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Nyakato M, Naggayi SK, Akun PR, Ononge S, Odong A, Baguma EA, Nansiiro H, Kalibbala D, Ouma S, Besigye I, Idro R. Poor neurodevelopment, nutritional and physical growth outcomes among children born to mothers with nodding syndrome. Seizure 2024:S1059-1311(24)00260-7. [PMID: 39343705 DOI: 10.1016/j.seizure.2024.09.012] [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: 07/15/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 10/01/2024] Open
Abstract
INTRODUCTION Nodding syndrome (NS), a poorly understood severe neurological disorder develops in children. In Uganda, some NS cases have grown into child-bearing adults. Babies born to mothers with NS may be prone to impaired neurodevelopmental outcomes. Cognitive deficits in mothers with NS may further inhibit care offered to their children hence compromising neurocognitive development, physical growth, and behaviour. OBJECTIVES The study aimed to determine the neurodevelopmental, behavioural, nutritional, and physical growth outcomes of children whose mothers have nodding syndrome. METHODS A comparative cross-sectional study was conducted between May 2021 and April 2022 in Northern Uganda. Children aged 0-5 years of mothers with NS were compared to those of mothers without NS, matched by age, gender and neighbouring residence. Neurodevelopment, behaviour, nutrition, and physical growth were assessed using standardized measures and t-tests employed for group comparisons of outcomes. RESULTS Overall,106 children participated. Fifty-three (53) were offspring of mothers with NS and 53 of mothers without NS; having a mean age of 26.9 (2.22) and 27.5(2.12) months respectively. Children whose mothers have NS had significantly lower neurodevelopmental scores than those of NS-unaffected mothers in fine motor (37.5(12.1) vs 44.2(14.3), p = 0.011), receptive language (37.8(10.8) vs 43.9(12.9), p = 0.010), overall cognitive development (74.36(17.8) vs 83.34(19.6), p = 0.015), and attention (0.64(0.20) vs 0.76(0.15), p = 0.001). There were no differences in the behaviour scores. Children of mothers with NS also had significantly lower weight-for-age z scores (WAZ) (p = 0.003) and length/height-for-age z scores (LAZ/HAZ) (p = 0.001); with 19(35.9 %) of them stunted. CONCLUSION Children whose mothers have NS have poorer neurodevelopmental, nutritional, and physical growth outcomes. Interventions to improve outcomes in these children are warranted.
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Affiliation(s)
- Mary Nyakato
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda; Global Health Uganda, P.O. Box 33842, Kampala-Uganda.
| | - Shubaya Kasule Naggayi
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda; Global Health Uganda, P.O. Box 33842, Kampala-Uganda
| | - Pamela Rosemary Akun
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda; Centre of Tropical Neuroscience, Kitgum Site, P.O. Box 27520, Kampala-Uganda
| | - Sam Ononge
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda
| | - Alfred Odong
- Global Health Uganda, P.O. Box 33842, Kampala-Uganda
| | - Erias Adams Baguma
- Makerere University-John Hopkins University Research Collaboration, P.O. Box 23491, Kampala-Uganda
| | - Hellen Nansiiro
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda
| | | | - Simple Ouma
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda
| | - Innocent Besigye
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda
| | - Richard Idro
- College of Health Sciences, Makerere University, P.O. Box 7072, Kampala-Uganda; Global Health Uganda, P.O. Box 33842, Kampala-Uganda; Centre of Tropical Neuroscience, Kitgum Site, P.O. Box 27520, Kampala-Uganda
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Walker LO. Maternal postpartum health and its impact on health and development of young children. WOMEN'S HEALTH NURSING (SEOUL, KOREA) 2024; 30:96-100. [PMID: 38853341 PMCID: PMC11237364 DOI: 10.4069/whn.2024.03.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/30/2024] [Indexed: 06/11/2024]
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Kim SI, Kim SM, Park SJ, Song J, Lee J, Kim KH, Park SM. Association of parental depression with adolescent children's psychological well-being and health behaviors. BMC Public Health 2024; 24:1412. [PMID: 38802817 PMCID: PMC11129386 DOI: 10.1186/s12889-024-18337-9] [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: 10/27/2023] [Accepted: 03/12/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Parental depression is a significant problem that negatively affects parents' welfare and influences family dynamics, children's academic and health behaviors, and mental health. However, there is limited evidence regarding the impact of the parental depression into the children's' psychological and physical wellbeing on Asian cultures. This study examined the psychological burdens and health behaviors of adolescent children with parents with depression in the Republic of Korea. METHODS We conducted a cross-sectional study using data from the Korean National Health and Nutrition Examination Survey (KNHANES) spanning 2013 to 2021 to compare health behaviors and mental health outcomes between 203 adolescent children with parents diagnosed with depression and 3,856 control adolescents aged 12-19 years. RESULTS Following multivariate adjustments, the risk of depressive mood for more than two weeks was significantly increased in boys with parental depression (adjusted Odds Ratio [aOR] = 2.05, 95% Confidence Interval [CI] = 1.91-3.52) and adolescents with parents with moderate-to-severe depression (aOR = 2.60, 95% CI = 1.17-5.77). Adolescents with parental depression reported significantly worse subjective health status (aOR = 1.88, 95% CI = 1.05-3.36) and higher stress levels (aOR = 1.91, 95% CI = 1.33-2.76). Additionally, when parental depression was present and the time since depression diagnosis was more than five years, adolescents with parental depression exhibited even poorer subjective health status and higher stress levels. CONCLUSIONS The study found that adolescents whose parents experienced depression had poorer mental health than those whose parents did not have mental health issues. These findings emphasize the importance of providing support for the mental health of adolescents in families affected by parental depression.
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Affiliation(s)
- Sung-In Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung Min Kim
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University Graduate School, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jihun Song
- Department of Biomedical Sciences, Seoul National University Graduate School, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jaewon Lee
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Kyae Hyung Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
- Home Healthcare Clinic, Public Healthcare Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
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Ohan JL, Jackson HM, Bett R, Farmer GM, Martini A. Experiences and needs of children and adolescents affected by a parent's acquired brain injury: a systematic review and thematic synthesis. Disabil Rehabil 2024; 46:1034-1044. [PMID: 36861777 DOI: 10.1080/09638288.2023.2179673] [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: 05/09/2021] [Revised: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To identify the experiences and needs of dependent children who have a parent with an acquired brain injury (ABI) using a systematic review and thematic synthesis. MATERIALS AND METHODS A systematic search of Medline, Embase, PsycINFO, CINAHL Plus, and Web of Science was conducted. The search included variants of: "children," "parents," "acquired brain injury," and "experiences" or "needs." Eligible articles reported on the experiences/needs of dependent children who have a parent with an ABI, from the child's perspective. Thematic analysis was used to identify themes. RESULTS A total of 4895 unique titles were assessed, and 9 studies met inclusion. Four themes were identified: (1) Sustained Emotional Toll (subthemes: (i) Initial Shock and Distress; (ii) Ongoing Loss and Grief; (iii) Present-Day Stress and Emotions), (2) Responsibilities Change and Children Help Out, (3) Using Coping Strategies (subtheme: Talking Can Help), and (4) Wanting Information about the Injury. CONCLUSION Themes highlighted significant disruption and challenges to children's wellbeing across development, with ongoing and considerable impacts many years after the parent's injury. The nature of the experiences shifted with time since the parent's injury. These children need ongoing support starting shortly after their parent's injury that is grounded in their particular experiences.IMPLICATIONS FOR REHABILITATIONWhen a parent has an acquired brain injury (ABI), dependent children and adolescents face emotional upheaval, significant stressors, increased responsibilities, and lack of information about their parent's injury that persist even many years after injury.The nature of these experiences and therefore their needs change based on the acute versus later stages of the parent's injury.Children often do not ask questions or tell others how they feel, which means that they need support that asks about, and listens and responds to their needs.Support for children needs to start soon after the parent's injury, be grounded in the lived experiences of this group, consider their parent's recovery stage, and be embedded as part of service provision rather than rely on children or families to make service contact.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Hayley M Jackson
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Robyn Bett
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Glenda M Farmer
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
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Powis KM, Lebanna L, Schenkel S, Masasa G, Kgole SW, Ngwaca M, Kgathi C, Williams PL, Slogrove AL, Shapiro RL, Lockman S, Mmalane MO, Makhema JM, Jao J, Cassidy AR. Lower academic performance among children with perinatal HIV exposure in Botswana. J Int AIDS Soc 2023; 26 Suppl 4:e26165. [PMID: 37909233 PMCID: PMC10618869 DOI: 10.1002/jia2.26165] [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: 01/24/2023] [Accepted: 08/23/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION Studies have reported a higher risk of suboptimal neurodevelopment among children who are HIV-exposed uninfected (HEU) compared to children HIV-unexposed uninfected (HUU). Actual academic performance among school-aged children by HIV exposure status has not been studied. METHODS Academic performance in Mathematics, Science, English, Setswana and overall among children enrolled in the Botswana-based FLOURISH study who were attending public primary school and ranging in age from 7.1 to 14.6 years were compared by HIV exposure status using a Cochran-Mantel-Haenszel test. Lower academic performance was defined as a grade of "C" or lower (≤60%). Unadjusted and adjusted logistic regression models were fit to assess for an association between HIV exposure and lower academic performance. RESULTS Between April 2021 and December 2022, 398 children attending public primary school enrolled in the FLOURSH study, 307 (77%) were HEU. Median age was 9.4 years (IQR 8.9-10.2). Only 17.9% of children HEU were breastfeed versus 100% of children HUU. Among children HEU, 80.3% had foetal exposure to three-drug antiretroviral treatment, 18.7% to zidovudine only and 1.0% had no antiretroviral exposure. Caregivers of children HEU were older compared to caregivers of children HUU (median 42 vs. 36 years) and more likely to have no or primary education only (15.0% vs. 1.1%). In unadjusted analyses, children HEU were more likely to have lower overall academic performance compared to their children HUU (odds ratio [OR]: 1.96 [95% confidence interval (CI): 1.16, 3.30]), and lower performance in Mathematics, Science and English. The association was attenuated after adjustment for maternal education, caregiver income, breastfeeding, low birth weight and child sex (aOR: 1.86 [95% CI: 0.78, 4.43]). CONCLUSIONS In this Botswana-based cohort, primary school academic performance was lower among children HEU compared to children HUU. Biological and socio-demographic factors, including child sex, appear to contribute to this difference. Further research is needed to identify modifiable contributors, develop screening tools to identify the risk of poor academic performance and design interventions to mitigate risk.
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Affiliation(s)
- Kathleen M. Powis
- Department of Internal Medicine and PediatricsMassachusetts General HospitalBostonMassachusettsUSA
- Department of Immunology and Infectious DiseasesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Botswana Harvard Health PartnershipGaboroneBotswana
| | - Lesedi Lebanna
- Department of Curriculum Development and EvaluationBotswana Ministry of Basic EducationGaboroneBotswana
| | - Sara Schenkel
- Department of Internal Medicine and PediatricsMassachusetts General HospitalBostonMassachusettsUSA
| | | | | | | | | | - Paige L. Williams
- Departments of Biostatistics and EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Amy L. Slogrove
- Department of Paediatrics & Child HealthFaculty of Medicine and Health SciencesStellenbosch UniversityWorcesterSouth Africa
| | - Roger L. Shapiro
- Department of Immunology and Infectious DiseasesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Botswana Harvard Health PartnershipGaboroneBotswana
| | - Shahin Lockman
- Department of Immunology and Infectious DiseasesHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Botswana Harvard Health PartnershipGaboroneBotswana
- Division of Infectious DiseasesBrigham and Women's HospitalBostonMassachusettsUSA
| | | | | | - Jennifer Jao
- Botswana Harvard Health PartnershipGaboroneBotswana
- Department of PediatricsNorthwestern Feinberg School of MedicineChicagoIllinoisUSA
| | - Adam R. Cassidy
- Botswana Harvard Health PartnershipGaboroneBotswana
- Departments of Psychiatry & Psychology and Pediatric & Adolescent MedicineMayo ClinicRochesterMinnesotaUSA
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6
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Schreier A, Stenersen MR, Strambler MJ, Marshall T, Bracey J, Kaufman JS. Needs of Caregivers of Youth Enrolled in a Statewide System of Care: A Latent Class Analysis. CHILDREN AND YOUTH SERVICES REVIEW 2023; 147:106838. [PMID: 37719138 PMCID: PMC10501261 DOI: 10.1016/j.childyouth.2023.106838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Objective Systems of care (SOC) provide a coordinated array of services to youth with serious emotional and behavioral problems and their families. Little is known about what caregiver-specific needs at presentation to care may contribute to use of and engagement with care coordination and subsequent youth and family outcomes. This study aimed to determine latent classes of youth enrolled in wraparound care coordination within a statewide SOC based on caregiver needs impacting youth functioning and identify the relationship between class membership and characteristics of participation in Child and Family Team meetings (CFTs) and mental health outcomes at six-month follow-up. Method Participants were 703 youth (Mage = 11.21, SD = 3.67) and their caregivers that had information about caregiver needs and received a six-month follow-up assessment. Latent class analysis determined latent classes of families based on caregiver service needs at presentation to care, and differences in participation in care coordination and youth outcomes at 6-month follow up based on class membership was examined. Results Results indicated four classes of caregivers: Physical Health Needs, No Needs, Basic Needs, and Mental Health/Trauma Needs. Class membership was associated with size of the CFT, number of CFTs attended by the youth, percentage of CFTs with a natural support present, and percentage of CFTs that occurred in the family's home. Class membership was associated with caregiver ratings of objective strain at 6-month follow-up. Conclusion Assessing caregiver needs at presentation to care can provide direction for care coordinators to more directly target areas of family need through wraparound and individualize services.
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Affiliation(s)
- Alayna Schreier
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine
| | - Madeline R Stenersen
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine
| | - Michael J Strambler
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine
| | - Tim Marshall
- Office of Community Based Mental Health Services, Connecticut Department of Children and Families
| | - Jeana Bracey
- Child Health and Development Institute of Connecticut, Inc
| | - Joy S Kaufman
- Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine
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Brucato M, Lance E, Lanzkron S, Wang X, Pecker LH. Developmental disorders in children born to women with sickle cell disease: A report from the Boston Birth Cohort. EJHAEM 2022; 3:894-898. [PMID: 36051016 PMCID: PMC9421989 DOI: 10.1002/jha2.478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
Children exposed to maternal sickle cell disease (SCD) have many theoretical risks for developmental disorders, but little is known about long-term outcomes for these children. We used the Boston Birth Cohort to compare developmental outcomes between children exposed to maternal SCD and matched, unexposed controls. Children with exposure to maternal SCD had increased risk of attention deficit hyperactivity disorder (OR 5.12, 95% CI 1.36-19.19, p = 0.02) and obesity (OR 2.74, 95% CI 1.10-6.87, p = 0.03). In utero and/or environmental exposures may help explain these findings. Further studies of outcomes of children born to women with SCD are needed.
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Affiliation(s)
- Martha Brucato
- Department of Internal Medicine/PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Eboni Lance
- Department of Neurology and Developmental MedicineKennedy Krieger Institute, BaltimoreMarylandUSA
| | - Sophie Lanzkron
- Division of HematologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Xiaobin Wang
- The Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Lydia H. Pecker
- Division of HematologyDepartment of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Berkelbach van der Sprenkel EE, Nijhof SL, Dalmeijer GW, Onland-Moret NC, de Roos S, Lesscher HMB, van de Putte EM, van der Ent CK, Finkenauer C, Stevens GWJM. Psychosocial functioning in adolescents growing up with chronic disease: The Dutch HBSC study. Eur J Pediatr 2022; 181:763-773. [PMID: 34595612 PMCID: PMC8821406 DOI: 10.1007/s00431-021-04268-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/29/2021] [Accepted: 09/17/2021] [Indexed: 11/30/2022]
Abstract
Many adolescents worldwide (indirectly) grow up with a chronic disease, which may impact their functioning and wellbeing. The objective of this study is to assess whether adolescents with a (family member with a) chronic disease differ from their healthy counterparts in terms of psychosocial functioning. Data from the Dutch 2013 HBSC-survey were used, including 7168 adolescents (Meanage = 13.7, SD = 1.57, 50.5% female). Participants indicated whether they or one of their family members had a long-term (> 3 months) disease or disability (mental/physical) and were categorized into four groups based on disease presence (none, other, self, both). Psychosocial functioning was assessed in terms of life satisfaction, self-rated health, psychosomatic health, mental health problems, support, substance use, physical exercise, screen time, and school liking. Chronically diseased adolescents (n = 162) reported lower life satisfaction, self-rated and psychosomatic health, more mental health problems, lower peer support, more substance use, and less physical exercise compared to healthy peers. Chronically diseased adolescents who also had a family member with a chronic disease (n = 74) showed comparable outcomes on these life domains, although they did not differ from their healthy peers regarding peer support, substance use, and physical activity. Healthy adolescents with a chronically diseased family member (n = 737) reported significantly lower life satisfaction, self-rated and psychosomatic health, more mental health problems, and less family support compared to healthy peers who grew up in healthy families; however, they reported more positive outcomes than adolescents who had a chronic disease themselves.Conclusion: Having a (family member with a) chronic disease is associated with impaired psychosocial functioning on various life domains. Our findings aid in understanding the psychosocial associates of chronic disease and imply that caregivers should be observant of psychosocial problems among vulnerable adolescents to provide appropriate guidance. What is Known: • Adolescents who grow up with a (family member with a) chronic disease encounter numerous challenges that may be related to poorer developmental outcomes on the long term. What is New: • This study adds a comprehensive overview of the psychosocial functioning of adolescents with a (family member with a) chronic disease, as compared to healthy counterparts that grow up in a healthy family.
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Affiliation(s)
| | - Sanne L. Nijhof
- Department of Pediatrics, Wilhelmina Children’s Hospital, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Geertje W. Dalmeijer
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - N. Charlotte Onland-Moret
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | -
Simone
A. de Roos
- The Netherlands Institute for Social Research (SCP), Ministry of Health, Welfare and Sport, The Hague, The Netherlands
| | - Heidi M. B. Lesscher
- Department of Animals in Science and Society, Division of Behavioural Neuroscience, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Elise M. van de Putte
- Department of Pediatrics, Wilhelmina Children’s Hospital, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Cornelis K. van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Gonneke W. J. M. Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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Kaasbøll J, Skokauskas N, Lydersen S, Sund AM. Parental Chronic Illness, Internalizing Problems in Young Adulthood and the Mediating Role of Adolescent Attachment to Parents: A Prospective Cohort Study. Front Psychiatry 2021; 12:807563. [PMID: 35035361 PMCID: PMC8758574 DOI: 10.3389/fpsyt.2021.807563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Parental chronic illness is associated with an elevated risk for developing social-emotional and behavioral problems in children, in particular internalizing symptoms. This study aimed to investigate the associations between parental chronic illness when participants were adolescents and subsequent internalizing symptoms in young adulthood and whether adolescent attachment to parents or peers mediates these associations. Methods: The study used longitudinal survey data from the Youth and Mental Health Study, a cohort study including a representative sample of youth in central Norway assessed in the period from 1999 to 2000 (mean age 14.9 years) and in 2012 (mean age 27.2 years) (N = 1,266). The data consist of youth self-reports at both time points. Parental chronic illness was reported by the adolescents, quality of attachment was measured using the Inventory of Parent and Peer Attachment (IPPA), and internalizing problems were assessed in young adulthood by using the Adult Self-Report (ASR). Data were analyzed using parallel mediation analyses, controlling for adolescent sex, parental socioeconomic status, and divorce. In addition, separate analyses were conducted for adolescent girls and boys. Results: The total longitudinal effect was significant for both maternal and paternal chronic illness on internalizing problems in young adulthood. The direct effect on internalizing problems was only significant for maternal chronic illness. Attachment to fathers partially mediated the relationship between maternal chronic illness in adolescence and internalizing symptoms in young adulthood, whereas attachment to both mothers and fathers fully mediated the relationship between paternal chronic illness in adolescence and internalizing symptoms in young adulthood. A separate analysis for girls and boys indicated that the results were only significant for girls. Parental chronic illness did not play a significant indirect effect via attachment to peers on internalizing problems. Conclusions: Identifying protective factors in the pathways between parental chronic illness and mental distress in children could guide measures that promote the well-being of the child and family. The study demonstrates the importance of targeting the entire family in chronic illness care.
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Affiliation(s)
- Jannike Kaasbøll
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Norbert Skokauskas
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Mari Sund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
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Geoffray MM, Robinson L, Ramamurthy K, Manderson L, O'Flaherty J, Lehtonen A, Tordjman S, Green J, Vassallo G, Garg S. Predictors of cognitive, behavioural and academic difficulties in NF1. J Psychiatr Res 2021; 140:545-550. [PMID: 34182240 DOI: 10.1016/j.jpsychires.2021.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
The impact of the Neurofibromatosis type 1 (NF1) on cognition have been subject to much clinical investigation, but environmental modifiers of disease expression have not yet been systematically investigated. The aim of this paper is to determine the role of demographic and environmental factors such as age, sex, socioeconomic status, parental NF1 status and neurological complications on the cognitive, behavioural and academic outcomes in NF1. Participants included 206 children aged 4-18 years seen within the Manchester clinical research NF1 service. Multiple linear regression models were used to study the effect of the hypothesized predictor variables on cognitive, behavioural and academic outcomes. Relative to population norms, 80% of the NF1 sample demonstrated significantly lower scores in at least one cognitive, behavioural or academic domains. Family history of NF1 and lower SES were independently associated with poorer cognitive, behavioural and academic outcomes. Neurological problems such as epilepsy and hydrocephalus were associated with lower IQ and academic skills. Cognitive and behavioural phenotypes emerge commonly via a complex interplay between genes and environmental factors, and this is true also of a monogenic condition such as NF1. Early interventions and remedial education may be targeted to risk groups such those with familial NF1, families with lower SES and those with associated neurological comorbidities.
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Affiliation(s)
- Marie-Maude Geoffray
- Centre Hospitalier le Vinatier, 95 Bd Pinel, 69500 Bron, France; Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Oxford Road, M13 9PL, UK
| | - Louise Robinson
- Dept of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, UK
| | - Kavitha Ramamurthy
- Dept of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, UK
| | - Lauren Manderson
- Dept of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, UK
| | - Julieta O'Flaherty
- Division of Cell Matrix Biology and Regenerative Medicine, Faculty of Biology Medicine and Health, University of Manchester, UK
| | | | - Sylvie Tordjman
- Pôle Hospitalo-Unuversitaire de Psychiatrie de l'Enfant et de l'Adolescent, Université de Rennes 1, Centre Hospitalier Guilllaume Régnier, 35703, Rennes, France; Integrative Neuroscience and Cognition Center (INCC), CNRS UMR 8002, Université de Paris, France
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Oxford Road, M13 9PL, UK; Dept of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, M13 9PL, UK
| | - Grace Vassallo
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, M13 9PL, UK
| | - Shruti Garg
- Division of Neuroscience and Experimental Psychology, Faculty of Biological Medical & Health Sciences, University of Manchester, Oxford Road, M13 9PL, UK; Dept of Child and Adolescent Mental Health, Manchester University NHS Foundation Trust, Manchester, UK; Manchester Academic Health Sciences Centre, Manchester, M13 9PL, UK.
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