Internalizing symptoms in adolescence are modestly affected by symptoms of anxiety, depression, and neurodevelopmental disorders in childhood

Screen Time and Child Behavioral Disorders During COVID-19 Pandemic: A Systematic Review

Background

The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic.

Methods

This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies.

Results

Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants.

Conclusions

The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

Distress, waitlists and unmet needs: parents' reports of child psychological difficulties in Aotearoa New Zealand

OBJECTIVE

Demand for children's mental health services has increased in New Zealand, yet little is known of young children's experience of psychological difficulties and treatment. This study investigated psychological symptoms and treatment experiences among primary-aged children.

METHOD

An online survey of parents assessed children's anxiety, depression, attentional, emotional, conduct and peer problems, and experiences seeking psychological treatment.

RESULTS

Based on 382 parental reports, between 24.9 and 34.6% of children experienced abnormal-range symptoms. Older children had higher distress, depression, and anxiety. Boys had more conduct, hyperactivity, and peer problems. Ethnicity was not associated with the incidence of symptoms, but parents of Pākeha/European children reported greater impact than Māori parents. One-third of children had been referred for assessment; more often older children, and those with higher hyperactivity, impact, and anxiety. Parents reported difficulties accessing assessment, common barriers included waitlists (53%), cost (43%), and not knowing who to contact (36%). Following intervention, only 51% of parents reported improvements.

CONCLUSION

NZ primary-aged children are experiencing more symptoms of psychological distress than previously reported and extensive difficulties accessing treatment.

IMPLICATIONS FOR PUBLIC HEALTH

There is a need for further screening and increased access to treatment to prevent worsening mental health outcomes in children.

Systematic review and meta-analysis of the prevention of internalizing disorders in early childhood

Introduction

Internalizing problems comprise a significant amount of the mental health difficulties experienced during childhood. Implementing prevention programs during early childhood may prevent internalizing problems. The present systematic review and meta-analysis aimed to evaluate the effect of both targeted and universal prevention programs in preventing internalizing problems for children aged 3- to 5-years and their parents.

Methods

PsycINFO, Embase, and MEDLINE were systematically searched, and 17 randomized control trials, consisting of 3,381 children, met eligibility criteria. There were seven universal prevention programs, and 10 targeted prevention programs. Four prevention programs were delivered to children, 10 prevention programs were delivered to parents/caregivers, and three prevention programs were delivered to both parents and children.

Results

Prevention programs led to significantly fewer internalizing problems at 6- and 7-month post-intervention (n = 7, p = 0.02, CI -0.69, 0.06) with a small-to-moderate effect size (g = -0.38), however, not at post-intervention or at 12-month follow up.

Discussion

Overall, findings suggest that there may be value in ongoing development and evaluation of prevention programs for internalizing problems, as they improve social and emotional wellbeing in students and reduce internalizing difficulties within the 6- to 7-month timeframe following prevention programs.

Systematic review registration

PROSPERO: CRD42021261323.

Childhood-onset versus adolescent-onset anxiety and depression: Epidemiological and neurodevelopmental aspects

Anxiety and depression are common in youth and are frequently accompanied by attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). However, it is unclear how common ADHD, ASD, and other neurodevelopmental disorders (NDDs, i.e., ADHD, ASD, developmental coordination disorder, learning disorder, and tic disorders) are in children versus adolescents with anxiety and depression. We aimed to delineate whether different anxiety/depression age-of-onset groups show distinguishable NDD patterns. The study was based on 4492 twins born in Sweden between 1998 and 2003 from the nation-wide population-based Child and Adolescent Twin Study in Sweden. Prevalence and odds ratios were calculated using screening measures of anxiety and depression at ages 9 and 15, and NDDs at age 9. Individuals with childhood-onset anxiety/depression had a substantially higher NDD prevalence compared to individuals with adolescent-onset anxiety/depression. Highest prevalence was found for individuals with anxiety/depression both in childhood and adolescence. In this group, individuals also had substantially higher odds of having at least one NDD (14.7, 95% CI 6.3 - 34.0) compared to individuals without anxiety/depression. This emphasizes the need to further investigate the etiology of childhood and adolescent anxiety/depression, as they most likely represent different constructs depending on age-of-onset, lending support for possibly different treatment approaches.