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Luoma I, Korhonen M, Salmelin RK, Siirtola A, Mäntymaa M, Valkonen-Korhonen M, Puura K. Mothers' and their children's emotional and behavioral symptom trajectories and subsequent maternal adjustment: Twenty-seven years of motherhood. J Affect Disord 2024; 361:299-309. [PMID: 38876318 DOI: 10.1016/j.jad.2024.06.027] [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: 10/25/2023] [Revised: 04/30/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems). METHODS The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4-5, 8-9, 16-17, and 26-27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4-5, 8-9, and 16-17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26-27 years after the birth of the first child. Complete follow-up data were available for 168 mothers. RESULTS We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning. LIMITATIONS Maternal and child measures were based on maternal reports only. CONCLUSIONS The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children.
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Affiliation(s)
- Ilona Luoma
- University of Eastern Finland, Faculty of Health Sciences, Kuopio, Finland; Kuopio University Hospital, Department of Child Psychiatry, Kuopio, Finland; Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Marie Korhonen
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Helsinki University Hospital, Department of Child Psychiatry, Helsinki, Finland
| | - Raili K Salmelin
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Tampere University Hospital, Department of Child Psychiatry, Tampere, Finland
| | - Arja Siirtola
- Tampere University Hospital, Department of Child Psychiatry, Tampere, Finland
| | - Mirjami Mäntymaa
- University of Oulu, Faculty of Medicine, Oulu, Finland; Oulu University Hospital, Department of Child Psychiatry, Oulu, Finland
| | - Minna Valkonen-Korhonen
- University of Eastern Finland, Faculty of Health Sciences, Kuopio, Finland; Kuopio University Hospital, Department of Psychiatry, Kuopio, Finland
| | - Kaija Puura
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland; Tampere University Hospital, Department of Child Psychiatry, Tampere, Finland
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Hen M, Shenaar-Golan V, Atia S, Yatzkar U. Child-parent agreement on the SDQ: The role of child-parent attachment and parental feelings. J Clin Psychol 2024; 80:2045-2062. [PMID: 38809521 DOI: 10.1002/jclp.23707] [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] [Received: 07/06/2023] [Revised: 04/16/2024] [Accepted: 05/11/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES Children and their parents often provide divergent reports regarding their mental health on the Strengths and Difficulties Questionnaire (SDQ). These discrepancies may impede the diagnostic processes. The present study aimed to explore how a child's attachment to the parent and parental feelings may explain some of the variability between parent's and children's reports on the SDQ. METHODS Data were collected using self-report questionnaires from 277 children and their parents (n = 421) who were referred to a public mental health clinic. This information was classified into clinical categories (normal and abnormal) and analyzed using multinomial logistic regression. RESULTS The agreement rates between children and parents on the normality of children were high in general and across gender and age. Insecure attachment to parents positively and significantly predicted the agreement of child and parent reporting abnormality and disagreement when parents reported normality and children reported abnormality. Parental anger positively and significantly predicted disagreement in reports in which parents reported abnormal anger and children reported normal anger. CONCLUSIONS These findings highlight the importance of assessing informant variability in association with emotional and relationship variables as clinically meaningful information for a clinical diagnosis.
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Affiliation(s)
- Meirav Hen
- Department of Psychology, Tel-Hai Academic College, Upper Galilee, Israel
| | | | - Stav Atia
- Department of Psychology, Tel-Hai Academic College, Upper Galilee, Israel
| | - Uri Yatzkar
- Child and Adolescent Mental Health Clinic, Ziv Medical Center, Safed, Israel
- Department of Psychiatry, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Iris SL, Ivonne MK, Liat AH, Noa BM, Alon L, Hila S, Shira B, Silvana F. Screening for Emotional Problems in Pediatric Hospital Outpatient Clinics: Psychometric Traits of the Pediatric Symptom Checklist (Hebrew Version). J Clin Psychol Med Settings 2024; 31:432-443. [PMID: 38001395 DOI: 10.1007/s10880-023-09982-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/26/2023]
Abstract
This study assessed feasibility and psychometric properties of the Hebrew parent version of the Pediatric Symptom Checklist (PSC-17), aiming to improve treatment access for children and adolescents with behavioral and mental needs through early screening. The PSC-17 and the Strengths and Difficulties Questionnaire (SDQ) were filled in the waiting room, at three ambulatory clinics in a tertiary pediatric center, by 274 parents using a tablet or their cellphone. Demographic and clinical data were retrieved from patients' files. PSC results were compared to SDQ results and assessed vis-a-vis a psychiatric diagnosis, determined previously and independently by trained pediatric psychiatrists for 78 pediatric patients who attended these clinics. Construct and discriminant validity of the PSC-17 Hebrew version were good. Sensitivity, specificity, and positive and negative predictive values are presented. The PSC-17 (Hebrew version) was found to be a feasible tool for mental health screening at pediatric ambulatory care clinics.
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Affiliation(s)
| | | | | | - Benaroya-Milshtein Noa
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Liberman Alon
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Segal Hila
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Brik Shira
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
| | - Fennig Silvana
- Schneider Children's Medical Center, Kaplan 14, Petach-Tikvah, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
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Ammerman RT, Rybak TM, Herbst RB, Mara CA, Zion C, Patel MA, Burstein E, Lauer BA, Fiat AE, Jordan P, Burkhardt MC, McClure JM, Stark LJ. Integrated Behavioral Health Prevention for Infants in Pediatric Primary Care: A Mixed-Methods Pilot Study. J Pediatr Psychol 2024; 49:298-308. [PMID: 38204356 PMCID: PMC11018362 DOI: 10.1093/jpepsy/jsad098] [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: 07/31/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE Pediatric primary care is a promising setting in which to deliver preventive behavioral health services to young children and their families. Integrated behavioral health care models typically emphasize treatment rather than prevention. This pilot study examined the efficacy of an integrated behavioral health preventive (IBH-P) intervention delivered by psychologists and focused on supporting parenting in low-income mothers of infants as part of well-child visits in the first 6 months of life. METHODS Using a mixed-methods approach that included a pilot randomized clinical trial and post-intervention qualitative interviews, 137 mothers were randomly assigned to receive IBH-P or usual care. Self-report measures of parenting, child behavior, and stress were obtained at pre- and/or post-intervention. Direct observation of mother-infant interactions was conducted at post-intervention. RESULTS No differences between groups were found on maternal attunement, knowledge of child development, nurturing parenting, or infant behavior. A secondary analysis on a subsample with no prior exposure to IBH-P with older siblings found that mothers in IBH-P reported increased self-efficacy relative to controls. In the qualitative interviews, mothers stated that they valued IBH-P, learning about their baby, liked the integration in primary care, and felt respected and comfortable with their provider. CONCLUSIONS Findings are discussed in terms of the next steps in refining IBH-P approaches to prevention in primary care.
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Affiliation(s)
- Robert T Ammerman
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Tiffany M Rybak
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Rachel B Herbst
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Constance A Mara
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Cynthia Zion
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Meera A Patel
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Emma Burstein
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Brea A Lauer
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Aria E Fiat
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Phoebe Jordan
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Mary Carol Burkhardt
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Jessica M McClure
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Lori J Stark
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Svensson Å, Warne M. Staff perspectives on poor mental health in secondary school students: an increasing problem handled with insufficient resources. Front Public Health 2024; 12:1292520. [PMID: 38496395 PMCID: PMC10940380 DOI: 10.3389/fpubh.2024.1292520] [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] [Received: 09/12/2023] [Accepted: 02/05/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction An increasing number of schools are recognizing the importance of addressing students' mental health based on the association with educational outcomes and long-term health. The school organization and the members of the school staff play important but, in several ways, challenging roles in this work. The purpose of this study was to explore views of staff from schools and school health services on mental ill health among students and their own role in detecting and managing it. Methods A qualitative study was conducted in a sparsely populated municipality in northern Sweden. In total, 40 participants from three secondary schools and the school health services participated either in focus groups or individual interviews. Participants were teachers, assistants, school nurses, school counselors and psychologists. Data were analyzed using thematic analysis. Results The analysis revealed the main theme Student mental ill health: an increasing problem handled with insufficient resources and two subthemes, i.e., Uncertainty in interpreting students' signs of mental ill health and the need to clarify roles and establish a supportive organization. Conclusions It was concluded that school staff were uncertain regarding how to interpret signs of mental ill health among students and required better knowledge and more resources to help students with mental ill health. A clearer organization and consensus regarding support for students with mental ill health were also necessary in light of the division of responsibilities between school staff and the school health services.
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Heslon K, Hanson JH, Ogourtsova T. Mental health in children with disabilities and their families: red flags, services' impact, facilitators, barriers, and proposed solutions. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1347412. [PMID: 38410177 PMCID: PMC10894921 DOI: 10.3389/fresc.2024.1347412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
Background Children and youth with neurodevelopmental disabilities (NDDs) and their caregivers are at a high risk of experiencing mental health challenges, that in turn can significantly affect their functioning, productivity, and quality of life. In this already vulnerable population, mental health difficulties are now more frequently reported and pronounced secondary to the isolation and uncertainties experienced during the pandemic. Our previous work has shown important mental health services' gaps for children/youth with NDDs and their families, highlighting the need to optimize and tailor existing practices. Objective To explore mental health services' barriers, facilitators, impact, and solutions from the perspectives of HCPs and CGs, and to describe common precursors to mental health challenges in children with NDDs from the perspectives of these two groups. Methods In a triangulation mixed-method study design embedding quantitative and qualitative approaches, participants completed a survey and a semi-structured interview. Descriptive statistics and a hybrid inductive/deductive thematic approach were used for data analysis. Results Over 700 utterances were analyzed (247 from caregivers [n = 10], 531 from clinicians [n = 16]) and included 143 and 173 statements related to the precursors and barriers/facilitators, respectively. Common precursors to mental health challenges (n = 7 categories) were identified and included reported feelings/perception of self, behavioral and physical manifestations, emotional dysregulation, and school-related factors, among others. Clinicians reported a widespread need for pediatric, family-centered mental health services and conveyed lacking mental health resources/training to meet the demand. Caregivers indicated being only moderately satisfied when care was received. Salient facilitators identified by clinicians were having an interdisciplinary team and caregiver's engagement in the therapeutic processes. Participants recommended improvements to increase accessibility to mediate the existing discrepancy between the emergence of precursors and care received; that services must target a broader population and be more comprehensive (e.g., family-centered care, addressing high-risk transition periods); and training/toolkits to support clinicians' evidence-based practice. Conclusion Our findings emphasize the necessity of a systematic and standardized approach to mental health services for children with NDDs and their families. Enhancing caregiver support, addressing barriers, and adopting a proactive, family-centered approach are crucial for improving accessibility and quality. These proposed solutions provide valuable insights for shaping policies and practices in pediatric mental health services.
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Affiliation(s)
- Kayla Heslon
- Integrated Center of Health and Social Services of Laval, The Research Center of the Jewish Rehabilitation Hospital, Laval, QC, Canada
- Faculty of Arts and Sciences, McGill University, Montreal, QC, Canada
| | - Jessica Helena Hanson
- Integrated Center of Health and Social Services of Laval, The Research Center of the Jewish Rehabilitation Hospital, Laval, QC, Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Tatiana Ogourtsova
- Integrated Center of Health and Social Services of Laval, The Research Center of the Jewish Rehabilitation Hospital, Laval, QC, Canada
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
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Weniger M, Beesdo-Baum K, Ernst J, Siegmund CB, Porst PT, McDonald M, Roessner V, Knappe S. [Indicative prevention programs for mental health promotion in preschool and primary school age: Willingness of pediatricians and families to participate in an innovative care chain]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:23-35. [PMID: 37921872 PMCID: PMC10776478 DOI: 10.1007/s00103-023-03787-0] [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: 02/26/2023] [Accepted: 09/22/2023] [Indexed: 11/05/2023]
Abstract
BACKGROUND Mental health problems usually have their onset in childhood. Undiagnosed, they may progress into mental disorders. Despite their effectiveness, existing preventive programs have been rarely used. We aimed to examine to what extent the establishment of a care chain can identify children at high risk at an early stage and assign them to preventive interventions. In addition, prevention program participation was assessed. METHODS In a prospective implementation study, the Strengths and Difficulties Questionnaire was administered as a screening instrument to families during regular pediatric health examinations (U9-U11, child age 5-10 years). Families received feedback directly from the pediatrician, and in the case of borderline abnormal emotional or behavioral problems, a recommendation for an indicative prevention program. Program indication was additionally determined in an entry examination prior to program participation. RESULTS In the area of Dresden (Germany), n = 46 (38.7%) pediatricians participated in the project. In n = 28 pediatric practices, n = 3231 (86.4%) families participated in the screening and n = 864 (26.7%) children received a prevention recommendation. Of the families, n = 118/864 (13.7%) self-registered for the prevention programs, n = 215/624 (35.5%) showed interest after being contacted by the study teamn. Through other pathways, n = 139 families requested participation. Clinical evaluation interviews to assess prevention indication were conducted in n = 337 children (n = 461; via all entry pathways). Finally, n = 237 (n = 337) children participated in an indicated prevention program. CONCLUSION Expanding screening to mental health problems during regular health checkups is feasible, useful, and widely accepted. In order to implement a care chain, a supply structure should be established to enable referral to and uptake of preventive interventions.
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Affiliation(s)
- Max Weniger
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Katja Beesdo-Baum
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Julia Ernst
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Cornelia Beate Siegmund
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Patricia Theresa Porst
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
| | - Maria McDonald
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Sachsen, Deutschland
| | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie, Professur für Behaviorale Epidemiologie, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Sachsen, Deutschland
- Evangelische Hochschule Dresden, Dresden, Sachsen, Deutschland
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Zhang M, Scandiffio J, Younus S, Jeyakumar T, Karsan I, Charow R, Salhia M, Wiljer D. The Adoption of AI in Mental Health Care-Perspectives From Mental Health Professionals: Qualitative Descriptive Study. JMIR Form Res 2023; 7:e47847. [PMID: 38060307 PMCID: PMC10739240 DOI: 10.2196/47847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is transforming the mental health care environment. AI tools are increasingly accessed by clients and service users. Mental health professionals must be prepared not only to use AI but also to have conversations about it when delivering care. Despite the potential for AI to enable more efficient and reliable and higher-quality care delivery, there is a persistent gap among mental health professionals in the adoption of AI. OBJECTIVE A needs assessment was conducted among mental health professionals to (1) understand the learning needs of the workforce and their attitudes toward AI and (2) inform the development of AI education curricula and knowledge translation products. METHODS A qualitative descriptive approach was taken to explore the needs of mental health professionals regarding their adoption of AI through semistructured interviews. To reach maximum variation sampling, mental health professionals (eg, psychiatrists, mental health nurses, educators, scientists, and social workers) in various settings across Ontario (eg, urban and rural, public and private sector, and clinical and research) were recruited. RESULTS A total of 20 individuals were recruited. Participants included practitioners (9/20, 45% social workers and 1/20, 5% mental health nurses), educator scientists (5/20, 25% with dual roles as professors/lecturers and researchers), and practitioner scientists (3/20, 15% with dual roles as researchers and psychiatrists and 2/20, 10% with dual roles as researchers and mental health nurses). Four major themes emerged: (1) fostering practice change and building self-efficacy to integrate AI into patient care; (2) promoting system-level change to accelerate the adoption of AI in mental health; (3) addressing the importance of organizational readiness as a catalyst for AI adoption; and (4) ensuring that mental health professionals have the education, knowledge, and skills to harness AI in optimizing patient care. CONCLUSIONS AI technologies are starting to emerge in mental health care. Although many digital tools, web-based services, and mobile apps are designed using AI algorithms, mental health professionals have generally been slower in the adoption of AI. As indicated by this study's findings, the implications are 3-fold. At the individual level, digital professionals must see the value in digitally compassionate tools that retain a humanistic approach to care. For mental health professionals, resistance toward AI adoption must be acknowledged through educational initiatives to raise awareness about the relevance, practicality, and benefits of AI. At the organizational level, digital professionals and leaders must collaborate on governance and funding structures to promote employee buy-in. At the societal level, digital and mental health professionals should collaborate in the creation of formal AI training programs specific to mental health to address knowledge gaps. This study promotes the design of relevant and sustainable education programs to support the adoption of AI within the mental health care sphere.
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Affiliation(s)
| | | | | | - Tharshini Jeyakumar
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Rebecca Charow
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Mohammad Salhia
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - David Wiljer
- University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Ammerman RT, Mara CA, Anyigbo C, Herbst RB, Reyner A, Rybak TM, McClure JM, Burkhardt MC, Stark LJ, Kahn RS. Behavior Problems in Low-Income Young Children Screened in Pediatric Primary Care. JAMA Pediatr 2023; 177:1306-1313. [PMID: 37843850 PMCID: PMC10580154 DOI: 10.1001/jamapediatrics.2023.4229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/10/2023] [Indexed: 10/17/2023]
Abstract
Importance Screening of behavior problems in young children in pediatric primary care is essential to timely intervention and optimizing trajectories for social-emotional development. Identifying differential behavior problem trajectories provides guidance for tailoring prevention and treatment. Objective To identify trajectories of behavior problems in children 2 to 6 years of age screened in pediatric primary care. Design, Setting, and Participants This retrospective cohort study identified trajectories of behavior problems and demographic and clinical correlates. Data were collected as part of routine care in 3 pediatric primary care offices and 3 school-based health centers in Ohio serving a primarily low-income population. In total, 15 218 children aged 2 to 6 years with well-child visits between July 13, 2016, and January 31, 2022, were included. Exposure Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) at annual well-child visits. Main Outcomes and Measures Trajectory groups were identified using latent growth mixture modeling of SDQ total difficulties scores, and relative risk ratio (RRR) of various demographic (eg, race) and clinical (eg, depression in caregiver) variables were assessed by multinomial logistic regression analysis. Results Of 15 281 children (51.3% males), 10 410 (68.1%) were African American or Black, 299 (2.0%) were Asian, 13 (0.1%) were American Indian or Alaska Native, 876 (5.7%) were multiracial, 26 (0.2%) were Native Hawaiian and Other Pacific Islander, 2829 (18.5%) were White, and 39 (0.02%) were categorized as other. In addition, 944 (6.2%) identified as Hispanic and 14 246 (93.2%) as non-Hispanic. Four behavior problem trajectory groups reflecting severity were identified: low-stable (LS; 10 096 [66.1%]), moderate-decreasing (MD; 16.6%), low-increasing (LI; 13.1%), and high-increasing (HI; 4.3%). Relative to the LS group, patients in each elevated group were more likely to be male (HI RRR, 1.87 [95% CI, 1.55-2.26]; MD RRR, 1.55 [95% CI, 1.41-1.71]; and LI RRR, 1.94 [95% CI, 1.70-2.21]), White (HI RRR, 2.27 [95% CI, 1.83-2.81]; MD RRR, 1.28 [95% CI, 1.13-1.45]; and LI RRR, 1.54, [95% CI, 1.32-1.81]), publicly insured (HI RRR, 0.49 [95% CI, 0.28-0.84]; MD RRR, 0.56 [95% CI, 0.43-0.73]; and LI RRR, 0.50 [95% CI, 0.35-0.73]), have a social need (HI RRR, 3.07 [95% CI, 2.53-3.73]; MD RRR, 2.02 [95% CI, 1.82-2.25]; and LI RRR, 2.12 [95% CI, 1.84-2.44]), and have a caregiver with depression (HI RRR, 1.66 [95% CI, 1.38-2.00]; MD RRR, 1.44 [95% CI, 1.31-1.58]; and LI RRR, 1.39 [95% CI, 1.23-1.58]). Relative to the LI group, patients in the MD group were less likely to be male (RRR, 0.80; 95% CI, 0.68-0.93). Conclusions The substantial portion of young children with increased behavior problems observed in this cohort study underscores the need for screening in pediatric primary care. Caregivers with depression and family social needs warrant prioritization in early prevention and treatment to alter elevated trajectories.
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Affiliation(s)
- Robert T. Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Constance A. Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Chidiogo Anyigbo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Rachel B. Herbst
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Allison Reyner
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Tiffany M. Rybak
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jessica M. McClure
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Mary Carol Burkhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Lori J. Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert S. Kahn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Michael Fisher Child Health Equity Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Zhang A, Shyam AB, Cunningham AM, Williams C, Brissenden A, Bartley A, Amsden B, Docoslis A, Kontopoulou M, Ameri SK. Adhesive Wearable Sensors for Electroencephalography from Hairy Scalp. Adv Healthc Mater 2023; 12:e2300142. [PMID: 37165724 DOI: 10.1002/adhm.202300142] [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] [Received: 01/12/2023] [Revised: 03/23/2023] [Indexed: 05/12/2023]
Abstract
Electroencephalography has garnered interest for applications in mobile healthcare, human-machine interfaces, and Internet of Things. Conventional electroencephalography relies on wet and dry electrodes. Despite favorable interface impedance of wet electrodes and skin, the application of a large amount of gel at their interface with skin limits the electroencephalography spatial resolution, increases the risk of shorting between electrodes, and makes them unsuited for long-term mobile recording. In contrast, dry electrodes are better suited for long-term recordings but susceptible to motion artifacts. In addition, both wet and dry electrodes are non-adhesive to the hairy scalp and mechanical support, or chemical adhesives are used to hold them in place. Herein, a conical microstructure array (CMSA) based sensor made of carbon nanotube-polydimethylsiloxane composite is reported. The CMSA sensor is fabricated using the innovative, cost-effective, and scalable method of viscosity-controlled dip-pull process. The sensor adheres to the hairy scalp by generating negative pressure in its conical microstructures when it is pressed against scalp. Aided by the application of a trace amount of gel, CMSA sensor establishes good electrical contact with the skin, enabling its applications in mobile electroencephalography over extended periods. Notably, the signal quality of CMSA sensors is comparable to that of medical-grade wet gel electrodes.
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Affiliation(s)
- Anan Zhang
- Department of Electrical and Computer Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | | | | | - Christopher Williams
- Department of Chemical Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Amanda Brissenden
- Department of Chemical Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Alex Bartley
- Department of Electrical and Computer Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Brian Amsden
- Department of Chemical Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Aristides Docoslis
- Department of Chemical Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Marianna Kontopoulou
- Department of Chemical Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Shideh Kabiri Ameri
- Department of Electrical and Computer Engineering, Queen's University, Kingston, Ontario, K7L 3N6, Canada
- Centre for Neuroscience Studies (CNS), Queen's University, Kingston, Ontario, K7L 3N6, Canada
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11
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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12
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Ryan CM, Innes CS, Kannis-Dymand L, Mason J, Lovell GP. An efficacy trial of a brief group based, single session intervention delivered through Australian community sport clubs to reduce mental illness stigma and increase help-seeking intention. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2023. [DOI: 10.1080/21507686.2023.2193751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Affiliation(s)
| | - Campbell S Innes
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
| | - Lee Kannis-Dymand
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
| | - Jonathon Mason
- School of Psychology, Counselling and Psychotherapy, Cairnmillar Institute, Melbourne, Victoria, Australia
| | - Geoff P Lovell
- School of Health, University of Sunshine Coast, Maroochydore, Queensland, Australia
- Kaplan Open Learning, Leeds, UK
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13
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Casale G, Herzog M, Volpe RJ. Measurement Efficiency of a Teacher Rating Scale to Screen for Students at Risk for Social, Emotional, and Behavioral Problems. J Intell 2023; 11:jintelligence11030057. [PMID: 36976150 PMCID: PMC10057924 DOI: 10.3390/jintelligence11030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Teacher rating scales are broadly used for psycho-educational assessment in schools. In particular, they play an important role in screening students for social, emotional, and behavioral problems. In order to optimize the efficiency of these measures, it is important to minimize the number of items comprising them while maintaining sound psychometric characteristics. This study examines the measurement efficiency of a teacher rating scale for student social, emotional, and behavioral risk. The goal was to shorten an existing behavior screening tool. A total of 139 classroom teachers and 2566 students from Grades 1-6 (Mage = 8.96 years, SD = 1.61) participated in the study. In sum, 35 items assessing internalizing and externalizing behavior problems were analyzed applying the item response theory (generalized partial credit model). The results show that social, emotional, and behavioral risks can be captured with a total of 12 items. This reduction of almost 66% of the initial item pool would take teachers about 90 s to fill out for one student. Thus, the rating scale can be used by teachers in an efficient yet psychometrically sound manner.
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Affiliation(s)
- Gino Casale
- School of Education, Institute for Educational Research, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - Moritz Herzog
- School of Education, Institute for Educational Research, University of Wuppertal, Gaußstraße 20, 42119 Wuppertal, Germany
| | - Robert J Volpe
- Department of Applied Psychology, Northeastern University, Boston, MA 02115, USA
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14
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Pang JCY, Chan ELS, Lau HMC, Reeves KKL, Chung THY, Hui HWL, Leung AHL, Fu ACL. The impacts of physical activity on psychological and behavioral problems, and changes in physical activity, sleep and quality of life during the COVID-19 pandemic in preschoolers, children, and adolescents: A systematic review and meta-analysis. Front Pediatr 2023; 11:1015943. [PMID: 36969271 PMCID: PMC10038232 DOI: 10.3389/fped.2023.1015943] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/21/2023] [Indexed: 03/29/2023] Open
Abstract
Background The COVID-19 pandemic has greatly affected the level of physical activity (PA). However, little is known about its effect on health outcomes. Methods Articles without language restrictions published from the database inception through March 16, 2022, were retrieved using the CINAHL Complete, Cochrane Library, EMBASE, Medline, PubMed, and PsycINFO databases. High-quality articles assessing the effect of PA on psychological and behavioral problems. Additionally, PA, QoL, and/or sleep problems before and during the pandemic were included. Articles without data regarding PA or involving non-general populations were excluded. The PRISMA and MOOSE guidelines were followed. Data quality of the selected articles was assessed using the Newcastle-Ottawa Scale and GRADE approach. Data were pooled using a random-effects model and sensitivity analysis if heterogenicity was high (I 2 ≥ 50%). The relationship between PA and psychological and behavioral problems; and changes in PA, QoL, and sleeping patterns before and during the pandemic in preschoolers, children, and adolescents were investigated. A meta-analysis was conducted; odds ratios (ORs), mean differences (MD), and standardized MDs (SMDs) were calculated. Results Thirty-four articles involving 66,857 participants were included. The results showed an overall significant protective effect between PA and psychological and/or behavioral problems (OR = 0.677; 95% CI = 0.630, 0.728; p-value <0.001; I 2 = 59.79%). This relationship was also significant in the subgroup analysis of children (OR = 0.690; 95% CI = 0.632, 0.752; p-value <0.001; I 2 = 58.93%) and adolescents (OR = 0.650; 95% CI = 0.570, 0.741; p-value <0.001; I 2 = 60.85%); however, no data on the relationship in preschoolers were collected. In addition, the overall time spent on PA significantly decreased by 23.2 min per day during the COVID-19 pandemic (95% CI = -13.5, -32.9; p-value <0.001; I 2 = 99.82%). Moreover, the results showed an overall significant decrease in QoL (SMD = -0.894, 95% CI = -1.180, -0.609, p-value <0.001, I 2 = 96.64%). However, there was no significant difference in sleep duration during the COVID-19 pandemic (MD = 0.01 h per day, 95% CI = -0.027, 0.225; p-value = 0.125; I 2 = 98.48%). Conclusion During the pandemic, less PA was contributed to poor QoL and sleep quality. However, increases in PA are associated with reduced occurrences of psychological and behavioral problems. Implementing recovery plans to address the health effect of the pandemic is essential.
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Affiliation(s)
- Johnson C. Y. Pang
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Eric L. S. Chan
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Herman M. C. Lau
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Kara K. L. Reeves
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Tina H. Y. Chung
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Heidi W. L. Hui
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Alfred H. L. Leung
- School of Health Sciences, Caritas Institute of HIgher Education, Tseung Kwan O, Hong Kong, Hong Kong SAR, China
| | - Allan C. L. Fu
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- China Studies Centre, The University of Sydney, Sydney, NSW, Australia
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15
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Daulay W, Wahyuni SE, Arruum D, Lailan M. Family Empowerment Models in Fighting the Problem of Mental Health Children and Adolescent. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Handling mental health problems in children and adolescents greatly help prevent the emergence of more severe problems. Early detection and treatment as early as possible can prevent a decrease in productivity and health costs and reduce the burden on families and communities
AIM: This study aims to develop a family empowerment model based on modifications and additions of existing designs that are applied operationally by families and health workers.
METHODS: The design of this study used a mixed method, the first stage of the study used a descriptive qualitative approach and the second stage of the study was a quasi-experiment. Respondents were 14 parents that had the risk of mental health problems in their adolescents. In the reconnaissance and reflecting stages, the data were analyzed qualitatively and the acting phase was included in the family empowerment model. After all the actions taken were completed, it was followed by observation and comparing of data before and after applying the empowerment model.
RESULTS: The reconnaissance stage was carried out to obtain the theme for the family behavior in overcoming mental health problems through early detection, education, and participation. The planning phase was developed using the early mental health detection instrument and workbook. During the acting stage, assistance was provided by the family through information in developing the designed model. The dependent t-test showed an increase in family knowledge after applying the empowerment model (p = 0,000; alpha = 0.05). This indicated that there was a significant effect in the implementation of the model in overcoming mental health problems in children and adolescents.
CONCLUSIONS: Family empowerment models include the detection of children with mental health issues, provision of education according to these problems, and participation in the care of those at risk of experiencing it.
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El Anwar A, El Nouman A, Kamel OM, Kamal NM, Fouad E. Enhancing “Health-Promoting Schools” through Implementing Mental Health Program. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The implementation of social and emotional learning program Social Emotional Learning (SEL) program is considered to be a low cost, simple method, and efficient intervention that shows a promise in promoting students’ mental health (MH).
AIM: We aimed to enhance “The Health-Promoting Schools” initiative through the implementation of a MH promotion program.
METHODS: The study is a school-based non-randomized controlled trial, in purposively selected schools. It included 460 students with a mean age of 11 (± 0.7) years old, all are boys, and were divided into two groups; intervention group (n = 230) and control group (n = 230). The ten components of the health-promoting school were assessed in the intervention school using the CDC tool “The School Health Index,” which enables the school team to identify the strengths and weaknesses of their school’s policies and programs. As a result, a tailored SEL program was developed fitting the Egyptian culture and students’ needs, along with the recommendations and trends.
RESULTS: The baseline assessment results for the intervention school were in the medium range percentages (20–80%). The social and emotional part had not been a major concern given for our students. The students who participated in the SEL program evidenced significant improvements in grit, growth mindset, self-management, social awareness, and school safety compared to the control group. According to the teachers’ perception scale, 70% of the teachers reported that the learning strategies of students have been improved.
CONCLUSION: The findings suggest that a relatively simple-to-administer SEL curriculum added to the regular school curriculum for a period of only 2–3 months can yield promising results as regard to positive behavioral and cognitive changes in students.
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Burgess A, Cavanagh K, Strauss C, Oliver BR. Headspace for parents: qualitative report investigating the use of a mindfulness-based app for managing parents' stress during COVID-19. BJPsych Open 2022; 8:e15. [PMID: 34956647 PMCID: PMC8692845 DOI: 10.1192/bjo.2021.1070] [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] [Received: 05/09/2021] [Revised: 09/24/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stress can compromise parental well-being and may contribute to harsh and critical parenting styles, which are in turn associated with children's conduct problems. Coronavirus disease 2019 (COVID-19)-related restrictions are likely to have exacerbated parental stress as, for many, UK-based family life was altered considerably. Mindfulness has been demonstrated to improve stress management and emotion regulation when delivered to parents in person, however, more accessible online interventions are under-researched. AIMS To provide preliminary data on family well-being and parent-child relationships as well as the acceptability and usability of the Headspace app - a self-delivered mindfulness-based intervention - for parents in low-risk families during the early days of the COVID-19 pandemic. METHOD We provided 12 parents with access to Headspace, and collected qualitative data (semi-structured interviews and 5 minute speech samples) immediately following the initial COVID-19 lockdown in the UK. The resulting transcripts were thematically analysed. RESULTS Most parents reported Headspace to be acceptable and useful - improvements in parents' own sleep were particularly noted - and there was high adherence to the intervention. However, difficulties related to family well-being and parent-child relationships following the lockdown were also reported. CONCLUSIONS As a result of the confounding impact of COVID-19 restrictions, and varied access to app content, we were unable to determine any outcomes to be a result of practising mindfulness specifically. However, COVID-19 has had a profound impact on many UK-based families, including those previously at low risk, and our results demonstrate that Headspace may have beneficial effects for parents. There is a need to more rigorously test this tool with a broader range of families.
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18
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Collegiate Athletic Trainers’ Use of Behavioral Health Screening Tools. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Screening for behavioral health (BH) concerns is important for early identification, referral, and management. The purpose of this study was to examine collegiate athletic trainers use of BH screening tools. We used a cross-sectional design with a web-based survey. Approximately 49% (n = 198/405) of participants used BH screening tools in their practice; the most used tools were PHQ-9 (n = 112/198, 56.6%) and GAD-7 (n = 54/198, 27.3%). Practice integration considerations and practice advancements occurred as a result of BH screening. Given rising incidence and severity of BH conditions in collegiate athletics, more training on screening and prevention is needed.
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19
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Beelmann A, Lutterbach S. Developmental Prevention of Prejudice: Conceptual Issues, Evidence-Based Designing, and Outcome Results. REVIEW OF GENERAL PSYCHOLOGY 2021. [DOI: 10.1177/10892680211056314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article reviews conceptual and empirical issues on the developmental prevention of prejudice in childhood and adolescence. Developmental prejudice prevention is defined as interventions that intentionally change and promote intergroup attitudes and behavior by systematically recognizing theories and empirical results on the development of prejudice in young people. After presenting a general conception of designing evidence-based interventions, we will discuss the application of this model in the field of developmental prejudice prevention. This includes the legitimation, a developmental concept of change, and the derivation of intervention content and implementation. Finally, we summarized recent evaluations results by reviewing meta-analytical evidence of programs and discuss important issues of future research and practice.
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Affiliation(s)
- Andreas Beelmann
- Institute of Psychology, Department of Research Synthesis, Intervention, Evaluation, Friedrich Schiller University Jena, Jena, Germany
| | - Sebastian Lutterbach
- Institute of Psychology, Department of Research Synthesis, Intervention, Evaluation, Friedrich Schiller University Jena, Jena, Germany
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20
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Gray EJ, Scott JG, Lawrence DM, Thomas HJ. Concordance between adolescents and parents on the Strengths and Difficulties Questionnaire: Analysis of an Australian nationally representative sample. Aust N Z J Psychiatry 2021; 55:1058-1070. [PMID: 33926246 DOI: 10.1177/00048674211009610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Differences between adolescent self-reported and parent-reported emotional and behavioural difficulties may influence psychiatric epidemiological research. This study examined concordance between adolescents and their parents about mental health symptoms using the Strengths and Difficulties Questionnaire. METHODS The study comprised a randomly selected, nationally representative sample of adolescents aged 11-17 years who participated in the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing (N = 2967). Matched adolescent and parent responses across the five Strengths and Difficulties Questionnaire subscales (emotional problems, hyperactivity, peer problems, conduct problems and prosocial behaviour), as well as total difficulties and total impact scores were examined to estimate concordance. Concordance patterns were analysed by sex, after stratifying the sample by age group (younger adolescents: 11-14 years; older adolescents: 15-17 years). RESULTS Concordance was 86.7% for total difficulties, 77.5% for total impact and ranged from 82.4% to 94.3% across the five Strengths and Difficulties Questionnaire subscales. There were no differences in concordance between sexes on the total difficulties score. Older females were more likely to disagree with their parents about emotional problems compared to males of the same age. Younger males were more likely to disagree with their parents compared to same-aged females about peer problems, hyperactivity, conduct problems and prosocial skills, as well as the impact of their problems. Older males were more likely to disagree with their parents about their prosocial skills compared to older females. CONCLUSION Overall, concordance between adolescents and parents on the Strengths and Difficulties Questionnaire was largely driven by the high proportion of respondents who reported having no problems. Discordance on a subscale increased as the prevalence of problems in a sex and age demographic subgroup increased. These findings highlight the need for a multi-informant approach to detect emotional and behavioural difficulties in adolescents, particularly when assessing the impact of symptoms, as this subscale had the lowest concordance.
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Affiliation(s)
- Emma J Gray
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - James G Scott
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - David M Lawrence
- Graduate School of Education, The University of Western Australia, Perth, WA, Australia
| | - Hannah J Thomas
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Abdullah A, Muhammad Amin H, Abdurrahman F, Idris J, Marthoenis M. Physiological Predictors of Mental Disorders Among Police Officers in Indonesia. Asia Pac J Public Health 2021; 33:888-898. [PMID: 34488472 DOI: 10.1177/10105395211027752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Police officers may be at a higher risk of suffering from mental disorders (MDs) compared with other occupations. This study aimed to examine the physiological predictors of MDs among police officers in Indonesia. The mental health status of each participant was examined using a standardized Minnesota Multiphasic Personality Inventory (MMPI) tool and underwent several laboratory examinations including hematology, urine, serology, and electrocardiogram tests. A logistic regression was performed to calculate the odds ratio. Of the 4590 participants, 2.14% were diagnosed with MDs. The study found 19 physiological variables are potential predictors of MDs. In multivariate analysis adjusted for body mass index, sex, and age, the concentration of ketones, protein, and specific gravity in urine and the amount of lymphocyte in the blood are among important predictors of MDs. This suggests that carefully examining the results of urinalysis and hematology tests can help us detect early cases of MDs among police officers.
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Affiliation(s)
- Asnawi Abdullah
- University Muhammadiyah Aceh, Banda Aceh, Indonesia.,Monash University, Melbourne, Victoria, Australia
| | - Hamidah Muhammad Amin
- University Muhammadiyah Aceh, Banda Aceh, Indonesia.,Medical and Health Services Division, Provincial Health Police Office, Biddokes Polda Aceh, Banda Aceh, Indonesia
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22
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Chen H, Fan Q, Nicholas S, Maitland E. The long arm of childhood: The prolonged influence of adverse childhood experiences on depression during middle and old age in China. J Health Psychol 2021; 27:2373-2389. [PMID: 34397302 DOI: 10.1177/13591053211037727] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Utilizing data from the nationally representative China Health and Retirement Longitudinal Study, this study analyzed the effect of intensity and duration of adverse childhood experiences on depression in middle aged and older aged adults in China. The mediating effect of cumulative health risk and personal factors were validated through the Karlson-Holm-Breen method. The results showed a significant dose-response relationship between adverse childhood experiences and adult depression. The elevated health risks of chronic diseases, disabilities, and physical pain, as well as the disadvantages in education, employment, and economic status caused by the adverse childhood experiences indirectly worsen adult depression.
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Affiliation(s)
| | | | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australia.,University of Newcastle, Australia
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Ogrodniczuk JS, Kealy D, Laverdière O. Who is coming through the door? A national survey of self‐reported problems among post‐secondary school students who have attended campus mental health services in Canada. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - David Kealy
- Department of Psychiatry University of British Columbia Vancouver BC Canada
| | - Olivier Laverdière
- Département de Psychologie Université de Sherbrooke Sherbrooke QC Canada
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24
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Damari B, Sharifi V, Asgardoon MH, Hajebi A. Community Action Package in Iran's Comprehensive Mental and Social Health Services (the SERAJ Program). IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:76-86. [PMID: 34054986 PMCID: PMC8140293 DOI: 10.18502/ijps.v16i1.5382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 11/24/2022]
Abstract
Objective: The social component of health plays a significant role in improving the mental health of the people of a district. A national program on providing comprehensive social and mental health services, entitled "SERAJ", was developed and piloted in three districts of Iran. The present study aims to determine its model for improving the indicators of the social component of mental health. Method : This study is a system design for which a literature review, interviews with experts, and focused group discussions with stakeholders were used. Results: Community action in promoting the mental health of the districts has three main components: strengthening intersectoral collaboration through the memorandum of understandings (MoU), increasing people's participation by establishing People's Participation House (PPH) with the presence of the representative of current People's network, and social protection of people suffering from mental disorders by establishing the Social Support Unit (SSU) for self-reliance activity. All three components are controlled by the governor and with supervision and technical consult of the health network of the district and stakeholder participation. Conclusion: The model uses the inner capacities of the city instead of creating new structures. The prerequisites for the effective function of the main three components are educating departments, educating members of the PPH, and hiring a social worker at the SSU. The effective measures taken by the departments to reduce the risk factors for mental disorders are dependent on the technical and financial support of relevant organizations at the provincial and national levels.
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Affiliation(s)
- Behzad Damari
- Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Asgardoon
- Department of Governance and Health, Neuroscience Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Student Society for Immunodeficiencies, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Hajebi
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran
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25
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Kubb C, Foran HM. Measuring COVID-19 Related Anxiety in Parents: Psychometric Comparison of Four Different Inventories. JMIR Ment Health 2020; 7:e24507. [PMID: 33197233 PMCID: PMC7717922 DOI: 10.2196/24507] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/21/2020] [Accepted: 11/05/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 outbreak and the measures to contain the global pandemic can have an impact on the well-being and mental health status of individuals. Parents of young children are particularly at risk for high levels of parental stress due to the current public health crisis, which can impact parenting behaviors and children's well-being. Although different initial scales have been developed to measure COVID-19-related anxiety, they have not yet been tested sufficiently in parent samples. A brief measure of COVID-19-related anxiety is necessary for both quick assessment in practice and in larger epidemiological studies of parents. OBJECTIVE The purpose of this study is to compare the distributions, validities, and reliabilities of four different COVID-19 anxiety scales: Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Pandemic Anxiety Scale, and one subscale of the COVID Stress Scales. Based on the psychometric properties of these scales, we aim to provide recommendations for a brief unidimensional inventory to assess COVID-19-related anxiety among parents. METHODS A cross-sectional web-based survey of 515 German-speaking parents (465 mothers, 90.3%) with at least one child aged 0-6 years was conducted during a 6-week period (June 29 to August 9, 2020). Half of the parents were recruited via Facebook parenting groups, while the other half were recruited through childcare centers. We psychometrically tested 25 items on COVID-19-related anxiety using the framework of classical test theory, including item analysis, correlational analysis of family variables, and exploratory factor analysis. Moreover, an item response theory approach was applied to estimate item discriminations and item difficulties. RESULTS Based on the psychometric properties, three items of the Pandemic Anxiety Scale were identified as a single unidimensional factor. The adapted scale demonstrated acceptable internal consistency (α=.79), moderate to high item discrimination, strong positive intercorrelation with two other COVID-19 anxiety scales, and a small positive association with parenting stress. Mothers and fathers did not differ in total scores (t513=-0.79, P=.42). CONCLUSIONS Factor analysis suggests that existing COVID-19-related anxiety scales measure different latent constructs of anxiety. Furthermore, all scales showed only small to moderate correlations with trait health anxiety, suggesting that COVID-19-related anxiety is distinct from general health anxiety. The adapted "disease anxiety" subscale of the Pandemic Anxiety Scale is an economical measure for assessing COVID-19-related anxiety in parents. Directions for future research are outlined.
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Affiliation(s)
- Christian Kubb
- Health Psychology Unit, Institute of Psychology, Universität Klagenfurt, Klagenfurt, Austria
| | - Heather M Foran
- Health Psychology Unit, Institute of Psychology, Universität Klagenfurt, Klagenfurt, Austria
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26
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Olashore AA, Paruk S, Ogunjumo JA, Ogundipe RM. Attention-deficit hyperactivity disorder in school-age children in Gaborone, Botswana: Comorbidity and risk factors. S Afr J Psychiatr 2020; 26:1525. [PMID: 33240552 PMCID: PMC7670025 DOI: 10.4102/sajpsychiatry.v26i0.1525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/05/2020] [Indexed: 11/12/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Its occurrence and pattern of presentation are unknown in Botswana. Aim To determine the prevalence of attention-deficit hyperactivity disorder (ADHD), associated comorbid conditions and risk factors amongst school-age children in Botswana. Setting Primary schools in Gaborone, Botswana. Methods This study used a cross-sectional design. A two-stage random sampling technique was utilised to select learners from 25 out of the 29 public schools in the city. The Vanderbilt ADHD Diagnostic Rating Scale (VADRS), teacher and parent versions, was administered. Results Of the 1737 children, 50.9% (n = 884) were male, and their mean age was 9.53 years (s.d. = 1.97). The prevalence of ADHD was 12.3% (n = 213). The most prevalent presentation was the predominantly inattentive, 7.2% (n = 125). A family history of mental illness (odds ratio [OR] = 6.59, 95% CI: 1.36–32.0) and perinatal complications (OR = 2.16, 95% CI: 1.08–4.29) emerged as the independent predictors of ADHD. Conclusions The prevalence of ADHD in Botswana is slightly higher than that reported in the literature, but the pattern of presentations and comorbidities is similar. A positive family history of mental illness and perinatal complications independently predicted ADHD. Mental health screening amongst families of the affected individuals and improved perinatal care should be considered as health care priorities in Botswana.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Saeeda Paruk
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban South Africa
| | - John A Ogunjumo
- Department of Family Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Radiance M Ogundipe
- Department of Family Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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27
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Ghafari SM, Fotouhi-Ardakani R, Parvizi P. Designing and developing a high-resolution melting technique for accurate identification of Leishmania species by targeting amino acid permease 3 and cytochrome oxidase II genes using real-time PCR and in silico genetic evaluation. Acta Trop 2020; 211:105626. [PMID: 32652055 DOI: 10.1016/j.actatropica.2020.105626] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/20/2022]
Abstract
Discrimination, accurate identification, and reliable techniques are required for accurate identification of Leishmania parasites. High-resolution melting (HRM) is recognized as an authentic and exact method. The main objective of this research was optimizing HRM analysis for detecting and screening Leishmania major, Leishmania tropica and mix infections. Thirty-six DNA samples of Leishmania parasite were prepared and analyzed. Two gene regions of amino acid permease 3 (AAP3) and cytochrome oxidase II (COII) were targeted and six pairs of specific new primers were designed. Bioinformatics analysis was employed to predict DNA temperature resolution for each species and compared with in-vitro results. The genetic diversity of the selected gene regions was analyzed using PCR-sequencing method and DnaSP 5.10.01 software. They were submitted in GenBank (KU680818- KU680821 and KY041643- KY041649). The haplotype diversity for both AAP3 and COII genes was 96% and 87%, respectively. Tajima's D index was 0.65 for AAP3 and 0.36 for COII. CLC Genomics Workbench 11 software predictions were significant and close to these findings. The designed primers could be able to identify at least two Leishmania species. Temperature variations in HRM technique separated Iranian Leishmania parasites of L. major, L. tropica and mix infections. The target genes and our modified HRM method proved this technique could be useful in both clinical and experimental settings. Also, it can be effective for detecting Leishmania parasites in different hosts such as humans, reservoir hosts and vectors. Indeed, HRM can be used as a technique in Leishmania identification as well as for ecological and epidemiological research.
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Affiliation(s)
- Seyedeh Maryam Ghafari
- Molecular Systematics Laboratory, Parasitology Department, Pasteur Institute of Iran, Tehran, Iran.
| | - Reza Fotouhi-Ardakani
- Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran; Department of Medical Biotechnology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
| | - Parviz Parvizi
- Molecular Systematics Laboratory, Parasitology Department, Pasteur Institute of Iran, Tehran, Iran.
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Abstract
Systematic mental health screening is a recommended but controversial process in the pediatricians' behavioral health tool kit. Although the American Academy of Pediatrics and other organizations promote routine behavioral health screening, implementing an effective and sustainable screening program can be challenging. We discuss the rationale for and barriers to screening in pediatric settings, identify accessible validated tools that can be easily incorporated into practice, and suggest a practical strategy for implementing a more accurate screening system for common mental health concerns in pediatric primary care. [Pediatr Ann. 2020;49(10):e421-e425.].
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29
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DOĞRU H, DURSUN OB, ÖZTEKİN N. Should children with sub-threshold ADHD predominantly inattentive subtype (ADHD-I) symptoms be treated with Sensory ıntegration therapy? A case-control study. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.709847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Heo J, Noh OK. Psychiatric comorbidities among patients with esophageal cancer in South Korea: a nationwide population-based, longitudinal study. J Thorac Dis 2020; 12:1312-1319. [PMID: 32395268 PMCID: PMC7212153 DOI: 10.21037/jtd.2020.02.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background This longitudinal study aimed to analyze the prevalence of psychological distress in esophageal cancer survivors, using claims data in South Korea. Methods From January 2010 to December 2014, we identified the four most frequent psychological distress in a nationwide cohort of 8,879 patients diagnosed with esophageal cancer. We analyzed the prevalence and the pattern of psychological distress before and after the initial treatment. Results Among esophageal cancer patients, 669 patients (7.5%) were diagnosed with a psychological distress between 1 year prior to initial treatment and the time of last follow-up. Among them, depression and anxiety had a similar frequency of 237 (35.4%). The overall frequency of psychological distress peaked within 2 months after the initial treatment. Stress reaction/adjustment disorders showed the highest increase rate after treatment. The rate of patients who had psychological distress was higher among those who underwent surgery as their initial treatment than in those who received radiotherapy [odds ratio (OR): 1.39, P<0.001]. Further, female patients were more likely to be diagnosed with psychological distress compared with male patients (OR: 1.30, P<0.001). Conclusions Psychological distress in esophageal cancer survivors showed different patterns of prevalence depending on the nature of disease, sex, and initial treatment. Considering individual factors, timely diagnosis and intervention for psychological distress could improve the quality of life for esophageal cancer survivors.
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Affiliation(s)
- Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - O Kyu Noh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.,Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.,Office of Biostatistics, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea
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31
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Uddin MN, Islam FMA. Psychometric evaluation of the modified Kessler seven-item version (K7) for measuring psychological distress using Rasch analysis: a cross-sectional study in a rural district of Bangladesh. BMJ Open 2020; 10:e034523. [PMID: 32086357 PMCID: PMC7045185 DOI: 10.1136/bmjopen-2019-034523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES This investigation expected to validate the psychometric properties of the modified seven-item Kessler psychological distress scale (K7) for measuring psychological distress in healthy rural population of Bangladesh. DESIGN Cross-sectional study. SETTING Narail district, Bangladesh. PARTICIPANTS A random sample of 300 adults of age 18-90 years were recruited. Face-to-face interviews were conducted between July and August 2018 using an Android phone installed with a mobile data collection application known as CommCare. OUTCOME MEASURE Validation of the K7 was the major outcome. Sociodemographic factors were measured to assess for Differential Item Functioning to check if the tool functions equally in different factors. Rasch analysis was carried out for the validation of the K7 scale in the healthy rural population of Bangladesh. RUMM2030 was used for the analyses. RESULTS Results showed good overall fit, as indicated by a non-significant item-trait interaction (χ2=44.54, df=28, p=0.0245) compared with a Bonferroni adjusted p value of 0.007. Both item fit (mean=0.30, SD 1.22) and person fit residuals (mean=-0.18, SD 0.85) showed perfect fit. Reliability was very good as indicated by a Person Separation Index=0.85 and Cronbach's alpha=0.89. All individual items were ordered thresholds. The K7 scale showed adequate reliability, unidimensionality and was free from local dependency. The K7 scale also showed similar functioning for adults and older adults, males and females, no education and any level of education, and at least some financial instability versus no financial instability. CONCLUSIONS Validation of K7 scale confirmed that the tool is suitable for measuring psychological distress among the rural Bangladeshi population. Further research should validate the K7 scale in different rural settings in Bangladesh to determine a valid cut-off score for assessment of severity levels of psychological distress. The K7 scale should also be tested in other developing countries where sociodemographic characteristics are similar to those of Bangladesh.
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Affiliation(s)
- Mohammed Nazim Uddin
- Department of Statistcs, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, Victoria, Australia
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32
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Castro-Kemp S, Palikara O, Gaona C, Eirinaki V, Furlong MJ. The Role of Psychological Sense of School Membership and Postcode as Predictors of Profiles of Socio-emotional Health in Primary School Children in England. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09349-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
A dual approach to mental health in schools has been widely defended, where the assessment of psychological distress and the examination of strengths/well-being are two separate continua. In line with a well-being approach, school belonging has been referenced as an important indicator of mental health in children. This study explored the predictive role of school sense of belonging alongside other demographic variables (gender, main language spoken at home, and socio-economic status of postcode) on the socio-emotional health profiles of primary school children in England. Children (N = 522) were recruited from three primary schools in Greater London. A survey including measures of school belonging and socio-emotional health was administered to all children. Results showed that it is possible to identify groups of students at primary school level based on socio-emotional health ratings on gratitude, zest, optimism, and perseverance. School sense of membership, as measured by the psychological sense of school membership primary (PSSM-P), was the best predictor of group membership and, together with socio-economic status, explains 37% of the variance in socio-emotional health profiles. Belonging starts affecting well-being and socio-emotional health as early as in primary school, hence the importance of universal screening and early preventive actions to promote well-being in this age range. The study provides evidence supporting the use of the abbreviated (PSSM-P) in predicting socio-emotional health profiles, with potential to complement distress-based measures.
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Allsopp K, Kinderman P. The use of diagnoses in mental health service eligibility and exclusion criteria. J Ment Health 2019; 30:97-103. [PMID: 31647342 DOI: 10.1080/09638237.2019.1677875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Diagnoses are controversial but ubiquitous in mental health; however, whether they are essential features of service entry has not been analysed. AIM To investigate the use of diagnosis in the service entry criteria of UK NHS adult mental health services. METHODS Freedom of Information requests were made to 17 NHS adult mental health Trusts; responses were analysed thematically. RESULTS Four service types were identified: broadly diagnostic, problem-specific, supporting specific life circumstances and needs-led. Diagnoses were used frequently but not universally. Non-diagnostic factors were central to service entry criteria. CONCLUSIONS Diagnoses were neither necessary nor sufficient in-service entry criteria. Broad clusters of difficulties were used rather than specific diagnoses. Extensive exceptions revealed diagnoses as inefficient proxies for risk, severity and need. Differences across criteria appeared largely driven by professional competencies. Implications for innovative care pathways include preventative services and working with psychosocial factors.
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Affiliation(s)
- Kate Allsopp
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Kinderman
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
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Bonati M, Cartabia M, Zanetti M. Waiting times for diagnosis of attention-deficit hyperactivity disorder in children and adolescents referred to Italian ADHD centers must be reduced. BMC Health Serv Res 2019; 19:673. [PMID: 31533711 PMCID: PMC6751639 DOI: 10.1186/s12913-019-4524-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/10/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To investigate timely access to and the time needed to complete the diagnostic path of children and adolescents with suspected attention deficit hyperactivity disorder (ADHD) in the 18 Italian Lombardy Region ADHD reference centers. METHODS Data of children and adolescents enrolled in the Regional ADHD disease-oriented Registry for suspected ADHD who requested their first visit in 2013-2017 were analyzed. RESULTS The sample comprised 2262 children and adolescents aged 5-17 years who accessed the ADHD centers for diagnostic classification and management. The median waiting time was of 177 days (range 66-375) from the request for the initial appointment to the completion of the diagnostic path, with a three - fold difference between centers. In addition to the center, the strongest significant predictors of long waiting times were age comorbidities, the severity of the disorder, and having already completed some diagnostic procedures provided by the common standard path. CONCLUSIONS To guarantee an equal standard of care in ADHD centers for all children and adolescents there is a pressing need to reduce the times to complete the diagnostic path. It is the task of both policymakers and each center to optimize the quality of the service and of the care delivered.
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Affiliation(s)
- Maurizio Bonati
- Laboratory for Mother Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy.
| | - Massimo Cartabia
- Laboratory for Mother Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy
| | - Michele Zanetti
- Laboratory for Mother Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Giuseppe La Masa 19, 20156, Milan, Italy
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35
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Chojenta C, William J, Martin MA, Byles J, Loxton D. The impact of a history of poor mental health on health care costs in the perinatal period. Arch Womens Ment Health 2019; 22:467-473. [PMID: 30251209 DOI: 10.1007/s00737-018-0912-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/17/2018] [Indexed: 11/29/2022]
Abstract
The perinatal period is a critical time for mental health and is also associated with high health care expenditure. Our previous work has identified a history of poor mental health as the strongest predictor of poor perinatal mental health. This study aims to examine the impact of a history of poor mental health on health care costs during the perinatal period. Data from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) were linked with a number of administrative datasets including the NSW Admitted Patient Data Collection and Perinatal Data Collection, the Medicare Benefits Scheme and the Pharmaceuticals Benefits Scheme between 2002 and 2011. Even when taking birth type and private health insurance status into account, a history of poor mental health resulted in an average increase of over 11% per birth across the perinatal period. These findings indicate that an investment in prevention and early treatment of poor mental health prior to child bearing may result in a cost saving in the perinatal period and a reduction of the incidence of women experiencing poor perinatal mental health.
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Affiliation(s)
- Catherine Chojenta
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Jananie William
- Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, 2601, Australia
| | - Michael A Martin
- Research School of Finance, Actuarial Studies and Statistics, Australian National University, Canberra, ACT, 2601, Australia
| | - Julie Byles
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
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36
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Liu J, Wong KKY, Dong F, Raine A, Tuvblad C. The Schizotypal Personality Questionnaire - Child (SPQ-C): Psychometric properties and relations to behavioral problems with multi-informant ratings. Psychiatry Res 2019; 275:204-211. [PMID: 30928723 PMCID: PMC6748384 DOI: 10.1016/j.psychres.2019.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 02/25/2019] [Accepted: 03/04/2019] [Indexed: 12/19/2022]
Abstract
The Schizotypal Personality Questionnaire (SPQ) is one of the most widely used screening tools for schizotypy in adults. The Schizotypal Personality Questionnaire-Child version (SPQ-C) was recently developed to assess schizotypy in children and has a similar three-factor structure to the adult SPQ (i.e., Cognitive-Perceptual, Interpersonal-Affective, and Disorganization). However, few studies to date have reported on the psychometric properties and the usefulness of the SPQ-C in Eastern populations, including Mainland China. This study presents the first psychometric assessment of the Chinese SPQ-C in Mainland China. Exploratory factor analysis and confirmatory factor analysis were used to assess the factor structure of the SPQ-C in 1668 children (M = 12.10, SD = 0.60 years) from the China Jintan Child Cohort Study. Our findings document a three-factor structure and partial measurement invariance across residential location and gender, replicating the psychometric properties of the SPQ-C in English. The Chinese SPQ-C further correlates with standard behavioral problems (i.e., Child Behavior Checklist, Youth Self-Report and Teacher Report Form), demonstrating construct validity and utility as a child psychopathology assessment tool. Our findings provide the first robust psychometric evidence for a three-factor structure of the Chinese SPQ-C in a large Mainland Chinese sample, and suggest that the SPQ-C is suitable as a screening tool for schizotypy in community children who may be at risk for behavioral problems and later psychosis.
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Affiliation(s)
- Jianghong Liu
- University of Pennsylvania, School of Nursing, 418 Curie Blvd., Claire M. Fagin Hall, Room 426, Philadelphia, PA 19104-6096, USA.
| | - Keri Ka-Yee Wong
- University of College London, Institute of Education, Department of Psychology and Human Development, London, UK.
| | - Fanghong Dong
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA.
| | - Adrian Raine
- University of Pennsylvania, Departments of Criminology, Psychiatry, and Psychology, Philadelphia, PA, USA.
| | - Catherine Tuvblad
- University of Southern California, Department of Psychology, Los Angeles, CA, USA; School of Law, Psychology and Social Work / Criminology Örebro University, SE-701 82 Örebro, Sweden.
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Skokauskas N, Fung D, Flaherty LT, von Klitzing K, Pūras D, Servili C, Dua T, Falissard B, Vostanis P, Moyano MB, Feldman I, Clark C, Boričević V, Patton G, Leventhal B, Guerrero A. Shaping the future of child and adolescent psychiatry. Child Adolesc Psychiatry Ment Health 2019; 13:19. [PMID: 31007713 PMCID: PMC6458731 DOI: 10.1186/s13034-019-0279-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 03/23/2019] [Indexed: 01/12/2023] Open
Abstract
Child and adolescent psychiatry is in a unique position to respond to the growing public health challenges associated with the large number of mental disorders arising early in life, but some changes may be necessary to meet these challenges. In this context, the future of child and adolescent psychiatry was considered by the Section on Child and Adolescent Psychiatry of the World Psychiatric Association (WPA CAP), the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), the World Association for Infant Mental Health (WAIMH), the International Society for Adolescent Psychiatry and Psychology (ISAPP), the UN Special Rapporteur on the Right to Health, representatives of the WHO Department of Mental Health and Substance Abuse, and other experts. We take this opportunity to outline four consensus priorities for child and adolescent psychiatry over the next decade: increase the workforce necessary for providing care for children, adolescents and families facing mental disorders; reorienting child and adolescent mental health services to be more responsive to broader public health needs; increasing research and research training while also integrating new research finding promptly and efficiently into clinical practice and research training; Increasing efforts in advocacy.
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Affiliation(s)
- Norbert Skokauskas
- Word Psychiatric Association, Child and Adolescent Psychiatry Section and Norwegian University of Science and Technology, Trondheim, Norway
| | - Daniel Fung
- The International Association for Child and Adolescent Psychiatry and Allied Professions and Institute of Mental Health, Singapore, Singapore
| | - Lois T. Flaherty
- International Society for Adolescent Psychiatry and Psychology and Harvard University, Cambridge, USA
| | - Kai von Klitzing
- World Association for Infant Mental Health and University Hospital Leipzig, Leipzig, Germany
| | - Dainius Pūras
- Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable, Standard of Health, United Nations and University of Vilnius, Vilnius, Lithuania
| | - Chiara Servili
- WHO Focal Point for Child and Adolescent Mental Health, Department of Mental Health and Substance Abuse, WHO, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, WHO, Geneva, Switzerland
| | | | | | | | | | | | | | | | - Bennett Leventhal
- Department of Psychiatry, University of California San Francisco, San Francisco, USA
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Farris MS, MacQueen G, Goldstein BI, Wang J, Kennedy SH, Bray S, Lebel C, Addington J. Treatment History of Youth At-Risk for Serious Mental Illness. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:145-154. [PMID: 30071747 PMCID: PMC6405799 DOI: 10.1177/0706743718792195] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim was to describe treatment history including medications, psychosocial therapy and hospital visits of participants in the Canadian Psychiatric Risk and Outcomes Study (PROCAN). METHODS PROCAN is a 2-site study of 243 youth/young adults aged 12 to 25 y, categorized into 4 groups: healthy controls ( n = 42), stage 0 (non-help seeking, asymptomatic with risk mainly family history of serious mental illness (SMI); n = 41), stage 1a (distress disorders; n = 52) and stage 1b (attenuated syndromes; n = 108). Participants were interviewed regarding lifetime and current treatments, including medications, psychosocial therapies and hospital visits. RESULTS The number receiving baseline medications differed significantly across groups ( P < 0.001): 0% healthy controls, 14.6% stage 0, 32.7% stage 1a and 34.3% stage 1b. Further, 26.9% and 49.1% of stage 1a and stage 1b participants received psychosocial therapy at baseline, indicative of statistically significant differences among the groups ( P < 0.001). Similar results were observed for lifetime treatment history; stage 1b participants had the highest frequency of lifetime treatment. Medications started in adulthood (>18 y of age) were the most common for initiation of treatment compared to childhood (0 to 12 y) and adolescence (13 to 17 y) for stage 1a and 1b participants. Lifetime mental health hospital visits differed significantly across groups ( P < 0.001) and were most common in stage 1b participants (29.6%) followed by stage 1a (13.5%), stage 0 (4.9%) and healthy controls (2.4%). CONCLUSION We found that treatment history for participants in the PROCAN study differed among the at-risk groups. Future initiatives focused on determining the effects of treatment history on SMI are warranted.
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Affiliation(s)
- Megan S Farris
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Glenda MacQueen
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Benjamin I Goldstein
- 2 Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,3 Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - JianLi Wang
- 4 Work & Mental health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.,5 Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sidney H Kennedy
- 6 Department of Psychiatry, University Health Network, Toronto, Ontario, Canada.,7 Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada.,8 Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada.,9 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,10 Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Signe Bray
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,11 Department of Radiology, University of Calgary, Calgary, Alberta Canada.,12 Alberta Children's Hospital Research Institute, Calgary, Alberta Canada.,13 Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Catherine Lebel
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,11 Department of Radiology, University of Calgary, Calgary, Alberta Canada.,12 Alberta Children's Hospital Research Institute, Calgary, Alberta Canada.,13 Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Jean Addington
- 1 Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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Abstract
Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.
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Affiliation(s)
- David McDaid
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
| | - A-La Park
- Personal Social Services Research Unit, Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, United Kingdom; ,
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Cocker C, Minnis H, Sweeting H. Potential value of the current mental health monitoring of children in state care in England. BJPsych Open 2018; 4:486-491. [PMID: 30564444 PMCID: PMC6293450 DOI: 10.1192/bjo.2018.70] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/18/2018] [Accepted: 10/11/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Routine screening to identify mental health problems in English looked-after children has been conducted since 2009 using the Strengths and Difficulties Questionnaire (SDQ). AIMS To investigate the degree to which data collection achieves screening aims (identifying scale of problem, having an impact on mental health) and the potential analytic value of the data set. METHOD Department for Education data (2009-2017) were used to examine: aggregate, population-level trends in SDQ scores in 4/5- to 16/17-year-olds; representativeness of the SDQ sample; attrition in this sample. RESULTS Mean SDQ scores (around 50% 'abnormal' or 'borderline') were stable over 9 years. Levels of missing data were high (25-30%), as was attrition (28% retained for 4 years). Cross-sectional SDQ samples were not representative and longitudinal samples were biased. CONCLUSIONS Mental health screening appears justified and the data set has research potential, but the English screening programme falls short because of missing data and inadequate referral routes for those with difficulties. DECLARATION OF INTEREST None.
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Affiliation(s)
- Christine Cocker
- Senior Lecturer in Social Work, School of Social Work, University of East Anglia, UK
| | - Helen Minnis
- Professor of Child and Adolescent Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK
| | - Helen Sweeting
- Reader, MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
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A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges. EDUCATION SCIENCES 2018. [DOI: 10.3390/educsci8040178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.
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Fernandez ME, Damme LV, Pauw SD, Costa-Ball D, Daset L, Vanderplasschen W. The moderating role of age and gender differences in the relation between subjective well-being, psychopathology and substance use in Uruguayan adolescents. REVISTA LATINOAMERICANA DE PSICOPATOLOGIA FUNDAMENTAL 2018. [DOI: 10.1590/1415-4714.2018v21n3p486.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to explore the Subjective well-being (SWB) of school-going adolescents in Uruguay (N= 325; Mage= 14.67; SD= 1.62). We investigate age- and gender-specific relationships between psychopathology and substance use on the one hand, and subjective well-being on the other hand. Multivariate linear regression analyses, indicated five significant predictors of SWB: three psychopathology factors (depression-anxiety, social anxiety and dissocial behaviour), and age displayed a negative association, while one psychopathology factor (resilience) showed a positive association. When extending the multivariate linear regression analysis with interaction effects, significant interactions appeared regarding gender and resilience and age and substance use. Our study focuses on the necessity to have evidence-based results in order to plan appropriate preventive interventions with adolescents.
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Uddin MN, Islam FMA, Al Mahmud A. Psychometric evaluation of an interview-administered version of the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh. BMJ Open 2018; 8:e022967. [PMID: 29961041 PMCID: PMC6042570 DOI: 10.1136/bmjopen-2018-022967] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE The aim of this study was to translate, adapt and validate the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh. DESIGN Cohort study. SETTING Narail district, Bangladesh. PARTICIPANTS A random sample of 2425 adults of age 18-90 years was recruited. OUTCOME MEASURE Validation of the K10 was the major outcome. Sociodemographic factors were measured to assess if the K10 needed adjustment for factors such as age or gender. The Rasch measurement model was used for the validation, and RUMM 2030 and SPSS V.24 software were used for analyses. RESULTS Initial inspection of the total sample showed poor overall fit. A sample size of 300, which is more satiated for Rasch analysis, also showed poor overall fit, as indicated by a significant item-trait interaction (χ2= 262.27, df=40, p<0.001) and item fit residual values (mean=-0.25, SD=2.49). Of 10 items, five items were disordered thresholds, and seven items showed misfit, suggesting problems with the response format and items. After removing three items ('feel tired', 'depressed' and 'worthless') and changing the Likert scale categories from five to four categories, the remaining seven items showed ordered threshold. A revised seven-item scale has shown adequate internal consistency, with no evidence of multidimensionality, no differential item functioning on age and gender, and no signs of local dependency. CONCLUSIONS Analysis of the psychometric validity of K10 using the Rasch model showed that 10 items are not appropriate for measuring psychological distress in rural Bangladesh. A modified version of seven items (K7) with four response categories would provide a psychometrically more robust scale than the original K10. The study findings suggest repeating the K7 version in other remote areas for further validation can substantiate an efficient screening tool for measuring psychological distress among the general Bangladeshi population.
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Affiliation(s)
- Mohammed Nazim Uddin
- Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Fakir M Amirul Islam
- Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Organisation for Rural Community Development, Dariapur, Bangladesh
| | - Abdullah Al Mahmud
- Centre for Design Innovation, School of Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Gaete J, Montero-Marin J, Valenzuela D, Rojas-Barahona CA, Olivares E, Araya R. Mental health among children and adolescents: Construct validity, reliability, and parent-adolescent agreement on the 'Strengths and Difficulties Questionnaire' in Chile. PLoS One 2018; 13:e0191809. [PMID: 29401472 PMCID: PMC5798763 DOI: 10.1371/journal.pone.0191809] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 01/11/2018] [Indexed: 12/13/2022] Open
Abstract
The Strengths and Difficulties Questionnaire (SDQ) is a screening tool used to measure psychological functioning among children and adolescents. It has been extensively used worldwide, but its psychometric properties, such as internal structure and reliability, seem to vary across countries. This is the first study exploring the construct validity and reliability of the Spanish version of SDQ among early adolescents (self-reported) and their parents in Latin America. A total of 1,284 early adolescents (9-15 years) and their parents answered the SDQ. We also collected demographic variables. A confirmatory factor analysis was conducted to assess the latent structure of the SDQ. We also used the multitrait-multimethod analysis to separate the true variance on the constructs from variance resulting from measurement methods (self-report vs. parent report), and evaluated the agreement between adolescents and their parents. We found that the original five-factor model was a good solution and the resulting sub-scales had good internal consistency. We also found that the self-reported and parental versions of SDQ provide different information, which are complementary and provide a better picture of the emotional, social, and conduct problems of adolescents. We have added evidence for the construct validity and reliability of the Spanish self-reported and parental SDQ versions in a Chilean sample.
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Affiliation(s)
- Jorge Gaete
- Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jesus Montero-Marin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Zaragoza, Spain
| | | | | | - Esterbina Olivares
- School of Nursing (Campus San Felipe), Universidad de Valparaíso, San Felipe, Chile
| | - Ricardo Araya
- Centre for Global Mental Health and Primary Care Research, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
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Prevalence of emotional and behavioral problems and subthreshold psychiatric disorders in Austrian adolescents and the need for prevention. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1325-1337. [PMID: 30159723 PMCID: PMC6267139 DOI: 10.1007/s00127-018-1586-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/20/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Epidemiological data are crucial to plan adequate prevention strategies. Thus, this study aims at obtaining the prevalence of mental health problems (MHP) and subthreshold psychiatric disorders based on a representative sample of Austrian adolescents. METHODS Adolescents aged 10-18 were recruited from Austrian schools. Emotional and behavioral problems were determined using the Youth Self-Report (YSR); the point prevalence of subthreshold psychiatric disorders was assessed using structured diagnostic interviews. Sociodemographic variables including socioeconomic background, migration status, family structure, and place of residence were obtained. In addition, a non-school sample (unemployed adolescents, and child and adolescent psychiatry patients) was included to enhance representativeness and generalizability. RESULTS 3446 students, 37 unemployed adolescents, and 125 child and adolescent psychiatric patients provided analyzable YSR data sets. In the school sample, 16.5% scored in the clinically relevant range, while internalizing problems were more prevalent (17.8%) than externalizing problems (7.4%). These prevalences increased by 0.7-2.0% when the non-school sample was taken into account. A low socioeconomic status (SES) and living in single parent families were associated with higher problem scores. Regarding the interviewed sample (377 students and 407 parents), subthreshold psychiatric disorders were observed in 12.7% of students. 92.5% of them have not yet received any kind of help. CONCLUSIONS A significant proportion of Austrian adolescents are at risk for MHP. A non-responder analysis indicates that the observed prevalence may be even underestimated. These findings emphasize the urgent need for targeted prevention, especially for reducing anxiety and depressive symptoms and for adolescents in disadvantaged families.
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Knowing Every Child: Validation of the Holistic Student Assessment (HSA) as a Measure of Social-Emotional Development. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 19:306-317. [DOI: 10.1007/s11121-017-0794-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Malti T, Noam GG, Beelmann A, Sommer S. Toward Dynamic Adaptation of Psychological Interventions for Child and Adolescent Development and Mental Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 45:827-836. [PMID: 27854120 DOI: 10.1080/15374416.2016.1239539] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Children's and adolescents' mental health needs emphasize the necessity of a new era of translational research to enhance development and yield better lives for children, families, and communities. Developmental, clinical, and translational research serves as a powerful tool for managing the inevitable complexities in pursuit of these goals. This article proposes key ideas that will strengthen current evidence-based intervention practices by creating stronger links between research, practice, and complex systems contexts, with the potential of extending applicability, replicability, and impact. As exemplified in some of the articles throughout this special issue, new research and innovative implementation models will likely contribute to better ways of assessing and dynamically adapting structure and intervention practice within mental health systems. We contend that future models for effective interventions with children and adolescents will involve increased attention to (a) the connection of research on the developmental needs of children and adolescents to practice models; (b) consideration of informed contextual and cultural adaptation in implementation; and (c) a rational model of evidence-based planning, using a dynamic, inclusive approach with high support for adaptation, flexibility, and implementation fidelity. We discuss future directions for translational research for researchers, practitioners, and administrators in the field to continue and transform these ideas and their illustrations.
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Affiliation(s)
- Tina Malti
- a Department of Psychology , University of Toronto
| | - Gil G Noam
- b Program in Education, Afterschool, and Resiliency , Harvard Medical School and McLean Hospital
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