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Dickson SJ, Oar EL, Kangas M, Johnco CJ, Lavell CH, Seaton AH, McLellan LF, Wuthrich VM, Rapee RM. A Systematic Review and Meta-Analysis of Impairment and Quality of Life in Children and Adolescents with Anxiety Disorders. Clin Child Fam Psychol Rev 2024; 27:342-356. [PMID: 38782783 PMCID: PMC11222200 DOI: 10.1007/s10567-024-00484-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/25/2024]
Abstract
Anxiety disorders are common, emerge during childhood, and pose a significant burden to society and individuals. Research evaluating the impact of anxiety on functional impairment and quality of life (QoL) is increasing; however, there is yet to be a systematic review and meta-analysis of these relationships in pediatric samples. This systematic review and meta-analysis were conducted to determine the extent of impairments in functioning and QoL that young people with anxiety disorders experience relative to their healthy peers, as well as sociodemographic and clinical moderators of these relationships. Studies were included when they compared young people (mean age range within studies 7-17 years) with a primary clinical anxiety disorder to a healthy comparison group and measured impairment and/or QoL via a validated instrument. A total of 12 studies met criteria for this review (N = 3,129 participants). A majority of studies (K = 9) assessed impairment as an outcome measure, and three assessed QoL outcomes. Meta-analysis of nine studies (N = 1,457 children) showed large relationships between clinical anxiety and life impairment (g = 3.23) with the strongest effects seen for clinician report (g = 5.00), followed by caregiver (g = 2.15) and child (g = 1.58) report. The small number of studies and diversity in methodology prevented quantitative investigation of moderating factors. In the systematic review of QoL outcomes, all three studies reported significantly poorer QoL for youth with anxiety disorders relative to unaffected peers. Findings support the importance of measuring functioning and QoL as outcomes in clinical research and practice among anxious young people.This study is registered with PROSPERO under the identification number CRD42023439040.
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Affiliation(s)
- Sophie J Dickson
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Ella L Oar
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Maria Kangas
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Carly J Johnco
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Cassie H Lavell
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Ashleigh H Seaton
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Lauren F McLellan
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Viviana M Wuthrich
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia
| | - Ronald M Rapee
- Macquarie University Lifespan Health and Wellbeing Research Centre, Sydney, 2109, Australia.
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Guo S, Goldfeld S, Mundy L. Factors that impact mental health help-seeking in Australian adolescents: a life-course and socioecological perspective. Child Adolesc Ment Health 2024; 29:170-180. [PMID: 38494190 DOI: 10.1111/camh.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Help-seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help-seeking from a life-course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help-seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms. METHODS We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14-15 years. Based on previous literature and life-course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0-1 year, 4-5 years and 12-13 years). Outcomes at 14-15 years were help-seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit-binomial links were used. RESULTS There were varying and common patterns of influencing factors across the three population groups and sources of help-seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help-seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help-seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support. CONCLUSION Both intrinsic and extrinsic barriers exist for adolescents' mental health help-seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help-seeking among adolescents.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Lisa Mundy
- Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
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McArthur G, Doust A, Banales E, Robidoux S, Kohnen S. Are comorbidities of poor reading related to elevated anxiety in children? ANNALS OF DYSLEXIA 2024; 74:47-65. [PMID: 38135828 DOI: 10.1007/s11881-023-00292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/01/2023] [Indexed: 12/24/2023]
Abstract
Studies of the association between dyslexia and mental health have typically tried to minimise the influence of dyslexia comorbidities on the outcomes. However, in the "real world", many children with dyslexia have these comorbidities. In this study, we tested (1) if children with dyslexia with three common comorbidities - inattention, hyperactivity, language difficulties - experience more anxiety than children with dyslexia without these comorbidities; and (2) if any type of comorbidity is related to a certain type of anxiety (reading, social, generalised, or separation). The data of 82 children with dyslexia (mean age = 9 years and 4 months; 25 girls) were analysed using Fisher exact tests, which revealed that those with inattention (40.54%) or hyperactivity (42.30%) were statistically significantly more likely to experience elevated anxiety than children with dyslexia without these comorbidities (8.11 and 14.28%, respectively). This was not the case for language difficulties (24.5% versus 30%). Spearman ρ correlations (α = .05) indicated significant moderate relationships between inattention and reading anxiety (.27), social anxiety (.37), and generalised anxiety (.24); and between hyperactivity and social anxiety (.24) and generalised anxiety (.28). There were no significant correlations between language and anxiety. Examination of highly inter-correlated variables suggested a specific relationship between one type of comorbidity (inattention) and one type of anxiety (reading anxiety).
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Affiliation(s)
- Genevieve McArthur
- Australian Centre for the Advancement of Literacy, Australian Catholic University, Sydney, Australia.
- Macquarie University Reading Clinic, Macquarie University, Sydney, Australia.
| | - Amy Doust
- Department of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Erin Banales
- Macquarie University Reading Clinic, Macquarie University, Sydney, Australia
| | - Serje Robidoux
- Department of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Saskia Kohnen
- Macquarie University Reading Clinic, Macquarie University, Sydney, Australia
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Ball S, Reardon T, Creswell C, Taylor L, Brown P, Ford T, Gray A, Hill C, Jasper B, Larkin M, Macdonald I, Morgan F, Pollard J, Sancho M, Sniehotta FF, Spence SH, Stainer J, Stallard P, Violato M, Ukoumunne OC. Statistical analysis plan for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice: identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i). Trials 2024; 25:62. [PMID: 38233861 PMCID: PMC10795300 DOI: 10.1186/s13063-023-07898-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i) trial is being conducted to establish whether 'screening and intervention', consisting of usual school practice plus a pathway comprising screening, feedback and a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety), bring clinical and health economic benefits compared to usual school practice and assessment only - 'usual school practice', for children aged 8-9 years in the following: (1) the 'target population', who initially screen positive for anxiety problems according to a two-item parent-report child anxiety questionnaire - iCATS-2, and (2) the 'total population', comprising all children in participating classes. This article describes the detailed statistical analysis plan for the trial. METHODS AND DESIGN iCATS-i2i is a definitive, superiority, pragmatic, school-based cluster randomised controlled trial (with internal pilot), with two parallel groups. Schools are randomised 1:1 to receive either screening and intervention or usual school practice. This article describes the following: trial objectives and outcomes; statistical analysis principles, including detailed estimand information necessary for aligning trial objectives, conduct, analyses and interpretation when there are different analysis populations and outcome measures to be considered; and planned main analyses, sensitivity and additional analyses. TRIAL REGISTRATION ClinicalTrials.gov ISRCTN76119074. Registered on 4 January 2022.
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Affiliation(s)
- Susan Ball
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
| | - Tessa Reardon
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
- Oxford NHS Foundation Trust, Oxford, UK
| | - Lucy Taylor
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
- Oxford NHS Foundation Trust, Oxford, UK
| | - Paul Brown
- Bransgore C of E Primary School, Christchurch, UK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation Trust, Cambridge, UK
| | - Alastair Gray
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Bec Jasper
- Parents and Carers Together, Suffolk, UK
| | - Michael Larkin
- Life and Health Sciences, Aston University, Birmingham, UK
| | | | | | - Jack Pollard
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
- UK Health Security Agency, HCAI, Fungal, AMR, AMU and Sepsis Division, London, UK
| | | | - Falko F Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
- Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digital Health (CPD), Universitätsmedizin Mannheim, Heidelberg University, Heidelberg, Germany
| | - Susan H Spence
- School of Applied Psychology and Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Australia
| | | | | | - Mara Violato
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Obioha C Ukoumunne
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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5
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Henderson RR, Nielsen AM, Fernandez AMP, Downing ST, McCarty RJ, Strekalova YA, Cobite-Njoh J, Mirhosseini T, Guzick AG, McNamara JPH, Mathews CA. Expectations and perspectives of cognitive behavioural therapy for childhood anxiety and related disorders. Behav Cogn Psychother 2024; 52:65-77. [PMID: 37699703 DOI: 10.1017/s1352465823000346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND Anxiety disorders are the most frequently diagnosed psychiatric conditions in children and adolescents. Cognitive behavioural therapy (CBT) is a well-established and effective treatment for anxiety and related disorders across the lifespan. Expectations of psychotherapy have been demonstrated to affect outcomes, yet there is sparse existing literature on adolescent patient and parent perspectives of CBT prior to engagement with treatment. AIMS This study aimed to qualitatively explore the expectations and perceptions of CBT for anxiety and related disorders among adolescent patients and parents. METHOD Fourteen adolescent patients and 16 parents participated in semi-structured individual interviews or focus groups consisting of 2-3 participants. Interview transcripts were analysed using inductive analysis. RESULTS Three themes were identified: worries about CBT, expectations and knowledge of the CBT process, and the role of parents and families. Overall, we found that adolescents and parents had generally positive views of CBT. The outset of CBT saw adolescents and parents express concern about stigma as well as the ambiguity of CBT. Parents continued to express a lack of understanding of what CBT entailed during their child's treatment course. CONCLUSION These results suggest that both adolescents and parents would benefit from early discussion and reinforcement of expectations for CBT treatment. Further research efforts are warranted and should be directed towards determining appropriate expectations for parental involvement in a child's CBT course and effective communication of treatment expectations to both adolescents and parents.
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Affiliation(s)
| | - Alyssa M Nielsen
- College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Seth T Downing
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Ryan J McCarty
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Yulia A Strekalova
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Journa Cobite-Njoh
- Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | | | - Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | | | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
- Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, USA
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Laninga-Wijnen L, Yanagida T, Garandeau CF, Malamut ST, Veenstra R, Salmivalli C. Is there really a healthy context paradox for victims of bullying? A longitudinal test of bidirectional within-and between-person associations between victimization and psychological problems. Dev Psychopathol 2023:1-15. [PMID: 37990407 DOI: 10.1017/s0954579423001384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
The finding that victims' psychological problems tend to be exacerbated in lower-victimization classrooms has been referred to as the "healthy context paradox." The current study has put the healthy context paradox to a strict test by examining whether classroom-level victimization moderates bidirectional within- and between-person associations between victimization and psychological adjustment. Across one school year, 3,470 Finnish 4th to 9th graders (Mage = 13.16, 46.1% boys) reported their victimization, depressive symptoms, anxiety, and self-esteem. Three types of multilevel models (cross-lagged panel, latent change score, and random-intercept cross-lagged panel) were estimated for each indicator of psychological adjustment. Findings indicated that the healthy context paradox emerges because classroom-level victimization moderates the prospective effect of victimization on psychological problems, rather than the effect of psychological problems on victimization. In classrooms with lower victimization, victims not only experience worse psychological maladjustment over time compared to others (between-person changes), but also higher maladjustment than before (absolute within-person changes).
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Affiliation(s)
| | - Takuya Yanagida
- Department of Developmental and Educational Psychology, University of Vienna, Wien, Austria
| | | | | | - René Veenstra
- Department of Sociology, University of Groningen, Groningen, The Netherlands
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Boyle C, Sanders MR, Ma T, Hodges J, Allen KA, Cobham VE, Darmawan I, Dittman CK, Healy KL, Hepburn SJ, MacLeod LM, Teng J, Trompf M. The thriving kids and parents schools project: protocol of an incomplete stepped wedged cluster randomised trial evaluating the effectiveness of a Triple P seminar series. BMC Public Health 2023; 23:2021. [PMID: 37848856 PMCID: PMC10580655 DOI: 10.1186/s12889-023-16962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted the normality of daily life for many children, their families, and schools, resulting in heightened levels of anxiety, depression, social isolation, and loneliness among young people. An integrated public health model of interventions is needed to address the problem and to safeguard the mental health and wellbeing of children. The Triple P - Positive Parenting Program is one system of parenting support with a strong evidence-base and wide international reach. When implemented as a public health approach, Triple P has demonstrated population level positive effects on child wellbeing. This study will be the first large-scale, multi-site randomised controlled trial of a newly developed, low-intensity variant of Triple P, a school-based seminar series, as a response to the impacts of the pandemic. METHODS The evaluation will employ an Incomplete Batched Stepped Wedge Cluster Randomised Trial Design. At least 300 Australian primary schools, from South Australia, Queensland, and Victoria will be recruited and randomised in three batches. Within each batch, schools will be randomly assigned to either start the intervention immediately or start in six weeks. Parents will be recruited from participating schools. The Triple P seminar series includes three seminars titled: "The Power of Positive Parenting", "Helping Your Child to Manage Anxiety", and "Keeping your Child Safe from Bullying". Parents will complete measures about child wellbeing, parenting, parenting self-regulation and other key intervention targets at baseline, six weeks after baseline, and 12 weeks after baseline. Intervention effectiveness will be evaluated with a Multilevel Piecewise Latent Growth Curve Modelling approach. Data collection is currently underway, and the current phase of the project is anticipated to be completed in January 2024. DISCUSSION The findings from this study will extend the current knowledge of the effects of evidence-based parenting support delivered through brief, universally offered, low intensity, school-based parenting seminars in a post pandemic world. TRIAL REGISTRATION The trial is registered at the Australian New Zealand Clinical Trials Registry (Trial Registration Number: ACTRN12623000852651).
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Affiliation(s)
- Christopher Boyle
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - Matthew R Sanders
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
| | - Tianyi Ma
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
| | - Julie Hodges
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
| | - Kelly-Ann Allen
- School of Educational Psychology & Counselling, Monash University, Victoria, Australia
| | - Vanessa E Cobham
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
- School of Psychology, The University of Queensland, Queensland, Australia
- Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Igusti Darmawan
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Cassandra K Dittman
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Queensland, Australia
- Manna Institute, Central Queensland University, Queensland, Australia
| | - Karyn L Healy
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Stevie-Jae Hepburn
- Parenting and Family Support Centre, The University of Queensland, Queensland, Australia
| | - Lynda M MacLeod
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Jiachen Teng
- School of Education, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Madilyn Trompf
- School of Educational Psychology & Counselling, Monash University, Victoria, Australia
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8
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Thomson KC, Jenkins E, Gill R, Hastings KG, Richardson CG, Gagné Petteni M, McAuliffe C, Gadermann AM. Parent psychological distress and parent-child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study. PLoS One 2023; 18:e0292670. [PMID: 37847679 PMCID: PMC10581480 DOI: 10.1371/journal.pone.0292670] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. Parents with children living at home were early on identified as a population at heightened mental health risk, with concerns about the potential long-term impacts of the pandemic on parents' mental health, family functioning, and children's well-being. This study investigates impacts of the pandemic on parents' psychological distress, contextual sources of distress, and associations with family functioning nearly two years into the pandemic. METHODS AND FINDINGS Data were drawn from a national cross-sectional survey of adults living in Canada in November and December 2021 that was representative by age, gender, household income, and region. Parents with children < 18 years old living at home (N = 553) reported their experiences of psychological distress, pandemic-related stressors, coping mechanisms, and family functioning (changes in parent-child interactions, children's anxiety). Chi-square tests, logistic regression, and linear regression analyses examined sociodemographic inequities in parents' levels of psychological distress, sources and mitigating mechanisms of distress, and associations between psychological distress and family functioning. Nearly two years into the pandemic, parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress. Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial stressors. Parents with greater psychological distress reported increases in negative parent-child interactions due to the pandemic and higher anxiety among their children. CONCLUSIONS This study identifies sustained negative impacts of the pandemic on parents' mental health and family functioning in Canada nearly two years into the pandemic, despite high vaccine uptake and declining infection rates. Disparities in financial stress, social support structures, and pre-existing mental health were identified as underlying sources of psychological distress. These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequities.
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Affiliation(s)
- Kimberly C. Thomson
- Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Randip Gill
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Katherine G. Hastings
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Chris G. Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Corey McAuliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Anne M. Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
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9
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Jackson A, Melvin GA, Mulraney M, Becker SP, Bellgrove MA, Quach J, Hutchinson D, Westrupp EM, Montgomery A, Sciberras E. Associations Between Anxiety and Home Learning Difficulties in Children and Adolescents with ADHD During the COVID-19 Pandemic. Child Psychiatry Hum Dev 2023; 54:1347-1359. [PMID: 35290556 PMCID: PMC8922068 DOI: 10.1007/s10578-022-01338-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 11/03/2022]
Abstract
The COVID-19 pandemic has markedly impacted functioning for children and adolescents including those with attention-deficit/hyperactivity disorder (ADHD). We explored home learning difficulties (HLD) during COVID-19 restrictions in Australian children (aged 5-17) with ADHD, aiming to: (1) describe home learning experiences, and (2) examine associations between child anxiety (i.e., concurrent anxiety symptoms and pre-existing anxiety disorder status) and HLD. Baseline data from the longitudinal ADHD COVID-19 Survey were used (n = 122). Parents reported on school factors and HLD; pre-existing anxiety and co-occurring difficulties; anxiety, ADHD, and oppositional symptoms; demographics; and medications. Parents retrospectively reported more children often looked forward to school pre-pandemic, than during the pandemic. Anxiety symptoms, but not pre-existing anxiety disorder status, were associated with HLD after accounting for covariates. ADHD inattention symptoms were also associated with HLD. Results support recommendations to continue pre-pandemic supports to assist with ADHD symptoms during home learning, and strategies/supports for families are discussed.
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Affiliation(s)
- Anna Jackson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia.
- Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Glenn A Melvin
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Melissa Mulraney
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Institute for Social Neuroscience, ISN Innovations, Ivanhoe, VIC, Australia
| | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Jon Quach
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC, Australia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- University of New South Wales, Kensington, NSW, Australia
| | - Elizabeth M Westrupp
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
- Judith Lumley Centre, La Trobe University, Victoria, Australia
| | - Alicia Montgomery
- University of New South Wales, Kensington, NSW, Australia
- Department of Community Paediatrics, Sydney Local Health District, Sydney, NSW, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
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10
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Orgilés M, Morales A, Fernández-Martínez I, Méndez X, Espada JP. Effectiveness of a transdiagnostic computerized self-applied program targeting children with emotional problems: A randomized controlled trial. J Affect Disord 2023; 338:155-162. [PMID: 37271291 DOI: 10.1016/j.jad.2023.06.004] [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: 01/02/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Super Skills for Life (SSL) is an eight-session transdiagnostic program based on cognitive-behavioral therapy (CBT), aimed at the indicated prevention of childhood emotional problems, which has been implemented with positive short- and long-term results. The present study aimed to examine the effects of a self-applied computerized program based on SSL that maintains the same objectives and contents as the face-to-face program. METHODS In this randomized controlled study, 75 children (49.3 % female) aged 8-12 years (Mage = 9.45, SD = 1.31), selected for exhibiting emotional symptoms, were randomly assigned to either the intervention (n = 35) or the waiting list control (WLC) group (n = 40). Pre- and post-intervention data were collected through self-reports and the report of parents who completed parallel versions of the same measures of emotional and behavioral problems. RESULTS Overall, compared to the WLC group, the intervention group showed positive effects on targeted emotional symptomatology in the short term. Based on parents' reports, a significant reduction was found in outcomes such as anxiety, depression, emotional symptoms, and internalizing problems, while self-reported results were similar except for anxiety. In addition, a positive impact was found on symptoms related to other types of difficulties (e.g., externalizing problems and general difficulties measured). LIMITATIONS Small sample size, non-inclusion of follow-up assessment and other informants (e.g., teachers). CONCLUSIONS In conclusion, this research provides novel and promising data on the self-applied computerized adapted version of the SSL program, within a multi-informant approach, suggesting that it may be a useful tool for the indicated prevention of childhood emotional problems.
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11
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Ludwig-Walz H, Dannheim I, Pfadenhauer LM, Fegert JM, Bujard M. Anxiety increased among children and adolescents during pandemic-related school closures in Europe: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2023; 17:74. [PMID: 37344892 DOI: 10.1186/s13034-023-00612-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Considering the heterogenous evidence, a systematic review of the change in anxiety in European children and adolescents associated with the COVID-19 pandemic is lacking. We therefore assessed the change compared with pre-pandemic baselines stratified by gender and age as well as evaluated the impact of country-specific restriction policies. METHODS A registration on the 'International Prospective Register of Systematic Reviews' (PROSPERO) occurred and an a priori protocol was published. We searched six databases (PubMed, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, WHO COVID-19) using a peer-reviewed search string with citation tracking and grey literature screening. Primary outcomes were: (1) general anxiety symptoms; and (2) clinically relevant anxiety rates. We used the Oxford COVID-19 Stringency Index as an indicator of pandemic-related restrictions. Screening of title/abstract and full text as well as assessing risk of bias (using the 'Risk of Bias in Non-randomized Studies of Exposure' [ROBINS-E]) and certainty of evidence (using the 'Grading of Recommendations Assessment, Development and Evaluation' [GRADE]) was done in duplicate. We pooled data using a random effects model. Reporting is in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. RESULTS Of 7,422 non-duplicate records, 18 studies with data from 752,532 pre-pandemic and 763,582 pandemic participants met full inclusion criteria. For general anxiety symptoms the total change effect estimate yielded a standardised mean difference (SMD) of 0.34 (95% confidence interval [CI], 0.17-0.51) and for clinically relevant anxiety rates we observed an odds ratio of 1.08 (95%-CI, 0.98-1.19). Increase in general anxiety symptoms was highest in the 11-15 years age group. Effect estimates were higher when pandemic-related restrictions were more stringent (Oxford Stringency Index > 60: SMD, 0.52 [95%-CI, 0.30-0.73]) and when school closures (School Closure Index ≥ 2: SMD, 0.44 [95%-CI, 0.23-0.65]) occurred. CONCLUSION General anxiety symptoms among children and adolescents in Europe increased in a pre/during comparison of the COVID-19 pandemic; particularly for males aged 11-15 years. In periods of stringent pandemic-related restrictions and/or school closures a considerable increase in general anxiety symptoms could be documented. PROSPERO registration: CRD42022303714.
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Affiliation(s)
| | - Indra Dannheim
- Regional Innovative Centre of Health and Quality of Live Fulda (RIGL), Fulda University of Applied Sciences, Fulda, Germany
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - Lisa M Pfadenhauer
- Chair of Public Health and Health Services Research, IBE, Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jörg M Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Competence Domain Mental Health Prevention, Ulm, Germany
| | - Martin Bujard
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Institute of Medical Psychology, Medical Faculty, University Heidelberg, Heidelberg, Germany
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12
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Ma SON, McCallum SM, Pasalich D, Batterham PJ, Calear AL. Understanding parental knowledge, attitudes and self-efficacy in professional help-seeking for child anxiety. J Affect Disord 2023:S0165-0327(23)00720-6. [PMID: 37245548 DOI: 10.1016/j.jad.2023.05.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Child anxiety disorders are highly prevalent yet undertreated. As parents are often 'gatekeepers' to children receiving treatment and support, this study aimed to investigate modifiable parental factors affecting professional help-seeking for their children from general practitioners (GPs), psychologists, and paediatricians. METHODS In this study, 257 Australian parents of children aged 5-12 years with elevated anxiety symptoms completed a cross-sectional online survey. The survey assessed help-seeking from a GP, psychologist, and paediatrician (General Help Seeking Questionnaire), as well as anxiety knowledge (Anxiety Literacy Scale), help-seeking attitudes (Attitudes Toward Seeking Professional Psychological Help), personal stigma (Generalised Anxiety Stigma Scale) and self-efficacy (Self-Efficacy in Seeking Mental Health Care). RESULTS 66.9 % of participants had sought help from a GP, 61.1 % from a psychologist, and 33.9 % from a paediatrician. Help-seeking from a GP or psychologist was associated with lower personal stigma (p = .02 and p = .03 respectively). Participants who sought help from a psychologist also had more positive attitudes toward seeking professional support (p = .01). Conversely, knowledge of anxiety disorders and self-efficacy were not associated with help-seeking from any source. LIMITATIONS Limitations of the study include the representativeness of our sample (female gender, higher education level); unexplained variance potentially accounted for by other factors (e.g., structural barriers); lack of prior validation of measures in a parent sample. CONCLUSIONS This research will inform the development of public health policy and psychoeducation interventions for parents, to reduce personal stigma and increase positive attitudes toward professional help-seeking, in turn improving help-seeking for child anxiety.
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Affiliation(s)
- Samuel O N Ma
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Sonia M McCallum
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Dave Pasalich
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
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13
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Newlove‐Delgado T, Russell AE, Mathews F, Cross L, Bryant E, Gudka R, Ukoumunne OC, Ford TJ. Annual Research Review: The impact of Covid-19 on psychopathology in children and young people worldwide: systematic review of studies with pre- and within-pandemic data. J Child Psychol Psychiatry 2023; 64:611-640. [PMID: 36421049 PMCID: PMC10952503 DOI: 10.1111/jcpp.13716] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high volume and pace of research has posed challenges to researchers, policymakers and practitioners wanting to understand the overall impact of the pandemic on children and young people's mental health. We aimed to search for and review the evidence from epidemiological studies to answer the question: how has mental health changed in the general population of children and young people? METHODS Four databases (Medline, CINAHL, EMBASE and PsychINFO) were searched in October 2021, with searches updated in February 2022. We aimed to identify studies of children or adolescents with a mean age of 18 years or younger at baseline, that reported change on a validated mental health measure from prepandemic to during the pandemic. Abstracts and full texts were double-screened against inclusion criteria and quality assessed using a risk of bias tool. Studies were narratively synthesised, and meta-analyses were performed where studies were sufficiently similar. RESULTS 6917 records were identified, and 51 studies included in the review. Only four studies had a rating of high quality. Studies were highly diverse in terms of design, setting, timing in relation to the pandemic, population, length of follow-up and choice of measure. Methodological heterogeneity limited the potential to conduct meta-analyses across studies. Whilst the evidence suggested a slight deterioration on some measures, overall, the findings were mixed, with no clear pattern emerging. CONCLUSIONS Our findings highlight the need for a more harmonised approach to research in this field. Despite the sometimes-inconsistent results of our included studies, the evidence supports existing concerns about the impact of Covid-19 on children's mental health and on services for this group, given that even small changes can have a significant impact on provision at population level. Children and young people must be prioritised in pandemic recovery, and explicitly considered in planning for any future pandemic response.
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Affiliation(s)
| | | | - Frances Mathews
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Lauren Cross
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Eleanor Bryant
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gudka
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Obioha C. Ukoumunne
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South West Peninsula (PenARC)ExeterUK
| | - Tamsin J. Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
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14
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Bennetts SK, Howell T, Crawford S, Burgemeister F, Burke K, Nicholson JM. Family Bonds with Pets and Mental Health during COVID-19 in Australia: A Complex Picture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5245. [PMID: 37047861 PMCID: PMC10094414 DOI: 10.3390/ijerph20075245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic has drawn attention to the health-promoting features of human-animal relationships, particularly for families with children. Despite this, the World Health Organization's (1986) Ottawa Charter remains human-centric. Given the reciprocal health impacts of human-animal relationships, this paper aims to (i) describe perceived pet-related benefits, worries, and family activities; and to (ii) examine differences in perceived benefits, worries, and activities for parents and children with and without clinical mental health symptoms. We recruited 1034 Australian parents with a child < 18 years and a cat or dog via a national online survey between July and October 2020. Most parents reported their pet was helpful for their own (78%) and their child's mental health (80%). Adjusted logistic regression revealed parents with clinical psychological distress were 2.5 times more likely to be worried about their pet's care, well-being, and behaviour (OR = 2.56, p < 0.001). Clinically anxious children were almost twice as likely to live in a family who engages frequently in pet-related activities (e.g., cooked treats, taught tricks, OR = 1.82, p < 0.01). Mental health and perceived benefits of having a pet were not strongly associated. Data support re-framing the Ottawa Charter to encompass human-animal relationships, which is an often-neglected aspect of a socioecological approach to health.
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Affiliation(s)
- Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| | - Tiffani Howell
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Bendigo, VIC 3552, Australia
| | - Sharinne Crawford
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Fiona Burgemeister
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Kylie Burke
- Metro North Mental Health, Metro North Health, Herston, QLD 4029, Australia
| | - Jan M. Nicholson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
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15
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Poole BJ, Lah S. Mathematics difficulties are related to mathematics anxiety in children with epilepsy: An online study. Epilepsy Behav 2023; 139:109068. [PMID: 36628849 DOI: 10.1016/j.yebeh.2022.109068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/14/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
AIM Children with epilepsy have an increased risk of difficulties with mathematics. Research into the mathematics difficulties of children with epilepsy, however, is limited. This study sought to determine whether the mathematics difficulties of children with epilepsy are related to mathematics anxiety over and above other previously identified factors (reading difficulties, generalized anxiety, and working memory). METHOD Seventy-nine parents of children with epilepsy and 72 parents of typically developing children completed online questionnaires on their child's mathematics and reading difficulties (CLDQ; Colorado Learning Difficulties Questionnaire), mathematics anxiety (mAMAS; Modified Abbreviated Math Anxiety Scale), general anxiety (SCAS; Spence Child Anxiety Scale), and working memory (BRIEF-2; Brief Rating Inventory of Executive Function-2nd Edition). Questionnaires also collected demographic information and epilepsy variables. RESULTS Children with epilepsy had higher scores on the CLDQ mathematics subscale (CLDQm) and the mAMAS compared to typically developing children. Younger age of epilepsy onset, higher seizure frequency, and a greater number of anti-seizure medications accounted for 20.4% of the variance on the CLDQm. The CLDQ reading subscale (CLDQr) justified an additional 14% of the variance on the CLDQm. Finally, the mAMAS explained 20.2% of the variance on the CLDQm, after controlling for epilepsy variables and CLDQr. In contrast, the BRIEF-2 and SCAS did not account for a significant amount of variance on the CLDQm. SIGNIFICANCE Mathematics anxiety is the most significant contributor to mathematics difficulties experienced by children with epilepsy. Difficulties with reading and epilepsy factors also have significant, albeit smaller contributions to mathematics difficulties in this clinical population. Given the multiplicity of factors contributing to mathematics difficulties, a comprehensive, multidisciplinary treatment is needed.
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Affiliation(s)
- Belinda J Poole
- School of Psychology, University of Sydney, Sydney, NSW, Australia.
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, NSW, Australia.
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16
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Westrupp EM, Bennett C, Berkowitz T, Youssef GJ, Toumbourou JW, Tucker R, Andrews FJ, Evans S, Teague SJ, Karantzas GC, Melvin GM, Olsson C, Macdonald JA, Greenwood CJ, Mikocka-Walus A, Hutchinson D, Fuller-Tyszkiewicz M, Stokes MA, Olive L, Wood AG, McGillivray JA, Sciberras E. Child, parent, and family mental health and functioning in Australia during COVID-19: comparison to pre-pandemic data. Eur Child Adolesc Psychiatry 2023; 32:317-330. [PMID: 34417875 PMCID: PMC8379590 DOI: 10.1007/s00787-021-01861-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/13/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0-18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0-18 years (N = 2365). Parents completed an online self-report survey during 'stage three' COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen's d = 0.26-0.81, all p < 0.001), higher parenting irritability (d = 0.17-0.46, all p < 0.001), lower family positive expressiveness (d = - 0.18, p < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.
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Affiliation(s)
- E M Westrupp
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia.
- Department of Paediatrics, University of Melbourne, Victoria, Australia.
- Judith Lumley Centre, La Trobe University, Victoria, Australia.
| | - C Bennett
- Judith Lumley Centre, La Trobe University, Victoria, Australia
| | - T Berkowitz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J W Toumbourou
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - R Tucker
- Deakin HOME Research Hub, Victoria, Australia
| | - F J Andrews
- Deakin HOME Research Hub, Victoria, Australia
| | - S Evans
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - S J Teague
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G C Karantzas
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G M Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Centre for Educational Development Research and Appraisal, University of Warwick, Coventry, UK
| | - C Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - C J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - D Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
- The National Drug and Alcohol Research Centre, University of Sydney, New South Wales, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - M A Stokes
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - L Olive
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- IMPACT Institute, School of Medicine, Faculty of Health, Deakin University, Victoria, Australia
| | - A G Wood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J A McGillivray
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - E Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
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Foster S, Estévez-Lamorte N, Walitza S, Dzemaili S, Mohler-Kuo M. Perceived stress, coping strategies, and mental health status among adolescents during the COVID-19 pandemic in Switzerland: a longitudinal study. Eur Child Adolesc Psychiatry 2022; 32:937-949. [PMID: 36515772 PMCID: PMC9749639 DOI: 10.1007/s00787-022-02119-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
This longitudinal, prospective study investigated associations between perceived COVID-19-related stress, coping strategies, and mental health status among adolescents during the first lockdown of the COVID-19 pandemic and one year after the lockdown in Switzerland within a large, national sample. A self-report on-line survey was completed by 553 adolescents (age-range 12-18 years in 2021) in the summers of 2020 and 2021, assessing symptoms of various mental health problems, perceived COVID-19-related stressors, and coping strategies. Overall, participants reported less COVID-19 related stress one year after the lockdown, though mental health status remained stable. 'Challenges at home or with others' were significantly associated with mental health problems in both genders, whereas 'trouble getting medical care or mental health services 'was associated with mental health problems in girls. Perceived stress and pre-existing psychiatric problem were significantly linked to all mental health outcomes at both time points. Parents' poor relationships with partners during the lockdown was associated with increased anxiety symptoms in their children. Using cognitive restructuring to cope with stress was associated with less, while negative coping was associated with more anxiety, depression, and attention deficit hyperactivity disorder (ADHD) symptoms one year post lockdown. Girls appear to have been more affected by the pandemic than boys, with youths with pre-existing psychiatric problems especially vulnerable to its detrimental effects. Healthcare and school professionals should support to identify high-risk adolescents with negative and avoidant coping strategies and train youths to use positive coping strategies.
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Affiliation(s)
- Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.
| | - Natalia Estévez-Lamorte
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Shota Dzemaili
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Meichun Mohler-Kuo
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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18
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Samson AC, Sokhn N, Van Herwegen J, Dukes D. An exploratory study on emotion regulation strategy use in individuals with Williams syndrome, autism spectrum disorder and intellectual disability. Front Psychiatry 2022; 13:940872. [PMID: 36506439 PMCID: PMC9726902 DOI: 10.3389/fpsyt.2022.940872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Individuals with neurodevelopmental disorders often have atypical emotion profiles, but little is known about how they regulate their emotions. While several studies have examined emotion regulation strategy use in autism spectrum disorder (ASD), only a few have included individuals with intellectual disability (ID) or focused on specific syndromes such as Williams syndrome (WS). Methods A parent-reported survey launched during the first months of the COVID-19 pandemic allowed to exploratorily study emotion regulation strategy use and its link to anxiety in individuals with ASD with (N=785) and without ID (N=596), WS (N=261), and Intellectual Disability not otherwise specified (N=649). Results Using multilevel analyses, besides revealing specific group differences in emotion regulation strategy use, a variety of strategies (e.g., rumination, avoiding information, repetitive behaviors) were found to be linked to elevated levels of anxiety, while focusing on the positive was linked to lower anxiety levels in all groups. Moreover, only autistic people without ID used humor more frequently while experiencing lower anxiety levels. Conclusion This study sheds light on an underexplored area of emotion regulation strategy use in different neurodevelopmental disorders. It also paves the way to further examine emotion regulation in more rigorous ways to better understand emotion regulation in different neurodevelopmental disorders as well as the impact on outcome measures such as anxiety. This exploratory study may help to develop and validate adequate measures to study a broad array of ER strategies used by individuals with neurodevelopmental disorders.
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Affiliation(s)
- Andrea C. Samson
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
| | - Nayla Sokhn
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
- Eye and Brain Mapping Laboratory (iBMLab), Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Jo Van Herwegen
- Department of Psychology and Human Development, UCL Institute of Education, London, United Kingdom
| | - Daniel Dukes
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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19
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Mundy LK, Canterford L, Moreno-Betancur M, Hoq M, Viner RM, Bayer JK, Lietz P, Redmond G, Patton GC. Learning outcomes in primary school children with emotional problems: a prospective cohort study. Child Adolesc Ment Health 2022. [PMID: 36400427 DOI: 10.1111/camh.12607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Academic difficulties are common in adolescents with mental health problems. Although earlier childhood emotional problems, characterised by heightened anxiety and depressive symptoms are common forerunners to adolescent mental health problems, the degree to which mental health problems in childhood may contribute independently to academic difficulties has been little explored. METHODS Data were drawn from a prospective cohort study of students in Melbourne, Australia (N = 1239). Data were linked with a standardised national assessment of academic performance at baseline (9 years) and wave three (11 years). Depressive and anxiety symptoms were assessed at baseline and wave two (10 years). Regression analyses estimated the association between emotional problems (9 and/or 10 years) and academic performance at 11 years, adjusting for baseline academic performance, sex, age and socioeconomic status, and hyperactivity/inattention symptoms. RESULTS Students with depressive symptoms at 9 years of age had lost nearly 4 months of numeracy learning two years later after controlling for baseline academic performance and confounders. Results were similar for anxiety symptoms. Regardless of when depressive symptoms occurred there were consistent associations with poorer numeracy performance at 11 years. The association of depressive symptoms with reading performance was weaker than for numeracy if they were present at wave two. Persistent anxiety symptoms across two waves led to nearly a 4 month loss of numeracy learning at 11 years, but the difference was not meaningful for reading. Findings were similar when including hyperactivity/inattention symptoms. CONCLUSIONS Childhood anxiety and depression are not only forerunners of later mental health problems but predict academic achievement. Partnerships between education and health systems have the potential to not only improve childhood emotional problems but also improve learning.
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Affiliation(s)
- Lisa K Mundy
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | | | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Monsurul Hoq
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Russell M Viner
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jordana K Bayer
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Petra Lietz
- Australian Council for Educational Research, Adelaide, SA, Australia
| | - Gerry Redmond
- College of Business, Government and Law, Flinders University, Bedford Park, SA, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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20
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Taylor L, Giles S, Howitt S, Ryan Z, Brooks E, Radley L, Thomson A, Whitaker E, Knight F, Hill C, Violato M, Waite P, Raymont V, Yu LM, Harris V, Williams N, Creswell C. A randomised controlled trial to compare clinical and cost-effectiveness of an online parent-led treatment for child anxiety problems with usual care in the context of COVID-19 delivered in Child and Adolescent Mental Health Services in the UK (Co-CAT): a study protocol for a randomised controlled trial. Trials 2022; 23:942. [PMID: 36384704 PMCID: PMC9667839 DOI: 10.1186/s13063-022-06833-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/06/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In the context of COVID-19, NHS Child and Adolescent Mental Health Services (CAMHS) and other children's mental health services have faced major challenges in providing psychological treatments that (i) work when delivered remotely and (ii) can be delivered efficiently to manage increases in referrals as social distancing measures have been relaxed. Anxiety problems are a common reason for referral to CAMHS, children with pre-existing anxiety problems are particularly vulnerable in the context of COVID-19, and there were concerns about increases in childhood anxiety as schools reopened. The proposed research will evaluate the clinical and cost-effectiveness of a brief online parent-led cognitive behavioural treatment (CBT) delivered by the OSI (Online Support and Intervention for child anxiety) platform with remote support from a CAMHS therapist compared to 'COVID-19 treatment as usual' (C-TAU) in CAMHS and other children's mental health services throughout the COVID-19 pandemic. METHODS We will conduct a two-arm, multi-site, randomised controlled non-inferiority trial to evaluate the clinical and cost-effectiveness of OSI with therapist support compared to CAMHS and other child mental health services 'COVID-19 treatment as usual' (C-TAU) during the COVID-19 outbreak and to explore parent and therapists' experiences. DISCUSSION If non-inferiority is shown, the research will provide (1) a solution for efficient psychological treatment for child anxiety disorders while social distancing (for the COVID-19 context and future pandemics); (2) an efficient means of treatment delivery as 'normal service' resumes to enable CAMHS to cope with the anticipated increase in referrals; and (3) a demonstration of rapid, high-quality evaluation and application of online interventions within NHS CAMHS to drive forward much-needed further digital innovation and evaluation in CAMHS settings. The primary beneficiaries will be children with anxiety disorders and their families, NHS CAMHS teams, and commissioners who will access a potentially effective, cost-effective, and efficient treatment for child anxiety problems. TRIAL REGISTRATION ISRCTN ISRCTN12890382 . Registered prospectively on 23 October 2020.
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Affiliation(s)
- Lucy Taylor
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Sophie Giles
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Sophie Howitt
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Zoe Ryan
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Emma Brooks
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Lucy Radley
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Abigail Thomson
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Emily Whitaker
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Fauzia Knight
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Claire Hill
- grid.9435.b0000 0004 0457 9566School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Mara Violato
- grid.4991.50000 0004 1936 8948Health Economics Research Centre, Nuffield Department of Population Health, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Polly Waite
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Vanessa Raymont
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- grid.4991.50000 0004 1936 8948Oxford Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Victoria Harris
- grid.4991.50000 0004 1936 8948Oxford Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Nicola Williams
- grid.4991.50000 0004 1936 8948Oxford Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Cathy Creswell
- grid.4991.50000 0004 1936 8948Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
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21
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Westrupp EM, Greenwood CJ, Fuller-Tyszkiewicz M, Olsson CA, Sciberras E, Mikocka-Walus A, Melvin GA, Evans S, Stokes MA, Wood AG, Karantzas GC, Macdonald JA, Toumbourou JW, Teague SJ, Fernando JW, Berkowitz TS, Ling M, Youssef GJ. Parent and child mental health trajectories April 2020 to May 2021: Strict lockdown versus no lockdown in Australia. Aust N Z J Psychiatry 2022; 56:1491-1502. [PMID: 34930045 DOI: 10.1177/00048674211065365] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. METHODS Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children's Anxiety Scale). RESULTS Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [β] = 0.09-0.46), parent/child diagnoses (β = 0.07-0.21), couple conflict (β = 0.07-0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (β = 0.12-0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). CONCLUSION Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.
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Affiliation(s)
- Elizabeth M Westrupp
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Judith Lumley Centre, La Trobe University, Burwood, VIC, Australia
| | - Christopher J Greenwood
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Craig A Olsson
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emma Sciberras
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Antonina Mikocka-Walus
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Glenn A Melvin
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Subhadra Evans
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Mark A Stokes
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Amanda G Wood
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Gery C Karantzas
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Jacqui A Macdonald
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - John W Toumbourou
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Samantha J Teague
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Julian W Fernando
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Tomer S Berkowitz
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Mathew Ling
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - George J Youssef
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
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22
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Reardon T, Ukoumunne OC, Violato M, Ball S, Brown P, Ford T, Gray A, Hill C, Jasper B, Larkin M, Macdonald I, Morgan F, Pollard J, Sancho M, Sniehotta FF, Spence SH, Stallard P, Stainer J, Taylor L, Williamson V, Day E, Fisk J, Green I, Halliday G, Hennigan C, Pearcey S, Robertson O, Creswell C. Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for a cluster randomised controlled trial to compare screening, feedback and intervention for child anxiety problems to usual school practice. Trials 2022; 23:896. [PMID: 36273185 PMCID: PMC9587579 DOI: 10.1186/s13063-022-06773-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background Systematically screening for child anxiety problems, and offering and delivering a brief, evidence-based intervention for children who are identified as likely to benefit would minimise common barriers that families experience in accessing treatment. We have developed a short parent-report child anxiety screening questionnaire, and procedures for administering screening questionnaires, sharing screening outcomes with families, and offering and delivering a brief parent-led online intervention (OSI: Online Support and Intervention for child anxiety) through schools. This trial aims to evaluate clinical and health economic outcomes for (1) children (aged 8–9) who screen positive for anxiety problems at baseline (target population) and (2) the wider population of all children in participating classes (total population) in schools randomly allocated to receive identification-to-intervention procedures and usual school practice (‘screening and intervention’), compared to assessment and usual school practice only (‘usual school practice’). Methods The trial design is a parallel-group, superiority cluster randomised controlled trial, with schools (clusters) randomised to ‘screening and intervention’ or ‘usual school practice’ arms in a 1:1 ratio stratified according to the level of deprivation within the school. We will recruit schools and participants in two phases (a pilot phase (Phase 1) and Phase 2), with progression criteria assessed prior to progressing to Phase 2. In total, the trial will recruit 80 primary/junior schools in England, and 398 children (199 per arm) who screen positive for anxiety problems at baseline (target population). In schools allocated to ‘screening and intervention’: (1) parents/carers will complete a brief parent-report child anxiety screening questionnaire (at baseline) and receive feedback on their child’s screening outcomes (after randomisation), (2) classes will receive a lesson on managing fears and worries and staff will be provided with information about the intervention and (3) parents/carers of children who screen positive for anxiety problems (target population) will be offered OSI. OSI will also be available for any other parents/carers of children in participating classes (total population) who request it. We will collect child-, parent- and teacher-report measures for the target population and total population at baseline (before randomisation), 4 months, 12 months and 24 months post-randomisation. The primary outcome will be the proportion of children who screen positive for anxiety problems at baseline (target population) who screen negative for anxiety problems 12 months post-randomisation. Discussion This trial will establish if systematic screening for child anxiety problems, sharing screening outcomes with families and delivering a brief parent-led online intervention through schools is effective and cost-effective. Trial registration ISRCTN registry ISRCTN76119074. Prospectively registered on 4.1.2022. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06773-0.
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Affiliation(s)
- Tessa Reardon
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
| | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Susan Ball
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Paul Brown
- Bransgore C of E Primary School, Bransgore, UK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation Trust, Cambridge, UK
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Bec Jasper
- Parents and Carers Together, Suffolk, UK
| | - Michael Larkin
- Life and Health Sciences, Aston University, Birmingham, UK
| | | | | | - Jack Pollard
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Falko F Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
| | - Susan H Spence
- School of Applied Psychology and Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Australia
| | | | | | - Lucy Taylor
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Victoria Williamson
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Day
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Jennifer Fisk
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Iheoma Green
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Gemma Halliday
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Ciara Hennigan
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Samantha Pearcey
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Olly Robertson
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
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23
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Hossain B, Bent S, Parenteau C, Widjaja F, Davis M, Hendren RL. The Associations Between Sluggish Cognitive Tempo, Internalizing Symptoms, and Academic Performance in Children With Reading Disorder: A Longitudinal Cohort Study. J Atten Disord 2022; 26:1576-1590. [PMID: 35373641 PMCID: PMC9373189 DOI: 10.1177/10870547221085493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate whether sluggish cognitive tempo (SCT) was associated with anxiety, depression, and academic performance (AP) in children with reading disorder (RD), and whether ADHD-Inattention (ADHD-IN) moderated these relationships. METHOD Parents and teachers of children with RD (N = 147, ages 6-18) completed evaluations of SCT, ADHD, anxiety, depression, and AP, every 3 months for 18 months. Baseline and longitudinal associations between SCT and outcomes, and effect moderation of ADHD-IN, were assessed. RESULTS Teacher-rated SCT was positively associated with teacher-rated anxiety (p < .001) and negatively associated with AP (p < .001) cross-sectionally and longitudinally, with significant effect modification by ADHD-IN for both outcomes. SCT was not associated with depression in adjusted cross-sectional and longitudinal analyses. There were no significant findings for any parent-reported measures. CONCLUSION SCT has negative effects on anxiety and AP in children with RD among individuals with low ADHD-IN according to teacher report. Targeted treatment of SCT may provide substantial benefits.
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Affiliation(s)
- Bushra Hossain
- University of California, San
Francisco, CA, USA,Bushra Hossain, Department of Psychiatry,
University of California, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Stephen Bent
- University of California, San
Francisco, CA, USA
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24
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Reardon T, Ball S, Breen M, Brown P, Day E, Ford T, Gray A, Green I, Hill C, Jasper B, King T, Larkin M, Macdonald I, Morgan F, Pollard J, Sancho M, Sniehotta FF, Spence SH, Stallard P, Stainer J, Ukoumunne OC, Violato M, Williams C, Williamson V, Creswell C. Identifying Child Anxiety Through Schools-identification to intervention (iCATS-i2i): protocol for single-arm feasibility trial. Pilot Feasibility Stud 2022; 8:176. [PMID: 35948994 PMCID: PMC9363860 DOI: 10.1186/s40814-022-01140-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/28/2022] [Indexed: 12/30/2022] Open
Abstract
Background Anxiety disorders are common among primary-school aged children, but few affected children receive evidence-based treatment. Identifying and supporting children who experience anxiety problems through schools would address substantial treatment access barriers that families and school staff often face. We have worked with families and school staff to co-design procedures that incorporate screening, feedback for parents, and the offer of a brief intervention in primary schools. This study sets out to assess the feasibility of a subsequent school-based cluster randomised controlled trial to evaluate these procedures. Our objectives are to ensure our procedures for identifying and supporting children with anxiety difficulties through primary schools are acceptable and there are no negative impacts, to estimate recruitment and retention rates, and to identify any changes needed to study procedures or measures. Methods We will recruit six primary/junior schools in England (2 classes per school), and invite all children (aged 8–9) (n = 360) and their parent/carer and class teacher in participating classes to take part. Children, parents and class teachers will complete questionnaires at baseline and 12-week follow-up. Children who ‘screen positive’ on a 2-item parent-report child anxiety screen at baseline will be the target population (expected n = 43). Parents receive feedback on screening questionnaire responses, and where the child screens positive the family is offered support (OSI: Online Support and Intervention for child anxiety). OSI is a brief, parent-led online intervention, supported by short telephone sessions with a Children’s Wellbeing Practitioner. Participants’ experiences of study procedures will be assessed through qualitative interviews/discussion groups. Discussion Evidence-based procedures for identifying and supporting children with anxiety difficulties through primary schools would improve children’s access to timely, effective intervention for anxiety difficulties. Trial registration ISRCTN registry: ISRCTN30032471. Retrospectively registered on 18 May 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01140-x.
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Affiliation(s)
- Tessa Reardon
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
| | - Susan Ball
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Maria Breen
- Thames Valley Clinical Trials Unit, University of Reading, Reading, UK
| | - Paul Brown
- Bransgore C of E Primary School, Christchurch, UK
| | - Emily Day
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Tamsin Ford
- University of Cambridge and Cambridge and Peterborough Foundation Trust, Cambridge, UK
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iheoma Green
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Bec Jasper
- Parents and Carers Together, Suffolk, UK
| | - Thomas King
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Michael Larkin
- Life and Health Sciences, Aston University, Birmingham, UK
| | | | | | - Jack Pollard
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Falko F Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
| | - Susan H Spence
- School of Applied Psychology and Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Australia
| | | | | | - Obioha C Ukoumunne
- NIHR ARC South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Mara Violato
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Chloe Williams
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
| | - Victoria Williamson
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.,Oxford NHS Foundation Trust, Oxford, UK
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25
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Orgilés M, Morales A, Espada JP, Rodríguez-Menchón M. Early detection of anxiety problems in childhood: Spanish validation of the brief Spence Children's Anxiety Scale for parents. Clin Child Psychol Psychiatry 2022; 27:836-851. [PMID: 35446140 DOI: 10.1177/13591045221089907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The small percentage of children with anxiety problems who receive psychological treatment, and the negative psychological consequences associated with these problems highlight the need for early detection. Although assessment instruments with appropriate measurement properties exist, they tend to be extensive, making it difficult to apply them in clinical settings, schools, or primary care practices. This study aimed to adapt the Spanish brief version for parents of the Spence Children's Anxiety Scale (SCAS-P-8). For this purpose, information on 215 children between 8 and 12 years of age was reported by 163 parents. The Spanish version of the SCAS-P-8 adequately fit a one-factor structure, χ2 = 44.25; df = 19; comparative fit index = .97; Tucker-Lewis index = .96; root mean square error of approximation: .07 (.04, .09); standardized root mean squared residual = .08. Evidence of internal consistency of the total SCAS-P-8 score was good (α = 0.82), and the direct correlations obtained between the SCAS-P-8 and internalizing problems showed evidence of convergent validity. Moreover, the appropriate measurement properties of the SCAS-P-8 were shown to be independent of gender. Differences in sociodemographic variables and SDQ-P between children with anxiety symptoms and those without anxiety symptoms were also discussed. Information reported by parents can help the clinician carry out an accurate diagnosis. A brief assessment scale can be easily applied in schools or primary care settings.
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Affiliation(s)
- Mireia Orgilés
- 16753Miguel Hernández University, Department of Health Psychology, Elche (Alicante), Spain
| | - Alexandra Morales
- 16753Miguel Hernández University, Department of Health Psychology, Elche (Alicante), Spain
| | - José P Espada
- 16753Miguel Hernández University, Department of Health Psychology, Elche (Alicante), Spain
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Williamson V, Larkin M, Reardon T, Pearcey S, Button R, Green I, Hill C, Stallard P, Spence SH, Breen M, Mcdonald I, Ukoumunne O, Ford T, Violato M, Sniehotta F, Stainer J, Gray A, Brown P, Sancho M, Morgan F, Jasper B, Creswell C. School-based screening for childhood anxiety problems and intervention delivery: a codesign approach. BMJ Open 2022; 12:e058089. [PMID: 35728898 PMCID: PMC9214411 DOI: 10.1136/bmjopen-2021-058089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES A very small proportion of children with anxiety problems receive evidence-based treatment. Barriers to access include difficulties with problem identification, concerns about stigma and a lack of clarity about how to access specialist services and their limited availability. A school-based programme that integrates screening to identify those children who are most likely to be experiencing anxiety problems with the offer of intervention has the potential to overcome many of these barriers. This article is a process-based account of how we used codesign to develop a primary school-based screening and intervention programme for child anxiety problems. DESIGN Codesign. SETTING UK primary schools. PARTICIPANTS Data were collected from year 4 children (aged 8-9 years), parents, school staff and mental health practitioners. RESULTS We report how the developed programme was experienced and perceived by a range of users, including parents, children, school staff and mental health practitioners, as well as how the programme was adapted following user feedback. CONCLUSIONS We reflect on the mitigation techniques we employed, the lessons learnt from the codesign process and give recommendations that may inform the development and implementation of future school-based screening and intervention programmes.
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Affiliation(s)
- Victoria Williamson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Michael Larkin
- Institute for Neurodevelopment and Health, Department of Psychology, Aston University, Birmingham, UK
| | - Tessa Reardon
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Samantha Pearcey
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
| | - Roberta Button
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Iheoma Green
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Susan H Spence
- Australian Institute of Suicide Research and Prevention and School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia
| | - Maria Breen
- Thames Valley Clinical Trials Unit, University of Reading, Reading, UK
| | | | - Obioha Ukoumunne
- NIHR ARC South West Peninsula, University of Exeter, Heavitree Rd, Exeter, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Falko Sniehotta
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Alastair Gray
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Brown
- Bransgore C Of E Primary School, Bransgore, UK
| | | | - Fran Morgan
- Square Peg (Team Square Peg CIC), London, UK
| | - Bec Jasper
- Square Peg (Team Square Peg CIC), London, UK
| | - Cathy Creswell
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
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Robstad N, Westergren T, Mølland E, Abildsnes E, Haraldstad K, Stamnes Köpp UM, Håland ÅT, Fegran L. Experiences of Norwegian child and school health nurses with the "Starting Right™" child health assessment innovation: a qualitative interview study. BMC Health Serv Res 2022; 22:728. [PMID: 35650581 PMCID: PMC9157476 DOI: 10.1186/s12913-022-08088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although child health services are well established in Norway, the use of information technology for the systematic collection of evidence-based child- and proxy-reported health measures may be beneficial in the early identification of child development problems. The Norwegian “Starting Right™” health service innovation consists of parent- and child-reported online structured health assessments tools, including practical routines for child and school health assessments. The aim of this study was to explore the experiences of child and school health nurses with the Starting Right innovation. Methods We used a qualitative design and conducted three focus group interviews with 18 child and school health nurses from three child health centres one year after the implementation of the innovation. Results The experiences of professionals with the Starting Right innovation were captured by three themes: (1) the digital innovation could be used to obtain a good overview of a child’s health and development; (2) interpreting the questionnaires was a challenge; and (3) implementing the new digital innovation was time-consuming. Conclusions Overall, the child and school health nurses experienced that the Starting Right innovation was useful for providing a comprehensive overview of child development and health. The challenges related to interpreting the parents’ scores and follow-up of children, as well as providing the questionnaires in relevant foreign languages, should be addressed to allow all children and families to be reached.
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Affiliation(s)
- Nastasja Robstad
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
| | - Thomas Westergren
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,NORCE, Universitetsveien 19, 4630, Kristiansand, Norway
| | - Eirin Mølland
- NORCE, Universitetsveien 19, 4630, Kristiansand, Norway.,Department of Economics and Finance, School of Business and Law, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Eirik Abildsnes
- Kristiansand municipality, P.O. Box 4, 4685, Nodeland, Norway.,Department of Psychosocial Health, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Unni Mette Stamnes Köpp
- Department of Pediatrics, Sørlandet Hospital, P.O. Box 416, Lundsiden, 4604, Kristiansand, Norway
| | - Åshild Tellefsen Håland
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,Department of Pediatrics, Sørlandet Hospital, P.O. Box 416, Lundsiden, 4604, Kristiansand, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
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Fernández-Martínez I, Morales A, Espada JP, Orgilés M. Nighttime coping response in children: Development and validation of a new scale. J Anxiety Disord 2022; 88:102572. [PMID: 35525073 DOI: 10.1016/j.janxdis.2022.102572] [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: 08/19/2021] [Revised: 03/09/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
Coping strategies can play an important role in dealing with nighttime fears and related anxiety problems in school-aged children, but well-established self-reporting tools are lacking, and research in this area is limited. The aim of this study was to develop a new self-report instrument assessing coping strategies in school-aged children when facing nighttime fears, the Nighttime Coping Response Scale (NCRS), and to examine its psychometric properties. Participants were 786 children (48.7% boys) aged 8-12 years, who completed the NCRS and other measures related to anxiety and behavioral problems. The construction of the NCRS was based on relevant prior literature and experts' criteria. Exploratory and confirmatory analyses supported a three-factor structure, comprising 15 items measuring coping strategies related to self-control, social support seeking, and avoidance. The NCRS was shown to have good internal consistency, test-retest reliability, and convergent and divergent validity. This research found preliminary support for the use of the NCRS, suggesting the potential suitability of this brief tool to be used by clinicians and researchers to identify and address the use of children's maladaptive coping strategies when dealing with nighttime fears. The NCRS could also be important to enable the development of further research in this field.
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Affiliation(s)
- Iván Fernández-Martínez
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain; Faculty of Education, Valencian International University (VIU), Valencia, 46002, Spain.
| | - Alexandra Morales
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
| | - José Pedro Espada
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
| | - Mireia Orgilés
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain
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Piehler TF, Zhang J, Bloomquist ML, August GJ. Parent and Child Risk Profiles as Predictors of Response to a Conduct Problem Preventive Intervention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1308-1320. [PMID: 35486296 DOI: 10.1007/s11121-022-01374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/27/2022]
Abstract
Current evidence-based prevention programming targeting child externalizing problems demonstrates modest overall effect sizes and is largely ineffective for a sizable proportion of youth who participate. However, our understanding of the youth and family characteristics associated with response to specific programming is quite limited. The current study used child and family risk profiles as predictors of response trajectories to the Early Risers conduct problem preventive intervention. A sample of 240 kindergarten-aged youth displaying elevated school-based aggression were randomized by school to either the Early Risers intervention or a control condition. Using a number of child and family risk variables, a latent profile analysis produced a solution consisting of five unique risk profiles. Three low and mixed risk profiles were associated with a limited response to the intervention. One high-risk profile characterized by maladaptive parenting and elevated child externalizing demonstrated notably improved trajectories of externalizing behavior over a 3-year period relative to the control condition. Another high-risk profile characterized by inconsistent discipline, high parental distress, and elevated child internalizing and externalizing symptoms seemed to have positive developmental trends disrupted by the intervention relative to the control condition, potentially consistent with an iatrogenic effect relative to the control condition. The study results support continued efforts to use broader risk profiles to examine heterogeneity in response to preventive interventions and, with replication, will have implications for intervention tailoring.
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Hill C, Reardon T, Taylor L, Creswell C. Online Support and Intervention for Child Anxiety (OSI): Development and Usability Testing. JMIR Form Res 2022; 6:e29846. [PMID: 35416781 PMCID: PMC9047721 DOI: 10.2196/29846] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/18/2021] [Accepted: 01/07/2022] [Indexed: 01/29/2023] Open
Abstract
Background Internet-based treatments for child anxiety may help to increase access to evidence-based therapies; however, user engagement, uptake, and adherence within routine clinical practice remain as challenges. Involving the intended end users in the development process through user-centered design and usability testing is crucial for maximizing user engagement and adoption of internet-based treatments, but so far this has been lacking for internet-based treatments for child anxiety. Objective The aim of this study is to develop an internet-based treatment for child anxiety through a process of user-centered design (phase 1) and usability testing (phase 2), based on an existing evidence-based, face-to-face, therapist-supported, parent-led cognitive behavioral therapy intervention. It is intended that the internet-based version of this treatment would consist of a parent website, case management system for clinicians, and mobile game app for children. Methods Parents, children, and clinicians who were familiar with the face-to-face version of the treatment were recruited from 2 National Health Service clinics. In phase 1, participants participated in 3 workshops to gain feedback on the overall concept, explore their wants and needs for the websites and game, generate ideas on how the treatment may look, and gain feedback on initial mock-ups of the websites and game. In phase 2, participants attended 3 individual usability testing sessions where they were presented with working prototypes of the website or game and asked to perform a series of tasks on the website (parents and clinicians) or play the game (children). The frequency and details on usability errors were recorded. Participants were asked for their feedback on the website and game using a standardized usability questionnaire and semistructured interviews. The websites and game were iterated after each round of usability testing in response to this feedback. Results In phase 1, participants approved the general concept and rated the initial mock-ups of the website and game positively. In phase 2, working prototypes were rated positively and usability errors declined across the iterations and were mainly cosmetic or minor issues relating to esthetic preference, with few issues regarding ability to navigate the website or technical issues affecting functionality. Feedback from the semistructured interviews further supported the positive response of participants to the website and game, and helped identify areas for improvement during the iteration process. The final iteration of the website and game are presented. Conclusions Taking an iterative approach to development through user-centered design and usability testing has resulted in an internet-based treatment for child anxiety (Online Support and Intervention for child anxiety) that appears to meet the needs and expectations of the intended users (parents, children, and clinicians) and is easy and enjoyable to use.
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Affiliation(s)
- Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Tessa Reardon
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Lucy Taylor
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Hossain B, Chen Y, Bent S, Parenteau C, Widjaja F, Haft SL, Hoeft F, Hendren RL. The role of grit and resilience in children with reading disorder: a longitudinal cohort study. ANNALS OF DYSLEXIA 2022; 72:1-27. [PMID: 34324164 PMCID: PMC8898035 DOI: 10.1007/s11881-021-00238-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
Prior studies have suggested that grit and resilience predict both academic and career success. However, these qualities have not been examined in children with reading disorder (RD). We therefore investigated whether grit and resilience were associated with anxiety, depression, academic performance, and quality of life (QOL) in these students. This 3-year longitudinal cohort study included 163 participants with RD from 3 schools. Evaluations were completed by parents and/or teachers every 3 months. The Grit and Resilience Scale was adapted from the 10-item Connor-Davidson Resilience Scale and the 12-item Grit Scale. Outcome measures included anxiety (School Anxiety Scale - Teacher Report and the 8-item Spence Children's Anxiety Scale), depression (Short Mood and Feelings Questionnaire), academic performance, and QOL (Pediatric QOL Inventory 4.0). Multivariate linear regression models (adjusting for age and sex) assessed the associations at baseline. Repeated measures analysis using mixed-effects models assessed the relationship longitudinally. There were statistically significant associations between grit and resilience and all outcomes at baseline and over time. After adjusting for age and sex, improved grit and resilience was associated with decreased anxiety (β = - 0.4, p < 0.001) and improved academic performance (β = 0.5, p < 0.001) when grit and resilience was measured by teachers, as well as decreased depression (β = - 0.3, p < 0.001) and improved QOL (β = 0.6, p < 0.001) when grit and resilience was measured by parents. Grit and resilience are significantly related to mental health, academic performance, and QOL in children with RD. This suggests that interventions to improve grit and resilience may lead to positive benefits.
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Affiliation(s)
- Bushra Hossain
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Yingtong Chen
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Stephen Bent
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - China Parenteau
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Felicia Widjaja
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Stephanie L Haft
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Fumiko Hoeft
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
- Department of Psychological Sciences, University of Connecticut, Mansfield, CT, USA
| | - Robert L Hendren
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA
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Lockwood J, Williams L, Martin JL, Rathee M, Hill C. Effectiveness, User Engagement and Experience, and Safety of a Mobile App (Lumi Nova) Delivering Exposure-Based Cognitive Behavioral Therapy Strategies to Manage Anxiety in Children via Immersive Gaming Technology: Preliminary Evaluation Study. JMIR Ment Health 2022; 9:e29008. [PMID: 35072644 PMCID: PMC8822420 DOI: 10.2196/29008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Childhood anxiety disorders are a prevalent mental health problem that can be treated effectively with cognitive behavioral therapy, in which exposure is a key component; however, access to treatment is poor. Mobile-based apps on smartphones or tablets may facilitate the delivery of evidence-based therapy for child anxiety, thereby overcoming the access and engagement barriers of traditional treatment. Apps that deliver therapeutic content via immersive gaming technology could offer an effective, highly engaging, and flexible treatment proposition. OBJECTIVE In this paper, we aim to describe a preliminary multi-method evaluation of Lumi Nova, a mobile app intervention targeting mild to moderate anxiety problems in children aged 7-12 years using exposure therapy delivered via an immersive game. The primary objective is to evaluate the effectiveness, user engagement and experience, and safety of the beta version of Lumi Nova. METHODS Lumi Nova was co-designed with children, parents, teachers, clinicians, game industry experts, and academic partnerships. In total, 120 community-based children with mild to moderate anxiety and their guardians were enrolled to participate in an 8-week pilot study. The outcome measures captured the app's effectiveness (anxiety symptoms, child-identified goal-based outcomes, and functional impairment), user engagement (game play data and ease-of-use ratings), and safety (mood ratings and adverse events). The outcome measures before and after the intervention were available for 30 children (age: mean 9.8, SD 1.7 years; girls: 18/30, 60%; White: 24/30, 80%). Additional game play data were automatically generated for 67 children (age: mean 9.6, SD 1.53 years; girls: 35/67, 52%; White: 42/67, 63%). Postintervention open-response data from 53% (16/30) of guardians relating to the primary objectives were also examined. RESULTS Playing Lumi Nova was effective in reducing anxiety symptom severity over the 8-week period of game play (t29=2.79; P=.009; Cohen d=0.35) and making progress toward treatment goals (z=2.43; P=.02), but there were no improvements in relation to functional impairment. Children found it easy to play the game and engaged safely with therapeutic content. However, the positive effects were small, and there were limitations to the game play data. CONCLUSIONS This preliminary study provides initial evidence that an immersive mobile game app may safely benefit children experiencing mild to moderate anxiety. It also demonstrates the value of the rigorous evaluation of digital interventions during the development process to rapidly improve readiness for full market launch.
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Affiliation(s)
- Joanna Lockwood
- National Institute of Health Research MindTech MedTech Co-operative, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Laura Williams
- National Institute of Health Research MindTech MedTech Co-operative, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jennifer L Martin
- National Institute of Health Research MindTech MedTech Co-operative, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Claire Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Bidirectional Relationship Between Family Accommodation and Youth Anxiety During Cognitive-Behavioral Treatment. Child Psychiatry Hum Dev 2022; 54:905-912. [PMID: 34997892 PMCID: PMC10140011 DOI: 10.1007/s10578-021-01304-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 12/12/2022]
Abstract
Family accommodation is associated with an increase in anxiety and has recently received attention as a target for intervention for youth anxiety. Existing theories posit that the increase in family accommodation increases youth anxiety and can attenuate the effect of psychotherapy. However, the directionality between family accommodation and youth anxiety has not been investigated. A cross-lagged cross-panel design was used to assess accommodation and anxiety for 10 sessions for 73 youths with an anxiety disorder, who were receiving cognitive-behavioral therapy. The analysis revealed a bidirectional relationship, such that to some extent previous session family accommodation increased youth anxiety symptoms (β = 0.11, 95% CI [0.06, 0.17]), but to an even greater extent previous session youth-rated anxiety symptoms increased family accommodation (β = 0.23, 95% CI [0.08, 0.38]). Family accommodation is an important target for reducing youth anxiety but should be addressed simultaneously as interventions directly targeting youth anxiety.
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Spence SH, Rapee RM. The development and preliminary validation of a brief scale of emotional distress in young people using combined classical test theory and item response theory approaches: The Brief Emotional Distress Scale for Youth (BEDSY). J Anxiety Disord 2022; 85:102495. [PMID: 34826643 DOI: 10.1016/j.janxdis.2021.102495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11-17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts.
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Affiliation(s)
- Susan H Spence
- Australian Institute of Suicide Research and Prevention and School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia.
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35
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Rodríguez-Menchón M, Orgilés M, Espada JP, Morales A. Validation of the brief version of the Spence Children's Anxiety Scale for Spanish children (SCAS-C-8). J Clin Psychol 2021; 78:1093-1102. [PMID: 34661915 DOI: 10.1002/jclp.23263] [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] [Received: 02/12/2021] [Revised: 09/22/2021] [Accepted: 10/06/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to validate the self-reported brief version of the Spence Children's Anxiety Scale-Children (SCAS-C-8) in pre-adolescent Spanish children. METHOD Participants were 824 children aged 8-12 from a community sample. The results revealed a good fit to the one-factor structure, adequate internal consistency (α = 0.75), and evidence of test-retest reliability (α = 0.77). RESULTS The strong relationship between the SCAS-C-8 and emotional problems provided evidence of convergent validity. Also, the results showed factorial gender invariance. CONCLUSION The SCAS-C-8 is a suitable instrument for pre-adolescent Spanish children. The brevity and simplicity of this scale may facilitate early detection and help to narrow the existent gap between the presence of anxiety problems and psychological assistance-seeking.
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Affiliation(s)
| | - Mireia Orgilés
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - José P Espada
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| | - Alexandra Morales
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
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Wright N, Hill J, Sharp H, Pickles A. Interplay between long-term vulnerability and new risk: Young adolescent and maternal mental health immediately before and during the COVID-19 pandemic. JCPP ADVANCES 2021; 1:e12008. [PMID: 34485987 PMCID: PMC8206735 DOI: 10.1111/jcv2.12008] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/10/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background We examine whether there has been an increase in young adolescent and maternal mental health problems from pre- to post-onset of the COVID-19 pandemic. Methods Children aged 11-12 years and their mothers participating in a UK population-based birth cohort (Wirral Child Health and Development Study) provided mental health data between December 2019 and March 2020, and again 3 months after lockdown, 89% (N = 202) of 226 assessed pre-COVID-19. Emotional and behavioural problems were assessed by self- and maternal reports, and long-term vulnerability by maternal report of prior child adjustment, and maternal prenatal depression. Results The young adolescents reported a 44% (95% confidence interval [CI: 23%-65%]) increase in symptoms of depression and 26% (95% CI [12%-40%]) for post-traumatic stress disorder, with corresponding maternal reports of child symptoms of 71% (95% CI [44%-99%]) and 43% (95% CI 29%-86%). Disruptive behaviour problem symptoms increased by 76% (95% CI [43%-109%]) particularly in children without previous externalising symptoms. Both female gender and having had high internalising symptoms earlier in childhood were associated with elevated rates of depression pre-pandemic, and with greater absolute increases during COVID-19. Mothers' own depression symptoms increased by 42% (95% CI [20%-65%]), and this change was greater among mothers who had prenatal depression. No change in anxiety was observed among children or mothers. None of these increases were moderated by COVID-19-related experiences such as frontline worker status of a parent. Prior to the pandemic, rates of maternal and child depression were greater in families experiencing higher deprivation, but changed only in less deprived families, raising their rates to those of the high deprivation group. Conclusions COVID-19 has led to a marked increase in mental health problems in young adolescents and their mothers with concomitant requirements for mental health services to have the resources to adapt to meet the level and nature of the needs.
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Affiliation(s)
- Nicola Wright
- Department of Biostatistics & Health Informatics Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences University of Reading Reading Berkshire UK
| | - Helen Sharp
- Department of Life and Human Sciences University of Liverpool Liverpool Merseyside UK
| | - Andrew Pickles
- Department of Biostatistics & Health Informatics Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
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Hossain B, Bent S, Hendren R. The association between anxiety and academic performance in children with reading disorder: A longitudinal cohort study. DYSLEXIA (CHICHESTER, ENGLAND) 2021; 27:342-354. [PMID: 33733531 DOI: 10.1002/dys.1680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/13/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to examine the association between anxiety and overall academic performance (AP) in children with reading disorder (RD). This two-year longitudinal cohort study included 128 participants (aged 7-14 years) with RD. Anxiety symptoms were evaluated using the School Anxiety Scale - Teacher Report for the first year and the eight-item Spence Children's Anxiety Scale for the second year. AP was assessed by teacher ratings of progress in academic content areas, including reading, writing and math. Teachers completed evaluations every 3 months. We standardized all scores (to z scores). Multivariate linear regression models (adjusting for age, sex and Attention-Deficit/Hyperactivity Disorder symptoms) assessed the association cross-sectionally at each timepoint of survey completion. Repeated measures analysis using mixed models assessed the relationship longitudinally. Results from both univariate and multivariate analyses showed anxiety being significantly negatively associated with AP in children with RD, both cross-sectionally and longitudinally. Importantly, increased anxiety was significantly associated with reduced AP over time within an individual (adjusted β = -0.22, p = .002). This lends support to screening for anxiety disorders in children with RD. Future research should examine the directionality of this relationship, potential mediators in the pathway and whether interventions to reduce anxiety increase AP.
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Affiliation(s)
- Bushra Hossain
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
| | - Stephen Bent
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Robert Hendren
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
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38
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Liang Z, Mazzeschi C, Delvecchio E. The Impact of Parental Stress on Italian Adolescents' Internalizing Symptoms during the COVID-19 Pandemic: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8074. [PMID: 34360369 PMCID: PMC8345594 DOI: 10.3390/ijerph18158074] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022]
Abstract
The challenges and consequences of COVID-19 imposed massive changes in adolescents' daily routines (e.g., school closures, home confinement, and social distancing rules), which impacted their mental health. This longitudinal study aimed to better understand the changes in adolescents' internalizing symptoms and the underlying mechanisms of parental stress due to COVID-19. We asked 1053 parents of adolescents to complete an online survey during the second and fifth weeks and at the end of home confinement (i.e., four weeks later). Results showed that parents reported their adolescents' anxiety and depression symptoms were more severe at Time 2 than at the first administration. Anxiety symptoms slightly decreased at Time 3, while there was no significant change in depression symptoms. Moreover, parents' expressive suppression mediated the association between parental stress and adolescents' anxiety and depression symptoms, respectively. The findings suggest that as restriction increased, adolescents' anxiety and depression became more severe. Moreover, due to the link between parental stress and adolescents' internalizing disorders helping families to cope with the distress due to the pandemic may have a positive impact on parents, the child, and the family as a whole (i.e., the family climate).
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Affiliation(s)
| | | | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza Ermini 1, 06123 Perugia, Italy; (Z.L.); (C.M.)
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Abstract
The purpose of the current article is to explore familial factors that influence the development of social anxiety disorder (SAD) in children and adolescents, including parenting, sibling relationships, and family environment. A multitude of interrelated genetic and familial factors have been found to cause and maintain SAD in children and adolescents. There are many challenges in diagnosing and treating the disorder. Knowledge and awareness of familial factors provide insight on targeted treatments that prevent or ameliorate SAD. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 23-34.].
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40
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Niman S, Dewa DK, Indriarini MY. The prevalent anxiety disorders among elementary students in Bandung, Indonesia. J Public Health Res 2021; 10. [PMID: 34060747 PMCID: PMC9309639 DOI: 10.4081/jphr.2021.2408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Anxiety constitutes one of the most prevalent childhood mental health
problems. It affects social functions, academic functions and increases the
risk of mental health problems at the next stage of development among
elementary school children. Besides, psychopathologic disorders in teenagers
appear in form of emotional symptoms. Early anxiety screening is important
for elementary students as anxiety disorders incur huge financial treatment
costs, meanwhile, related data are needed to provide early and adequate
interventions. This study is expected to be the basis for developing mental
health programs at the elementary school level. Furthermore, aims to
identify types of anxiety disorders among grade 4 and 5 students at the
elementary level. Design and Methods The study was conducted using a quantitative method with a descriptive
design. Meanwhile, the Screen for Child Anxiety Related Disorders (SCARED)
model consisting of 41 questions was used, while the instrument's
Reliability and Validity was 0.81 and 0.67 respectively. A total of 135
students from the private elementary schools participated in this study. Results Among the 135 elementary students aged 10 to 11, 48.9% were males while 51.1%
were females, 79.3% had anxiety consisting of generalized anxiety 40%, panic
disorder 48.1%, separation anxiety 40%, social anxiety 65.9%, while 28.9%
experienced school avoidance. Conclusions Based on the results, health workers, teachers and parents need to work
together to manage anxiety in elementary students. In addition, nurses as
health workers at community primary health need to work together with
counselling and guidance teachers to provide preventive and promotive
interventions through the school's mental health services.
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Affiliation(s)
- Susanti Niman
- Faculty of Nursing, Universitas Indonesia, Depok; Department of Mental Health, Bachelor Nursing Programme, STIKes Santo Borromeus, Padalarang, West Java.
| | - Deo Kumala Dewa
- Department of Mental Health, Bachelor Nursing Programme, STIKes Santo Borromeus, Padalarang, West Java.
| | - Maria Yunita Indriarini
- Department of Medical Surgical, Bachelor Nursing Programme, STIKes Santo Borromeus, Padalarang, West Java.
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41
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Mundy LK, Canterford L, Moreno-Betancur M, Hoq M, Sawyer SM, Allen NB, Patton GC. Social networking and symptoms of depression and anxiety in early adolescence. Depress Anxiety 2021; 38:563-570. [PMID: 33225486 DOI: 10.1002/da.23117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/04/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Use of social networking in later childhood and adolescence has risen quickly. The consequences of these changes for mental health are debated but require further empirical evaluation. METHODS Using data from the Childhood to Adolescence Transition Study (n = 1,156), duration of social networking use was measured annually at four time points from 11.9 to 14.8 years of age (≥1 h/day indicating high use). Cross-sectional and prospective relationships between social networking use and depressive and anxiety symptoms were examined. RESULTS In adjusted (age, socioeconomic status, prior mental health history) cross-sectional analyses, females with high social networking use had greater odds of depressive (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.58-2.91) and anxiety symptoms (OR: 1.99; 95% CI: 1.32-3.00) than those that used a few minutes at most, while males with high social networking use had 1.60 greater odds of reporting depressive symptoms (95% CI: 1.09-2.35). For females, an increased odds of depressive symptoms at age 14.8 was observed for high social networking use at one previous wave and at two or three previous waves, even after adjustment (OR: 1.76; 95% CI: 1.11-2.78; OR: 2.06, 95% CI: 1.27-3.37, respectively) compared to no wave of high use. CONCLUSIONS Our results suggest weak to moderate increased odds of depression and anxiety in girls and boys with high social networking use versus low/normal use. These findings indicate that prevention programs for early mental health problems might benefit from targeting social networking use in early adolescence.
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Affiliation(s)
- Lisa K Mundy
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Louise Canterford
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margarita Moreno-Betancur
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Monsurul Hoq
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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42
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Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094668. [PMID: 33925743 PMCID: PMC8124779 DOI: 10.3390/ijerph18094668] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 12/22/2022]
Abstract
The present study aimed to assess various stressful situations and the psychological impact of the first COVID-19 pandemic lockdown among youths in Switzerland. We included samples of 1627 young adults aged 19–24 from the Swiss Youth Epidemiological Study on Mental Health and 1146 children and adolescents aged 12–17 years and their parents. We assessed symptoms of various mental health problems, internet use, and perceived stress during the first COVID-19 lockdown. In the analyses, data were weighted to be representative of the Swiss population. During the first lockdown in Switzerland, the most common sources of perceived stress were the disruption of social life and important activities, uncertainty about how long the state of affairs would last, and the pandemic itself. In addition, around one-fifth of the young adults met the criteria for at least one of the mental health problems (attention deficit hyperactivity disorder, depression, generalized anxiety disorder), while one-third of children/adolescents screened positive for at least one of the mental health problems (attention deficit hyperactivity disorder, oppositional defiant disorder, depression, anxiety). Moreover, 30.1% of children and 21.3% of young adults met the criteria for problematic internet use. The study showed considerable stress perceived by young adults and symptoms of mental health problems, especially among females, during the first COVID-19 lockdown in Switzerland.
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43
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Williamson V, Larkin M, Reardon T, Pearcey S, Hill C, Stallard P, Spence SH, Breen M, Macdonald I, Ukoumunne O, Ford T, Violato M, Sniehotta F, Stainer J, Gray A, Brown P, Sancho M, Creswell C. Codesign and development of a primary school based pathway for child anxiety screening and intervention delivery: a protocol, mixed-methods feasibility study. BMJ Open 2021; 11:e044852. [PMID: 33879487 PMCID: PMC8061838 DOI: 10.1136/bmjopen-2020-044852] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Anxiety difficulties are among the most common mental health problems in childhood. Despite this, few children access evidence-based interventions, and school may be an ideal setting to improve children's access to treatment. This article describes the design, methods and expected data collection of the Identifying Child Anxiety Through Schools - Identification to Intervention (iCATS i2i) study, which aims to develop acceptable school-based procedures to identify and support child anxiety difficulties. METHODS AND ANALYSIS: iCATS i2i will use a mixed-methods approach to codesign and deliver a set of procedures-or 'pathway'-to improve access to evidence-based intervention for child anxiety difficulties through primary schools in England. The study will consist of four stages, initially involving in-depth interviews with parents, children, school staff and stakeholders (stage 1) to inform the development of the pathway. The pathway will then be administered in two primary schools, including screening, feedback to parents and the offer of treatment where indicated (stage 2), with participating children, parents and school staff invited to provide feedback on their experience (stages 3 and 4). Data will be analysed using Template Analysis. ETHICS AND DISSEMINATION The iCATS i2i study was approved by the University of Oxford's Research Ethics Committee (REF R64620/RE001). It is expected that this codesign study will lead on to a future feasibility study and, if indicated, a randomised controlled trial. The findings will be disseminated in several ways, including via lay summary report, publication in academic journals and presentation at conferences. By providing information on child, parent, school staff and other stakeholder's experiences, we anticipate that the findings will inform the development of an acceptable evidence-based pathway for identification and intervention for children with anxiety difficulties in primary schools and may also inform broader approaches to screening for and treating youth mental health problems outside of clinics.
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Affiliation(s)
- Victoria Williamson
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, Oxfordshire, England
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Michael Larkin
- Aston Neuroscience Institute, Department of Psychology, Aston University, Birmingham, Birmingham, UK
| | - Tessa Reardon
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, Oxfordshire, England
| | - Samantha Pearcey
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, Oxfordshire, England
| | - Claire Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berkshire, UK
| | - Paul Stallard
- University of Bath, Claverton Down, Bath, Somerset, UK
| | - Susan H Spence
- Griffith University, 16 Russell Street South Bank, Brisbane, Queensland, Australia
| | - Maria Breen
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berkshire, UK
| | - Ian Macdonald
- Charlie Waller Memorial Trust, First Floor, Rear Office, Thatcham
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Mara Violato
- Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, UK
| | - Falko Sniehotta
- Population Health Science Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, UK
| | | | - Alastair Gray
- Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, UK
| | - Paul Brown
- Bransgore C Of E Primary School, Ringwood Rd, Bransgore, Christchurch, UK
| | - Michelle Sancho
- West Berkshire Council, Council Offices, Market St, Newbury, UK
| | - Cathy Creswell
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, Oxfordshire, England
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44
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Orgilés M, Fernández-Martínez I, Espada JP, Morales A. The Nighttime Fears Scale: Development and psychometric evidence of a standardized self-report scale to assess nighttime fears in children. J Anxiety Disord 2021; 79:102369. [PMID: 33610851 DOI: 10.1016/j.janxdis.2021.102369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/04/2021] [Accepted: 02/07/2021] [Indexed: 11/19/2022]
Abstract
Nighttime fears are highly prevalent in children and are linked to children's distress and internalizing problems, especially childhood anxiety. Although its assessment may be critical, there is a lack of available standardized self-reports. This study aimed to describe the development and psychometric evaluation of the Nighttime Fears Scale (NFS), a new standardized self-report for assessing nighttime fears in school-aged children. The construction of the scale was based on prior relevant research and involvement of researchers and clinicians, experts in childhood anxiety, and fears. A total of 794 Spanish-speaking children (51.1 % girls) aged 8-12 years completed the NFS along with measures of anxiety, sleep problems, internalizing and externalizing problems, and positive behaviors. Exploratory and confirmatory factor analyses supported a four-factor structure of the NFS, consisting of 21 items measuring a range of potentially fear-provoking stimuli at nighttime. Strong internal consistency (alphas ranging from .87 to .94), adequate test-retest reliability, and evidence of convergent, divergent and incremental validity was found. This study provides initial support for the use of the NFS by clinicians and researchers, suggesting that it is a promising tool for a rapid and easily-administered assessment to identify the presence and intensity levels of a set of common children's nighttime fears.
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Affiliation(s)
- Mireia Orgilés
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, Alicante, 03202, Spain
| | - Iván Fernández-Martínez
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, Alicante, 03202, Spain.
| | - José P Espada
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, Alicante, 03202, Spain
| | - Alexandra Morales
- Miguel Hernández University, Department of Health Psychology, Avda. de la Universidad s/n, Elche, Alicante, 03202, Spain
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45
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Radez J, Waite P, Chorpita B, Creswell C, Orchard F, Percy R, Spence SH, Reardon T. Using the 11-item Version of the RCADS to Identify Anxiety and Depressive Disorders in Adolescents. Res Child Adolesc Psychopathol 2021; 49:1241-1257. [PMID: 33792821 PMCID: PMC8321965 DOI: 10.1007/s10802-021-00817-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 12/13/2022]
Abstract
The purpose of this study was to identify items from the Revised Children's Anxiety and Depression Scale - RCADS-C/P that provided a brief, reliable and valid screen for anxiety and/or depressive disorders in adolescents. In addition, we examined whether adding items assessing suicidal ideation (Moods and Feelings Questionnaire - MFQ- C/P) and symptom impact and duration (items adapted from the Strengths and Difficulties Questionnaire - SDQ) improved the identification of adolescents with anxiety and/or depressive disorders. We compared two samples of adolescents and their parents - a community sample, recruited through secondary schools in England (n = 214) and a clinic-referred sample, who met diagnostic criteria for anxiety and/or depressive disorder and were recruited through a university-based research clinic (n = 246). Participants completed the RCADS-C/P with additional symptom impact and duration items, and the MFQ-C/P. Using ROC curve analyses, we identified a set of 11 RCADS-C/P items (6 addressing anxiety and 5 depression symptoms) for adolescent- and parent-report. This set of 11 symptom items achieved sensitivity/specificity values > .75, which were comparable to corresponding values for the RCADS-47-C/P. Combining adolescent and parent-report improved the identification of anxiety/depression in adolescents compared to using adolescent-report alone. Finally, adding two symptom impact items further improved the sensitivity/specificity of the 11 symptom items, whereas adding suicidal ideation items did not. The 11 RCADS items accurately discriminated between the community and clinic-referred sample with anxiety and/or depressive disorders and have the potential to quickly and accurately identify adolescents with these disorders in community settings.
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Affiliation(s)
- Jerica Radez
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK.,The Oxford Institute of Clinical Psychology Training and Research, University of Oxford and Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK. .,Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, OX2 6GG, UK.
| | - Bruce Chorpita
- Department of Psychology, University of California, Box 951563, Los Angeles, CA, 90095, USA
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, OX2 6GG, UK
| | - Faith Orchard
- School of Psychology, University of Sussex, Brighton, BN1 9RH, UK
| | - Ray Percy
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Susan H Spence
- School of Applied Psychology and Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, QLD 4121, Australia
| | - Tessa Reardon
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, OX2 6GG, UK
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46
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Graupensperger S, Sutcliffe J, Vella SA. Prospective Associations between Sport Participation and Indices of Mental Health across Adolescence. J Youth Adolesc 2021; 50:1450-1463. [PMID: 33689103 DOI: 10.1007/s10964-021-01416-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/14/2021] [Indexed: 01/21/2023]
Abstract
Youth sport offers physical and psychosocial components that may be beneficial for adolescents' mental health, but the prospective directionality between sport participation and mental health has not been clearly established. The current study examined longitudinal associations between sport participation (individual and team sport) and mental health indices (depressive symptoms, anxiety symptoms, emotional symptoms, hyperactivity symptoms, conduct problems, peer problems, and prosocial behavior) across adolescence (ages 12-17) in a nationally representative Australian sample of 3956 participants at T1 (Mage = 12.41 years, SD = 0.49; 49% female), 3537 at T2 (Mage = 14.41 years, SD = 0.49; 49% female), and 3089 at T3 (Mage = 16.46 years, SD = 0.51; 49% female). Using random intercept cross-lagged panel modeling, several significant within-person effects were found. Notably, greater participation in team sport prospectively predicted fewer symptoms of depression and anxiety at subsequent timepoints. This study increases the understanding of how sport participation may relate to mental health among adolescents and provides critical evidence to inform policy.
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Affiliation(s)
- Scott Graupensperger
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Jordan Sutcliffe
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Stewart A Vella
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
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47
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Creswell C, Nauta MH, Hudson JL, March S, Reardon T, Arendt K, Bodden D, Cobham VE, Donovan C, Halldorsson B, In-Albon T, Ishikawa SI, Johnsen DB, Jolstedt M, de Jong R, Kreuze L, Mobach L, Rapee RM, Spence SH, Thastum M, Utens E, Vigerland S, Wergeland GJ, Essau CA, Albano AM, Chu B, Khanna M, Silverman WK, Kendall PC. Research Review: Recommendations for reporting on treatment trials for child and adolescent anxiety disorders - an international consensus statement. J Child Psychol Psychiatry 2021; 62:255-269. [PMID: 32683742 DOI: 10.1111/jcpp.13283] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/03/2020] [Accepted: 05/12/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Anxiety disorders in children and young people are common and bring significant personal and societal costs. Over the last two decades, there has been a substantial increase in research evaluating psychological and pharmacological treatments for anxiety disorders in children and young people and exciting and novel research has continued as the field strives to improve efficacy and effectiveness, and accessibility of interventions. This increase in research brings potential to draw together data across studies to compare treatment approaches and advance understanding of what works, how, and for whom. There are challenges to these efforts due largely to variation in studies' outcome measures and variation in the way study characteristics are reported, making it difficult to compare and/or combine studies, and this is likely to lead to faulty conclusions. Studies particularly vary in their reliance on child, parent, and/or assessor-based ratings across a range of outcomes, including remission of anxiety diagnosis, symptom reduction, and other domains of functioning (e.g., family relationships, peer relationships). METHODS To address these challenges, we convened a series of international activities that brought together the views of key stakeholders (i.e., researchers, mental health professionals, young people, parents/caregivers) to develop recommendations for outcome measurement to be used in treatment trials for anxiety disorders in children and young people. RESULTS AND CONCLUSIONS This article reports the results of these activities and offers recommendations for selection and reporting of outcome measures to (a) guide future research and (b) improve communication of what has been measured and reported. We offer these recommendations to promote international consistency in trial reporting and to enable the field to take full advantage of the great opportunities that come from data sharing going forward.
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Affiliation(s)
- Cathy Creswell
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Maaike H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Jennifer L Hudson
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Sonja March
- School of Psychology and Counselling, University of Southern Queensland, Springfield, QLD, Australia
| | - Tessa Reardon
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Denise Bodden
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Vanessa E Cobham
- Children's Health QLD Child and Youth Mental Health Service, Brisbane, QLD, Australia.,School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Caroline Donovan
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Brynjar Halldorsson
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Tina In-Albon
- Clinical Child and Adolescent Psychology and Psychotherapy Unit, University of Koblenz and Landau, Landau, Germany
| | | | | | - Maral Jolstedt
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Rachel de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Leonie Kreuze
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Lynn Mobach
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Susan H Spence
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.,Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, QLD, Australia
| | | | - Elisabeth Utens
- Research Institute of Child Development and Education, University of Amsterdam / The Bascule / Amsterdam UMC, Amsterdam, The Netherlands.,Sophia Children's Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Sarah Vigerland
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Gro Janne Wergeland
- Division of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Cecilia A Essau
- Department of Psychology, University of Roehampton, London, UK
| | - Anne Marie Albano
- Columbia University Irving Medical Center, Columbia University, New York, NY, USA
| | - Brian Chu
- Department of Clinical Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Muniya Khanna
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Wendy K Silverman
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Westergren T, Mølland E, Haraldstad K, Tellefsen Håland Å, Stamnes Köpp UM, Fegran L, Abildsnes E. Implementation of the norwegian 'Starting right' child health service innovation: implementation adjustments, adoption, and acceptability. BMC Health Serv Res 2021; 21:86. [PMID: 33485333 PMCID: PMC7824922 DOI: 10.1186/s12913-021-06096-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An increased and/or stable proportion of the child and adolescent population reports symptoms of impaired health, and the symptoms can be identified early. Therefore, structured child- and parent-reported outcome measures need to be implemented in child and school health services for decision support and identification of children at risk. We aimed to (a) qualitatively examine adjustments of active implementation from the pilot implementation of the Norwegian 'Starting Right' health service innovation including an online child health assessment tool and practical routines, and (b) measure practitioners´ adoption and parental acceptability. METHODS We used a mixed-methods design to qualitatively examine adjustments from working notes and meeting memoranda, and quantitatively assess adoption and acceptability from user rates provided by the systems log. Twenty-one child and school health nurses (CSHNs) from two child health centers participated in the implementation pilot of online health assessments in children aged 2-, 4- and 6-year. We used a deductive and narrative analysis approach using Fixsen et al.´s core implementation components to code and sort adjustments. RESULTS Core implementation components were adjusted throughout the pilot implementation. Researchers´ increased their availability in reciprocity with staff evaluation to integrate active implementation adjustments. We launched a project for improved data systems integration. The overall CSHNs adoption rate was satisfactory and higher in center A, where a medical secretary supported the nurses through the entire pilot phase, than in center B (96 vs. 55 %). Parental acceptability rate was overall high (77 %) with increased rates among parents of 6-year-old children (98 %) compared with younger ones (78-85 %), and in cases where both parents received the questionnaires. CONCLUSIONS The 'Starting Right' health service innovation implementation was actively adjusted by integration of core implementation components mainly based on staff evaluation. The CSHNs adopted the innovation which was also acceptable to parents.
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Affiliation(s)
- Thomas Westergren
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway. .,NORCE, Universitetsveien 19, 4630, Kristiansand, Norway.
| | - Eirin Mølland
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,NORCE, Universitetsveien 19, 4630, Kristiansand, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Åshild Tellefsen Håland
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,Sørlandet Hospital, P.O. Box 416 Lundsiden, 4604, Kristiansand, Norway
| | | | - Liv Fegran
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,Sørlandet Hospital, P.O. Box 416 Lundsiden, 4604, Kristiansand, Norway
| | - Eirik Abildsnes
- Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,Kristiansand Municipality, P.O. Box 4, 4685, Nodeland, Norway
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Etkin RG, Shimshoni Y, Lebowitz ER, Silverman WK. Using Evaluative Criteria to Review Youth Anxiety Measures, Part I: Self-Report. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:58-76. [PMID: 32915074 PMCID: PMC7914129 DOI: 10.1080/15374416.2020.1802736] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Evidence-based assessment serves several critical functions in clinical child psychological science, including being a foundation for evidence-based treatment delivery. In this Evidence Base Update, we provide an evaluative review of the most widely used youth self-report measures assessing anxiety and its disorders. Guided by a set of evaluative criteria (De Los Reyes & Langer, 2018), we rate the measures as Excellent, Good, or Adequate across their psychometric properties (e.g., construct validity). For the eight measures evaluated, most ratings assigned were Good followed by Excellent, and the minority of ratings were Adequate. We view these results overall as positive and encouraging, as they show that these youth anxiety self-report measures can be used with relatively high confidence to accomplish key assessment functions. Recommendations and future directions for further advancements to the evidence base are discussed.
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50
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Hugh-Jones S, Beckett S, Tumelty E, Mallikarjun P. Indicated prevention interventions for anxiety in children and adolescents: a review and meta-analysis of school-based programs. Eur Child Adolesc Psychiatry 2021; 30:849-860. [PMID: 32535656 PMCID: PMC8140963 DOI: 10.1007/s00787-020-01564-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 05/21/2020] [Indexed: 11/09/2022]
Abstract
Anxiety disorders are among the most common youth mental health disorders. Early intervention can reduce elevated anxiety symptoms. School-based interventions exist but it is unclear how effective targeted approaches are for reducing symptoms of anxiety. This review and meta-analysis aimed to determine the effectiveness of school-based indicated interventions for symptomatic children and adolescents. The study was registered with PROSPERO [CRD42018087628]. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Library for randomised-controlled trials comparing indicated programs for child and adolescent (5-18 years) anxiety to active or inactive control groups. Data were extracted from papers up to December 2019. The primary outcome was efficacy (mean change in anxiety symptom scores). Sub-group and sensitivity analyses explored intervention intensity and control type. We identified 20 studies with 2076 participants. Eighteen studies were suitable for meta-analysis. A small positive effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test (g = - 0.28, CI = - 0.50, - 0.05, k = 18). This benefit was maintained at 6 (g = - 0.35, CI = - 0.58, - 0.13, k = 9) and 12 months (g = - 0.24, CI = - 0.48, 0.00, k = 4). Based on two studies, > 12 month effects were very small (g = - 0.01, CI = - 0.38, 0.36). No differences were found based on intervention intensity or control type. Risk of bias and variability between studies was high (I2 = 78%). Findings show that school-based indicated programs for child and adolescent anxiety can produce small beneficial effects, enduring for up to 12 months. Future studies should include long-term diagnostic assessments.
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Affiliation(s)
| | - Sophie Beckett
- grid.6572.60000 0004 1936 7486The Barberry National Centre for Mental Health, University of Birmingham, Birmingham, B15 2FG UK
| | - Ella Tumelty
- grid.6572.60000 0004 1936 7486The Barberry National Centre for Mental Health, University of Birmingham, Birmingham, B15 2FG UK
| | - Pavan Mallikarjun
- grid.6572.60000 0004 1936 7486The Barberry National Centre for Mental Health, University of Birmingham, Birmingham, B15 2FG UK
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