and adolescents. These findings underscore the critical need for early detection and intervention to mitigate the consequences of traumatic childhood experiences.

Trends in adolescent emotional problems in Wales between 2013 and 2019: the contribution of peer relationships

BACKGROUND

Epidemiological evidence shows a substantial increase in adolescent emotional problems in many countries, but reasons for this increase remain poorly understood. We tested change in emotional problems in a national sample of young people in Wales in 2013, 2017 and 2019 using identical symptom screens, and examined whether trends were accounted for by changes in youth friendship quality and bullying.

METHODS

The present study of 230,735 11-16-year olds draws on repeat cross-sectional data obtained on three occasions (2013, 2017 and 2019) in national school-based surveys in Wales (conducted by the School Health Research Network). Emotional problems were assessed with a brief validated symptom screen (the SCL-4).

RESULTS

There was a significant increase in emotional problem scores between 2013 and 2019 (b[95% CI] = 1.573 [1.380, 1.765]). This increase was observed for all ages and was more pronounced for girls than boys (interaction b [95% CI] = 0.229 [0.004, 0.462]) and for young people from less affluent families (interaction b [95% CI] = -0.564[-0.809, -0.319]). Of the total sample, 14.2% and 5.7% reported frequent face-to-face and cyberbullying respectively. There were modest decreases in friendship quality and increases in rates of bullying between 2013 and 2019, but accounting for these changes did not attenuate estimates of the population-level increase in emotional problems.

CONCLUSIONS

This study provides evidence of a substantial increase in emotional problems among young people in Wales, particularly for young people from less affluent backgrounds. Changes in bullying or friendship quality did not explain this increase.

An intergenerational examination of retrospective and current depression patterns among Black families

BACKGROUND

There is limited information regarding the intergenerational transmission of mental health among three generations (i.e., grandparents, parents, and children) of Black families. Given that intergenerational and kinship ties are integral in Black families, this study explores the context that might contribute to the generational transmission of mental health among Black families.

METHODS

The present study examined the retrospective family history of mental health among fathers and mothers, current reports of their depression, and their children's internalizing and depressive symptoms among a sample of 2530 Black families from the Future of Families and Child Wellbeing Study using waves 4 to 6. All analyses were conducted using STATA 15.1.

RESULTS

Focal children's maternal and paternal grandparents' history of mental health was associated with higher odds of depression in their mothers and fathers; in addition, child-internalizing symptoms were associated with a report of depression in maternal grandparents in waves 4 and 5. Children of mothers who were depressed had higher internalizing scores in waves 4, 5, and 6.

LIMITATIONS

This descriptive study did not account for how parenting might also be protective against childhood internalizing behaviors. A retrospective account may not fully encapsulate a complete understanding of mental health patterns.

CONCLUSIONS

In treating the mental and behavioral health of Black families, it is essential to focus on multiple generations of family health, given that family history is the strongest predictor of the youth's onset of depression. The utility of these findings in understanding psychological distress and strengths among Black families is discussed.

Cross-cohort change in parent-reported emotional problem trajectories across childhood and adolescence in the UK

BACKGROUND

Over the past three decades, the prevalence of adolescent emotional problems (ie, anxiety and depression) has risen. Although the onset and developmental course of emotional symptoms shows high variability, no study has directly tested secular differences across development. Our aim was to investigate whether and how developmental trajectories of emotional problems have changed across generations.

METHODS

We used data from two UK prospective cohorts assessed 10 years apart: the Avon Longitudinal Study of Parents and Children (ALSPAC) including individuals born in 1991-92, and the Millennium Cohort Study (MCS) with individuals born in 2000-02. Our outcome was emotional problems, assessed using the parent-rated emotional subscale of the Strengths and Difficulties Questionnaire (SDQ-E) at approximate ages 4, 7, 8, 10, 11, 13, and 17 years in ALSPAC and ages 3, 5, 7, 11, 14, and 17 years in MCS. Participants were included if the SDQ-E was completed at least once in childhood and at least once in adolescence. Trajectories were generated using multilevel growth curve models using the repeated assessments of the SDQ-E in children aged 3-17 years.

FINDINGS

Data were available for 19 418 participants (7012 from ALSPAC and 12 406 from the MCS), of whom 9678 (49·8%) were female and 9740 (50·2%) were male, and 17 572 (90·5%) had White mothers. Individuals born between 2000 and 2002 had higher emotional problem scores from around 9 years (intercept statistic β 1·75, 95% CI 1·71-1·79) than did individuals born in 1991-92 (1·55, 1·51-1·59). The later cohort had an earlier onset of problems than the earlier cohort, and sustained higher average trajectories from around 11 years, with female adolescents showing the steepest trajectories of emotional problems. Differences between cohorts peaked overall at age 14 years.

INTERPRETATION

Our comparison of two cohorts of young people provides evidence that compared with a cohort assessed 10 years prior, emotional problems emerge earlier in development in the more recent cohort, and these are especially pronounced for females during mid-adolescence. Such findings have implications for public health planning and service provision.

FUNDING

Wolfson Centre for Young People's Mental Health, Wolfson Foundation.

Variability in mental health reporting among refugees and migrants in need of protection: new evidence from a weekly panel survey

BACKGROUND

The global population of refugees and other migrants in need of protection (MNP) is swiftly growing. Prior scholarship highlights that MNP have poorer mental health than other migrant and non-migrant populations. However, most scholarship on MNP mental health is cross-sectional, leaving open questions about temporal variability in their mental health.

METHODS

Leveraging novel weekly survey data from Latin American MNP in Costa Rica, we describe the prevalence, magnitude, and frequency of variability in eight indicators of self-reported mental health over 13-weeks; highlight which demographic characteristics, incorporation hardships, and violence exposures are most predictive of variability; and determine how variability corresponds to baseline mental health.

RESULTS

For all indicators, most respondents (> 80%) varied at least occasionally. Typically, respondents varied 31% to 44% of weeks; for all but one indicator they varied widely-by ~ 2 of 4 possible points. Age, education, and baseline perceived discrimination were most consistently predictive of variability. Hunger and homelessness in Costa Rica and violence exposures in origin also predicted variability of select indicators. Better baseline mental health was associated with less subsequent variability.

CONCLUSIONS

Our findings highlight temporal variability in repeated self-reports of mental health among Latin American MNP and further highlight sociodemographic heterogeneity therein.

Daily Association between COVID-19 cases and parents' emotions: the role of marital relationship quality

The continuing impact of daily stress during the COVID-19 pandemic has disrupted the lives of families worldwide, and increased the risk of psychological problems for parents and their children. The current study investigated the daily effect of COVID-19 cases on parents' positive and negative emotions among 163 Taiwanese families using daily diary methodology across 10 weekdays. Results of multilevel modeling indicated that parents reported fewer positive emotions on days when COVID-19 cases were higher than average. Further moderating analyses showed the adverse effect of COVID-19 cases was only evident when the same-day marital relationship quality was lower than usual. The findings highlight the psychological stress of COVID-19 cases on parents' daily emotions and identify the protective role of marital relationship quality. Policies and clinical interventions should consider the implications of daily COVID-19 stressors for parents' emotional well-being, and target the protective role of marital relationship quality in daily life.

The COV-ED Survey: exploring the impact of learning and teaching from home on parent/carers' and teachers' mental health and wellbeing during COVID-19 lockdown

BACKGROUND

Following the emergence of COVID-19 in the UK, on March 18^th 2020 the majority of schools in England closed and families and teachers were tasked with providing educational support for children and adolescents within the home environment. Little is known, however, regarding the impact of remote teaching and learning on the mental wellbeing of parents/carers and teaching staff.

METHODS

The Coronavirus Education (COV-ED) online survey explored the practicalities of learning and teaching from home for 329 parents/carers and 117 teachers of 11-15 year old adolescents in England, during June/July 2020, and the associated impact on their mental wellbeing. Participants were recruited through schools and via University of Warwick social media channels. Data was analysed using a series of Multiple Linear and Multivariate Regressions.

RESULTS

Despite coping well with the challenges of remote learning, a third of teachers reported below average mental wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale. Multivariate regression revealed that wellbeing was associated with access to resources and confidence to teach from home. Almost half of parents/carers surveyed reported below average wellbeing. Multivariate regression revealed that poor wellbeing was more common in those who were also working from home and who lacked support for their own mental health. Concerns about their child's mental health and lack of access to electronic devices and workspace were also significantly associated with the mental wellbeing of parents/carers.

CONCLUSIONS

Whilst young people's mental health and wellbeing has, and continues to be a national priority, the mental health and wellbeing of the families and teachers supporting them has not previously been explored. Our survey population was of predominantly white British heritage, female and living in the West Midlands UK, therefore, findings should be treated with caution. Findings provide a snapshot of factors that may be of significance to families and schools in supporting the mental wellbeing of those tasked with learning from home. They will help i) increase knowledge and awareness with regard to future support of families and teachers during similar crises; ii) enable the design and development of practical solutions in the delivery of remote teaching and learning; and, iii) help address the mental wellbeing needs of those tasked with supporting adolescents.

Early-life exposure to parental mental distress and adulthood depression among middle-aged and elderly Chinese

Although mental illness among the middle-aged and the elderly has become a global public health issue and there is a burgeoning interest in the intergenerational transmission of mental health concerns in recent years, the long-term impact of parental mental health problems on child mental health conditions in developing countries remains unknown. Using the China Health and Retirement Longitudinal Study (CHARLS), which provides both contemporaneous and retrospective data collected from a nationally representative sample of Chinese residents aged 45 years and above, this study employed a multilevel modeling approach to investigate the association between early-life exposure to parental mental distress and adulthood depression among the middle-aged and elderly Chinese. Our study showed that childhood parental mental health problems predicted mid- and late-life depression in Chinese contexts and the result remained robust to a suite of robustness checks. Our exploration of potential pathways of the relationship found the following adversities that were associated with the exposure to parental mental distress in early life and may have contributed to the depression among the middle-aged and elderly: higher rates of childhood physical abuse by parents, poor childhood health, lower levels of educational attainment, poor physical health and individual economic status in adulthood. Further, our heterogeneity analysis indicated that the transmission effect was stronger for the elderly than the middle-aged and that the improvement of childhood SES mitigated the intergenerational transmission. We also found that childhood parental mental distress was potentially a moderator, which inhibited the recovery from depression. The findings will inform the design, implementation, and evaluation of relevant public health policies. It highlights the need for more efforts to prevent and mitigate the profound impacts of childhood parental mental distress on the late-life well-being of child generations.

The Long-Term Impact of Parental Mental Health on Children's Distress Trajectories in Adulthood

Using six waves of data from the Panel Study of Income Dynamics (2007-2017) and the Childhood Retrospective Circumstances Study (2014) (n=3,240), this paper estimates how childhood experiences with parental mental health problems shape trajectories of children's own distress in adulthood. Findings indicate that those who experience poor parental mental health have consistently greater distress than their non-exposed counterparts throughout adulthood. More severe and longer exposures to parental mental health problems corresponds to even greater distress in adulthood. The gender of the parent afflicted does not predict differences in adult mental health, but those individuals exposed to both maternal and paternal poor mental health have the greatest distress in adulthood. Together, results suggest that parental mental health during children's formative years is a significant predictor of life course distress and that heterogeneity in this experience corresponds to unique mental health trajectories.

Factors Associated with Mental Health Problems among Malaysian Children: A Large Population-Based Study

Mental health problems are a major public health issue, particularly among children. They impair children’s development, academic achievement, and ability to live a productive life. The present study aimed to determine the prevalence and factors associated with mental health problems among children aged 5 to 15 years old in Malaysia. Data from the National Health and Morbidity Survey (NHMS) 2015 were analyzed. A validated Strengths and Difficulties Questionnaire (SDQ) was used. The overall prevalence of mental health problems among children in Malaysia was 11.1%. Multiple logistic regression analysis revealed that for every year increment in age, mental health problems decreased by 5%. Further analysis found that children who had fathers with a non-formal education and worked in the private sector, had parents who were widowed or divorced, and had either parent with mental health problems were more likely to have mental health problems themselves. Children from the lower socioeconomic group and who had either parent with mental health problems had higher odds of having mental health problems in Malaysia.

Relationship between parents' mental disorders and socioeconomic status and offspring's psychopathology: A cross-sectional study

Mental disorders (MD) are one of the main causes of the disease burden worldwide. Associations between socioeconomic status (SES) and presence of MD in parents have been related with increased odds of MD in offspring. However, there is a lack of population-based research in this field. The aim of the present study was to examine together the relationship between the presence of MD in children, and the SES and presence of MD in their parents, in a whole of population data. A gender approach was undertaken aiming to discern how these variables influence children's mental health when related with the father and the mother. Using administrative individual data from the National Health System, a retrospective cross-sectional study was conducted. The entire children population aged 6 to 15 resident in Catalonia in 2017 was examined. A logistic regression model was performed. Low SES was associated with increased odds of children's MD. Offspring of a parent with MD were at more risk of presenting MD than offspring of parents without these problems. Although these associations were consistent for both boys and girls when looking at the father's or mother's SES and MDs, the mother's SES and MDs showed a higher association with the offspring's MDs than the father's. Lowest associations, found for boys when looking at the father's SES and MDs, were: OR of 1.21, 95%CI 1.16 to 1.27 for lowest SES, and OR of 1.66, 95%CI 1.61 to 1.70 for parental MDs. Children's familiar environment, which includes SES and mental health of parents, plays an important role in their mental health. Socially constructed gender roles interfere with SES and parent's MD. These findings support the relevance of examining MD and its risk factors within a gender approach.

Intergenerational patterns of mental health problems: the role of childhood peer status position

BACKGROUND

Past research has established the intergenerational patterning of mental health: children whose parents have mental health problems are more likely to present with similar problems themselves. However, there is limited knowledge about the extent to which factors related to the child's own social context, such as peer relationships, matter for this patterning. The aim of the current study was to examine the role of childhood peer status positions for the association in mental health across two generations.

METHODS

The data were drawn from a prospective cohort study of 14,608 children born in 1953, followed up until 2016, and their parents. Gender-specific logistic regression analysis was applied. Firstly, we examined the associations between parental mental health problems and childhood peer status, respectively, and the children's mental health problems in adulthood. Secondly, the variation in the intergenerational patterning of mental health according to peer status position was investigated.

RESULTS

The results showed that children whose parents had mental health problems were around twice as likely to present with mental health problems in adulthood. Moreover, lower peer status position in childhood was associated with increased odds of mental health problems. Higher peer status appeared to mitigate the intergenerational association in mental health problems among men. For women, a u-shaped was found, indicating that the association was stronger in both the lower and upper ends of the peer status hierarchy.

CONCLUSIONS

This study has shown that there is a clear patterning in mental health problems across generations, and that the child generation's peer status positions matter for this patterning. The findings also point to the importance of addressing gender differences in these associations.

Do emotional difficulties and peer problems occur together from childhood to adolescence? The case of children with a history of developmental language disorder (DLD)

Children and adolescents with developmental language disorder (DLD) are, overall, vulnerable to difficulties in emotional adjustment and in peer relations. However, previous research has shown that different subgroups follow different trajectories in respect to the quality of peer relations. Less is known about the trajectories of emotional development. We consider here the possibility that development in these two domains is interrelated: that is, the trajectories of emotional and peer problems will proceed in parallel. We conducted longitudinal joint trajectories analyses of emotional and peer relations in a sample of young people identified as having DLD at the age of 7 years and seen at intervals up to 16 years. Potential influences on joint trajectory group membership were examined. Findings revealed five distinct joint trajectories. Emotional and peer difficulties do occur together from childhood to adolescence for just over half of the sample, but not all. The variables most clearly associated with group membership were pragmatic language ability, prosociality and parental mental health. This is the first study to examine joint longitudinal trajectories of emotional and peer difficulties in individuals with DLD. We demonstrate that development in individuals with DLD is heterogeneous and identify three key variables associated with personal and social adjustment from childhood to adolescence. Theoretical and clinical implications of these findings are discussed.

Trends in parent- and teacher-rated mental health problems among 10- and 11-year-olds in Great Britain: 1999-2012

BACKGROUND

Previous evidence indicates that mental health problems are becoming more common for adolescents. Less is known about whether these trends have continued and there has been no study to date which has specifically focused on early adolescents over a sufficiently long period. This study examines changes in parent- and teacher-reported mental health problems among 10- and 11-year-olds in 1999, 2004 and 2012 in Great Britain.

METHOD

Parent and teacher ratings of the Strengths and Difficulties Questionnaire were used to compare the prevalence of conduct problems, hyperactivity/inattention, emotional problems, peer problems and total difficulties among 10- and 11-year-olds in three nationally representative British samples assessed in 1999 (n = 1904), 2004 (n = 1348) and 2012 (n = 11,397).

RESULTS

Teacher reports showed improving trends for boys' and girls' mental health from 1999 to 2012, particularly for externalizing behaviours (i.e. conduct problems and hyperactivity/inattention). Parent reports, on the other hand, identified only one area of sustained improvement between 1999 and 2012, namely hyperactivity/inattention among boys. Although parent reports of girls' mental health indicate improving trends from 1999 to 2004, they also suggest worsening mental health from 2004.

CONCLUSIONS

These findings suggest that perceptions of emotional and behavioural problems vary by the gender of the adolescent, the context in which they are observed or by whom they are reported.

Trends in adolescent mental health during economic upturns and downturns: a multilevel analysis of Swedish data 1988-2008

Background

A long-term trend of increasing mental health problems among adolescents in many Western countries indicates a great need to investigate if and how societal changes have contributed to the reported increase. Using seven waves of repeated cross-sectional data collected between 1988 and 2008 in Sweden, the current study examined if economic factors at the societal level (municipality unemployment rate) and at the individual level (worry about family finances), and their interaction could explain a secular trend in mental health problems.

Methods

Participants were 17 533 students of age 15–16 years (49.3% girls), from 14 municipalities in a county of Sweden. Data on adolescents’ mental health (psychosomatic problems) and worry about family finances were obtained using a self-report questionnaire. A series of multilevel regression analyses were conducted in order to explain the trends in adolescents’ mental health.

Results

The results indicated that the individual-level predictor (worry about family finances) significantly explained the increasing rates of adolescents’ psychosomatic problems. This was particularly the case during the mid-1990s, which was characterised by a severe recession in Sweden with high unemployment rates. For example, after accounting for adolescents’ worry, a significant increase in psychosomatic symptoms between 1988 and 1998 among girls (b=0.112, P<0.05) disappeared (b=0.018, P>0.05) and a non-significant decrease between 1988 and 1995 among boys (b=−0.017, P>0.05) became significant (b=−0.142, P<0.05). Neither municipality unemployment rate nor its interaction with adolescents’ worry explained psychosomatic problems.

Conclusions

The findings demonstrate the effects of adolescents’ worry about family finances on a secular trend in mental health problems during an economically bleak period of time. The study highlights the need for repeated measurements including a large number of time points over a long time period in order to analyse time-specific putative explanatory factors for trends in adolescent mental health problems.

Could scale-up of parenting programmes improve child disruptive behaviour and reduce social inequalities? Using individual participant data meta-analysis to establish for whom programmes are effective and cost-effective

Background

Child disruptive behavioural problems are a large and costly public health problem. The Incredible Years®(IY) parenting programme has been disseminated across the UK to prevent this problem and shown to be effective in several trials. It is vital for policy to know for which families IY is most effective, to be sure that it helps reduce, rather than widen, socioeconomic inequalities. Individual trials lack power and generalisability to examine differential effects; conventional meta-analysis lacks information about within-trial variability in effects.

Objectives

To overcome these limitations by pooling individual-level data from the IY parenting trials in Europe to examine to what extent it benefits socially disadvantaged families. Secondary objectives examine (1) additional moderators of effects on child behaviour, (2) wider health benefits and potential harms and (3) costs, cost-effectiveness and potential long-term savings.

Design

Individual participant data meta-analysis of 14 randomised trials of the IY parenting intervention.

Settings

UK (eight trials), the Netherlands, Ireland, Norway, Sweden and Portugal.

Participants

Data were from 1799 families, with children aged 2–10 years (mean 5.1 years; 63% boys).

Interventions

IY Basic parenting programme.

Main outcome measures

Primary outcome was disruptive child behaviour, determined by the Eyberg Child Behavior Inventory Intensity scale (ECBI-I). Secondary outcomes included self-reported parenting practices, parenting stress, mental health, children’s attention deficit hyperactivity disorder (ADHD) and emotional symptoms.

Results

There were no differential effects of IY on disruptive behaviour in families with different levels of social/socioeconomic disadvantage or differential effects for ethnic minority families, families with different parenting styles, or for children with comorbid ADHD or emotional problems or of different ages. Some moderators were found: intervention effects were strongest in children with more severe baseline disruptive behaviour, in boys, and in children with parents who were more depressed. Wider health benefits included reduced child ADHD symptoms, greater parental use of praise, and reduced harsh and inconsistent discipline. The intervention did not improve parental depression, stress, self-efficacy or children’s emotional problems. Economic data were available for five UK and Ireland trials (maximumn = 608). The average cost per person of the IY intervention was £2414. The probability that the IY intervention is considered cost-effective is 99% at a willingness to pay of £145 per 1-point improvement on the ECBI-I. Estimated longer-term savings over 20 years range from £1000 to £8400 per child, probably offsetting the cost of the intervention.

Limitations

Limitations include a focus on one parenting programme; the need to make assumptions in harmonising data; and the fact that data addressed equalities in the effectiveness of, not access to, the intervention.

Conclusions

There is no evidence that the benefits of the IY parenting intervention are reduced in disadvantaged or minority families; benefits are greater in the most distressed families, including parents who are depressed. Thus, the intervention is unlikely to widen socioeconomic inequalities in disruptive behaviour and may have effects in narrowing inequalities due to parent depression. It was as likely to be effective for older as for younger children. It has wider benefits for ADHD and parenting and is likely to be considered to be cost-effective. Researchers/funders should encourage data sharing to test equity and other moderator questions for other interventions; further research is needed on enhancing equality of access to interventions.

Funding

The National Institute for Health Research Public Health Research programme.

The mental health of adolescents with and without mild/moderate intellectual disabilities in England: Secondary analysis of a longitudinal cohort study

BACKGROUND

Children with mild/moderate intellectual disabilities are at greater risk for mental health problems, with socio-economic factors and adversity partly accounting for this. Fewer data are available for adolescents.

METHODS

Secondary analysis was undertaken of the Next Steps annual panel study following a cohort through adolescence into adulthood containing self-report mental health data up to age 16/17. Participants with mild/moderate intellectual disabilities were identified through data linkage with educational records.

RESULTS

Adolescents with mild/moderate intellectual disabilities were more likely than non-disabled peers to experience socio-economic disadvantage and bullying. Incidence rates of mental health problems were generally not significantly different between adolescents with and without intellectual disabilities.

CONCLUSIONS

These findings are consistent with higher rates of persistent mental health problems beginning earlier among children with intellectual disabilities. Greater attention needs to be paid to the timecourse of mental health problems, and the impact of socio-economic factors, family and peers on mental health.

Time trends in mental well-being: the polarisation of young people's psychological distress

PURPOSE

Previous research on time trends of young people's mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period.

METHODS

GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16-24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene's homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean.

RESULTS

There was a small but significant increase in mean GHQ-12 among young women (b 0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (p < 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men.

CONCLUSIONS

The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008.

Annual Research Review: Threats to the validity of child psychiatry and psychology

BACKGROUND

Suggestions have been made that many claims concern false-positive findings in the field of child psychology and psychiatry.

FINDINGS

The literature was searched for concepts and findings on the validity of child psychiatry and psychology. Substantial progress has been made in some, but not all, areas and considerable challenges remain in all.

CONCLUSIONS

The two major threats to validity concern the inability to examine brain tissues in life and the evidence that there is a high overlap among disorders. We emphasize the need to follow published guidelines on preplanned analyses and we note the dangers associated with unregulated flexibility in data analysis. We note the very important clinical and developmental findings that have been ignored, perhaps partly because of an excessive focus on technologies. Nevertheless, we are positive about both the accomplishments and the ways in which challenges are being met.

Maternal depression and anxiety predicts the pattern of offspring symptoms during their transition to adulthood

BACKGROUND

Episodes of depression and anxiety (D&A) during the transition from late adolescence to adulthood, particularly when persistent, are predictive of long-term disorders and associated public health burden. Understanding risk factors at this time is important to guide intervention. The current objective was to investigate the associations between maternal symptoms of D&A with offspring symptoms during their transition to adulthood.

METHOD

Data from a large population-based birth cohort study, in South Brazil, were used. Prospective associations between maternal D&A and offspring risk of these symptoms during the transition to adulthood (18/19, 24 and 30 years) were estimated.

RESULTS

Maternal D&A in adolescence was associated with offspring symptoms across the transition to adulthood, associations were consistently stronger for females than for males. Daughters whose mothers reported D&A were 4.6 times (95% confidence interval 2.71-7.84) as likely to report D&A at all three time-points, than daughters of symptom-free mothers.

CONCLUSIONS

Maternal D&A is associated with persistent D&A during the daughter's transition to adulthood. Intervention strategies should consider the mother's mental health.

Annual research review: Secular trends in child and adolescent mental health

BACKGROUND

Child and adolescent mental health problems are common, associated with wide-ranging functional impairments, and show substantial continuities into adult life. It is therefore important to understand the extent to which the prevalence of mental health problems has changed over time, and to identify reasons behind any trends in mental health.

SCOPE AND METHODOLOGY

This review evaluates evidence on whether the population prevalence of child and adolescent mental health problems has changed. The primary focus of the review is on epidemiological cross-cohort comparisons identified by a systematic search of the literature (using the Web of Knowledge database).

FINDINGS

Clinical diagnosis and treatment of child and adolescent psychiatric disorders increased over recent decades. Epidemiological comparisons of unselected population cohorts using equivalent assessments of mental health have found little evidence of an increased rate of ADHD, but cross-cohort comparisons of rates of ASD are lacking at this time. Findings do suggest substantial secular change in emotional problems and antisocial behaviour in high-income countries, including periods of increase and decrease in symptom prevalence. Evidence from low- and middle-income countries is very limited. Possible explanations for trends in child and adolescent mental health are discussed. The review also addresses how cross-cohort comparisons can provide valuable complementary information on the aetiology of mental illness.

Secular trends in depressive symptoms among Norwegian adolescents from 1992 to 2010

Several survey studies among adolescents have shown increasing rates of depressive symptoms over the last two to three decades. We know however little about mechanisms that might explain this increase. The present study uses data from three nationwide representative surveys of 16-17 year-old Norwegian adolescents that were conducted according to identical procedures in 1992, 2002, and 2010 (response rates 97.0, 91.0, 84.3 %, respectively). At each time point, approximately 3,000 adolescents participated (48.8 % girls and 51.2 % boys). Questionnaire data on depressive symptoms and a variety of potential risk and protective factors that might explain time trends in such symptoms were assessed at all time points. The results showed that the prevalence of high scores on depressive symptoms increased significantly between 1992 and 2002 among both boys and girls. No significant changes were observed between 2002 and 2010. The increase from 1992 to 2002 among girls and boys could be partially attributed to increases in eating problems and cannabis use, while reduced satisfaction with own appearance among girls contributed as well. Although the study does not provide information about the causal direction between putative risk factors and depressive symptoms, the results provide some indication that eating problems, cannabis use, and appearance related factors may contribute in explaining secular trends in depressive symptoms.

Are child and adolescent mental health problems increasing in the 21st century? A systematic review

OBJECTIVE

Up to one in five children experience mental health problems. Social and cultural factors may influence emergence of mental health problems. The 21st century has led to changes in many of these factors, but it is unclear whether rates of internalizing and externalizing problems have also changed in recent cohorts of young people.

METHODS

A comprehensive literature search was undertaken to locate cohort or population studies that examined changes in mental health of children over time, where participants were aged 18 years and under, and the time frame for change was at least 10 years, with data for at least one time point in the 21st century being statistically compared to at least one time point in the 20th century. Studies were reviewed for quality and outcome.

RESULTS

Nineteen studies met criteria for review. These included studies of toddlers, children, and adolescents. Seventeen studies examined internalizing problems, and 11 studies examined externalizing problems. For both children and toddlers, recent cohorts did not exhibit worsening of mental health symptoms. In adolescents, the burden of externalizing problems appear to be stable. However, the majority of studies report an increase in internalizing problems in adolescent girls. The findings for internalizing problems in boys were mixed.

CONCLUSIONS

These findings suggest that recent cohorts of adolescent girls are experiencing increases in internalizing symptoms compared to previous cohorts. Approaches for prevention and early intervention should be explored.

Exploring the intergenerational persistence of mental health: evidence from three generations

This paper uses data from the 1970 British Cohort Study to quantify the intergenerational persistence of mental health, and the long-run economic costs associated with poor parental mental health. We find a strong and significant intergenerational correlation that is robust to different covariate sets, sample restrictions, model specifications and potential endogeneity. Importantly, the intergenerational persistence is economically relevant, with maternal mental health associated with lasting effects on the child's educational attainment, future household income and the probability of having criminal convictions. These results do not disappear after controlling for children's own childhood and adulthood mental health.

Violence exposure as a predictor of internalizing and externalizing problems among children of substance abusers

We explore the associations between exposure to conflict and crime in the home and community, and child anxiety and self-control problems among 60 children whose mothers were in treatment for substance abuse problems. Experiences with violence and crime were widespread, with many children exposed to multiple incidents. Approximately one-third (35.5%) of children exhibited clinically elevated anxiety. Controlling for other potential predictors, both children's exposure to violence and the number of years the mother had been using substances predicted higher anxiety in children, while only exposure to violence predicted problems in self-control. Results highlight the importance of screening for violence exposure.

Immigration, transition into adult life and social adversity in relation to psychological distress and suicide attempts among young adults

BACKGROUND

The increasing incidence of mental health problems among young people is a major concern in many Western countries. The causal mechanisms underlying these trends are not well established, but factors influenced by current societal changes ought to be implicated. Such factors include immigration and social adversity as well as the timing of taking on adult social roles (e.g. gainful employment, parenthood and own housing tenure). We therefore examined relationships between these factors and the risks of psychological distress as well as suicide attempts in young adults, with a focus on gender differences.

METHODS

We conducted a population-based study including 10,081 individuals aged 18-29, recruited in 2002 and 2006 in Stockholm, Sweden. Data were collected by record linkage and questionnaires.

RESULTS

Non-European immigrants had an increased risk of distress, and female non-European immigrants had a markedly higher risk of suicide attempts. Both early parenthood (≤ 24 years) and not being a parent, being a student and the lack of own housing tenure were associated with distress, but only in women. In both sexes, financial strain was associated with the increased risk of distress and suicide attempts, while unemployment was only associated with distress.

CONCLUSIONS

Immigration from outside Europe and social adversity are associated with mental health problems in young adults, especially females. Postponed transition into adulthood is associated with poor mental health in young women. These factors are influenced by current societal changes, and may have contributed to the increasing incidence of mental health problems among young people in Western countries.