Work and behavioural problems in children and adolescents

Socio-Cultural Discourses of Children Engaged in Child Labor in India: A Macro-Ethnographic Study

Background

Child labor is considered one of the main social problems that affect the community and has a physical and psychosocial impact on a child's health, growth, and development. The study aimed to describe the sociocultural discourses of children involved in child labor. A macroethnographic approach was used to collect the data from the selected community areas of Punjab, India.

Materials and Methods

A community-based qualitative study using purposive sampling was carried out among children engaged in child labor (n = 8). The data were gathered through in-depth or semi-structured interviews and non-participant observation under four phases: community context assessment, egocentric network analysis, validation, and dissemination of study findings. The guide for consolidated criteria for reporting qualitative research (COREQ) was followed. Ongoing analysis was conducted using Spradley's analysis approach to identify the themes.

Results

Thematic analysis resulted in the emergence of various themes related to child labor, namely, adaptability, money-centric attitude, sense of being underserved, social deprivation, work burden, reduced emotional expression, workaholism, abuse, family shoulder, family cohesion, and sense of industry. Apart from that, inhuman living and working conditions, as well as school deprivation among study subjects, were observed. Poverty emerged as the single most compelling factor for child labor in India.

Conclusion

The study concluded that child labor had a negative impact on children's overall development. An effective intervention to stop child labor is if vulnerable children are identified through primary healthcare, and a relationship of trust is built that allows for the provision of health care, education, support, and referral to additional services outside the health sector.

Hazardous Child Labour, Psychosocial Functioning, and School Dropouts among Children in Bangladesh: A Cross-Sectional Analysis of UNICEF's Multiple Indicator Cluster Surveys (MICS)

Child labour is a common financial coping strategy in poor households, especially in low-and middle-income countries with many children working under hazardous conditions. Little is known about the linkages between hazardous work conditions and psycho-social and educational outcomes. We analysed the Bangladesh Multiple Indicator Cluster Survey (BMICS) round 6 to assess the association between the exposure variables, including child labour, hazardous child labour (HZCL) and hazardous work, and outcome variables, including psychosocial functioning difficulty and school dropout, in children aged 5 to 17 years. We conducted bivariable and multivariable analyses to examine the association. In the adjusted analyses, children engaged in HZCL had increased odds of psychosocial functioning difficulty (aOR: 1.41; 95% CI: 1.16-1.72) and school dropout (aOR: 5.65; 95% CI: 4.83-6.61) among 5-14-year-olds compared to children who did not engage in child labour and hazardous work. Other independent factors associated with psychosocial functioning difficulty and school dropout included being male, living in a deprived neighbourhood, being exposed to violent punishment, the caregiver's attitude towards physical punishment, the mother's functional difficulty and lower maternal education. The linkages between hazardous work and psychosocial functioning difficulty appear more prominent among children not in school. Further, the evidence on the relationship between hazardous work and school dropout is stronger among children with psychosocial functioning difficulty. Policies and programmes that target the most hazardous forms of work are likely to have the greatest benefits for children's mental health, social well-being and educational attainment.

Use of routine health records to study mental health care of Brazilian children

ABSTRACT Objective To investigate the clinical epidemiological characteristics of a large data set of visits to outpatient children mental health services in Brazil, as well as to identify relevant relationships between age, sex and three common mental disorders in childhood: pervasive developmental disorders, ADHD, and mild depressive disorders. Methods We extracted data from the Ambulatorial Information System (SIA) part of a public repository, Datasus, regarding child outpatient mental health services in Brazil, from 2008 to 2012. We performed an analysis of the number of visits per one hundred thousand inhabitants and further analyses with logistic regressions for ADHD (F90.0), Pervasive Developmental Disorders (F84.0-F84.9), and Mild Depressive Episode (F32.0) as outcomes, controlling for age, year of the visit, number of new CAPSI stratified by region. Results Attention-deficit hyperactivity disorder (ADHD) was the most common condition identified across the country. The analyses by region showed a high number of visits due to mental retardation in the Northeast and depressive episodes in the South. Regressions showed that older children are less likely to visit outpatient services with a diagnosis of ADHD (F90.0). Conclusions Our analysis shows the conditions which cause the most burden to the child psychiatry outpatient centers in Brazil and relevant differences between regions. This information has immediate use for the training of staff and allocation of resources in each region.

Child Labor and Psychosocial Wellbeing: Findings from Ethiopia

For children who work, there has been little research into the intricate relationship between their home lives and their work lives and the implications that this relationship might hold for their psychosocial development and functioning. This cross-sectional study was conducted in the Amhara region, Ethiopia, between March and April 2020 on a sample of 1311 working children with the aim, in part, of exploring ways in which various dimensions of children’s psychological wellbeing are influenced by their working conditions and their family contexts. In addition to collecting data on some personal traits, family relationships, home environments, and detailed occupational characteristics, we gathered information on psychosocial wellbeing using 22 items from the Instrument for the Psychosocial Assessment of Working Children (IPAC). Exploratory factor analysis enabled us to identify five factors characterizing the dimensions of psychosocial wellbeing: work-related self-esteem, work-related stress, workplace supervision, emotional and somatic wellbeing, and self-determination. Linear regressions of these factors were then conducted on social, occupational, and environmental variables. We found that all dimensions of psychosocial wellbeing were significantly associated with the children’s working conditions. Of particular interest, work-related dimensions of wellbeing, such as stress, self-esteem, and supervision, were significantly associated with the characteristics of the home and family environment. These findings illustrate that work and working conditions must be considered jointly, along with family life and home environments, as factors in both environments affect working children’s socioemotional development and wellbeing. They also strengthen the call for a systemic approach to protecting children involved in child labor, in which families are central to all discussions.

Child Domestic Work, Violence, and Health Outcomes: A Rapid Systematic Review

This rapid systematic review describes violence and health outcomes among child domestic workers (CDWs) taken from 17 studies conducted in low- and middle-income countries. Our analysis estimated the median reported rates of violence in CDWs aged 5-17-year-olds to be 56.2% (emotional; range: 13-92%), 18.9% (physical; range: 1.7-71.4%), and 2.2% (sexual; range: 0-62%). Both boys and girls reported emotional abuse and sexual violence with emotional abuse being the most common. In Ethiopia and India, violence was associated with severe physical injuries and sexual insecurity among a third to half of CDWs. CDWs in India and Togo reported lower levels of psycho-social well-being than controls. In India, physical punishment was correlated with poor psycho-social well-being of CDWs [OR: 3.6; 95% CI: 3.2-4; p < 0.0001]. Across the studies, between 7% and 68% of CDWs reported work-related illness and injuries, and one third to half had received no medical treatment. On average, children worked between 9 and 15 h per day with no rest days. Findings highlight that many CDWs are exposed to abuse and other health hazards but that conditions vary substantially by context. Because of the often-hidden nature of child domestic work, future initiatives will need to be specifically designed to reach children in private households. Young workers will also benefit from strategies to change social norms around the value and vulnerability of children in domestic work and the long-term implications of harm during childhood.

Evaluations of Interventions with Child Domestic Workers: A Rapid Systematic Review

Little is known about interventions to support the education, skills training, and health of female child domestic workers (CDWs). This rapid systematic literature review followed PRISMA guidelines (PROSPERO registration: CRD42019148702) and summarises peer-reviewed and grey literature on health, education, and economic interventions for CDWs and interventions targeting employers. We searched six electronic databases and purposively searched grey literature. We included observational studies, which included an intervention, quasi-experimental, and experimental studies. Two reviewers independently screened articles. Data were extracted on intervention description, inputs, activities, type of evaluation, outcomes, effect size or impact where applicable, limitations, and ethical considerations. All studies were quality appraised. We identified eight papers from five studies. Six papers reported on health-related outcomes, two on education-related outcomes, and three on economic outcomes. No evaluations of employer-related interventions were identified. Only one intervention specifically targeted CDWs. Others included CDWs in their sample but did not disaggregate data for CDWs. Findings suggest that the evaluated interventions had a limited impact on CDW’s health, education, and economic outcomes. While it appears feasible to reach CDWs with outreach interventions, further work is needed to improve the consistency of their effectiveness and their ability to improve CDWs’ current and future prospects.

Study of Cardiovascular Risks in Adolescents (ERICA): factors associated with work in adolescence

This study aimed to verify the association between work and sociodemographic factors, health behaviors, and cardiovascular risk in Brazilian adolescents. Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were analyzed, with a sample of 37,815 adolescents aged 12-17 years and morning shift students. Considering complex sampling, crude and adjusted Prevalence Ratios (PR) were calculated with interval estimates for variables by Poisson multiple regression model with robust variance estimate. The sociodemographic factors associated with work among Brazilian adolescents were male gender (PR 1.34), aged 15-17 years, with maternal schooling up to elementary school (PR 1.26), public school students (PR 1.63), and from the rural area (PR 1.90). Regarding lifestyle habits and social behavior, the association was significant in physically active (PR 1.19) and alcohol-consuming students (PR 1.35). In conclusion, work among Brazilian adolescent morning shift students is still strongly linked to social issues. Work was associated with alcohol consumption, and there was no association with metabolic markers.

Prevalence of mental health problems in preschoolers and the impact of maternal depression

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.

Child labor, sex and mental health outcomes amongst adolescent refugees

INTRODUCTION

Refugee adolescents living in camps and settlements in low and middle-income countries are a vulnerable population who face protection and psychosocial risks. This study explores prevalence of child labor amongst adolescent refugees from South Sudan in two refugee settlements in Uganda, to understand impacts of child labor on mental health outcomes, and examines the influence of sex on these impacts.

METHODS

Surveys were conducted in Adjumani and Kiryandongo refugee settlements, Uganda, with 470 adolescents between 13 and 17 interviewed between December 2014-February 2015. Univariate finite mixture modeling identified a two-cluster model of child labor. Logistic regression models assessed the association of child labor and mental health.

RESULTS

A two-cluster solution for child labor activity was determined among the 332 adolescents who self-reported engaging in any child labor (Significant child labor: n = 174, 37%; moderate child labor cluster: n = 158, 34%; no child labor cluster: n = 138, 29%. Odds of depression amongst adolescents exposed to significant vs. no child labor was 4.15 (95% CI: 2.01-8.56), in a model examining interaction of sex and child labor and controlling for socio-demographic variables. For the anxiety outcome, girls exposed to significant vs. no child labor are less likely to report higher levels of anxiety (OR: 0.29, 95% CI: 0.09-0.90).

CONCLUSIONS

Adolescents living in refugee settlements in Uganda report high levels of participation in child labor. Protection of adolescents from the risks involved with child labor in refugee contexts is an important and often over-looked area of child protection in humanitarian settings.

Household Food Insecurity and Mental Health Among Teenage Girls Living in Urban Slums in Varanasi, India: A Cross-Sectional Study

This study was undertaken to investigate the relation between household food insecurity and mental health problems in teenage girls living in urban slums. This community-based cross-sectional study was conducted in 5 urban slums in Varanasi, India, between September 2016 and July 2017. A probability proportion to size (PPS) method was employed to select 5 of 210 urban slums at a first stage, and in the second stage, 418 teenage girls were chosen randomly from selected households. The Household Food Insecurity Access Scale (HFIAS) and mental health inventory tools were employed to assess food insecurity and mental health status. Multivariable logistic regression analysis with at a 95% confidence interval (CI) was used to assess the association between household food insecurity and mental health status. Of 418 respondents, 47.6% were food insecure; 64.1%, 57.7%, and 58.4% had high levels of anxiety, depression, or psychological distress, respectively; and 57.2% exhibited a medium level of loss of behavioral control. Furthermore, teenage girls from food insecure households were more likely to have high levels of anxiety, depression, loss of behavioral control and psychological distress than those living in food secure households. This study shows food insecurity is independently associated with mental health problems among teenage girls. Food insecurity in Indian slums should be addressed by specific public health intervention programs that provide access to sufficient safe, nutritious food.

The Magnitude and Determinants of Emotional-Behavioral Problems in Working Adolescents in Turkey

OBJECTIVE

Working adolescents are at a greater risk of mental disorders than are non-working adolescents. The present study was aimed at determining the magnitude and determinants of emotional and behavioral problems in working adolescents.

METHODS

This cross-sectional study was conducted with 343 adolescents attending two vocational training centers in the province of Balikesir between January 2016 and March 2016. The data were collected with the Personal Information Form, and the Strengths and Difficulties Questionnaire. In the analysis, descriptive statistics, the t-test, Mann Whitney U test and one way ANOVA were used.

RESULTS

In the study of the adolescents, 16.9% were determined to have abnormal emotional and behavioral problems. Of the participating adolescents, girls, those with physical illnesses, living in fragmented families, perceiving their economic status as good, having fathers with primary school education and/or having mothers with high school or higher education had significantly higher emotional and behavioral problem scores (p<0.05).

CONCLUSION

In this study, approximately one-fifth working Turkish adolescents had abnormal mental status. Based on the aforementioned results, it can be suggested to develop intervention programs for the prevention, early diagnosis and treatment of emotional and behavioral problems in working adolescents.

Depression and Behavioral Problems Among Adolescent Girls and Young Women Employees of the Textile Industry in India

Stress and depression are common in textile industry employees due to inadequate working conditions and challenging socioeconomic conditions. The objective of the study was to assess depression and mental health among adolescent and young females currently employed in a textile factory located in Tamil Nadu compared with past employees and women who have never been employed. This cross-sectional study included a total of 107 participants in each study group who were interviewed. The Patient Health Questionnaire-9 and Strengths and Difficulties Questionnaire were administered to screen participants for depression and mental health. More current employees (16.82%) and past employees (15.88%) suffered from depression severe enough to require treatment compared with never employed girls and young women (2.8%). Of the study participants, 59.8% of current employees, 63.6% of past employees, and 32.7% of never employed women had mental health or behavior problems. In the regression model, history of abuse was significantly associated with depression. Participants who were current employees and reported family debt and a history of abuse were significantly more likely to have mental health or behavior problems. Mental health issues such as depression and behavior problems were more likely among adolescent girls currently employed in textile industries. Further studies into the causes of this phenomenon are needed.

Child labour in low- and middle-income countries and its consequences for mental health: a systematic literature review of epidemiologic studies

In low- and middle-income countries, large numbers of children are involved in work. Whilst studies have shown that child labour may be harmful to children's physical health, little is known about child labour's effects on mental health. It is important to understand the relationship between work and mental health problems during childhood, and identify possible risk factors for poorer mental health. A systematic literature review was conducted. Published papers in any language that compared the mental health of children (<18 years) who had been exposed to work with those who had not been exposed to work were included. Twelve published observational studies on the association between child labour and general psychopathology, internalising and externalising problems were identified. Child labour was found to be strongly associated with poor mental health outcomes in seven studies. More significant associations were found between child labour and internalising problems than externalising problems. The burden of poor mental health as a result of child labour is significant given the numbers of children in work. Risk factors for poorer mental health were involvement in domestic labour, younger age, and greater intensity of work, which could be due to the potential of child labour to cause isolation, low self-esteem, and perception of an external locus of control. The risk factors suggested by this review will have implications for policy makers. Additional research is needed in low-income countries, risk factors and also into the potential psychological benefits of low levels of work.

[Demographic, socioeconomic, and health profile of working and non-working Brazilian children and adolescents: an analysis of inequalities]

The objectives of this study were to describe the work done by Brazilian children and adolescents and compare the socioeconomic and health profile of those that worked (or were looking for work) versus non-working youngsters. Based on the 2008 Brazilian National Sample Household Survey (PNAD/2008), we selected children and adolescents 5 to 17 years of age, divided into two analytical categories: "workers" (working or looking for employment) and "non-workers". We calculated prevalence rates for the characteristics of their main work, as well as socioeconomic and health variables comparing the two categories. Poisson regression was used to estimate prevalence ratios, adjusted by health characteristics, with "non-workers" as the reference category. Compared to "non-workers", the "workers" category was associated with a higher proportion of boys; age 14 to 17 years; black or brown skin color; lower school attendance; and worse housing conditions. Child labor was associated with worse self-rated health; chronic backache; arthritis or rheumatism; and depression. Effective policies to support families need to be strengthened to effectively fight child labor.

Associação do trabalho infantil com transtornos de comportamento do tipo introversão e extroversão: um estudo transversal no Sul do Brasil

Resumo Objetivo avaliar a associação entre trabalho infantil e transtornos de comportamento do tipo introversão e extroversão. Métodos estudo transversal com entrevistas domiciliares e aplicação do Child Behavior Check List em 1.608 jovens de 10 a 13 anos e 1.530 jovens de 14 a 17 anos da área urbana de Pelotas, Sul do Brasil. Resultados a prevalência do trabalho foi de 7,3% entre os mais jovens e de 20,7% entre os de mais idade, e a de transtornos de comportamento, de introversão, 25%, e de extroversão, 22%, sem diferença por idade. Análise multivariada (Poisson), estratificada por idade, mostrou associação entre extroversão e trabalho, com prevalência maior entre os mais novos e menor entre os mais velhos. Extroversão associou-se diretamente, nos mais novos, com serviços domésticos e construção civil, e inversamente, nos mais velhos, com serviços não domésticos. Não houve associação com introversão em nenhuma das faixas de idade. Para os mais velhos, o trabalho foi protetor para extroversão, em particular nos serviços não domésticos, porém há possibilidade de causalidade reversa. Discussão o prejuízo ao comportamento na faixa de 10 a 13 anos indica a necessidade de erradicação do trabalho infantil, com atenção especial ao serviço doméstico e à construção civil; o trabalho de adolescentes mais velhos em serviços não domésticos pode trazer benefícios ao comportamento.

Fatores de proteção associados a problemas emocionais e comportamentais em escolares

O estudo teve como objetivo verificar associações entre fatores de risco e proteção e problemas emocionais/ comportamentais em escolares. A amostra foi composta por 181 alunos do 2º a 5º anos (6 a 12 anos de idade) e seus respectivos cuidadores. Os instrumentos de coleta de dados foram o Inventário de Comportamentos para Crianças e Adolescentes de 6 a 18 anos, um questionário de avaliação socioeconômico familiar, de médias finais de Matermática e Português fornecidas pela escola. Foram investigados problemas emocionais/comportamentais e competências sociais com base no inventário, no desempenho acadêmico e na classificação socioeconômica familiar. Foi conduzida uma análise de regressão logística para gerar um modelo que buscasse associações entre o desfecho (problemas emocionais e comportamentais) e idade, sexo, classificação socioeconômica familiar, desempenho acadêmico e indicadores de socialização. Os resultados indicaram associações entre melhor desempenho acadêmico e indicadores positivos de socialização, com menor probabilidade de as crianças apresentarem problemas emocionais/comportamentais.

Labor in early life, vulnerability for health in Brazilian schoolchildren: National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE

This study describes exposure labor among Brazilian 9th grade students from public and private schools and investigates socio-demographic characteristics, behaviors, violent situations and psychosocial factors associated with labor among adolescents.

METHODS

The present study included 108,984 students from the National Adolescent School-based Health Survey carried out in 2012. Variables were grouped into sociodemographic characteristics, behavioral factors, violent situations and psychosocial aspects. Associations between labor and several health risk variables were identified by multiple logistic regression analysis, after adjustment for sex and age.

RESULTS

Approximately 13% of the students reported having a job: 17.4% of them were male. The chance of working was lower between females and individuals whose fathers' have incomplete superior education. Students who worked had greater chances to smoke (OR = 2.26; 95%CI 2.04 - 2.51), drink alcohol, use illicit drugs (OR = 2.63; 95%CI 2.29 - 3.02), drive motorized vehicles (OR = 2.15; 95%CI 2.03 2.27), have sexual intercourse (OR = 2.10; 95%CI 1.99 - 2.24), suffer physical violence (OR = 1.57; 95%CI 1.46 1.68), engage in fights (OR = 1.65; 95%CI 1.55 - 1.76), feel lonely (OR = 1.26; 95%CI 1.17 - 1.36) and report sleeping problems (OR = 1.46; 95%CI 1.34 - 1.60). They also have lower chances of having close friends (OR = 0.78; 95%CI 0.68 - 0.90).

CONCLUSION

The prevalence of labor among students is high. Socioeconomical disadvantages increase the chances of early working. Early working is also associated to health damaging behavior, violent situations, sleeping problems, and social isolation. Adolescents who study and work experiment expositions that may affect distinct health dimensions and perpetuate disadvantages over lifetime.

Risk factors associated with mental health issues in adolescents: a integrative review

Objective: To identify the risk factors associated with mental health issues in adolescents. Method: An integrative review was conducted in four databases with publications from 2007 to 2013. The terms Adolescent and Mental Health were used to search adequate articles as DeCs/MeSH bases. Results: Publications were found in different journals in different fields of knowledge and the quantitative research was the most frequent. The mental health issues were categorized as individual factors; drug related factors, school factors, family factors, social factors and STDs/Aids related factors. The most addressed category was individual factors, with 23 publications. Conclusion: The integrative review allowed to point important questions to be addressed in preventive actions by the health professional, including the nurse, to create a space that works with risk conditioning factors in adolescents for mental health aggravation.


Lifetime paid work and mental health problems among poor urban 9-to-13-year-old children in Brazil

Objective. To verify if emotional/behavioral problems are associated with lifetime paid work in poor urban children, when taking into account other potential correlates. Methods. Cross-sectional study focused on 9-to-13-year-old children (n = 212). In a probabilistic sample of clusters of eligible households (women 15–49 years and son/daughter <18 years), one mother-child pair was randomly selected per household (n = 813; response rate = 82.4%). CBCL/6-18 identified child emotional/behavioral problems. Potential correlates include child gender and age, socioeconomic status/SES, maternal education, parental working status, and family social isolation, among others. Multivariate analysis examined the relationship between emotional/behavioral problems and lifetime paid work in the presence of significant correlates. Findings. All work activities were non-harmful (e.g., selling fruits, helping parents at their small business, and baby sitting). Children with lower SES and socially isolated were more involved in paid work than less disadvantaged peers. Children ever exposed to paid work were four times more likely to present anxiety/depression symptoms at a clinical level compared to non-exposed children. Multivariate modeling identified three independent correlates: child pure internalizing problems, social isolation, and low SES. Conclusion. There is an association between lifetime exposure to exclusively non-harmful paid work activities and pure internalizing problems even when considering SES variability and family social isolation.

Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study

BACKGROUND

Longitudinal epidemiological studies involving child/adolescent mental health problems are scarce in developing countries, particularly in regions characterized by adverse living conditions. We examined the influence of psychosocial factors on the trajectory of child/adolescent mental health problems (CAMHP) over time.

METHODS

A population-based sample of 6- to 13-year-olds with CAMHP was followed-up from 2002-2003 (Time 1/T1) to 2007-2008 (Time 2/T2), with 86 out of 124 eligible children/adolescents at T1 being reassessed at T2 (sample loss: 30.6%).

OUTCOME

CAMHP at T2 according to the Child Behavior Checklist/CBCL's total problem scale. Psychosocial factors: T1 variables (child/adolescent's age, family socioeconomic status); trajectory of variables from T1 to T2 (child/adolescent exposure to severe physical punishment, mother exposure to severe physical marital violence, maternal anxiety/depression); and T2 variables (maternal education, child/adolescent's social support and pro-social activities).

RESULTS

Multivariate analysis identified two risk factors for child/adolescent MHP at T2: aggravation of child/adolescent physical punishment and aggravation of maternal anxiety/depression.

CONCLUSIONS

The current study shows the importance of considering child/adolescent physical punishment and maternal anxiety/depression in intervention models and mental health care policies.

Concepções de saúde e doença mental na perspectiva de jovens brasileiros

O estudo investiga a perspectiva de adolescentes e jovens acerca de suas concepções de saúde e doença mental. Compreende-se que o processo de construção da saúde-doença é influenciado pela perspectiva individual, familiar e sociocultural. Participaram do estudo 1163 jovens de ambos os sexos, com idade média de 15,84 anos. Utilizou-se como instrumento um questionário autoaplicável, formulado em estudo anterior com jovens suíços de língua portuguesa. Investigaram-se as concepções de saúde e doença mental, dentre outros aspectos do tema. Nos resultados, observaram-se aspectos da visão holística e do modelo tradicional de saúde mental. A doença mental foi caracterizada como uma desordem emocional, revelando a influência das experiências internas e relacionais na concepção de adoecimento mental. Diferenças de nível socioeconômico foram observadas nas concepções de saúde e doença mental.

Youth employment, income, and smoking initiation: results from Korean panel data

PURPOSE

To estimate the effect of youth employment and income on smoking initiation, this study tests whether youth with higher incomes from either employment or allowance are more likely to smoke, and, if so, whether it is the employment effect or the income effect that affects youth smoking initiation.

METHODS

Data from the 2003-2007 Korea Youth Panel Study were used to estimate the effect of youth employment and income on smoking initiation. A fixed-effects linear probability model was estimated to control for unobserved individual heterogeneity, which may affect both youth employment/income and smoking initiation.

RESULTS

Even after controlling for unobserved individual heterogeneity, youth employment raised the probability of smoking initiation by 4.4% points, but neither employment income nor allowance was significantly associated with youth smoking initiation.

CONCLUSIONS

Youth employment is an important risk factor for smoking initiation in South Korea, suggesting that workplaces that hire youth may be an appropriate target for antismoking interventions.

Child work and labour among orphaned and abandoned children in five low and middle income countries

BACKGROUND

The care and protection of the estimated 143,000,000 orphaned and abandoned children (OAC) worldwide is of great importance to global policy makers and child service providers in low and middle income countries (LMICs), yet little is known about rates of child labour among OAC, what child and caregiver characteristics predict child engagement in work and labour, or when such work infers with schooling. This study examines rates and correlates of child labour among OAC and associations of child labour with schooling in a cohort of OAC in 5 LMICs.

METHODS

The Positive Outcomes for Orphans (POFO) study employed a two-stage random sampling survey methodology to identify 1480 single and double orphans and children abandoned by both parents ages 6-12 living in family settings in five LMICs: Cambodia, Ethiopia, India, Kenya, and Tanzania. Regression models examined child and caregiver associations with: any work versus no work; and with working <21, 21-27, and 28+ hours during the past week, and child labour (UNICEF definition).

RESULTS

The majority of OAC (60.7%) engaged in work during the past week, and of those who worked, 17.8% (10.5% of the total sample) worked 28 or more hours. More than one-fifth (21.9%; 13% of the total sample) met UNICEF's child labour definition. Female OAC and those in good health had increased odds of working. OAC living in rural areas, lower household wealth and caregivers not earning an income were associated with increased child labour. Child labour, but not working fewer than 28 hours per week, was associated with decreased school attendance.

CONCLUSIONS

One in seven OAC in this study were reported to be engaged in child labour. Policy makers and social service providers need to pay close attention to the demands being placed on female OAC, particularly in rural areas and poor households with limited income sources. Programs to promote OAC school attendance may need to focus on the needs of families as well as the OAC.

Problemas de saúde mental na adolescência: características familiares, eventos traumáticos e violência

A ocorrência de situações traumáticas, exposição à violência e características das relações parentais são fatores de risco para saúde mental. Este estudo procurou identificar as situações individuais, familiares e contextuais associadas às manifestações de problemas de saúde mental em adolescentes estudantes da região metropolitana de Porto Alegre, RS. Os instrumentos utilizados foram o Inventário de Eventos Estressores na Adolescência, Triagem da Exposição de Crianças à Violência na Comunidade, Inventário de Estilos Parentais e o Child Behavior Checklist- versão YRF. Participaram 245 adolescentes, sendo 114 (46,5%) do sexo masculino com idade média de 16,02 anos (DP=1,83). A análise dos dados realizou-se através de estatística descritiva e inferencial para estimar os determinantes do diagnóstico clínico. Situações de violência, práticas parentais negativas e eventos traumáticos associaram-se ao diagnóstico clínico. Aponta-se a necessidade de implantação de ações preventivas e de atenção em saúde mental na infância e adolescência.

Fatores de risco para problemas de saúde mental na infância/adolescência

Estudo de corte transversal conduzido em comunidade urbana de baixa renda do município de Embu-SP com objetivo de identificar fatores associados a problemas de saúde mental em crianças/adolescentes (PSMCA) em amostra probabilística (N=67, faixa etária 4-17 anos). Foram aplicados instrumentos estruturados às mães: Child Behavior Checklist (PSMCA); WorldSAFE Core Questionnaire (dados sociodemográficos; violência doméstica; embriaguez do pai/padrasto); Self-Report Questionnaire (problemas de saúde mental maternos, ideação suicida materna). Os resultados do estudo apontaram fatores estatisticamente associados aos PSMCA: criança/adolescente ser do sexo masculino e sofrer punição física grave; ideação suicida da mãe e violência conjugal física grave contra a mãe; embriaguez do pai/padrasto. Concluindo, grupos vulneráveis com características individuais/familiares identificadas neste estudo devem ser considerados prioritários em propostas de prevenção/tratamento.

Situação de crianças e adolescentes brasileiros em relação à saúde mental e à violência

Este artigo reflete sobre as violências cometidas contra crianças e adolescentes brasileiros e suas repercussões sobre a saúde mental, propondo um debate sobre a necessidade das políticas públicas de saúde priorizarem temáticas de tamanha relevância. No país, tem-se verificado que a discussão dos temas "violência e problemas de saúde mental em crianças e adolescentes" vem ocorrendo de forma fragmentada e pouco consistente. Este trabalho traz uma seleção não sistemática de estudos epidemiológicos desenvolvidos em escolas e comunidades brasileiras sobre o assunto. A ampla variedade e a prevalência da violência familiar e comunitária e dos problemas de saúde mental são apontadas, ressaltando-se as diferenças metodológicas dos métodos de aferição e a concentração de estudos nas regiões sul e sudeste do país. A ainda escassa rede de atendimento para os problemas aqui tratados é sinalizada, assim como a falta de preocupação com a prevenção do transtorno mental e com a promoção da saúde mental.

Mental health and quality of life in pre- and early adolescents: a school-based study in two contrasting urban areas

OBJECTIVE

To estimate the prevalence of mental health problems and to assess the quality of life in pre- and early adolescents living in two contrasting urban areas in Brazil, as well as to identify the impact of demographic factors on mental health, quality of life and school performance.

METHOD

Using school samples, the Strength and Difficulties Questionnaire and the Quality of Life Inventory were administered to 424 (52%) boys and 387 (48%) girls (mean age 12.6+/-1.3 years) in better-off central and poorer outer-city areas.

RESULTS

In the total sample, the prevalence of probable psychiatric cases was 10.1% (n=77). There were no significant differences in the overall prevalence of behavior problems or global quality of life between central and outer-city areas. However, boys from the outer-city had a higher prevalence of conduct problems (12% vs. 6.2%, p=0.04), although girls did not differ significantly on any measure. In general, factors associated with poorer mental health were: having no religion, divorced parents, and being male.

CONCLUSIONS

Living in the poorer outer-city was not associated with worse mental health or quality of life in this sample. This is in contrast with the findings of some other studies, and possible protective factors such as female gender and religion are discussed.