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Hayes D, Olsson A, Begum S, Bertotti M, Jarvis-Beesley P, Stapley E. Barriers and facilitators to social prescribing in child and youth mental health: perspectives from the frontline. Eur Child Adolesc Psychiatry 2024; 33:1465-1479. [PMID: 37405485 PMCID: PMC11098893 DOI: 10.1007/s00787-023-02257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
There is growing interest in the role of Social Prescribing (SP) to help promote mental well-being and support individuals with mental health difficulties. Yet, implementation of SP to children and young people (CYP) has proved slow and underdeveloped compared with adult populations. Understanding the barriers and facilitators will help key stakeholders to better embed SP for CYP into practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, perceived barriers and facilitators to SP were investigated. The sample comprised of 11 Link Workers and 9 individuals involved in facilitating SP with CYP, who took part in semi-structured interviews. Transcripts were analysed using a deductive thematic analysis, and themes were coded under each theoretical domain. Overall, 33 barriers and facilitators for SP were identified across 12 domains of the TDF. Under capability, barriers and facilitators were found for knowledge, skills, memory/attention/decision making processes, and behavioural regulation. For opportunity, barriers and facilitators were found for social/professional influences, as well as environmental context and resources. Finally, for motivation, domains covered included: beliefs about consequences, beliefs about capabilities, optimism, motivations/goals, reinforcement, and emotions. Findings suggest that a wide range of barriers and facilitators affect the implementation of CYP SP to improve mental health and well-being. Interventions which target different domains related to capability, opportunity and motivation should be developed to better facilitate CYP SP.
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Affiliation(s)
- D Hayes
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England.
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, England.
| | - A Olsson
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge, Cambridge, England
| | - S Begum
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
| | - M Bertotti
- Institute for Connected Communities, University of East London, London, England
| | - P Jarvis-Beesley
- Social Prescribing Youth Network (SPYN), Streetgames, Manchester, England
| | - E Stapley
- Evidence Based Practice Unit (EBPU), University College London and the Anna Freud National Centre for Children and Families, London, England
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Baldwin JR. Editorial Perspective: Misaligned incentives in mental health research - the case for Registered Reports. J Child Psychol Psychiatry 2024; 65:251-255. [PMID: 37782033 PMCID: PMC10952312 DOI: 10.1111/jcpp.13898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 10/03/2023]
Abstract
Current incentive structures reward mental health researchers for producing positive, novel, and clean results. This can promote questionable research practices which contribute to a distorted evidence base, in turn limiting progress in mental health research. Registered Reports (RRs) offer a solution to realign the incentives towards conducting high-quality, rigorous, and accurate studies, by preventing publication and reporting biases. However, the uptake of RRs in mental health research has so far been limited. This editorial perspective highlights the advantages of RRs for mental health research, before discussing potential challenges and how they can be addressed. Greater uptake of RRs in mental health research could help to promote a fairer research culture, limit publication bias and questionable research practices, and ultimately, improve understanding of mental health.
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Affiliation(s)
- Jessie R. Baldwin
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language SciencesUniversity College LondonLondonUK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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Samji H, Long D, Herring J, Correia R, Maloney J. Positive childhood experiences serve as protective factors for mental health in pandemic-era youth with adverse childhood experiences. CHILD ABUSE & NEGLECT 2024:106640. [PMID: 38278687 DOI: 10.1016/j.chiabu.2024.106640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND While adverse childhood experiences (ACEs) predict poorer mental health across the life course, positive childhood experiences (PCEs) predict better mental health. It is unclear whether PCEs protect against poor mental health outcomes and promote mental well-being in pandemic-era adolescents with ACEs. METHODS We examined the individual and joint contributions of ACEs and PCEs to mental health and well-being (MHW) in eleventh-grade British Columbian adolescents (N = 8864) during the fifth wave of COVID-19. We used a novel measure of ACEs that included community- and societal-level ACEs in addition to ACEs experienced at home to investigate the role of social and structural determinants of mental health in supporting the MHW of pandemic-era adolescents. A series of two-way ANCOVAs were conducted comparing MHW outcomes between adolescents with and without ACEs. Interaction effects were examined to investigate whether PCEs moderated the association between ACEs and MHW. RESULTS Adolescents with no ACEs had significantly better MHW than those with one or more ACE. Having six or more PCEs was associated with better MHW in adolescents with and without ACEs. PCEs significantly moderated the association between ACEs and depression. Effect sizes were larger for PCEs than ACEs in relation to depression, mental well-being, and life satisfaction. CONCLUSIONS PCEs may protect against depression among adolescents with ACEs and promote MHW among all pandemic-era adolescents. These findings emphasize the importance of addressing social determinants of mental health to mitigate the impact of ACEs and promote PCEs as part of a public health approach to MHW.
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Affiliation(s)
- Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, British Columbia, Canada; Population and Public Health Division, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, British Columbia V5Z 4R4, Canada.
| | - David Long
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, British Columbia, Canada; Faculty of Medicine, University of British Columbia, 317 - 2194, Health Sciences Mall, Vancouver, British Columbia V6T 1Z3, Canada.
| | - Jillian Herring
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, British Columbia, Canada.
| | - Rachel Correia
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, British Columbia, Canada.
| | - Jacqueline Maloney
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, British Columbia, Canada.
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Hayes D, Fancourt D, Burton A. The experiences and impact of the COVID-19 pandemic on young carers: practice implications and planning for future health emergencies. Child Adolesc Psychiatry Ment Health 2024; 18:2. [PMID: 38172971 PMCID: PMC10765662 DOI: 10.1186/s13034-023-00697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. METHOD We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. RESULTS We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. CONCLUSIONS Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future.
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Affiliation(s)
- D Hayes
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
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Marquez J, Francis-Hew L, Humphrey N. Protective factors for resilience in adolescence: analysis of a longitudinal dataset using the residuals approach. Child Adolesc Psychiatry Ment Health 2023; 17:140. [PMID: 38115137 PMCID: PMC10731682 DOI: 10.1186/s13034-023-00687-8] [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: 05/27/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION The residuals approach, in which residual scores from regression models are used as a proxy for resilient functioning, offers great potential to increase understanding of resilience processes. However, its application in child and adolescent wellbeing research is limited to date. We use this approach to examine how adversity exposure impacts later wellbeing (life satisfaction, and internalising mental health difficulties) in the early-to-middle adolescence transition; whether gender and ethnic differences in resilience exist; which internal and external factors confer protective effects for resilience; and, whether the protective effect of these factors differs by gender and level of adversity exposure. METHOD Secondary analysis of the #BeeWell longitudinal data set (N = 12,130 adolescents, aged 12/13 at T1 and 13/14 at T2, representative of Greater Manchester, England) was undertaken, using a series of linear regressions to establish adversity indices for later wellbeing, before assessing the protective effects of internal and external factors on resilience. RESULTS Multiple adversity factors (e.g., home material deprivation, sexuality discrimination, bullying) were found to impact later wellbeing. Girls and white adolescents presented lower levels of resilience than their peers. Internal psychological factors (self-esteem, emotional regulation, optimism) consistently conferred the strongest protective effects, but behavioural/activity factors (physical activity, sleep) also contributed to resilience. Among external factors, friendships and peer support were the most salient. Physical activity yielded stronger protective effects among boys (compared to girls). Effects of protective factors were stronger among those at lower (compared to higher) levels of adversity exposure. CONCLUSION The residuals approach can make a considerable contribution to our understanding of the interplay between adversity exposure and access to protective factors in determining adolescent wellbeing outcomes. Moreover, its application provides clear implications for policy and practice in terms of prevention (of adversity exposure) and intervention (to facilitate resilience).
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Affiliation(s)
- Jose Marquez
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK.
| | - Louis Francis-Hew
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
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Hu J, Feng Y, Su H, Xu Z, Ho HC, Zheng H, Zhang W, Tao J, Wu K, Hossain MZ, Zhang Y, Hu K, Huang C, Cheng J. Seasonal peak and the role of local weather in schizophrenia occurrence: A global analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 899:165658. [PMID: 37478950 DOI: 10.1016/j.scitotenv.2023.165658] [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: 04/25/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Many studies have shown that the onset of schizophrenia peaked in certain months within a year and the local weather conditions could affect the morbidity risk of schizophrenia. This study aimed to conduct a systematic analysis of schizophrenia seasonality in different countries of the world and to explore the effects of weather factors globally. METHODS We searched three databases (PubMed, Web of Science, and China National Knowledge Infrastructure) for eligible studies published up to September 2022. Schizophrenia seasonality was compared between hemispheres and within China. A meta-analysis was conducted to pool excess risk (ER, absolute percentage increase in risk) of the onset of schizophrenia associated with various weather factors including temperature (an increase or decrease of temperature as a reflection of high or low temperature; heatwave; temperature variation), precipitation, etc. RESULTS: We identified 84 relevant articles from 22 countries, mainly in China. The seasonality analysis found that the onset of schizophrenia mostly peaked in the cold season in the southern hemisphere but in the warm season in the northern hemisphere. Interestingly in China, schizophrenia seasonality presented two peaks, respectively in the late cold and warm seasons. The meta-analysis further revealed an increased risk of schizophrenia after short-term exposure to high temperature [ER%: 0.45 % (95 % confidence interval (CI): 0.14 % to 0.76 %)], low temperature [ER%: 0.52 % (95%CI: 0.29 % to 0.75 %)], heatwave [ER%: 7.26 % (95%CI: 4.45 % to 10.14 %)], temperature variation [ER%: 1.02 % (95%CI: 0.55 % to 1.50 %)], extreme precipitation [ER%: 3.96 % (95%CI: 2.29 % to 5.67 %)]. The effect of other weather factors such as sunlight on schizophrenia was scarcely investigated with inconsistent findings. CONCLUSION This study provided evidence of intra- and inter-country variations in schizophrenia seasonality, especially the double-peak seasons in China. Exposure to local weather conditions mainly temperature changes and precipitation could affect the onset risk of schizophrenia.
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Affiliation(s)
- Jihong Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Yufan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Hung Chak Ho
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China.
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Wang M, Richmond LL, Schleider JL, Nelson BD, Luhmann CC. Predicting internalizing symptoms with machine learning: identifying individuals that need care. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37943500 DOI: 10.1080/07448481.2023.2277185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
Objective The current project aims to identify individuals in urgent need of mental health care, using a machine learning algorithm (random forest). Comparison/contrast with conventional regression analyses is discussed. Participants: A total of 2,409 participants were recruited from an anonymous university, including undergraduate and graduate students, faculty, and staff. Methods: Answers to a COVID-19 impact survey, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were collected. The total scores of PHQ-9 and GAD-7 were regressed on six composites that were created from the questionnaire items, based on their topics. A random forest was trained and validated. Results: Results indicate that the random forest model was able to make accurate, prospective predictions (R2 = .429 on average) and we review variables that were deemed predictively relevant. Conclusions: Overall, the study suggests that predictive models can be clinically useful in identifying individuals with internalizing symptoms based on daily life disruption experiences.
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Affiliation(s)
- Mengxing Wang
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Christian C Luhmann
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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Carey EG, Ridler I, Ford TJ, Stringaris A. Editorial Perspective: When is a 'small effect' actually large and impactful? J Child Psychol Psychiatry 2023; 64:1643-1647. [PMID: 37226639 DOI: 10.1111/jcpp.13817] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 05/26/2023]
Abstract
Reporting of effect sizes is standard practice in psychology and psychiatry research. However, interpretation of these effect sizes can be meaningless or misleading - in particular, the evaluation of specific effect sizes as 'small', 'medium' and 'large' can be inaccurate depending on the research context. A real-world example of this is research into the mental health of children and young people during the COVID-19 pandemic. Evidence suggests that clinicians and services are struggling with increased demand, yet population studies looking at the difference in mental health before and during the pandemic report effect sizes that are deemed 'small'. In this short review, we utilise simulations to demonstrate that a relatively small shift in mean scores on mental health measures can indicate a large shift in the number of cases of anxiety and depression when scaled up to an entire population. This shows that 'small' effect sizes can in some contexts be large and impactful.
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Affiliation(s)
- Emma Grace Carey
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Isobel Ridler
- Division of Psychiatry, University College London, London, UK
| | - Tamsin Jane Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Argyris Stringaris
- Division of Psychiatry, University College London, London, UK
- First Dept of Psychiatry, National and Kapodistrian University of Athens, Greece
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Calderón Alfaro FA, Li YM, Okely J. Symptoms of depression and anxiety in young people in El Salvador: Associations with peer and family relationships, artistic activities and health behaviours during the COVID-19 pandemic. J Affect Disord 2023; 339:838-846. [PMID: 37481127 DOI: 10.1016/j.jad.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/08/2023] [Accepted: 07/08/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Little is known regarding the correlates of mental health, during the COVID-19 pandemic, in lower income countries. Using data from almost the entire population of graduating high school students in El Salvador, we examine the associations between depression and anxiety symptoms and potentially protective factors including peer and family relationships, health behaviours and artistic leisure activities. METHODS Data comes from the AVANZO survey conducted in El Salvador with 42,314 graduating high school students aged 15-21 in November 2020. Participants completed the Revised Child Anxiety and Depression Scale and Socioemotional Skills Scale. Using a structural equation modelling framework, we tested the associations between these variables and whether these associations varied by sex. RESULTS Participants who experienced more positive family relationships reported fewer symptoms of depression (β = -0.304, p < .001) and anxiety (β = -0.103, p < .001). Similar results were found between health behaviours and symptoms of depression (β = -0.398, p < .001), and anxiety (β = -0.312, p < .001). Peer relationships were non-significantly associated with depression and anxiety symptoms. Associations were similar for boys and girls. LIMITATIONS Students undertook the mental health survey as part of an academic test, which might have increased mental stress. The Socioemotional Skills Scales is newly developed, and results are cross-sectional. CONCLUSIONS Our findings provide insight into the experiences of an understudied population during the pandemic and identify positive family relationships and health behaviours as important correlates of mental health during this time.
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O'Neill A, Stapley E, Rehman I, Humphrey N. Adolescent help-seeking: an exploration of associations with perceived cause of emotional distress. Front Public Health 2023; 11:1183092. [PMID: 37849721 PMCID: PMC10578439 DOI: 10.3389/fpubh.2023.1183092] [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: 03/09/2023] [Accepted: 08/31/2023] [Indexed: 10/19/2023] Open
Abstract
Background Help-seeking is intrinsic to efforts to manage the onset, maintenance, or escalation of mental health difficulties during adolescence. However, our understanding of adolescent help-seeking remains somewhat nebulous. A greater comprehension of help-seeking behavior from the perspective of adolescents is needed. It is also prudent to explore help-seeking behavior in the context of perceived cause for emotional distress, particularly as causal beliefs have been found to influence help-seeking behavior in adults. Objectives The present study sought to categorize adolescents' experiences of help-seeking, and to examine the extent to which these categories (or "types") of help-seeking behavior are associated with their perceptions of causal factors for emotional distress. Methods The data for this study were drawn from interviews conducted as part of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11-12 years. Ideal-type analysis, a qualitative form of person-centered analysis, was used to construct a typology of adolescent help-seeking. Participants' help-seeking "type" was then compared with their perceived cause for emotional distress "type." Findings We developed four distinct categories of help-seeking: (1) guided by others who have taken notice; (2) skeptical with unmet needs; (3) motivated and solution focused; and (4) preference for self-regulation. Simultaneously, we identified principal associations between perceived cause of emotional distress-(1) perceived lack of control; (2) unfair treatment; (3) others: their actions and judgements as the catalyst; (4) concern for self and others; and (5) self as cause-and help-seeking approaches. "Perceived lack of control" was most likely to be associated with "others who have taken notice"; "Unfair treatment" with "skeptical with unmet needs"; "others: their actions and judgements as the catalyst" with "motivated and solution focused"; "concern for self and others' with 'guided by others who have taken notice"; finally, "self as cause" was most likely to be associated with "preference for self-regulation." Conclusions This study demonstrates meaningful and distinct categories of adolescent help-seeking and offers empirical evidence to support the assertion that perceived cause for emotional distress may influence the help-seeking approaches of adolescents.
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Affiliation(s)
- Alisha O'Neill
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
| | - Emily Stapley
- Evidence Based Practice Unit (EBPU), Anna Freud National Centre for Children and Families and University College London (UCL), London, United Kingdom
| | - Ishba Rehman
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
| | - Neil Humphrey
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
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Choi SSW, Sakong JK, Woo HJ, Lee SK, Lee BC, Yoon HJ, Yang JC, Sohn M. The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study. CHILD HEALTH NURSING RESEARCH 2023; 29:271-279. [PMID: 37939673 PMCID: PMC10636528 DOI: 10.4094/chnr.2023.29.4.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/01/2023] [Accepted: 09/19/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. METHODS A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. RESULTS Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). CONCLUSION The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.
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Affiliation(s)
| | - Jeong-Kyu Sakong
- Professor, Department of Psychiatry, Dongkuk University, Gyeongju, Korea
| | - Hyo Ju Woo
- Graduate Student, Department of Nursing, Inha University, Incheon, Korea
| | - Sang-Kyu Lee
- Professor, Department of Psychiatry, Hallym University, Chuncheon, Korea
| | - Boung Chul Lee
- Professor, Department of Psychiatry, Hallym University, Chuncheon, Korea
| | - Hyung-Jun Yoon
- Professor, Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
| | - Jong-Chul Yang
- Professor, Department of Psychiatry, Jeonbuk National University, Jeonju, Korea
| | - Min Sohn
- Professor, Department of Nursing, Inha University, Incheon, Korea
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Montero-Marin J, Hinze V, Mansfield K, Slaghekke Y, Blakemore SJ, Byford S, Dalgleish T, Greenberg MT, Viner RM, Ukoumunne OC, Ford T, Kuyken W. Young People's Mental Health Changes, Risk, and Resilience During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2335016. [PMID: 37733343 PMCID: PMC10514742 DOI: 10.1001/jamanetworkopen.2023.35016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Importance As young people's mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical. Objective To explore the outcomes of the COVID-19 pandemic on secondary school students' mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics. Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated "inadequate" in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021). Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students' mental health were explored. Main Outcomes and Measures Changes in students' risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale). Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, -2.08; 95% CI, -2.80 to -1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school. Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.
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Affiliation(s)
- Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
| | - Verena Hinze
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Karen Mansfield
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Yasmijn Slaghekke
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Sarah-Jayne Blakemore
- Department of Psychology, University of Cambridge, Cambridge, England, United Kingdom
| | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King’s Health Economics, King’s College London, London, England, United Kingdom
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, England, United Kingdom
| | - Mark T. Greenberg
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, State College, Pennsylvania
| | - Russell M. Viner
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, England, United Kingdom
| | - Obioha C. Ukoumunne
- National Institute for Health and Care Research Applied Research Collaboration (PenARC) South West Peninsula, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, England, United Kingdom
| | - Tamsin Ford
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, England, United Kingdom
| | - Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
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13
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de Faria SR, Pedras S, Inman R, Lopes JC, Moreira PAS. Subjective well-being and school engagement before versus during the COVID-19 pandemic: What good are positive emotions? JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:973-985. [PMID: 37073453 DOI: 10.1111/jora.12853] [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: 03/08/2022] [Revised: 01/31/2023] [Accepted: 04/02/2023] [Indexed: 05/03/2023]
Abstract
The present study overcomes the limited empirical evidence on the association between well-being and school engagement in times of adversity by exploiting available data from two large and comparable samples of eighth graders; one obtained prior to the COVID-19 pandemic and the second obtained during the pandemic. Results suggest that adolescents were less engaged with their learning context during the pandemic, as well as lower in positive and negative affect, but slightly more satisfied with life. Through SEM we found a stronger positive association between positive affect and school engagement in the COVID-19 group compared with the pre-COVID-19 group. This finding highlights the important role of positive affect in supporting better academic functioning in the aftermath of a global crisis.
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Affiliation(s)
- Sara Ribeiro de Faria
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD) [The Psychology for Positive Development Research Center], Universidade Lusíada, Porto, Portugal
- Faculdade de Psicologia e Ciências da Educação [Faculty of Psychology and Education Sciences] Universidade do Porto [University of Porto], Porto, Portugal
- Centro de Psicologia da Universidade do Porto [Center for Psychology at the University of Porto], Porto, Portugal
| | - Susana Pedras
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD) [The Psychology for Positive Development Research Center], Universidade Lusíada, Porto, Portugal
- Instituto de Psicologia e de Ciências da Educação [Institute of Psychology and Education], Universidade Lusíada, Porto, Portugal
| | - Richard Inman
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD) [The Psychology for Positive Development Research Center], Universidade Lusíada, Porto, Portugal
- Instituto de Psicologia e de Ciências da Educação [Institute of Psychology and Education], Universidade Lusíada, Porto, Portugal
| | - Joana Correia Lopes
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD) [The Psychology for Positive Development Research Center], Universidade Lusíada, Porto, Portugal
| | - Paulo A S Moreira
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD) [The Psychology for Positive Development Research Center], Universidade Lusíada, Porto, Portugal
- Escola de Ciências Humanas e Sociais [School of Human and Social Sciences], Universidade de Trás-os-Montes e Alto Douro, Vila-Real, Portugal
- Centro de Investigação e Intervenção Educativas [Centre for Research and Intervention in Education], Universidade do Porto [University of Porto], Porto, Portugal
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14
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Kokkonen P, Athanasopoulou C, Leino-Kilpi H, Puukka P, Sakellari E. Adolescents' difficulties, strengths and feelings of insecurity: a cross-sectional descriptive survey in Finland. DISCOVER MENTAL HEALTH 2023; 3:17. [PMID: 37861814 PMCID: PMC10501005 DOI: 10.1007/s44192-023-00043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/23/2023] [Indexed: 10/21/2023]
Abstract
The present study aimed to describe adolescents' self-reported emotional and behavioural strengths and difficulties, as well as their insecurity feeling. In addition, the aim was to examine the association with background characteristics, and explore the association between strengths and difficulties and insecurity factors. The study was conducted among 114 secondary school pupils in Finland, using an online questionnaire. Adolescents' emotional and behavioural difficulties and strengths, were mostly classified as normal. Strengths and Difficulties Questionnaire total score as well as internal and external score, were inversely associated with insecurity factors. Girls had significantly higher prosocial behavior compared to boys (P = 0.0007). The age of adolescents was found to be related to their internal difficulties (P = 0.02) and prosocial behavior (P = 0.01). Adolescent's perception of their family relations as poor was associated with external difficulties (P = 0.04). The current results, can be helpful for mental health professionals who work with adolescents in order to implement appropriate and needs specific mental health promotion interventions at individual but also community level. Finally, more research is needed to validate measures for insecurity. This will support mental health professionals in their clinical practice by providing them with all the important factors needed to support adolescents.
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Affiliation(s)
- Pinja Kokkonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Christina Athanasopoulou
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Occupational Therapy, University of West Attica, Athens, Greece
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | | | - Evanthia Sakellari
- Department of Nursing Science, University of Turku, Turku, Finland.
- Department of Public and Community Health, University of West Attica, Athens, Greece.
- , 196 Alexandras Av., 11521, Athens, Greece.
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Hayes D, Mansfield R, Mason C, Santos J, Moore A, Boehnke J, Ashworth E, Moltrecht B, Humphrey N, Stallard P, Patalay P, Deighton J. The impact of universal, school based, interventions on help seeking in children and young people: a systematic literature review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-022-02135-y. [PMID: 36637482 PMCID: PMC9837763 DOI: 10.1007/s00787-022-02135-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/21/2022] [Indexed: 01/14/2023]
Abstract
Reviews into universal interventions to improve help seeking in young people focus on specific concepts, such as behaviour, do not differentiate between interpersonal and intrapersonal help seeking, and often report on statistical significance, rather than effect size. The aim of this review was to address the gaps highlighted above, to investigate the impact of universal, school-based interventions on help-seeking in children and young people, as well as to explore longer term impact. Four databases were searched. Data were extracted on country of origin, design, participant, school, and intervention characteristics, the help-seeking concept measured (e.g. knowledge, attitude/intention, behaviour), the duration between baseline and each follow-up (if applicable) and effect sizes at each follow-up. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Overall, 14 different interventions met inclusion criteria. The majority of the studies were rated low in the quality assessment. Three constructs were most frequently reported a) intrapersonal attitudes towards help-seeking, b) interpersonal attitudes towards help-seeking and c) intrapersonal intended help-seeking. Findings around intervention effect were mixed. There was tentative evidence that interventions impacting interpersonal attitudes produced small effect sizes when measured between 3 and 6 months post intervention and that when effect sizes were initially observed intrapersonal attitudes, this remained at 3-6 month follow-up. Further work should pay attention to implementation factors, understanding the core ingredients needed to deliver effective interventions and whether embedding mental health education could help sustain or top up effect sizes from help-seeking interventions.
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Affiliation(s)
- Daniel Hayes
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK.
- Social Biobehavioural Research Group, Department of Behavioural Science and Health, University College London, London, UK.
| | - Rosie Mansfield
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Carla Mason
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Joao Santos
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Anna Moore
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
| | - Jan Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Bettina Moltrecht
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | | | - Praveetha Patalay
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
- Population Science and Experimental Medicine, MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jessica Deighton
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
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Foster S, Estévez-Lamorte N, Walitza S, Dzemaili S, Mohler-Kuo M. Perceived stress, coping strategies, and mental health status among adolescents during the COVID-19 pandemic in Switzerland: a longitudinal study. Eur Child Adolesc Psychiatry 2022; 32:937-949. [PMID: 36515772 PMCID: PMC9749639 DOI: 10.1007/s00787-022-02119-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022]
Abstract
This longitudinal, prospective study investigated associations between perceived COVID-19-related stress, coping strategies, and mental health status among adolescents during the first lockdown of the COVID-19 pandemic and one year after the lockdown in Switzerland within a large, national sample. A self-report on-line survey was completed by 553 adolescents (age-range 12-18 years in 2021) in the summers of 2020 and 2021, assessing symptoms of various mental health problems, perceived COVID-19-related stressors, and coping strategies. Overall, participants reported less COVID-19 related stress one year after the lockdown, though mental health status remained stable. 'Challenges at home or with others' were significantly associated with mental health problems in both genders, whereas 'trouble getting medical care or mental health services 'was associated with mental health problems in girls. Perceived stress and pre-existing psychiatric problem were significantly linked to all mental health outcomes at both time points. Parents' poor relationships with partners during the lockdown was associated with increased anxiety symptoms in their children. Using cognitive restructuring to cope with stress was associated with less, while negative coping was associated with more anxiety, depression, and attention deficit hyperactivity disorder (ADHD) symptoms one year post lockdown. Girls appear to have been more affected by the pandemic than boys, with youths with pre-existing psychiatric problems especially vulnerable to its detrimental effects. Healthcare and school professionals should support to identify high-risk adolescents with negative and avoidant coping strategies and train youths to use positive coping strategies.
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Affiliation(s)
- Simon Foster
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.
| | - Natalia Estévez-Lamorte
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Shota Dzemaili
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Meichun Mohler-Kuo
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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