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Chambers CT, Dol J, Tutelman PR, Langley CL, Parker JA, Cormier BT, Macfarlane GJ, Jones GT, Chapman D, Proudfoot N, Grant A, Marianayagam J. The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis. Pain 2024; 165:2215-2234. [PMID: 38743558 PMCID: PMC11404345 DOI: 10.1097/j.pain.0000000000003267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
ABSTRACT Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and other) in children and adolescents. EMBASE, PubMed, CINAHL, and PsycINFO were searched for publications between January 1, 2009, and June 30, 2023. Studies reporting population-based estimates of chronic nondisease related pain prevalence in children or adolescents (age ≤ 19 years) were included. Two independent reviewers screened articles based on a priori protocol. One hundred nineteen studies with a total of 1,043,878 children (52.0% female, mean age 13.4 years [SD 2.4]) were included. Seventy different countries were represented, with the highest number of data points of prevalence estimates coming from Finland and Germany (n = 19 each, 4.3%). The overall prevalence of chronic pain in children and adolescents was 20.8%, with the highest prevalence for headache and musculoskeletal pain (25.7%). Overall, and for all types of pain except for back pain and musculoskeletal pain, there were significant differences in the prevalence between boys and girls, with girls having a higher prevalence of pain. There was high heterogeneity (I 2 99.9%). Overall risk of bias was low to moderate. In summary, approximately 1 in 5 children and adolescents experience chronic pain and prevalence varies by pain type; for most types, there is higher pain prevalence among girls than among boys. Findings echo and expand upon the systematic review conducted in 2011.
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Affiliation(s)
- Christine T Chambers
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Justine Dol
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
| | - Perri R Tutelman
- Centre for Pediatric Pain Research, IWK Health, Halifax, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | | | | | | | - Gary J Macfarlane
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom
| | - Gareth T Jones
- Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, United Kingdom
| | | | | | - Amy Grant
- Maritime SPOR Support Unit, Halifax, Canada
| | - Justina Marianayagam
- Patient Partner and Resident Physician, Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Fechner R, Verhagen A, Alcock M, Norton J, Stubbs PW, Harrison LE, Pate JW. The Effectiveness of Pain Science Education on Caregiver and Children's Knowledge, Beliefs, Attitudes, and Behaviors-A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2024; 25:104578. [PMID: 38796130 DOI: 10.1016/j.jpain.2024.104578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/01/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
Pain science education (PSE) can be used as part of treatment and prevention for chronic pain in children. We assessed the effectiveness of PSE on knowledge, beliefs, attitudes, and behaviors in children and the people that care for children. We set a minimum criterion for education to address pain biology knowledge. We included studies aimed at both treatment and prevention of chronic pain. We conducted searches using 5 databases. We assessed the risk of bias using the Cochrane Risk of Bias 2 tool. Data were pooled using a random-effects meta-analysis or assessed using a narrative synthesis. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation. We screened 14,505 records and included 7 studies involving 351 caregivers and 1,285 children. Four studies were included in meta-analyses. We found low-certainty evidence that PSE has a large beneficial effect on caregiver knowledge and beliefs compared with alternative education (standardized mean difference = 1.14 [95% confidence interval: .88-1.42]; I2 = 0%). We found no difference in functional disability in children with chronic pain after PSE (Functional Disability Inventory score mean difference = .73 [95% confidence interval: -.81 to 2.27; I = 0%]). Narrative syntheses showed low-certainty evidence for improved knowledge and beliefs in children with preventative and treatment effects. Overall, we found few studies, and along with high risk of bias, this significantly contributed to the low certainty of findings. The effect of learning pain science for both preventative and treatment effects in children, carers, and the child/carer dyad remains mostly unknown. This review was prospectively registered with The international Prospective register of systematic reviews (CRD42022344382) on July 22, 2022. PERSPECTIVE: This review examines the effect of PSE on pain-related knowledge, beliefs, attitudes, and behaviors in children and the people that care for children (0-18). The findings contribute to knowledge about pain treatments and health promotion for caregivers and their children with and without chronic pain.
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Affiliation(s)
- Rebecca Fechner
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; QIPPPS Queensland Interdisciplinary Paediatric Persistent Pain Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia.
| | - Arianne Verhagen
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mark Alcock
- QIPPPS Queensland Interdisciplinary Paediatric Persistent Pain Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Jennifer Norton
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Peter W Stubbs
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lauren E Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Joshua W Pate
- Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Brady K, Cleary R, O'Gorman E, McDonough S, Kerr C, Kiernan D, McConkey E, Ryan J, Malone A. Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study. Dev Med Child Neurol 2024. [PMID: 38815177 DOI: 10.1111/dmcn.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
AIM To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity. METHOD We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions. Free-text responses were then analysed thematically, creating items categorized according to the family of participation-related constructs (fPRC). In round 2, participants rated the perceived importance of these items using a 5-point Likert scale. The top 10 priorities were constructed from the highest-ranked items. RESULTS One hundred and sixteen participants (mean age = 14 years 7 months, range = 13-17 years; 66 males; 58 with cerebral palsy; 43 wheelchair users) completed round 1; 108 items were included in round 2. Fifty-eight items were rated as either 'important' or 'really important' by 70% of participants. The top 10 priorities were rated as important or really important by 82% to 94% of participants with a mean Likert score of 4.40 (range = 4.25-4.63). Seven of the top 10 priorities were related to the environmental context of the fPRC. The other three were related to involvement and the related concept of preference. INTERPRETATION The priorities identified will help inform future physical activity interventions for adolescents with a physical disability.
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Affiliation(s)
- Karen Brady
- Central Remedial Clinic, Dublin, Ireland
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ronan Cleary
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Suzanne McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Jennifer Ryan
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ailish Malone
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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Bedard C, King-Dowling S, Timmons BW, Ferro MA. A Matched-Pair Analysis of Gross Motor Skills of 3- to 5-Year-Old Children With and Without a Chronic Physical Illness. Pediatr Exerc Sci 2024:1-6. [PMID: 38364814 DOI: 10.1123/pes.2023-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/05/2023] [Accepted: 12/12/2023] [Indexed: 02/18/2024]
Abstract
PURPOSE The purpose of this study was to compare the gross motor skills of children with a chronic physical illness with those of their healthy peers. METHODS Data for children with a chronic physical illness come from the Multimorbidity in Children and Youth Across the Life Course study, and data from children without a physical illness come from the Health Outcomes and Physical Activity in Preschoolers study. Multimorbidity in Children and Youth Across the Life Course and Health Outcomes and Physical Activity in Preschoolers included children ages 3-5 years and administered the Peabody Development Motor Scales-second edition. Participants were sex and age matched (20 male and 15 female pairs; Mage = 54.03 [9.5] mo). RESULTS Gross motor skills scores were "below average" for 47% of children with a physical illness compared with 9% of children without a physical illness (P = .003). Matched-paired t tests detected significant differences in total gross motor scores (dz = -0.35), locomotor (dz = -0.31), and object control (dz = -0.39) scores, with healthy children exhibiting better motor skills, and no significant difference in stationary scores (dz = -0.19). CONCLUSIONS This skill gap may increase burden on children with physical illness and future research should assess gross motor skills longitudinally to establish whether the gap widens with age.
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Affiliation(s)
- Chloe Bedard
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
| | - Sara King-Dowling
- Department of Oncology, The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA,USA
| | - Brian W Timmons
- Department of Pediatrics, McMaster University, Hamilton, ON,Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
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Goodfellow C, Willis M, Inchley J, Kharicha K, Leyland AH, Qualter P, Simpson S, Long E. Mental health and loneliness in Scottish schools: A multilevel analysis of data from the health behaviour in school-aged children study. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:608-625. [PMID: 36683467 PMCID: PMC10952245 DOI: 10.1111/bjep.12581] [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: 02/09/2022] [Accepted: 12/26/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood. AIMS Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health. SAMPLE Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286). METHODS Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation. RESULTS Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores. CONCLUSIONS The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.
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Affiliation(s)
- Claire Goodfellow
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Kalpa Kharicha
- Campaign to End Loneliness part of What Works Centre for WellbeingLondonUK
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Pamela Qualter
- Manchester Institute of EducationUniversity of ManchesterManchesterUK
| | - Sharon Simpson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Emily Long
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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Al Omari O, Al Sabei S, Al Rawajfah O, Abu Sharour L, Al-Hashmi I, Al Qadire M, Khalaf A. Prevalence and Predictors of Loneliness Among Youth During the Time of COVID-19: A Multinational Study. J Am Psychiatr Nurses Assoc 2023; 29:204-214. [PMID: 34047225 PMCID: PMC10189531 DOI: 10.1177/10783903211017640] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Given the restrictions associated with COVID-19, feelings of loneliness among youth may increase. AIMS The aims of the current study were to assess the prevalence of loneliness among young people at the time of COVID-19 and to identify whether selected variables related to the pandemic predicted the level of loneliness. METHOD A cross-sectional study using WhatsApp and Facebook social media platforms was conducted to survey 1,057 young people aged 15 to 24 years from six Middle Eastern countries. Participants completed survey items including demographic and COVID-19-related questions; the Depression, Anxiety and Stress Scale (DASS); the Satisfaction With Life Scale (SWLS); and the UCLA Loneliness Scale. RESULTS The prevalence of experienced loneliness was 1 (0.1%), 625 (59.1%), 429 (40.6%), and 2 (0.2%), reflecting low, moderate, moderately high, and high experiences for loneliness, respectively. History of depression or anxiety, being dissatisfied with life, and having depression at the time of COVID-19 were significant predictors of loneliness among youth. The model was significant (F = 44.95, p < .05) and accounted for 29.8% of the variance in UCLA Loneliness Scale scores. CONCLUSIONS We found that the high prevalence rate of loneliness during the COVID-19 pandemic was correlated with depression and impaired life satisfaction among Middle Eastern youth. Thus, special attention and interventional action plans need to be developed taking into consideration the youths' special situation during COVID-19.
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Affiliation(s)
- Omar Al Omari
- Omar Al Omari, PhD, Sultan Qaboos
University, Muscat, Oman; Curtin University, Perth, Western Australia,
Australia
| | | | - Omar Al Rawajfah
- Omar Al Rawajfah, PhD, Sultan Qaboos
University, Muscat, Oman; Al al-Bayt University, Mafraq, Jordan
| | - Loai Abu Sharour
- Loai Abu Sharour, PhD, ALZaytoonah
University of Jordan, Amman, Jordan
| | - Iman Al-Hashmi
- Iman Al-Hashmi, PhD, Sultan Qaboos
University, Muscat, Oman
| | - Mohammad Al Qadire
- Mohammad Al Qadire, PhD, Sultan Qaboos
University, Muscat, Oman; Al al-Bayt University, Mafraq, Jordan
| | - Atika Khalaf
- Atika Khalaf, PhD, Sultan Qaboos
University, Muscat, Oman; Kristianstad University, Kristianstad, Sweden
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Marquez J, Goodfellow C, Hardoon D, Inchley J, Leyland AH, Qualter P, Simpson SA, Long E. Loneliness in young people: a multilevel exploration of social ecological influences and geographic variation. J Public Health (Oxf) 2023; 45:109-117. [PMID: 34999845 PMCID: PMC10017088 DOI: 10.1093/pubmed/fdab402] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 11/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness is a growing public health concern, yet little is known about loneliness in young people. The current study aimed to identify social ecological factors related to loneliness and examine the extent to which geographic region may account for differences in loneliness. METHODS The data come from a cross-sectional sample of 6503 young people living in the UK. Loneliness was measured using the UCLA 3-item scale. Bivariate analyses were used to test associations between each predictor and loneliness. Multilevel models were used to identify key social ecological factors related to loneliness, and the extent to which loneliness may vary across geographic regions (local authority districts). RESULTS Sociodemographic, social, health and well-being, and community factors were found to be associated with loneliness. Geographic region was associated with 5-8% of the variation in loneliness. The effect of gender, sexual orientation and minority ethnic background on loneliness differed across regions. CONCLUSIONS This is the first study to highlight modifiable social and community factors related to youth loneliness, and individual vulnerabilities, such as poor mental well-being. Results related to geographic differences suggest that local-level initiatives may be most appropriate in tackling loneliness, rather than wider, less contextualized national efforts.
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Affiliation(s)
- J Marquez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - C Goodfellow
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - D Hardoon
- What Works Centre for Wellbeing, London SW1H 9EA, UK
| | - J Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - A H Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - P Qualter
- University of Manchester, Manchester Institute of Education, Manchester M13 9PL, UK
| | - S A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
| | - E Long
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G3 7HR UK
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Brown KL, Fairclough D, Noll RB, Barrera M, Kupst MJ, Gartstein MA, Egan AM, Bates CR, Gerhardt CA, Vannatta K. Emotional Well-Being of Pediatric Brain Tumor Survivors and Comparison Peers: Perspectives From Children and Their Parents. J Pediatr Psychol 2023; 48:166-175. [PMID: 36190446 PMCID: PMC9941833 DOI: 10.1093/jpepsy/jsac077] [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: 02/03/2022] [Revised: 08/13/2022] [Accepted: 09/18/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the emotional well-being of pediatric brain tumor survivors (PBTS) from the perspective of children's self-reports and parents' reports relative to matched comparison peers (COMP) and their parents. It was hypothesized that PBTS would self-report more depression symptoms, loneliness, and lower self-concept than COMP. We also hypothesized that mothers and fathers of PBTS would report more internalizing symptoms and lower total competence for their children. Age and sex effects were examined in exploratory analyses. METHODS Families of 187 PBTS and 186 COMP participated across 5 sites. Eligible children in the PBTS group were 8-15 years of age and 1-5 years post-treatment for a primary intracranial tumor without progressive disease. COMP were classmates matched for sex, race, and age. RESULTS PBTS self-reported lower scholastic, athletic, and social competence, but not more depression, loneliness, or lower global self-worth than COMP. Parents of PBTS reported more internalizing symptoms and lower total competence than parents of COMP. With few exceptions, group differences did not vary as a function of child age and sex. CONCLUSION PBTS reported diminished self-concept in scholastic, athletic, and social domains, while their parents reported broader challenges with internalizing symptoms and total competence. Discrepancies between self-report and parent report require further study to inform targeted interventions for PBTS. Screening survivors for emotional challenges in follow-up clinic or in school setting may help with the allocation of psychosocial support and services for PBTS and their families.
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Affiliation(s)
- Kara L Brown
- Department of Psychology, Washington State University, USA
| | - Diane Fairclough
- Department of Biostatistics and Informatics, Colorado School of Public Health, USA
| | - Robert B Noll
- Department of Pediatrics, University of Pittsburgh Medical Center, USA
| | - Maru Barrera
- Psychology Department, The Hospital for Sick Children, USA
| | - Mary Jo Kupst
- Department of Pediatrics, Medical College of Wisconsin, USA
| | | | - Anna M Egan
- Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City, USA
- University of Missouri Kansas City School of Medicine, USA
| | - Carolyn R Bates
- Department of Pediatrics, The University of Kansas Medical Center, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, Nationwide Children’s Hospital, USA
- Department of Pediatrics, The Ohio State University, USA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, Nationwide Children’s Hospital, USA
- Department of Pediatrics, The Ohio State University, USA
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Kallio M, Tornivuori A, Miettinen P, Kolho KL, Culnane E, Sawyer S, Kosola S. Disease control and psychiatric comorbidity among adolescents with chronic medical conditions: a single-centre retrospective study. BMJ Paediatr Open 2023; 7:e001605. [PMID: 36746523 PMCID: PMC9906183 DOI: 10.1136/bmjpo-2022-001605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To investigate disease control, psychiatric comorbidity, substance use and their possible associations in adolescents with chronic medical conditions before transfer to adult healthcare. METHODS We collected clinical data from the year preceding transfer of care and psychiatric data from the records of the paediatric hospital in Helsinki, Finland (population base 1.7 million). Participants were grouped into three disease and/or adherence control categories (good, some evidence of concern, poor) based on clinical data from the medical records of the year preceding the transfer of care. Participants completed the Adolescent's Substance Use Measurement Questionnaire before transfer of care and were divided into four risk subgroups accordingly. RESULTS In total, 253 adolescents (mean age 17.3 years, SD 1.2) from six paediatric subspecialties participated in this study. Disease control and/or adherence were rated as good in 28% (n=70), moderate in 42% (n=105) and poor in 30% (n=76) in the year before participants transferred to adult health services. A quarter of participants had at least one psychiatric diagnosis during adolescence. Adolescents with concomitant psychiatric diagnoses more often had poor disease control of their chronic medical condition than adolescents with only a medical condition (44% vs 26%; n=25 of 59 vs 51 of 194, respectively). More than half of adolescents (56%) were abstinent or used substances infrequently; 10% (n=26) reported hazardous substance use. CONCLUSIONS Psychiatric comorbidity in adolescents with chronic medical conditions is common. Its negative association with disease control and possible substance use should be considered in the transition process to adult health services.
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Affiliation(s)
- Mira Kallio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anna Tornivuori
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Nursing Science, University of Turku, Turku, Finland
| | - Päivi Miettinen
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Evelyn Culnane
- Transition Support Service, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan Sawyer
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute and the Royal Children's Hospital, Parkville, Victoria, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
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Hards E, Orchard F, Khalid S, D’souza C, Cohen F, Gowie E, Loades M. Self-evaluation and depression in adolescents with a chronic illness: A systematic review. Clin Child Psychol Psychiatry 2023; 28:382-397. [PMID: 35853094 PMCID: PMC9902973 DOI: 10.1177/13591045221115287] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness. METHODS A systematic search was conducted using MEDLINE, EMBASE, PsycINFO, Web of Science, The Cochrane Library, and hand-searching. We sought to identify primary research that examined both the cross-sectional and longitudinal associations between depression and self-evaluation in adolescents with chronic illness. The search resulted in 8941 retrieved articles that were screened against an inclusion criteria. A total of 4 papers were included in the review. The MMAT used to assess study methodological quality. RESULTS A narrative synthesis was conducted, and a summary figure was included. These 4 studies included 236 adolescents aged 9-18 years with depression and either Type 1 Diabetes (T1D), chronic pain, headaches, or Inflammatory Bowel Disease (IBD). The limited existing evidence indicated that that depression was associated with negative self-evaluation in adolescents in some but not all chronic illnesses investigated to date. We also found some evidence that psychological intervention can help to improve self-evaluation, specifically in adolescents with T1D. CONCLUSIONS More robust studies of the association between self-evaluation and depression in adolescents with a chronic illness is needed, with attention to the nuances of differences between chronic illnesses. The existing evidence indicates that there may be a stronger association in some chronic illnesses. Pilot data suggest that specific psychological therapies may improve self-evaluation, although much more extensive evaluation is needed.
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Affiliation(s)
- Emily Hards
- Department of Psychology, University of Bath, UK
| | | | | | - Clea D’souza
- Department of Psychology, University of Bath, UK
| | - Flora Cohen
- Department of Psychology, University of Bath, UK
| | | | - Maria Loades
- Department of Psychology, University of Bath, UK
- Centre for Academic Child Health, University of Bristol, UK
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Koerner R, Rechenberg K. Psychosocial Outcomes in Adolescents With Type 1 Diabetes: Associations With Grade Level and Disease Duration. J Pediatr Health Care 2023; 37:25-29. [PMID: 36163117 DOI: 10.1016/j.pedhc.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/15/2022] [Accepted: 09/03/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The purpose of this study was to examine anxiety and depressive symptoms in adolescents with type 1 diabetes (T1D) to determine differences based on grade level and disease duration. METHOD We conducted a secondary data analysis of adolescents with T1D, which included demographic characteristics, general anxiety symptoms, and depressive symptoms. RESULTS Of the 147 adolescents included in the analysis, 32% (n=47) were in middle school and 68% (n=100) were in high school. Most had been diagnosed with diabetes for less than 3 years (67.3%, n=99). When controlling for covariates, middle schoolers were more likely to report clinically significant depressive symptoms compared to their high school peers (β = 0.83, p = 0.008). DISCUSSION Younger adolescents may be at a higher risk of a clinically significant symptom burden from depression and should be screened regularly. Future research should include tailoring psychosocial interventions specifically to an adolescent's age and disease duration.
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Affiliation(s)
- Rebecca Koerner
- Rebecca Koerner, Graduate Student, College of Nursing, University of South Florida, Tampa, FL.
| | - Kaitlyn Rechenberg
- Kaitlyn Rechenberg, Assistant Professor, College of Nursing, University of South Florida, Tampa, FL
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12
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Alexandridis D, Nijhof SL, van der Rijst VG, van der Neut DY, Spijkerman R, Stevens GWJM, Bakkes SCJ, Lesscher HMB, van den Eijnden RJJM, van der Ent CK, van den Berg G, Peeters M. A cross-sectional study on gaming intensity and social vulnerability in adolescents that have a chronic condition. Front Public Health 2023; 11:1128156. [PMID: 37139357 PMCID: PMC10149830 DOI: 10.3389/fpubh.2023.1128156] [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: 12/20/2022] [Accepted: 03/29/2023] [Indexed: 05/05/2023] Open
Abstract
Background Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD). Methods Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition. Results No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group. Conclusion Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers.
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Affiliation(s)
- Dionysis Alexandridis
- Multimedia Group, Interaction Division, Department of Computer Science, Faculty of Science, Utrecht University, Utrecht, Netherlands
- *Correspondence: Dionysis Alexandridis
| | - Sanne L. Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Vincent G. van der Rijst
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Damian Y. van der Neut
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC, Brijder Addiction Treatment), The Hague, South Holland, Netherlands
| | - Gonneke W. J. M. Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Sander C. J. Bakkes
- Multimedia Group, Interaction Division, Department of Computer Science, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Heidi M. B. Lesscher
- Department of Population Health Sciences, Division of Behavioural Neuroscience, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Regina J. J. M. van den Eijnden
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Cornelis K. van der Ent
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Gerrit van den Berg
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
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Miró J, Roman-Juan J, Sánchez-Rodríguez E, Solé E, Castarlenas E, Jensen MP. Chronic Pain and High Impact Chronic Pain in Children and Adolescents: A Cross-Sectional Study. THE JOURNAL OF PAIN 2022; 24:812-823. [PMID: 36577459 DOI: 10.1016/j.jpain.2022.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/26/2022]
Abstract
The aims of this study were to: 1) estimate the prevalence of chronic pain (CP) and high impact chronic pain (HICP) in a community sample of children and adolescents; and 2) compare groups (those without CP, those with CP but no HICP, and those with HICP) with respect to demographic variables, pain variables, and physical, psychological, and school-related function. One thousand one hundred and fifteen children and adolescents participated (56% girls; age: ߂ = 11.67; SD = 2.47; range = 8-18 years). The prevalence of CP and HICP was 46% and 5%, respectively, and was higher in girls and increased with age. Participants with HICP reported greater pain intensity and higher pain frequency than those with CP but no HICP. In addition, participants with HICP reported lower mobility, greater fatigue, worst sleep quality, more anxiety and depression symptoms, worst cognitive function, missing more school days, and worse perceived school performance. HICP is a prevalent condition in children and adolescents and is associated with many negative consequences. Stakeholders must be aware of this and ensure that treatment programs are available to reduce the individual and societal impact of HICP in young individuals. PERSPECTIVE: This article provides information on CP and HICP prevalence and impact in children and adolescents. By better understanding the nature and score of these conditions, we will be able to develop more effective early interventions to help this population and thereby reduce their long-term negative impact.
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Affiliation(s)
- Jordi Miró
- Universitat Rovira i Virgili; Department of Psychology, URV, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain.
| | - Josep Roman-Juan
- Universitat Rovira i Virgili; Department of Psychology, URV, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Elisabet Sánchez-Rodríguez
- Universitat Rovira i Virgili; Department of Psychology, URV, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Ester Solé
- Universitat Rovira i Virgili; Department of Psychology, URV, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Elena Castarlenas
- Universitat Rovira i Virgili; Department of Psychology, URV, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
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14
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Hosozawa M, Cable N, Yamasaki S, Ando S, Endo K, Usami S, Nakanishi M, Niimura J, Nakajima N, Baba K, Oikawa N, Stanyon D, Suzuki K, Miyashita M, Iso H, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Predictors of chronic loneliness during adolescence: a population-based cohort study. Child Adolesc Psychiatry Ment Health 2022; 16:107. [PMID: 36544216 PMCID: PMC9769463 DOI: 10.1186/s13034-022-00545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adolescent loneliness is a growing public health issue owing to its adverse health impact. Although adolescent loneliness is common, its trajectories can show distinct patterns over time. However, there is limited knowledge regarding their determinants, particularly for chronic loneliness. We aimed to determine the predictors of loneliness trajectories across early-to-mid adolescence and examine their association with later suicidality. METHODS Data were collected from 3165 participants from the population-based Tokyo Teen Cohort. Participants reported their loneliness at 10, 12, 14, and 16 years. Loneliness trajectories were identified using latent class growth analysis. We examined the predictive role of bullying victimization and parental psychological distress at age 10 via a multinomial logistic regression. Sociodemographic and child-related factors (i.e., chronic health conditions and cognitive delay) were included as covariates. The association between the trajectories, self-harm, and suicidal ideation by age 16 was investigated using Poisson regression. RESULTS Four trajectories were identified: "consistently low" (2448, 77.3%), "moderate-decreasing" (185, 5.8%), "moderate-increasing" (508, 16.1%), and "consistently high" (24, 0.8%). Taking "consistently low" as a reference, experiences of bullying victimization predicted all the remaining trajectories [adjusted relative risk ratio 1.64, 95% confidence interval (CI) 1.18-2.28 for "moderate-decreasing," 1.88, 1.52-2.33 for "moderate-increasing," and 4.57, 1.97-10.59 for "consistently high"]. Parental psychological distress predicted the "moderate-increasing" (1.84, 1.25-2.71) and "consistently high" (5.07, 1.78-14.42) trajectories. The "consistently high" trajectory showed the greatest risk for self-harm and suicidal ideation (adjusted relative risk ratio 6.01, 95% CI 4.40-8.22; 2.48, 1.82-3.37, respectively); however, the "moderate-increasing" and "moderate-decreasing" trajectories were also at increased risk (moderate-increasing: 2.71, 2.23-3.30 for self-harm, 1.93, 1.69-2.19 for suicidal ideation; moderate-decreasing: 2.49, 1.91-3.26 for self-harm, 1.59, 1.33-1.91 for suicidal ideation). CONCLUSIONS Bullying victimization and parental psychological distress at age 10 were independent determinants of increased and chronic loneliness trajectories across early-to-mid adolescence. Compared with "consistently low," all other loneliness trajectories were associated with an increased risk of adolescent suicidality. Interventions targeting adolescent loneliness should include approaches to mitigate bullying and parental psychological distress. These strategies may help prevent adolescent suicidality.
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Affiliation(s)
- Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. .,Department of Pediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan.
| | - Noriko Cable
- grid.83440.3b0000000121901201Department of Epidemiology and Public Health, University College London, London, UK
| | - Syudo Yamasaki
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Endo
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Usami
- grid.26999.3d0000 0001 2151 536XGraduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Miharu Nakanishi
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Junko Niimura
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Naomi Nakajima
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kaori Baba
- grid.419588.90000 0001 0318 6320Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
| | - Nao Oikawa
- grid.258269.20000 0004 1762 2738Department of Pediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan
| | - Daniel Stanyon
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazuhiro Suzuki
- grid.263518.b0000 0001 1507 4692Department of Community Mental Health, Shinshu University School of Medicine, Matsumoto, Japan
| | - Mitsuhiro Miyashita
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hiroyasu Iso
- grid.45203.300000 0004 0489 0290Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655 Japan ,grid.136593.b0000 0004 0373 3971Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mariko Hiraiwa-Hasegawa
- grid.275033.00000 0004 1763 208XDepartment of Evolutionary Studies of Biosystems, The Graduate University for the Advanced Studies, Kanagawa, Japan
| | - Kiyoto Kasai
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan ,grid.26999.3d0000 0001 2151 536XThe International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, Tokyo, Japan
| | - Atsushi Nishida
- grid.272456.00000 0000 9343 3630Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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The development of Cognitive Behavioural Therapy (CBT) for chronic loneliness in children and young people: Protocol for a single-case experimental design. PLoS One 2022; 17:e0278746. [PMID: 36490292 PMCID: PMC9733892 DOI: 10.1371/journal.pone.0278746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Loneliness is a significant problem for young people and is associated with a range of physical and mental health difficulties. Meta-analyses have identified that interventions aimed at young people who report loneliness as their primary problem are lacking within the literature. In adults, the most effective interventions for loneliness are those which target the underlying maladaptive social cognitions. Therefore, we have developed a modular Cognitive Behavioural Therapy (CBT) intervention for children and young people. The aim of this study is to conduct a multiple baseline single-case experimental design (SCED) to assess the efficacy, feasibility and acceptability of this intervention. In total 6-8 11-18-year-olds and their families will be recruited. The design consists of AB+ post-intervention, where A is the baseline phase, B is the intervention phase and then a post-intervention phase. Participants will complete a baseline assessment, before being randomised to one of four different baseline lengths (12 days, 19 days, 26 days or 33 days). Participants will then complete an average of 12 sessions of CBT, with the aim being to reduce their feelings of loneliness. Participants will then complete a 12-day post-intervention phase. Participant loneliness will be repeatedly assessed throughout the three phases of the intervention using the Three-item Loneliness Scale, which will be the primary outcome. Secondary outcomes will be reliable and clinically meaningful change on the UCLA Loneliness Scale, Revised Child Anxiety and Depression Scale (RCADS) and Strengths and Difficulties Questionnaire (SDQ). Feasibility and participant satisfaction will also be assessed and reported. Trial registration: ClinicalTrails.gov trial registration number: NCT05149963 (Date registered: 07.12.2021). https://www.clinicaltrials.gov/ct2/show/NCT05149963?term=cbt&cond=loneliness&draw=2&rank=1.
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16
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Zillner C, Turner A, Rockenbauer G, Röhsner M, Pletschko T. Use of Telepresence Systems to Enhance School Participation in Pediatric Patients with Chronic Illnesses Involving the CNS. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract: Background: Due to hospitalization, medical treatment and/or rehabilitation stays, children and adolescents with diseases of the central nervous system (CNS; e.g. tumors, epilepsies or traumatic brain injuries) often cannot participate in everyday school life to the same extent as their peers. To counteract social isolation and negative consequences (e.g. lack of a sense of belonging, reduced well-being and self-esteem, more frequent class repetitions or low educational attainment) telepresence systems are increasingly being discussed as a way to enable participation for children and adolescents with chronic illnesses. Method: This paper presents different telepresence systems and their advantages and disadvantages, effects of use, and potential difficulties. Conclusion: Telepresence systems offer an innovative and promising perspective to enable patients with CNS-associated diseases to participate in everyday school life.
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Affiliation(s)
- Clarissa Zillner
- Comprehensive Center for Pediatrics, Medical University of Vienna, Austria
| | - Agnes Turner
- Institut für Unterrichts- und Schulentwicklung, University of Klagenfurt, Austria
| | | | | | - Thomas Pletschko
- Comprehensive Center for Pediatrics, Medical University of Vienna, Austria
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17
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Miró J, Narváez MA, Orrillo E, Ingelmo P, Garcia JBS. The declaration of lima on pain in childhood. Pain Rep 2022; 7:e1055. [PMID: 36570738 PMCID: PMC9771156 DOI: 10.1097/pr9.0000000000001055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open
Abstract
The Declaration of Lima on Pain in Childhood is a call into action to improve the care provided to children and adolescents with pain.
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Affiliation(s)
- Jordi Miró
- Universitat Rovira i Virgili, Catalonia, Spain
- Unit for the Study and Treatment of Pain—ALGOS, Chair in Pediatric Pain URV-FG, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Catalonia, Spain
| | - Marco A. Narváez
- Unidad de Dolor, Hospital Obrero N.1-H. Materno Infantil, La Paz, Bolivia
| | - Enrique Orrillo
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Pablo Ingelmo
- Edwards Family Interdisciplinary Center for Complex Pain, Montréal Children's Hospital, Montreal, Canada
- Department of Anesthesia, McGill University, Montreal, Canada
| | - João Batista S. Garcia
- Department of Pain and Palliative Care, Federal University of Maranhao, Maranhao, Brazil
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18
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Fang Y, Chen C, Zhong Q, Wang L, Gui Z, Zhu J, Manyande A, Xu F, Wang J, Zhang Z. Influence of Cerebral Glucose Metabolism by Chronic Pain-Mediated Cognitive Impairment in Adolescent Rats. Mol Neurobiol 2022; 59:3635-3648. [PMID: 35355195 DOI: 10.1007/s12035-022-02816-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Abstract
Chronic pain during adolescence can lead to mental health disorders in adulthood, but the underlying mechanism is still unclear. Furthermore, the homeostasis of cerebral glucose metabolism and neurotransmitter metabolic kinetics are closely associated with cognitive development and pain progression. The present study investigated changes in cognitive function and glucose metabolism in adult rats, which had experienced chronic pain during their adolescence. Here, spared nerve injury (SNI) surgery was conducted in 4-week-old male rats. Mechanical nociceptive reflex thresholds were analyzed, and SNI chronic pain (SNI-CP) animals were screened. Based on animal behavioral tests (open field, three-chambered social, novel object recognition and the Y maze), the SNI-CP animals showed learning and memory impairment and anxiety-like behaviors, compared to SNI no chronic pain (SNI-NCP) animals. The cerebral glucose metabolism in the prefrontal cortex and hippocampus of adult SNI-CP animals was decreased with positron emission tomography/computed tomography. GABA2 and Glu4 levels in the metabolic kinetics study were significantly decreased in the hippocampus, frontal cortex, and temporal cortex, and the expression of GLUT3 and GLUT4 was also significantly downregulated in the prefrontal cortex and hippocampus of adult rats in the SNI-CP group. These findings suggest that the rats which suffered chronic pain during adolescence have lower cerebral glucose metabolism in the cortex and hippocampus, which could be related to cognitive function during the development of the central nervous system.
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Affiliation(s)
- Yuanyuan Fang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Chang Chen
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Qi Zhong
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Lirong Wang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Zhu Gui
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Jinpiao Zhu
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, Brentford, TW8 9GA, Middlesex, UK
| | - Fuqiang Xu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Jie Wang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China.
- Institute of Neuroscience and Brain Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People's Republic of China.
- University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
| | - Zongze Zhang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China.
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Physical and mental health in young adults with heart disease - a national survey of Norwegian university students. Cardiol Young 2022; 32:257-265. [PMID: 34100351 DOI: 10.1017/s1047951121001815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Young adults with heart disease constitute a growing group with the risk of cognitive and physical impairment. The knowledge of their academic performance and mental and physical health is, however, scant. This study aimed to compare young adults with CHDs or arrhythmia with their peers. METHODS Information on physical health (Somatic Symptom Scale-8), mental health problems (Hopkins Symptoms Checklist-25), quality of life (Satisfaction With Life Scale), physical activity, and academic performance was collected online in a national cross-sectional survey in Norway among students in higher education (the SHoT2018 study). RESULTS Among 50,054 students, 172 (0.34%) reported CHD and 132 (0.26%) arrhythmias. Students reporting arrhythmias scored significantly higher than the control group on somatic symptoms (OR = 2.3 (95% CI: 1.62-3.27)), anxiety (OR = 1.60 (1.08-2.37)), depression (OR = 1.49 (1.05-2.11)), self-harm, and suicide attempt (OR = 2.72 (1.56-4.75)), and lower quality of life (OR 1.64 (1.16-2.32)) and more loneliness (OR = 1.99 (1.28-3.10)) compared to participants without heart disease. Participants with CHD reported an increased somatic symptom burden (OR = 1.58 (1.16-2.16)). Despite a tendency to a higher score, this group did not differ significantly from the control group on anxiety or depression, quality of life, or loneliness. However, the risk of self-harm thoughts and suicidality was significantly increased (OR for suicide attempt 2.22 (1.3-3.77)). There was no difference between the groups on academic performance. CONCLUSIONS Although Norwegian students with heart disease reported more somatic symptoms, their academic progress was not reduced compared to students without heart disease. Students with CHD or arrhythmias showed an increased risk of self-harm thoughts and suicidality.
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Holt-Lunstad J. Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the "Social" in Social Determinants of Health. Annu Rev Public Health 2022; 43:193-213. [PMID: 35021021 DOI: 10.1146/annurev-publhealth-052020-110732] [Citation(s) in RCA: 97] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is growing interest in and renewed support for prioritizing social factors in public health both in the USA and globally. While there are multiple widely recognized social determinants of health, indicators of social connectedness (e.g., social capital, social support, social isolation, loneliness) are often noticeably absent from the discourse. This article provides an organizing framework for conceptualizing social connection and summarizes the cumulative evidence supporting its relevance for health, including epidemiological associations, pathways, and biological mechanisms. This evidence points to several implications for prioritizing social connection within solutions across sectors, where public health work, initiatives, and research play a key role in addressing gaps. Therefore, this review proposes a systemic framework for cross-sector action to identify missed opportunities and guide future investigation, intervention, practice, and policy on promoting social connection and health for all. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Christiansen J, Qualter P, Friis K, Pedersen SS, Lund R, Andersen CM, Bekker-Jeppesen M, Lasgaard M. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health 2021; 141:226-236. [PMID: 34148462 DOI: 10.1177/17579139211016077] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS The present study investigates whether loneliness and social isolation are associated with poor physical and mental health among adolescents and young adults, and whether age and gender play a role in the associations of loneliness and social isolation with mental and physical health. METHODS This study used cross-sectional self-report data from the 2017 Danish Health and Morbidity Surveys titled 'How are you?' (N = 19,890, M = 22.6 years). RESULTS Logistic regression analyses showed that loneliness and social isolation were independently associated with poor physical and mental health. Loneliness was associated with increased odds of asthma, migraine, osteoarthritis, rheumatoid arthritis, hypertension, slipped disc/back pain, tinnitus, long-term mental illness, depressive symptomatology, anxiety symptomatology and alcohol problems. Social isolation was associated with decreased odds of having migraine, osteoarthritis and alcohol problems, and an increased risk of long-term mental illness and depressive symptomatology. Small age and gender differences were detected. CONCLUSIONS In adolescents and young adults, loneliness and social isolation were associated with poor mental health and loneliness with poor physical health. These findings highlight the need for targeted prevention and intervention initiatives to alleviate loneliness and social isolation.
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Affiliation(s)
- J Christiansen
- Public Health & Health Services Research, DEFACTUM, Central Denmark Region, Olof Palmes Allé 15, DK-8200 Aarhus N, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - P Qualter
- Manchester Institute of Education, The University of Manchester, Manchester, UK
| | - K Friis
- Public Health & Health Services Research, DEFACTUM, Central Denmark Region, Aarhus N, Denmark
| | - S S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - R Lund
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - C M Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - M Bekker-Jeppesen
- Center for Clinical Research and Prevention, The Capital Region of Denmark, Copenhagen, Denmark
| | - M Lasgaard
- Public Health & Health Services Research, DEFACTUM, Central Denmark Region, Aarhus N, Denmark
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22
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Wetzel B, Pryss R, Baumeister H, Edler JS, Gonçalves ASO, Cohrdes C. "How Come You Don't Call Me?" Smartphone Communication App Usage as an Indicator of Loneliness and Social Well-Being across the Adult Lifespan during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6212. [PMID: 34201322 PMCID: PMC8227237 DOI: 10.3390/ijerph18126212] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
Loneliness and lack of social well-being are associated with adverse health outcomes and have increased during the COVID-19 pandemic. Smartphone communication data have been suggested to help monitor loneliness, but this requires further evidence. We investigated the informative value of smartphone communication app data for predicting subjective loneliness and social well-being in a sample of 364 participants ranging from 18 to 78 years of age (52.2% female; mean age = 42.54, SD = 13.22) derived from the CORONA HEALTH APP study from July to December 2020 in Germany. The participants experienced relatively high levels of loneliness and low social well-being during the time period characterized by the COVID-19 pandemic. Apart from positive associations with phone call use times, smartphone communication app use was associated with social well-being and loneliness only when considering the age of participants. Younger participants with higher use times tended to report less social well-being and higher loneliness, while the opposite association was found for older adults. Thus, the informative value of smartphone communication use time was rather small and became evident only in consideration of age. The results highlight the need for further investigations and the need to address several limitations in order to draw conclusions at the population level.
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Affiliation(s)
- Britta Wetzel
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-University of Würzburg, 97080 Würzburg, Germany;
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany;
| | - Johanna-Sophie Edler
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
| | | | - Caroline Cohrdes
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (B.W.); (J.-S.E.)
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23
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Pediatric sarcoma survivorship: A call for a developmental cascades approach. Dev Psychopathol 2021; 34:1221-1230. [PMID: 33851573 DOI: 10.1017/s095457942100002x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Survivors of pediatric sarcomas often experience greater psychological and psychosocial difficulties than their non-afflicted peers. We consider findings related to poorer outcomes from a developmental cascade perspective. Specifically, we discuss how physical, neurocognitive, psychological, and psychosocial costs associated with pediatric sarcomas and their treatment function transactionally to degrade well-being in long-term pediatric sarcoma survivors. We situate the sarcoma experience as a broad developmental threat - one stemming from both the presence and treatment of a life-imperiling disease, and the absence of typical childhood experiences. Ways in which degradation in one developmental domain spills over and effects other domains are highlighted. We argue that the aggregate effect of these cascades is two-fold: first, it adds to the typical stress involved in meeting developmental milestones and navigating developmental transitions; and second, it deprives survivors of crucial coping strategies that mitigate these stressors. This position suggests specific moments of intervention and raises specific hypotheses for investigators to explore.
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24
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Morina N, Kip A, Hoppen TH, Priebe S, Meyer T. Potential impact of physical distancing on physical and mental health: a rapid narrative umbrella review of meta-analyses on the link between social connection and health. BMJ Open 2021; 11:e042335. [PMID: 33737424 PMCID: PMC7978290 DOI: 10.1136/bmjopen-2020-042335] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The imperative for physical distancing (mostly referred to as social distancing) during COVID-19 pandemic may deteriorate physical and mental health. We aimed at summarising the strength of evidence in the published literature on the association of physical and mental health with social connection via social isolation, living alone and loneliness. METHODS We conducted a systematic search in April 2020 to identify meta-analyses using the Medline, PsycINFO and Web of Science databases. The search strategy included terms of social isolation, loneliness, living alone and meta-analysis. Eligible meta-analyses needed to report any sort of association between an indicator of social connection and any physical or mental health outcome. The findings were summarised in a narrative synthesis. RESULTS Twenty-five meta-analyses met our criteria, of which 10 focused on physical health and 15 on mental health outcomes. The results suggest that lack of social connection is associated with chronic physical symptoms, frailty, coronary heart disease, malnutrition, hospital readmission, reduced vaccine uptake, early mortality, depression, social anxiety, psychosis, cognitive impairment in later life and suicidal ideation. CONCLUSIONS The existing evidence clearly indicates that social connection is associated with a range of poor physical and mental health outcomes. A potential negative impact on these outcomes needs to be considered in future decisions on physical distancing measures.
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Affiliation(s)
- Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Ahlke Kip
- Institute of Psychology, University of Münster, Münster, Germany
| | | | - Stefan Priebe
- Unit of Social and Community Psychiatry, Queen Mary University of London, Faculty of Medicine and Dentistry, London, UK
| | - Thomas Meyer
- Institute of Psychology, University of Münster, Münster, Germany
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25
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Jordan A, Carter B, Forgeron P, Fournier K, Sanders K. Romantic Relationships in Young People with Long-Term Health Conditions: A Scoping Review. J Pediatr Psychol 2021; 46:264-279. [PMID: 33306805 DOI: 10.1093/jpepsy/jsaa106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Forming and maintaining romantic relationships is an important developmental task in adolescence and young adulthood. This scoping review seeks to explore how young people with long-term physical health conditions understand and experience romantic relationships. METHODS Using Arksey and O'Malley's scoping review framework, a systematic search of five databases was conducted (PsychINFO, Cinahl, MEDLINE, Embase, and Web of Science). Studies were eligible for inclusion in the review if they were published in peer-reviewed journals, used primary data collection methods, and adopted quantitative, qualitative, or mixed-methods approaches to study romantic relationships in 11-25 year olds with long-term physical health conditions. Using a data extraction form, data pertaining to demographic characteristics of young people with long-term physical health conditions and relationship engagement were extracted from eligible papers. RESULTS Searches returned 4645 papers after duplicate removal, with a two-stage screening process resulting in 111 full-text papers being reviewed. Thirty-three eligible papers were included across a range of long-term physical health conditions. Findings identified that living with a long-term physical health condition impacted young people's perceptions and experiences of romantic relationships across the relationship lifespan, from envisaging future relationships, to forming relationships, and sustaining relationships. Issues around body confidence and self-esteem were identified as challenging in terms of perceptions and experiences of romantic relationships. CONCLUSIONS Findings demonstrate that young people wish to engage with romantic relationships, yet many report particular challenges associated with forming and sustaining relationships due to the constraints of their condition and treatment. Future research should consider nonheterosexual relationships.
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Affiliation(s)
- Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK.,Centre for Pain Research, University of Bath, Bath, UK
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Paula Forgeron
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa, ON, Canada
| | - Kate Sanders
- Department of Psychology, University of Bath, Bath, UK
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26
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Tutelman PR, Langley CL, Chambers CT, Parker JA, Finley GA, Chapman D, Jones GT, Macfarlane GJ, Marianayagam J. Epidemiology of chronic pain in children and adolescents: a protocol for a systematic review update. BMJ Open 2021; 11:e043675. [PMID: 33593785 PMCID: PMC7888311 DOI: 10.1136/bmjopen-2020-043675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem and can profoundly impact children's physical, psychological and social functioning. The last comprehensive systematic review estimating the prevalence of chronic pain in children and adolescents was published in 2011. Since then, the literature on paediatric chronic pain has grown substantially. This manuscript outlines a protocol for an updated systematic review to provide updated estimates of the prevalence of various forms of chronic pain in children and adolescence. The review will also examine the relationship between sociodemographic and psychosocial factors related to chronic pain prevalence. METHODS AND ANALYSIS This review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search EMBASE, PubMed, CINAHL and PsycINFO for observational studies published in English between 2009 and 2020 reporting population-based estimates of chronic non-disease-related pain prevalence in children or adolescents (age ≤19 years). Two independent reviewers will screen the titles and abstracts retrieved from the search based on predefined eligibility criteria. The full texts of relevant studies will then be assessed by two reviewers. Studies meeting inclusion criteria will be categorised according to the type of pain investigated: headache only, abdominal pain only, back pain only, musculoskeletal pain, combined pain, general pain and other pain. Data will be extracted using customised forms and studies will be assessed for risk of bias using a 10-item tool developed by Hoy et al (2012). A narrative synthesis will summarise the prevalence estimates of paediatric chronic pain and associated sociodemographic and psychosocial correlates. Meta-analyses and meta-regressions will be performed if the data permit. ETHICS AND DISSEMINATION Ethical approval is not required. Findings will be disseminated through publication in an academic journal, presentations at conferences and in various media. PROSPERO REGISTRATION NUMBER CRD42020198690.
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Affiliation(s)
- Perri R Tutelman
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Charlotte L Langley
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennifer A Parker
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - G Allen Finley
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Darlene Chapman
- Library Services, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Gareth T Jones
- Epidemiology Group and Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | - Gary J Macfarlane
- Epidemiology Group and Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | - Justina Marianayagam
- Patient Partner, Thunder Bay, Ontario, Canada
- Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
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27
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Santino N, Arbour-Nicitopoulos KP, Sharma R, Graham JD, Bassett-Gunter RL. Physical activity and loneliness among adolescents with disabilities: Examining the quality of physical activity experiences as a possible moderator. Disabil Health J 2021; 14:101060. [PMID: 33478910 DOI: 10.1016/j.dhjo.2021.101060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/23/2020] [Accepted: 01/01/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adolescents with disabilities (AWD) often report higher loneliness levels than adolescents without disabilities, as they frequently encounter barriers to social participation. A negative relationship between physical activity (PA) and loneliness has been established outside of AWD populations, while few studies have examined this association among AWD. Research investigating the relationship between PA and loneliness has not systematically examined aspects of PA experiences that may influence this relationship. OBJECTIVES The objectives of this study were to: a) examine the direct relationship between PA and loneliness among AWD, and b) examine the quality of PA experiences, as framed within a quality participation conceptualization, as a possible moderator of the relationship between PA and loneliness. METHODS This study was a cross-sectional sub-analysis of data from The National Physical Activity Measurement Study. Participants included 40 Canadian adolescents, age 10-17, with any type of disability who completed a series of questionnaires either online or via telephone/video interview. RESULTS PA and loneliness were not significantly related at the bivariate level (r = -0.10, p = .54), but quality of PA participation significantly moderated the relationship between PA and loneliness (95% C.I. = 0.002-0.019, p = .02). These results suggest that greater PA rates were significantly and negatively associated with loneliness among AWD who reported experiencing high quality PA experiences. CONCLUSIONS This research can be used as evidence to inform mechanistic studies with causal data to provide more robust findings on the possible value of high-quality PA experiences to mitigate feelings of loneliness among AWD.
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Affiliation(s)
- Nicholas Santino
- School of Kinesiology & Health Science, Faculty of Health, York University, Toronto, Canada.
| | - Kelly P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada; Bloorview Research Institute, Toronto, Canada
| | - Ritu Sharma
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Jeffrey D Graham
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
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28
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McGlone M, Long E. Are young adults with long-standing illness or disability at increased risk of loneliness? Evidence from the UK Longitudinal Household Study. J Public Health Res 2020; 9:1861. [PMID: 33409244 PMCID: PMC7771026 DOI: 10.4081/jphr.2020.1861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/27/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Recent evidence has shown that young adults experience significant levels of loneliness, and those with longstanding illness or disability (LSID) may be particularly vulnerable. This study investigated whether young adults with LSID were more likely to experience loneliness than their 'healthy' peers, after accounting for key socio-contextual and health-related factors associated with loneliness. Design and Methods: The sample consists of 4510 16-24- year-old individuals from Wave 9 of the UK Household Longitudinal Study (UKHLS). Loneliness was measured using the UCLA 3-item loneliness scale, in addition to a direct indicator of frequency of loneliness. Correlation tests measured associations between both measures of loneliness and LSID. Ordinal logistic regression was used to examine the association between LSID and UCLA loneliness, after accounting for key demographic and socio-contextual variables. Results: Results from the correlation tests demonstrated significant associations between LSID and both measures of loneliness. Results from the ordinal logistic regression models indicated that chronic illness was significantly associated with loneliness, after accounting for various demographic, social, and well-being factors. In addition, individuals with fewer close friends reported higher loneliness, as did those with poorer mental health, and low well-being scores. Younger participants, age brackets 16-18 and 19-21, were found to report higher loneliness than the individuals aged 22-24-year-old. Conclusions: Overall, the study found significant evidence of associations between the presence of LSID and loneliness in young adults (16-24 years old), suggesting these individuals are at an increased risk of loneliness, and could be a focus for future public health interventions.
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Affiliation(s)
- Megan McGlone
- Department of General Practice and Primary Care, University of Glasgow,MVLS, University of Glasgow, G12 8QQ Glasgow, Scotland, UK.
| | - Emily Long
- Social and Public Health Sciences Unit, School of Social & Political Sciences, University of Glasgow, Scotland, UK
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29
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Bay LT, Ellingsen T, Giraldi A, Graugaard C, Nielsen DS. "To be lonely in your own loneliness": The interplay between self-perceived loneliness and rheumatoid arthritis in everyday life: A qualitative study. Musculoskeletal Care 2020; 18:450-458. [PMID: 32491275 DOI: 10.1002/msc.1480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Loneliness has a negative impact on physical health, and rheumatoid arthritis symptoms can lead to social isolation. However, there is a lack of research exploring patients' perspectives on self-perceived loneliness in everyday life with rheumatoid arthritis. The purpose of this study was to gain insight into the meaning and importance of self-perceived loneliness among adult patients diagnosed with rheumatoid arthritis. METHODS This study was designed as a qualitative, exploratory interview study using a narrative framework. Semi-structured interviews were conducted with Danish adults with rheumatoid arthritis. All interviews were recorded, transcribed verbatim, and analyzed within a narrative thematic framework. RESULTS Ten women and seven men were interviewed, aged between 18 and 73 years and a disease duration between 6 months and 40 years. Three themes were identified during the analysis: (1) explanations of loneliness in everyday life with rheumatoid arthritis, (2) disclosing or disguising loneliness, and (3) feelings of loneliness in social life. CONCLUSION The findings from this study show that loneliness can be burdensome when living with RA. Narratives of loneliness can be hard for patients to disclose, so health care practitioners should take responsibility for legitimizing this subject. A narrative approach in consultations may be helpful to support patients and to encourage a dialogue about loneliness in everyday life with rheumatoid arthritis.
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Affiliation(s)
- Laila Twisttmann Bay
- Rheumatology Research Unit, Department of Rheumatology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Torkell Ellingsen
- Rheumatology Research Unit, Department of Rheumatology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Centre Copenhagen and Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dorthe S Nielsen
- University College Lillebaelt, Odense, Denmark
- Migrant Health Clinic, Odense University Hospital, Odense, Denmark
- Center for Global Health, University of Southern Denmark, Odense, Denmark
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30
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Qualter P, Rouncefield-Swales A, Bray L, Blake L, Allen S, Probert C, Crook K, Carter B. Depression, anxiety, and loneliness among adolescents and young adults with IBD in the UK: the role of disease severity, age of onset, and embarrassment of the condition. Qual Life Res 2020; 30:497-506. [PMID: 32997335 PMCID: PMC7886765 DOI: 10.1007/s11136-020-02653-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Abstract
Purpose Adolescents and young adults (AYA) with Inflammatory Bowel Disease (IBD) report higher depressive symptoms and anxiety compared to healthy controls, with disease severity and abdominal pain being important factors. In the current study, building on what young people had told us in our previous work, we examined whether embarrassment of the condition, social self-efficacy, and friendship quality mediated the relationship between abdominal pain and disease severity, and mental health/well-being. We also included loneliness as a component of well-being. Methods Data on depression, anxiety, loneliness, friendship quality, social self-efficacy, and disease embarrassment were collected from 130 AYA with IBD ages 14–25 years; data on disease severity and abdominal pain were taken from their medical records. Structural Equation Modeling (SEM) was used to test the relationships between the variables. Results Using SEM, we established that higher IBD disease activity negatively impacted how AYA felt about their friendships and how embarrassed they were about their condition; embarrassment then influenced reports of mental health, including loneliness. Abdominal pain, disease onset, and social self-efficacy directly predicted internalising problems. Conclusion In this sample of 14–25-year-old patients with IBD, specifics about the disease (severity and pain) predicted poorer mental health, suggesting discussion of mental health should be part of the clinical dialogue between patient and consultant. In addition, embarrassment about their condition increased depression, anxiety, and loneliness, mediating the relationship between disease severity and well-being. Thus, it is important to consider how perceived stigma affects those with chronic illness, and those issues should be explored in clinic.
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Affiliation(s)
- Pamela Qualter
- Institute of Education, University of Manchester, Manchester Oxford Road, Manchester, M13 9PL, UK.
| | - Alison Rouncefield-Swales
- Children, Young People and Families, Faculty of Health, Social Care & Medicine, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK
| | - Lucy Bray
- Children, Young People and Families, Faculty of Health, Social Care & Medicine, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK
| | - Lucy Blake
- Children, Young People and Families, Faculty of Health, Social Care & Medicine, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK
| | - Steven Allen
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Chris Probert
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Kay Crook
- St Marks & Northwick Park, London North West University Healthcare NHS Trust, London, UK
| | - Bernie Carter
- Children, Young People and Families, Faculty of Health, Social Care & Medicine, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.
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Woodgate RL, Tennent P, Barriage S, Legras N. The centrality of disclosure decisions to the illness experience for youth with chronic conditions: A qualitative study. J Health Psychol 2020; 27:521-533. [PMID: 32985894 PMCID: PMC8832564 DOI: 10.1177/1359105320962242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper is to illuminate findings of disclosure experiences for youth living with chronic illness using a non-categorical approach. The findings were derived from a larger qualitative study framed by social constructivist grounded theory that sought to understand youth’s involvement in healthcare decision-making in the context of chronic illness. Fifty-four youth participated in the study, ranging from 9 to 24 years. Three main themes representing the youth’s perspectives and experiences of disclosing chronic illness were identified: (1) disclosure is central to the illness experience; (2) spectrum of disclosure; and (3) navigating others’ reactions to disclosure. The findings reinforce that more emphasis on decisions related to disclosing illness in research and clinical care for youth with chronic conditions is warranted.
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Children as frequent attenders in primary care: a systematic review. BJGP Open 2020; 4:bjgpopen20X101076. [PMID: 32873539 PMCID: PMC7606143 DOI: 10.3399/bjgpopen20x101076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/08/2019] [Indexed: 11/04/2022] Open
Abstract
Background Frequent paediatric attendances make up a large proportion of a GP's workload. Currently, there is no systematic review on frequent paediatric attendances in primary care. Aim To identify the sociodemographic and clinical characteristics of children who attend primary care frequently. Design & setting A systematic review. Method The electronic databases MEDLINE, Embase, and PsycINFO were searched up to January 2020, using terms relating to frequent attendance in primary care settings. Studies were eligible if they considered children frequently attending in primary care (aged 0–19 years). Relevant data were extracted and analysed by narrative synthesis. Results Six studies, of fair quality overall, were included in the review. Frequent attendance was associated with presence of psychosocial and mental health problems, younger age, school absence, presence of chronic conditions, and high level of anxiety in their parents. Conclusion Various sociodemographic and medical characteristics of children were associated with frequent attendance in primary care. Research on interventions needs to account for the social context and community characteristics. Integrating GP services with mental health and social care could potentially provide a response to medical and psychosocial needs of frequently attending children and their families.
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Quadt L, Esposito G, Critchley HD, Garfinkel SN. Brain-body interactions underlying the association of loneliness with mental and physical health. Neurosci Biobehav Rev 2020; 116:283-300. [DOI: 10.1016/j.neubiorev.2020.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
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Achterbergh L, Pitman A, Birken M, Pearce E, Sno H, Johnson S. The experience of loneliness among young people with depression: a qualitative meta-synthesis of the literature. BMC Psychiatry 2020; 20:415. [PMID: 32831064 PMCID: PMC7444250 DOI: 10.1186/s12888-020-02818-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/12/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Young people have a higher prevalence of loneliness than other age groups, and they are also at risk of depression. Quantitative studies describe a bidirectional association between loneliness and depression, but there is limited understanding of how these influence each other. Little is known about the experience of loneliness among young people with depression. Qualitative approaches may help understand the relationship between loneliness and depression among young people, and how to intervene to improve outcomes. We aimed to conduct a meta-synthesis to understand the complex inter-relationship between loneliness and depression among young depressed people by synthesising evidence from a systematic review of qualitative studies. METHODS We conducted a meta-synthesis of qualitative studies capturing experiences of loneliness among young people with depression. We systematically searched six electronic databases for selected search terms, critically appraised eligible studies, and analysed the data from included studies using the approach of thematic synthesis. We used feedback from an inter-disciplinary research workshop to improve reflexivity. RESULTS Our inclusion criteria identified fourteen studies. Our analysis identified four themes: (1) social withdrawal due to poor mental health, (2) non-disclosure of depression contributing to social distance, (3) the desire to connect, and (4) paradoxes of loneliness and depression. These themes illustrated a range of pathways between depression and loneliness, and a sense of how these might be mutually reinforcing. Our findings suggest that where depressed individuals engage in certain behaviours (withdrawing; not confiding) for a range of reasons, this can lead to feelings of loneliness, an awareness of which worsens their mood, thus perpetuating their depression. CONCLUSIONS Young people with depression experience loneliness as an insurmountable distance between themselves and others. Our findings identified non-disclosure of depression, and the debilitating nature of the depressive symptomatology, as factors perpetuating a vicious cycle of loneliness and depression. They suggest that approaches to tackling the problem might include helping young people communicate about their depression to trusted friends and educating their social networks in how to support them. The wider research literature suggests that cognitive interventions may have a role in shifting maladaptive cognitions about their social world.
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Affiliation(s)
- Louis Achterbergh
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105, Amsterdam, AZ, Netherlands.
| | - Alexandra Pitman
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
| | - Mary Birken
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Eiluned Pearce
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Herman Sno
- grid.7177.60000000084992262Amsterdam UMC, location AMC (University of Amsterdam), Meibergdreef 9, 1105 Amsterdam, AZ Netherlands
| | - Sonia Johnson
- grid.83440.3b0000000121901201UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.439468.4Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE UK
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De Nardi L, Trombetta A, Ghirardo S, Genovese MRL, Barbi E, Taucar V. Adolescents with chronic disease and social media: a cross-sectional study. Arch Dis Child 2020; 105:744-748. [PMID: 31941715 DOI: 10.1136/archdischild-2019-317996] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aims to explore the attitude of adolescents with chronic diseases toward social media exposure, focusing in particular on Facebook. DESIGN Cross-sectional study. SETTING An anonymous semistructured survey was distributed to an Italian hospital-based cohort of adolescents with chronic disease to explore the role of Facebook in their daily life. PATIENTS We recruited 212 adolescents (aged between 13 and 24 years) with a diagnosis of inflammatory bowel disease, coeliac disease, diabetes mellitus type 1 and cystic fibrosis. RESULTS Two hundred and seven of the 212 (97.6%) expressed the need of sharing their illness experience with friends, 201 out of 212 (94.8%) usually searched information on the internet to find new therapies and to discover their prognosis. One hundred and forty-nine out of 212 adolescents (70.3%) perceived dependence on their parents as the most negative aspect of having a chronic disease, and 200 out of 212 (94.3%) were looking for friends with the same disease on Facebook. Two hundred and ten out of 212 (99.1%) did not want their doctors or nurse on their social media platforms. During the active disease periods, the time spent with social media increased from an average of 5 to 11 hours. CONCLUSIONS This descriptive analysis focused on the Facebook impact on chronic disease perception among affected adolescents. It showed that they used to spend an increased amount of time on this platform during disease flare-up and highlighted their wish of keeping doctors and nurses away from their social dimension.
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Affiliation(s)
- Laura De Nardi
- Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Andrea Trombetta
- Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Sergio Ghirardo
- Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Maria Rita Lucia Genovese
- Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, Department of Pediatrics, University of Trieste, Trieste, Italy.,Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Valentina Taucar
- Institute for Maternal and Child Health IRCCS 'Burlo Garofolo', Trieste, Italy
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Lee SL, Lin SY, Ko HK, Liu YY. Construct Validity and Reliability of the Chinese Version Personal Adjustment and Role Skills Scale III for Adolescents With Chronic Disease. J Pediatr Nurs 2020; 53:e136-e141. [PMID: 32220423 DOI: 10.1016/j.pedn.2020.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE A valid and reliable scale to evaluate psychosocial adjustment in adolescents with chronic disease is prudent for improving their health outcome. This study aimed to develop a Chinese version Personal Adjustment and Role Skills Scale III for Adolescents (C-PARSIII-A) with chronic disease and to examine its construct validity and reliability. DESIGN AND METHODS A cross-sectional design was conducted. A total of 145 participants were enrolled from a hospital in Taiwan. Content validity, exploratory factor analysis, and corrected item-total correlations were used to explore a factor structure with appropriate items in a C-PARSIII-A. Confirmatory factor analysis was conducted to confirm its factor structure. Cronbach's α and test-retest reliability were performed to examine the reliability. RESULTS The 18-item C-PARSIII-A with six inter-correlated factors was developed. The standardized factor loadings of each item on its corresponding factor were statistically significant and higher than 0.50; composite reliability and average variance extracted were higher than 0.70 and 0.50 respectively. The correlation coefficients among the six factors in the C-PARSIII-A ranged from 0.10 to 0.84. Cronbach α and test-retest reliability of the C-PARSIII-A were 0.86 and 0.92 respectively. CONCLUSIONS The six-factor 18-item C-PARSIII-A is supported by sufficient empirical evidence for construct validity and reliability to assess the psychosocial adjustment of adolescents with chronic disease. PRACTICE IMPLICATIONS Nurses can use the C-PARSIII-A to perform assessment and follow-up on the psychosocial adjustment of adolescents with chronic disease, as well as develop interventions.
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Affiliation(s)
- Shu-Li Lee
- College of Nursing, Kaohsiung Medical University, Taiwan.
| | - Shu-Yuan Lin
- College of Nursing, Kaohsiung Medical University, Taiwan.
| | - Hsun-Kuei Ko
- College of Nursing, Kaohsiung Medical University, Taiwan.
| | - Yea-Yan Liu
- Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
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The application of meta-analytic (multi-level) models with multiple random effects: A systematic review. Behav Res Methods 2020; 52:2031-2052. [DOI: 10.3758/s13428-020-01373-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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38
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Shah SGS, Nogueras D, van Woerden H, Kiparoglou V. Effectiveness of digital technology interventions to reduce loneliness in adults: a protocol for a systematic review and meta-analysis. BMJ Open 2019; 9:e032455. [PMID: 31562164 PMCID: PMC6773278 DOI: 10.1136/bmjopen-2019-032455] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/30/2019] [Accepted: 08/29/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Loneliness is an emerging public health problem that is associated with social, emotional, mental and physical health issues. The application of digital technology (DT) interventions to reduce loneliness has significantly increased in the recent years. The effectiveness of DT interventions needs to be assessed systematically. METHODS AND ANALYSIS Aim: To undertake a systematic review and meta-analysis on the effectiveness of DT interventions to reduce loneliness among adults. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Medline, CINAHL, EMBASE and Web of Science.Publication period: 1 January 2010 to 31 July 2019. INCLUSION CRITERIA Primary studies involving the application of DT interventions to reduce loneliness, involving adult participants (aged ≥18 years), follow-up period ≥3 months and published in the English language.Synthesis and meta-analysis: A narrative summary of the characteristics of included studies, findings by the type of DT intervention, and the age, gender and ethnicity of participants. A meta-analysis by the study design and duration of follow-up and determination of random effects size using the RevMan V.5 software.Quality of evidence and bias: Quality of evidence assessed the RoB V.2.0 (revised tool for Risk of Bias in randomized trials) and ROBINS-I (Risk Of Bias in Non-randomized Studies-of Interventions) tools for randomised control trials and non-randomised studies, respectively. Heterogeneity between studies will be determined by the I2 and Cochran's Q statistics and publication bias checked with funnel plots and the Egger's test. ETHICS AND DISSEMINATION Ethics approval was not required for this protocol. The findings will be disseminated through journal articles and conference presentations. PROSPERO REGISTRATION NUMBER CRD42019131524.
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Affiliation(s)
- Syed Ghulam Sarwar Shah
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | | | - Hugo van Woerden
- NHS Highland, Assynt House, Inverness, UK
- Centre for Health and Science, University of the Highlands and Islands, Inverness, UK
| | - Vasiliki Kiparoglou
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Vancampfort D, Ashdown-Franks G, Smith L, Firth J, Van Damme T, Christiaansen L, Stubbs B, Koyanagi A. Leisure-time sedentary behavior and loneliness among 148,045 adolescents aged 12-15 years from 52 low- and middle-income countries. J Affect Disord 2019; 251:149-155. [PMID: 30925265 DOI: 10.1016/j.jad.2019.03.076] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/11/2019] [Accepted: 03/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Loneliness is widespread in adolescents and associated with a myriad of adverse physical and mental health outcomes. Exploring variables associated with loneliness is important for the development of targeted interventions. The aim of the current study was to explore associations between leisure-time sedentary behavior (LTSB) and loneliness in adolescents from 52 low- and middle-income countries. METHODS Data from the Global School-based Student Health Survey were analyzed. Data on past 12-month self-perceived loneliness and LTSB were collected. Multivariable logistic regression and meta-analysis were conducted to assess the associations. RESULTS Among 148,045 adolescents (mean age 13.7± SD 1.0 years; 48.5% female), the prevalence of loneliness increased from 8.7% among those with 1-2 h/day of LTSB to 17.5% among those spending >8 h/day sedentary. Compared to those who engage in less than 1 h of LTSB per day, the OR (95%CI) of loneliness for 1-2 h/day, 3-4 h/day, 5-8 h/day and >8 h/day were 1.00 (0.91-1.11), 1.29 (1.15-1.45), 1.37 (1.17-1.61), and 1.66 (1.39-1.99), respectively. LIMITATIONS The study is cross-sectional, therefore the directionality of the relationships cannot be deduced. CONCLUSIONS Our data suggest that LTSB is associated with increased odds for feeling lonely in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public health campaigns.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - Garcia Ashdown-Franks
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Exercise Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Lore Christiaansen
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven Centre of Contextual Psychiatry, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Sibulwa S, Chansa-Kabali T, Hapunda G. "Every part of me has changed"-shared lived experiences of adolescents living with cancer in Zambia. Health Psychol Open 2019; 6:2055102919833537. [PMID: 30915226 PMCID: PMC6429662 DOI: 10.1177/2055102919833537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study explored experiences of adolescents living with cancer, focusing on physical and psychosocial problems. Semi-structured interviews were carried out on 18 adolescents aged between 12 and 18 years. Transcripts were analyzed using thematic analysis. Results showed that the adolescents faced a lot of physical, psychological, and social problems due to cancer diagnosis, treatment, and care. In order to improve their well-being and quality of life, psychosocial interventions should be incorporated in biomedical interventions that adolescents with cancer receive. This study proposes cost-effective interventions that can be implemented in resource-restricted sub-Saharan countries like Zambia.
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Affiliation(s)
| | | | - Given Hapunda
- Department of Psychology, University of Zambia, Zambia
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Nijhof SL, Vinkers CH, van Geelen SM, Duijff SN, Achterberg EM, van der Net J, Veltkamp RC, Grootenhuis MA, van de Putte EM, Hillegers MH, van der Brug AW, Wierenga CJ, Benders MJ, Engels RC, van der Ent CK, Vanderschuren LJ, Lesscher HM. Healthy play, better coping: The importance of play for the development of children in health and disease. Neurosci Biobehav Rev 2018; 95:421-429. [DOI: 10.1016/j.neubiorev.2018.09.024] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/27/2018] [Accepted: 09/26/2018] [Indexed: 12/20/2022]
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Majorano M, Maes M, Morelli M, Bastianello T, Guerzoni L, Murri A, Cuda D. Socio-emotional adjustment of adolescents with cochlear implants: Loneliness, emotional autonomy, self-concept, and emotional experience at the hospital. J Child Health Care 2018; 22:359-370. [PMID: 29400078 DOI: 10.1177/1367493518757065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent studies have reported contrasting results in the socio-emotional adjustment of Italian adolescents with cochlear implants (CIs). The aim of the present study is to explore the relationship between the socio-emotional adjustment of adolescents with CIs, the quality of their hospital stay, and their age at CI activation. The participants were 29 adolescents with CIs (CI group) and 29 typically developing adolescents (TD group). The Emotional Autonomy Scale, the Loneliness and Aloneness Scale for Children and Adolescents, and the Multidimensional Self-Concept Scale were administered to each participant. The emotional experience reported during the hospital stay was considered for each participant in the CI group. The adolescents with CIs displayed significantly higher levels of loneliness and lower levels of aversion toward aloneness than the TD group participants. Adolescents who had received the CI in preschool displayed a higher level of physical self-concept than adolescents who had received it later. The adolescents' emotional experiences at the hospital were reported to be quite complex and related to their relationships with parents. In summary, the findings point to a specific type of fragility in socio-emotional adjustment-focused on loneliness/aloneness-rather than a general one.
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Affiliation(s)
| | - Marlies Maes
- 2 School Psychology and Development, KU Leuven, Leuven, Belgium
| | - Marika Morelli
- 1 University of Verona, Department of Human Sciences, Verona, Italy
| | | | | | | | - Domenico Cuda
- 3 Guglielmo da Saliceto Hospital, Emilia-Romagna, Italy
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Douma M, Scholten L, Maurice-Stam H, Grootenhuis MA. Online cognitive-behavioral based group interventions for adolescents with chronic illness and parents: study protocol of two multicenter randomized controlled trials. BMC Pediatr 2018; 18:235. [PMID: 30021540 PMCID: PMC6052594 DOI: 10.1186/s12887-018-1216-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/09/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Adolescents with chronic illness (CI) and parents of a child with CI are at risk for psychosocial problems. Psychosocial group interventions may prevent these problems. With the use of cognitive-behavioral therapy, active coping strategies can be learned. Offering an intervention online eliminates logistic barriers (travel time and distance) and improves accessibility for participants. Aim of this study is to examine the effectiveness of two cognitive-behavioral based online group interventions, one for adolescents and one for parents: Op Koers Online. The approach is generic, which makes it easier for patients with rare illnesses to participate. METHODS/DESIGN This study conducts two separate multicenter randomized controlled trials. Participants are adolescents (12 to 18 years of age) with CI and parents of children (0 to 18 years of age) with CI. Participants are randomly allocated to the intervention group or the waitlist control group. Outcomes are measured with standardized questionnaires at baseline, after 8 (adolescents) or 6 (parents) weeks of treatment, and at 6- and 12-month follow-up period. Primary outcomes are psychosocial functioning (emotional and behavioral problems) and disease-related coping skills. Secondary outcomes for adolescents are self-esteem and quality of life. Secondary outcomes for parents are impact of the illness on family functioning, parental distress, social involvement and illness cognitions. The analyses will be performed according to the intention-to-treat principle. Primary and secondary outcomes will be assessed with linear mixed model analyses using SPSS. DISCUSSION These randomized controlled trials evaluate the effectiveness of two online group interventions improving psychosocial functioning in adolescents with CI and parents of children with CI. If proven effective, the intervention will be optimized and implemented in clinical practice. TRIAL REGISTRATION ISRCTN ISRCTN83623452 . Registered 30 November 2017. Retrospectively registered.
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Affiliation(s)
- Miriam Douma
- Psychosocial Department, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Linde Scholten
- Psychosocial Department, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Martha A. Grootenhuis
- Psychosocial Department, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Princess Maxima Center for Pediatric Oncology, University Medical Center, Lundlaan 6, Postbus 85090, 3508 AB Utrecht, the Netherlands
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Geerlings RPJ, Gottmer-Welschen LMC, Machielse JEM, de Louw AJA, Aldenkamp AP. Failed transition to independence in young adults with epilepsy: The role of loneliness. Seizure 2018; 69:207-212. [PMID: 31102826 DOI: 10.1016/j.seizure.2018.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/01/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Many young adults with epilepsy are still living with their parents ('failed transition to independence') despite reaching the adult age. This study evaluated patient-related variables and measures of loneliness correlated to 'failed transition to independence' in adults, 25-30 years of age, with (childhood-onset) epilepsy. METHODS Patients with (childhood-onset) epilepsy and 25-30 years of age were recruited from Epilepsy Center Kempenhaeghe. Inclusion criteria were: diagnosis of (childhood-onset) epilepsy, and an (estimated) IQ > 70. Patients were sent one questionnaire and informed consent was obtained from all participants. Questions included the patient's level of functioning and satisfaction on three transitional domains (medical status, educational/vocational status, independence/separation from their parents), satisfaction with their friendships, and the validated De Jong-Gierveld Loneliness Scale. 'Transition to independence' was defined and categorized in a continuum with scores ranging from 0 ('Failed transition') to 4 for all patients. A Bivariate Correlation analysis was used to compute correlations between patient characteristics and failed transition to independence. RESULTS 59 patients were included in the analysis, of which 19 (32.2%) had a failed transition to independence. A statistically significant correlation was found between transition to independence and the social loneliness scale (p = 0.047) and the total loneliness scale (p = 0.04), and for the patients self-reported satisfaction with their independence/separation from parents (p = 0.01) and friendships (p = 0.04). CONCLUSIONS Adults with epilepsy with a failed transition to independence experience loneliness and are not satisfied with their current developmental and social situation.
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Affiliation(s)
- R P J Geerlings
- Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Department of Neurology, University Hospital RWTH Aachen, Germany.
| | | | | | - A J A de Louw
- Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; University of Humanistic Studies, Utrecht, The Netherlands.
| | - A P Aldenkamp
- Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands; Faculty of Electrical Engineering, University of Technology, Eindhoven, The Netherlands; Department of Neurology, Maastricht University Hospital, The Netherlands.
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A demonstration and evaluation of the use of cross-classified random-effects models for meta-analysis. Behav Res Methods 2018; 51:1286-1304. [DOI: 10.3758/s13428-018-1063-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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[Psychological Health of Children with Chronic Physical Illness and their Parents - Results from Meta-Analyses]. Prax Kinderpsychol Kinderpsychiatr 2017; 66:656-671. [PMID: 29111893 DOI: 10.13109/prkk.2017.66.9.656] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Psychological Health of Children with Chronic Physical Illness and their Parents - Results from Meta-Analyses The present paper summarizes results from meta-analyses on psychological well-being of children with chronic physical illnesses and their parents. At the beginning, we discuss potential reasons for psychological effects of a chronic physical illness on children and adolescents as well as their parents. We then summarize results of meta-analyses of studies that compared aspects of mental health of children with a chronic physical illness and their parents with families of healthy children. Depressive symptoms, anxiety, and internalizing symptoms in general were most elevated in children with chronic fatigue syndrome and chronic headache while externalizing symptoms were most elevated in young people with epilepsy, chronic headache, and cerebral palsy. Depression and anxiety was less elevated in the ill children than in their parents. Parents of children with HIV-infection/AIDS and cerebral palsy reported the highest levels of distress, followed by parents of children diagnosed with cancer and spina bifida. Conclusions are drawn for future research and practice.
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Griffin A. Adolescent Neurological Development and Implications for Health and Well-Being. Healthcare (Basel) 2017; 5:healthcare5040062. [PMID: 28961184 PMCID: PMC5746696 DOI: 10.3390/healthcare5040062] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 12/18/2022] Open
Abstract
Adolescence is evolution’s solution to bringing the capacity of our large, complex brains to fruition. It is a critical period for brain development and the experiences of each adolescent during this time helps to shape their adult brain. Brain developments lead to both the hormonal changes and the emotional, cognitive, and behavioral characteristics of the teenage years. They drive a growth towards independence via more complex reasoning skills, increased importance of social affiliations outside the family, and an urge to experiment and explore boundaries. In the context of still incomplete inhibitory systems, a heightened sensitivity to rewards, including the need for social acceptance, can mean risk-taking or impulsive behaviour in some. The continued plasticity of the brain can also mean a creativity and openness to novel solutions. These normative steps of adolescence are especially relevant to young people with chronic health conditions. An understanding of brain development at this time can help us appreciate the perspective and priorities of adolescents with health conditions. It can also guide us towards better ways of collaborating with them.
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Affiliation(s)
- Angela Griffin
- Child Psychology Department, Southampton Children's Hospital, Mailpoint 133, Block 8, Tremona Rd., Southampton SO16 6YD, UK.
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