Promoting resilience in children and youth: preventive interventions and their interface with neuroscience

Maternal adverse childhood experiences, child resilience factors, and child mental health problems: A multi-wave study

BACKGROUND

Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association.

OBJECTIVES

The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention.

PARTICIPANTS AND SETTING

The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study.

METHODS

Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total.

RESULTS

Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (β = 0.174, p = .02) and depression (β = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (β = -0.29, p = .02, β = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors.

CONCLUSIONS

Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.

Resilience in children of parents with mental illness, alcohol or substance misuse-An integrative review

AIM

The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse.

DESIGN

An integrative review.

METHOD

The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors.

RESULTS

Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family.

PATIENT OR PUBLIC CONTRIBUTION

Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations.

Neuropsychological Stimulation Program for Children from Low Socioeconomic Backgrounds: Study Protocol for a Randomized Controlled Trial

BACKGROUND

Guatemala remains one of the poorest countries in Central America and suffers from high rates of social inequality and violence. In addition to the negative impact that two years without attending school has had on Guatemalan children due to the consequences of the COVID-19 pandemic, this unfavourable socioeconomic context poses a risk to children's emotional and cognitive development. This work presents a protocol for implementing a cognitive and emotional stimulation program aimed at increasing the academic performance of these children and consequently improving their quality of life.

METHODS

The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It targets the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to an Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles. Results will be compared for the first and second years, looking for differences in academic and cognitive performance between groups.

DISCUSSION

Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances.

Identifying structural brain markers of resilience to adversity in young people using voxel-based morphometry

There is increasing evidence that resilience in youth may have a neurobiological basis. However, the existing literature lacks a consistent way of operationalizing resilience, often relying on arbitrary judgments or narrow definitions (e.g., not developing PTSD) to classify individuals as resilient. Therefore, this study used data-driven, continuous resilience scores based on adversity and psychopathology to investigate associations between resilience and brain structure in youth. Structural MRI data from 298 youth aged 9-18 years (Mage = 13.51; 51% female) who participated in the European multisite FemNAT-CD study were preprocessed using SPM12 and analyzed using voxel-based morphometry. Resilience scores were derived by regressing data on adversity exposure against current/lifetime psychopathology and quantifying each individual's distance from the regression line. General linear models tested for associations between resilience and gray matter volume (GMV) and examined whether associations between resilience and GMV differed by sex. Resilience was positively correlated with GMV in the right inferior frontal and medial frontal gyri. Sex-by-resilience interactions were observed in the middle temporal and middle frontal gyri. These findings demonstrate that resilience in youth is associated with volume in brain regions implicated in executive functioning, emotion regulation, and attention. Our results also provide evidence for sex differences in the neurobiology of resilience.

Pre-pandemic Executive Function Protects Against Pandemic Anxiety in Children with and Without Autism Spectrum Disorder

The COVID-19 pandemic may have exacerbated depression, anxiety, and executive function (EF) difficulties in children with autism spectrum disorder (ASD). EF skills have been positively associated with mental health outcomes. Here, we probed the psychosocial impacts of pandemic responses in children with and without ASD by relating pre-pandemic EF assessments with anxiety and depression symptoms several months into the pandemic. We found that pre-pandemic inhibition and shifting difficulties, measured by the Behavior Rating Inventory of Executive Function, predicted higher risk of anxiety symptoms. These findings are critical for promoting community recovery and maximizing clinical preparedness to support children at increased risk for adverse psychosocial outcomes.

Effectiveness of resilience-based interventions in schools for adolescents: a systematic review and meta-analysis

Introduction

Resilience has been identified as a dynamic process that provides capabilities to face adversity. Considering the many protective factors involved in resilience and that the school is a key context to promote resilience, this review aimed to examine the effect of school-based interventions on resilience in adolescents.

Methods

A systematic literature review and meta-analysis were conducted in July 2021 on four databases. The risk of bias was assessed using the Cochrane risk of bias tool. Random-effects meta-analysis was used to obtain pooled estimates. Stratified analyses were done according to population type (general, at risk), intervention type, and follow-up assessments.

Results

Of the 1,667 articles obtained, 27 were included in the systematic review and 16 in the meta-analysis. The random effects indicated a significant increase in resilience after the intervention [SMD = 0.58, 95% CI (0.29-0.87)]. Subgroup analysis showed effectiveness only in the population at risk [SMD = 1.28, 95% CI (0.53-2.03)] and early adolescence [SMD = 1.28, 95% CI (0.42-2.14), PI (-7.44 to 10.33)]. Multicomponent intervention [SMD = 1.45, 95% CI (0.11-2.80)] and Cognitive Behavioural Therapy (CBT) [SMD = 0.20, 95% CI (0.06-0.34)] demonstrated substantial effectiveness. Significant results were observed within 8-week follow-ups or less [SMD = 1.55, 95% CI (0.61-2.48)].

Discussion

These findings provide evidence that multicomponent and CBT interventions increase resilience in early at-risk adolescents only in the short term. Developing resilience interventions is useful in schools exposed to unfavourable socioeconomic contexts. Furthermore, long-term interventions should be redesigned to improve their effectiveness.

Systematic review registration

PROSPERO [CRD42021277493].

Can a Pessimistic Outlook Moderate the Victimization-Delinquency Relationship?

This study was designed to shed light on the relationship between victimization and offending, a pattern commonly known as the victim-offender overlap, by exploring whether victimization and pessimism toward the future interact in association with self-reported delinquency. This study was performed on 1,300 (444 males, 645 females, and 211 sex not identified) members of the 2018 High School Senior Monitoring the Future cross-sectional study. Multiple regression analysis was conducted using a maximum likelihood estimator and bias-corrected bootstrapped 95% confidence intervals. The analysis revealed that victimization and the victimization × pessimism interaction correlated significantly with delinquency, after controlling for a series of demographic, family, and peer factors. These results indicate that pessimism toward the future may exacerbate the already strong relationship known to exist between victimization and delinquency.

Conceptualizing psychological resilience through resting-state functional MRI in a mentally healthy population: a systematic review

Conceptualizations and operational definitions of psychological resilience vary across resilience neuroimaging studies. Data on the neural features of resilience among healthy individuals has been scarce. Furthermore, findings from resting-state functional magnetic resonance imaging (fMRI) studies were inconsistent across studies. This systematic review summarized resting-state fMRI findings in different modalities from various operationally defined resilience in a mentally healthy population. The PubMed and MEDLINE databases were searched. Articles that focused on resting-state fMRI in relation to resilience, and published before 2022, were targeted. Orbitofrontal cortex, anterior cingulate cortex, insula and amygdala, were reported the most from the 19 included studies. Regions in emotional network was reported the most from the included studies. The involvement of regions like amygdala and orbitofrontal cortex indicated the relationships between emotional processing and resilience. No common brain regions or neural pathways were identified across studies. The emotional network appears to be studied the most in association with resilience. Matching fMRI modalities and operational definitions of resilience across studies are essential for meta-analysis.

Functional neuroimaging of resilience to trauma: convergent evidence and challenges for future research

Resilience is broadly defined as the ability to adapt successfully following stressful life events. Here, we review functional MRI studies that investigated key psychological factors that have been consistently linked to resilience to severe adversity and trauma exposure. These domains include emotion regulation (including cognitive reappraisal), reward responsivity, and cognitive control. Further, we briefly review functional imaging evidence related to emerging areas of study that may potentially facilitate resilience: namely social cognition, active coping, and successful fear extinction. Finally, we also touch upon ongoing issues in neuroimaging study design that will need to be addressed to enable us to harness insight from such studies to improve treatments for - or, ideally, guard against the development of - debilitating post-traumatic stress syndromes.

Effectiveness of a preschool emotional education programme administered over 3 grades: a cluster randomised controlled trial

INTRODUCTION

Emotional education programmes are universal preventive strategies for health promotion, especially mental health. The aim of this study is to evaluate the effectiveness and implementation of '1,2,3, emoció!': a preschool-based programme designed to improve emotional competence and targeted to 3-5-year-old children in Barcelona during three academic years.

STUDY DESIGN

Cluster randomised trial, using schools as clusters.

METHODS

The study's population included preschoolers 3-5 years old from Barcelona. Teachers offered the programme during one or three academic years in the intervention groups. We evaluated the emotional competence of each child at the beginning and the end of the academic year with the Emotional Competence Assessment Questionnaire (30-180 scale). We studied the implementation process and analysed the outcomes with nested linear regression models. Considering sociodemographic variables and implementation outcomes, we obtained the individual differences in emotional competence at the end of the school year-segregated by sex-for intervention and comparison groups.

RESULTS

1586 children participated in the study. The emotional competence level increased significantly after one year (4.1 in boys; 5.6 in girls; P < 0.05) and after three years of intervention (5.5 in boys; 8.0 in girls; P < 0.01), compared to comparison group. The level of emotional competence was the highest for the 3-year intervention group: we obtained an average ECAQ score of 131.1 (95% CI 126.9-135.2) for boys and 141 (95% CI 137.2-144.9) for girls. We observed that an accurate implementation improved its results.

CONCLUSIONS

The programme '1,2,3, emoció!' effectively increases preschool children's emotional competence, especially when the programme is rigorously implemented for three years.

Fostering Resilience in Adolescents at Risk: Study protocol for a cluster randomized controlled trial within the resilience school-based intervention

Introduction

Resilience is considered of high relevance when developing interventions to cope with stressful situations. Schools are one of the key settings to promote resilience among adolescents. The purpose of this cluster randomized controlled trial is to assess the effectiveness of an intervention in adolescents at risk, aged 12-to-15 years old, to increase resilience and emotional regulation strategies.

Methods

The recruitment period started in January 2022. Schools will be randomly allocated to control and intervention groups by an external researcher using computer-generated random numbers. The minimum sample size was estimated to be 70 participants per group. Primary health care nurses will carry out the intervention during the school period (January to June 2022). Students will follow a specific training consisting of six 55-min sessions, for 6 weeks. Each session will consist of 5 min of mindfulness, followed by 45 min of the corresponding activity: introducing resilience, self-esteem, emotional regulation strategies, social skills, problem-solving, community resources, social and peer support, and 5 min to explain the activity to do at home. Data will be collected at baseline, 6 weeks, and 24 weeks after the intervention. The child youth resilience measure-32 (CYRM-32) scale will be used to assess the effectiveness of the intervention. This study received a grant in June 2021.

Discussion

The intervention is intended to improve mental health through resilience. Different factors related to resilience will be promoted, such as self-esteem, emotional regulation, social and communication skills, problem-solving and peer support, among others. As it has been designed as a cluster-randomized school-based intervention, we will directly ameliorate the participation and engagement of the target population. With the present intervention, we expect to improve coping skills in adolescents by enhancing resilience capacities.

The RUMERTIME Process as a Protective Factor in School Attendance Problems

The RUMERTIME Process (RP) is a five-step culturally responsive social-emotional, problem-solving, prevention-intervention strategy used to educate, equip, and empower students, educators, and families. The RP equips individuals with the abilities to recognize, understand, manage, express, and reflect on their thoughts, interactions, mindsets, and emotions (RUMERTIME) in relation to themselves, others, and the daily life challenges they face within multiple systems and settings. The RP is embedded within the Cultivating SEEDS System framework (CSS) and is utilized to equip culturally diverse communities, inclusive of students, family members, educators, and administrators, with the social-emotional skills to effectively solve student attendance problems (SAPs). The data shared in this practice intervention article are descriptive in nature and highlight the RP as a protective factor and explain its three goals. The paper consists of three parts: (a) introduction of the RP, which is embedded in the CSS framework; (b) description of implementation of the RP as integral to the Daytime Intervention Room (DIR) program; and (c) discussion of risk factors that qualified students to receive services through the DIR program as well as data that demonstrated how the RP performed as a protective factor. The DIR program was aimed at creating an alternative to out-of-school suspension (OSS) and the traditional punitive in-school suspension (ISS). The program was established in each of the four schools in an urban high-needs school district in the midwest region of the United States. The DIR program was intentionally designed to include multiple levels, stakeholders, and delivery support, thus creating a solid base for the holistic development of students, educators, and parents. In conjunction with the CSS framework, the DIR program sought to increase academic performance, decrease the number of behavior referrals, and improve attendance rates in this high-needs urban school district.

Resilience in deaf children: A comprehensive literature review and applications for school staff

Resilience is a dynamic, multidimensional complex concept that implies risk and protective factors, adaptation, and success. Communication and language are often identified as barriers in deaf children's development. However, research linking deafness in childhood and resilience is scarce. The present comprehensive literature review aims to verify which are the predominant risk factors for this group, which protective factors may be identified and if significant differences have been found between deaf and hearing children regarding resilience. A systematic search, performed in seven databases, identified 11 articles published in peer-reviewed journals between 2000 and 2019 that met the criteria. Deaf children experience exposure to risk through obstacles in communication, language, and information failure. Consequently, differences between hearing and deaf children are related to more difficulties in emotion regulation and interpersonal relationships. Principal protective factors are a supportive family, school staff, and peers. Practical implications and recommendations for future research are provided.

A preliminary randomized, controlled trial of executive function training for children with autism spectrum disorder

LAY ABSTRACT

Executive function, which is a set of thinking skills that includes stopping unwanted responses, being flexible, and remembering information needed to solve problems, is a challenge for many children on the autism spectrum. This study tested whether executive function could be improved with a computerized executive function training program under the guidance of a coach who reinforced the use of executive function skills. Seventy children with autism spectrum disorder from age 7 to 11 years of age participated in the study. They were randomly assigned to receive training or to a waiting group. The tests most likely to determine whether the training may be effective were chosen from a larger battery before the study started and included one task measuring brain responses, two measures of executive function in the lab, and a parent questionnaire. Changes in social functioning and repetitive behaviors were also explored. All children assigned to training completed the program and families generally reported the experience was positive. Brain responses of the training group changed following training, but not within the waiting group during a similar time period. Children who received training did not exhibit behavioral changes during the two the lab-based tasks. Parent report on questionnaires indicated that neither group showed a significant change in their broad use of executive function in other settings. Yet, children who received training were reported to have fewer restricted and repetitive behaviors following training. These initial findings suggest that short executive function training activities are feasible and may improve some functioning of school-aged children on the autism spectrum.

Sleep Moderates Improvements in Mental Health Outcomes in Youth: Building Resilience for Healthy Kids

PURPOSE

To examine the role of sleep in a school-based resiliency intervention.

DESIGN

Single group feasibility study.

SETTING

Urban middle school Subjects: Sixth grade students Intervention: A total of 285, 11-12-year-old students (70% White, 18% Hispanic, 55% female) participated in the six-week 1:1 Healthy Kids intervention. Youth (n=248) completed electronic surveys at pre-post the 6-week study assessing mental health parameters and self-reported bed and wake time.

MEASURES

Students were categorized as having insufficient sleep opportunity if they reported time in bed of <9 hours per night.

ANALYSIS

General linear models examined differences between groups for each mental health parameters pre-post study.

RESULTS

A third of participants (28%) were classified as having insufficient sleep opportunity. Youth with insufficient sleep were more often Hispanic (27% vs 16%; p<0.001) and were more often classified with both mild to severe depression and anxiety symptoms (55% vs 35%; p=0.004). The health coaching intervention was found to have a significant improvement on overall resilience and self-efficacy only among students who reported sufficient sleep, while no significant intervention effect was found for those students who reported insufficient sleep.

CONCLUSIONS

Our findings suggest that youth with poor sleep health may not benefit from school-based resiliency interventions.

Stressful life events and children's socioemotional difficulties: Conditional indirect effects of resilience and executive function

Although the association between life stress and children's socioemotional difficulties has been widely documented, few studies have adopted a cognitive-based resilience framework studying preadolescent psychosocial adjustment. This study examined whether the stress-difficulties associations are mediated by resilience and moderated by executive function (EF). A sample of 144 typically developing Chinese children (aged 10-12 years) completed measures assessing stressful life events, socioemotional difficulties, resilience, and computer-based EF (including working memory [WM] capacity and WM updating, inhibitory control, and cognitive flexibility). The results showed that stressful life events were positively associated with socioemotional difficulties through the mediating effect of diminished resilience. The direct and indirect effects of stressful life events on socioemotional difficulties varied across individual differences in EF. Specifically, compared with low to medium levels, high-level WM capacity and WM updating moderated the association between stressful life events and socioemotional difficulties. Cognitive flexibility moderated both direct and indirect effects, showing that for children with low to medium levels of cognitive flexibility, life stress was positively associated with socioemotional difficulties via the role of lower resilience; however, for those with high levels of cognitive flexibility, the direct and indirect effects were not significant. Inhibitory control showed significant direct associations with resilience and socioemotional difficulties but failed to be a moderator. The characteristics of the low-stress sample might limit the generalizability of this study. Nevertheless, our findings provide a rationale for integrating a cognitive-based resilience process and the multifaceted structure of EF to understand and promote preadolescents' positive adaptation.

The Relations Among Types of Parentification, School Achievement, and Quality of Life in Early Adolescence: An Exploratory Study

Children who experience parentification may have trouble performing developmental tasks due to being overwhelmed by their family caregiving roles and responsibilities. Past studies have found that parentification is negatively associated with academic achievement. However, most of these studies are limited in that they are retrospective and examine the association but not the mechanisms shaping them. The aim of the study was to explore to what extent diverse types of parentification relate to academic achievement and to what extent these relations are mediated by self-reported quality of life among adolescents. The study sample was composed of Polish early adolescents (N = 191; age: M = 14.61; SD = 1.26). Types of parentification were measured with the Parentification Questionnaire for Youth, and quality of life was assessed with KidScreen27. School achievement was measured based on mean semester grade. We explored the associations among study variables and performed six mediation models in the planned analyses. Overall, bivariate relations were significant in a theoretically expected way, although the effect sizes for these associations were rather small. In the mediation analyses, the results showed that four of the six models were not significant. Different from previous studies, instrumental parentification was positively related to school achievement. Additionally, this positive association was mediated by adolescents' general quality of life. Taken together, the findings were similar and different from the empirical literature base on types of parentification and select outcomes.

Study protocol for a school-based single group pragmatic trial to promote resilience in youth: Building Resilience for Healthy Kids

BACKGROUND

There is a growing prevalence of mental health disorders among youth. Helping youth develop skills that promote and support mental well-being is an important strategy for addressing this public health concern. Building Resilience for Healthy Kids (Healthy Kids) is a school-based program designed to improve resiliency in youth aged 9-13 years old using an innovative health coaching framework.

METHODS

Healthy Kids is a multi-phased intervention that aims to improve youth resilience using a 6-week, 1:1 health coaching program. The program develops youth resilience and was derived from models for developing youth resilience: Positive Relationships, Coping, Skill Development, Healthy Lifestyle, Sense of Culture, and Connectedness. Effectiveness of the intervention will be evaluated using a single-group, pragmatic trial design with pretest-posttest and follow-up assessments up to 12 months. Process measures will evaluate youth's acceptance and satisfaction of the program and attendance rates. Effectiveness will be evaluated by examining changes in resilience and mental health indicators from pre-to-post program and tracking sustainment of changes in mental health indicators over time.

DISCUSSION

Given the pragmatic nature of the study design to work with generally healthy populations of students, we expect small, but sustainable, improvements in youth resilience to be achieved through the intervention. Further, this study will provide insight into the potential effectiveness of using health coaching as a strategy to support and promote youth mental well-being in school settings.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04202913. Registered December 18, 2019.

Can the migration process influence the clinical expression of heroin use disorder in migrants to Italy?

BACKGROUND

For some time now, there has been a strong consensus that the migration process can influence the onset, course, development, outcome, and clinical aspects of psychiatric pathologies.

METHODS

In this study, we have analyzed the influence of the migration process on the clinical expression of heroin use disorder (HUD). In a naturalistic case-control study, we compared, both at univariate and multivariate level, 30 migrant HUD (M-HUD) patients with 30 age/gender-matched Italian HUD (IT-HUD) patients. We also analyzed demographic data, drug addiction history, psychopathological symptoms, addictive behavior, and emotional reactivity to life events.

RESULTS

Compared with IT-HUD pairs, at HUD Agonist Opioid Treatment, M-HUD patients were characterized by inadequate income and the presence of legal problems. They were more frequently at stage 3 of heroin addiction, with a concomitantly less frequent use of stimulants. Their age at the onset of heroin use was greater than that of subjects in the IT-HUD group. HUD post-traumatic stress disorder spectrum was present and was more severe in all M-HUD patients, but grief reactions and maladaptive behavior were the most discriminant traits. No differences were found in terms of addictive behaviors related to heroin craving or with respect to the severity/typology of psychopathology specific to HUD.

CONCLUSIONS

The migratory process does not seem to be correlated with addictive behaviors or with psychopathology specific to HUD. It partly affects HUD history, and specifically correlates with emotional reactivity to loss and traumatic life events, so suggesting that in M-HUD individuals, the link between the migratory syndrome and HUD is very close.

Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study

Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.

Does the Delivery System Matter? The Scaling-Out of a School-Based Resilience Curriculum to the Social Services Sector

Background: The context is highly relevant to the implementation of new health-related programs and is an implicit or explicit part of the major implementation models in the literature. The Resilience Curriculum (RESCUR) program was developed to foster the psychosocial development of children in early and primary education. RESCUR seeks specifically to decrease children's vulnerability. It aims to promote the emotional and social learning of children who may be at risk of leaving school pre-maturely, social exclusion and mental-health problems. The program is taught using a teachers' manual to support consistency of delivery, a parents' guide, and a resource package. This study aimed to examine the scaling-out of RESCUR to social services, and specifically to test if implementation differs between the school and social services sectors. Methods: RESCUR was implemented in schools and social services in Sweden 2017-2019. Data were collected via group leaders' self-reports and observation protocols for 3 months after implementation started. There were 34 self-reports from schools, and 12 from the social services sector; 30 observation protocols were collected from schools, and 10 from social services. We examined whether there were differences in implementation outcomes (in, for example, dosage, duration, fidelity, adaptation, quality of delivery) between the two delivery systems. Descriptive statistics were prepared and non-parametric tests of significance conducted to compare implementation-related factors across the two settings. Results: Analyses of both the observation protocols and group leaders' self-reports revealed that RESCUR was well-implemented in both schools and social services. The results showed a few significant differences in the outcomes of implementation between the sectors. First, regarding observations, school staff more often adapted the pace of RESCUR lessons to ensure that the children could understand than did social services staff (p < 0.01). Second, social services staff demonstrated greater interest in students and sensitivity to the needs of individual students than did school staff (p = 0.02). Regarding self-reports, social services staff reported having delivered more (p = 0.4) and longer (p < 0.01) lessons than did school staff. Second, school staff reported greater fidelity to (p = 0.02) and less adaptation of (p < 0.01) the intervention than did social services staff. Both observations and self-reports, however, indicated a high fidelity of implementation. Conclusions: Overall, the findings suggest that the resilience program, designed for delivery in schools, can be scaled-out to social services with its implementation outcomes retained. Further research is needed to test the effectiveness of the program regarding child health-related outcomes. Clinical Trial Registration: National Institute of Health, ClinicalTrials.gov, identifier: NCT03655418. Registered August 31, 2018.

Association Between Physical Fitness and Anxiety in Children: A Moderated Mediation Model of Agility and Resilience

Background: Anxiety is one of the most prevalent mental health problems in children. Although physical fitness as a predictor of mental health, the mechanisms underlying any association between physical fitness and anxiety in children have been understudied. Thus, the aim of the present study was to determine whether an association exists between physical fitness and anxiety and to explore the roles of agility and resilience in such an association.

Methods: This cross-sectional study investigated 269 children aged 7 to 12 years from three public primary schools in Shanghai (China). Physical fitness and agility were objectively measured, and resilience and anxiety were assessed using self-reported questionnaires. The moderated mediation model was examined using the SPSS PROCESS macro, in which the moderator variable was agility, and the mediator variable was resilience.

Results: Physical fitness was inversely associated with anxiety. Resilience partially and indirectly mediated this association, and agility moderated the association between physical fitness and resilience. Physical fitness had a greater impact on resilience in children with higher agility levels.

Conclusions: Agility moderated the mediation of resilience on the indirect, inverse association between physical fitness and anxiety; thus, incorporating methods to develop agility and resilience may lead to better outcomes for physical fitness programs designed to prevent or alleviate anxiety in children.

Evaluation of a Resiliency Focused Health Coaching Intervention for Middle School Students: Building Resilience for Healthy Kids Program

Introduction:

Youth mental health issues are a growing public health concern. Resilience has been identified as a mitigating factor for adverse mental health outcomes. Schools have shown an increasing interest in strategies to support students’ mental health. The purpose of this study was to evaluate a school-based 1:1 health coaching program designed to build resilience by teaching students coping skills and strategies to increase their self-efficacy.

Study Design:

Single group intervention study with pre/post measures.

Setting/Participants:

Sixth grade students (aged 11-12 years) attending an urban middle school.

Intervention:

Youth participated in up to 6 resiliency-focused, 1:1 health coaching sessions completed over 8 weeks and conducted during the school day. Health coaches utilized motivational interviewing techniques to set and work toward resilience-related goals focused on improving coping skills and self-efficacy with youth during the intervention (January through March 2020).

Main Outcome Measures:

The Child and Youth Resilience Measure-Revised and other mental health assessments were completed at baseline and immediately following completion of the intervention to evaluate outcomes. Paired sample t-tests and Hedges’ g effect sizes were conducted to evaluate intervention effectiveness. Student participation rates were assessed throughout the intervention.

Results:

287 youth participated in the study (87% participation rate) and participated in over 85% of health coaching sessions offered. A paired samples t-test revealed the youth resilience significantly increased from pre ( M = 75.7, SD = 6.9) to post ( M = 77.6, SD = 6.8) intervention ( t[257] = 3.73, p < .001) and the size of the effect was medium ( g = 0.29, 95% CI = 0.11, 0.46).

Conclusions:

The findings demonstrate that health coaching can be an effective strategy for improving resiliency in youth. Future studies evaluating how to effectively disseminate this intervention strategy are planned.

The Effect of Resilience and Cognition on (Im)Migrant Students’ Academic Adaptation

Abstract This study aimed to identify cognitive (reasoning and executive functions) and resilient behavioral variables of (im)migrant university students which are related to different aspects on their adaptation to academic experiences. It is a descriptive exploratory cross-sectional study. The sample consisted of 64 undergraduate and graduate students from three universities of Porto Alegre, with average age 23.75 years old (DP = 2.9), from other Brazilian state or other country. The results pointed that significant predictors of all five academic experiences’ dimensions were resilience’s aspects and none cognitive. Among these resilience’s aspects, it was highlighted Structured style, which predicted three different dimensions. Those findings show the relevant role of resilience in adaptive process faced by this population and, consequently, in their academic success.

Resilience and Adverse Childhood Experiences: Associations With Poor Mental Health Among Homeless Adults

INTRODUCTION

Adverse childhood experiences are known risk factors for a range of social, economic, and health-related outcomes over the life course. Resilience is a known protective factor. This study examines the associations of adverse childhood experiences and resilience with poor mental health outcomes among homeless adults with mental illness.

METHODS

This study utilized data from 565 homeless adults with mental illness participating in a Housing First intervention in Toronto (2009-2013) to evaluate their sociodemographic characteristics, adverse childhood experience exposure, resilience, and mental health outcomes. Descriptive statistics were generated, and logistic regression models were used to examine the association of total adverse childhood experience score and resilience with poor mental health outcomes. Analyses were conducted in 2019.

RESULTS

The average total adverse childhood experience score was 4.1 (SD=2.8) among all study participants. Individuals with a lifetime duration of homelessness exceeding 36 months (p=0.011) had higher mean scores. Total score was positively associated with several mental illness diagnoses and psychopathology severity, indicated by co-occurring mental illness diagnoses (AOR=1.23, 95% CI=1.13, 1.33) and high Colorado Symptom Index scores (AOR=1.26, 95% CI=1.14, 1.38). Resilience served as a protective factor against several individual mental illness diagnoses, co-occurring mental illness diagnoses (AOR=0.85, 95% CI=0.76, 0.95), and high Colorado Symptom Index scores (AOR=0.69, 95% CI=0.61, 0.79).

CONCLUSIONS

Findings highlight the high prevalence of adverse childhood experiences and their negative impact on homeless adults with mental illness. Resilience protects against adverse childhood experience-associated poor mental health outcomes, thereby serving as a potential interventional target in homeless populations.

Sustained effects of a school readiness intervention: 5th grade outcomes of the Head Start REDI program

This study examined the sustained effects of the Head Start Research-based Developmentally Informed (REDI) program, which enriched preschools with evidence-based programming targeting social-emotional and language/emergent literacy skills. 44 Head Start classrooms were randomly assigned to intervention or a usual practice control group, and 356 4-year-olds (25% African American, 17% Latino, 54% female) were followed through the end of 5th grade. Growth curve analyses revealed that significant intervention effects on teacher-rated social adjustment, academic engagement, and parent involvement identified at the end of the Head Start year were sustained throughout elementary school. These findings demonstrate that evidence-based curricula combined with professional development support can enhance preschool programming and promote the elementary school adjustment of children living in poverty.

Exploring practitioner and policymaker perspectives on public health approaches to address Adverse Childhood Experiences (ACEs) in South Carolina

OBJECTIVE

We examined the perspectives of child and family-serving professionals (CFSP) and state policymakers on protective factors to develop policy and program recommendations including current and needed approaches for addressing ACEs.

METHODS

In 2018, we conducted semi-structured, in-depth interviews with 23 CFSP and 24 state policymakers in South Carolina. Data were analyzed applying the Multiple Streams Theory using thematic analyses.

RESULTS

CFSPs and policymakers had varying opinions on state government involvement and primary prevention for ACEs. Three protective factors emerged from their perspectives: 1) loving, trusting, and nurturing relationships; 2) safe home environments; and 3) opportunities to thrive. For each of these protective factors, participants suggested policy options that support existing community efforts, attempt to alleviate poverty, and improve child and family serving systems.

CONCLUSION

This study suggests that CFSPs and policymakers recognize the importance of protective factors in a child's life to buffer the effect of ACEs. More awareness is needed about the feasibility and significance of primary prevention of ACEs. The study's findings can be used to strengthen advocacy priorities for a wide range of public health outcomes associated with ACEs and help further bridge the gap between research and policy.

Personalizing and Optimizing Preventive Intervention Models via a Translational Neuroscience Framework

A new generation of research, building upon developmental psychopathology (Luthar et al. 1997; Luthar et al. (Child Development, 71, 543-562, 2000)), provides evidence that individual differences in risk for behavioral health problems result from intrapersonal and environmental modulation of neurophysiologic and genetic substrates. This transdisciplinary model suggests that, in any given individual, the number of genetic variants implicated in high-risk behavior and the way in which they are assorted and ultimately suppressed or activated in the brain by experiential and contextual factors help to explain behavioral orientations. Implications are that behavioral health problems can be amplified or reduced based on characteristics of an individual and socio-contextual influences on those characteristics. This emerging research has extraordinary implications for the design of prevention programs that more precisely target the malleable mechanisms that underlie behavioral health problems and, hence, more effectively prevent behavioral problems and promote resilience. A detailed, theory-driven examination of all evidence-based interventions is called for to identify the active ingredients that specifically impact these underlying mechanisms. Such an approach will enhance the ability of preventive interventions to achieve effect sizes indicative of beneficial impacts for a greater number of recipients. This paper presents the significant implications of this collective knowledge base for the next generation of precision-based, prevention-focused personalized interventions.

A Smart Toy Intervention to Promote Emotion Regulation in Middle Childhood: Feasibility Study

BACKGROUND

A common challenge with existing psycho-social prevention interventions for children is the lack of effective, engaging, and scalable delivery mechanisms, especially beyond in-person therapeutic or school-based contexts. Although digital technology has the potential to address these issues, existing research on technology-enabled interventions for families remains limited. This paper focuses on emotion regulation (ER) as an example of a core protective factor that is commonly targeted by prevention interventions.

OBJECTIVE

The aim of this pilot study was to provide an initial validation of the logic model and feasibility of in situ deployment for a new technology-enabled intervention, designed to support children's in-the-moment ER efforts. The novelty of the proposed approach relies on delivering the intervention through an interactive object (a smart toy) sent home with the child, without any prior training necessary for either the child or their carer. This study examined (1) engagement and acceptability of the toy in the homes during 1-week deployments, and (2) qualitative indicators of ER effects, as reported by parents and children. In total, 10 families (altogether 11 children aged 6-10 years) were recruited from 3 predominantly underprivileged communities in the United Kingdom, as low SES populations have been shown to be particularly at risk for less developed ER competencies. Children were given the prototype, a discovery book, and a simple digital camera to keep at home for 7 to 8 days. Data were gathered through a number of channels: (1) semistructured interviews with parents and children prior to and right after the deployment, (2) photos children took during the deployment, and (3) touch interactions automatically logged by the prototype throughout the deployment.

RESULTS

Across all families, parents and children reported that the smart toy was incorporated into the children's ER practices and engaged with naturally in moments the children wanted to relax or calm down. Data suggested that the children interacted with the toy throughout the deployment, found the experience enjoyable, and all requested to keep the toy longer. Children's emotional connection to the toy appears to have driven this strong engagement. Parents reported satisfaction with and acceptability of the toy.

CONCLUSIONS

This is the first known study on the use of technology-enabled intervention delivery to support ER in situ. The strong engagement, incorporation into children's ER practices, and qualitative indications of effects are promising. Further efficacy research is needed to extend these indicative data by examining the psychological efficacy of the proposed intervention. More broadly, our findings argue for the potential of a technology-enabled shift in how future prevention interventions are designed and delivered: empowering children and parents through child-led, situated interventions, where participants learn through actionable support directly within family life, as opposed to didactic in-person workshops and a subsequent skills application.

An Applied Contextual Model for Promoting Self-Regulation Enactment Across Development: Implications for Prevention, Public Health and Future Research

This theoretical paper presents a public health approach for promoting self-regulation across development that is based in cross-disciplinary theory and research. The self-regulation promotion model includes three key approaches that are each dependent on the relationship that children and youth have with caregivers: teaching self-regulation skills, building supportive environments, and providing co-regulation. This model extends the science of self-regulation insofar as it: (1) focuses on promoting wellbeing (not only reducing risks) across domains of functioning, (2) addresses self-regulation intervention across childhood and through young adulthood, (3) integrates multiple theories and applies them to intervention in meaningful ways, and (4) identifies specific strategies that can be used in natural developmental contexts and that address the social ecological environment as well as the individual child. We describe seven key principles that support the model including a description of self-regulation processes and implications for promoting self-regulation at each developmental stage. We end with broad implications for intervention, highlighting the relevance of the self-regulation promotion model for practitioners, policy makers, and prevention researchers.

The feasibility and appropriateness of a peer-to-peer, play-based intervention for improving pragmatic language in children with autism spectrum disorder

Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants. Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant's social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach. Result: Children demonstrated gains in pragmatic language on the POM (χ²(3) = 11.160, p = 0.011) and related higher-level language on the SEE (χ²(2) = 6.686, p = 0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved. Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size.

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

Non-suicidal self-injury (NSSI) affects 15-20% of adolescents-disproportionately girls-and is a strong predictor of eventual suicide attempts and suicide. Many girls now initiate NSSI before age 10. These early-starters exhibit greater frequency of NSSI, use more diverse methods, and are hospitalized more often, yet there are no empirically supported prevention programs for preadolescents. Obstacles to prevention include ascertaining who is sufficiently vulnerable and specifying mechanistic intervention targets. Recent research indicates that (1) preadolescent girls with ADHD who are also maltreated are at alarming risk for NSSI and suicide attempts by adolescence, and (2) the conjoint effects of these vulnerabilities are sufficiently potent for targeted prevention. Research also indicates that existing interventions are effective in altering child- and family-level mechanisms of NSSI. These interventions alter neurobiological markers of vulnerability, which can be used as proximal efficacy signals of prevention response, without waiting for NSSI and suicide attempts to emerge.

Socioeconomic status and neural processing of a go/no-go task in preschoolers: An assessment of the P3b

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Children aged 4.5–5.5 years completed a go/no-go task while recording EEG.

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P3b amplitudes were assessed, indexing inhibition and attention processes.

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Higher household income related to larger P3b amplitudes on go and no-go trials.

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Results show that SES has implications for children’s neural processing.

While it is well established that lower socioeconomic status (SES) is associated with poorer executive functioning (EF), how SES relates to the neural processing of EF in childhood remains largely unexplored. We examined how household income and parent education related to amplitudes of the P3b, an event-related potential component, during one EF task. We assessed the P3b, indexing inhibition and attention allocation processes, given the importance of these skills for academic success. Children aged 4.5–5.5 years completed a go/no-task, which assesses inhibitory control and attention, while recording EEG. The P3b was assessed for both go trials (indexing sustained attention) and no-go trials (indexing inhibition processes). Higher household income was related to larger P3b amplitudes on both go and no-go trials. This was a highly educated sample, thus results indicate that P3b amplitudes are sensitive to household income even within the context of high parental education. Findings build on the behavioral literature and demonstrate that SES also has implications for the neural mechanisms underlying inhibition and attention processing in early childhood.

Environmental Health Education for Asbestos-Contaminated Communities in Italy: The Casale Monferrato Case Study

BACKGROUND

Environmental health education contributes towards increasing awareness of communities to prevent exposure to hazardous substances. Casale Monferrato, the operating site for the Eternit asbestos-cement factory from 1907 to 1986, is a prioritized asbestos-contaminated site for remediation in Italy. The area is prone to severe asbestos-related diseases. About 50 cases of mesothelioma are diagnosed in Casale Monferrato annually; mesothelioma has been shown to be caused by occupational, environmental and domestic asbestos exposure.

OBJECTIVES

The goal of this paper is to analyze the Casale Monferrato case study in terms of youth engagement in environmental health education initiatives on asbestos risk and health impact. The paper aims at underlining the lessons learned in order to share the success of this initiative with other communities living in asbestos-contaminated sites in different countries.

METHODS

Peer education methodology has been used through the Asbestos Classroom to involve teachers, students and other local stakeholders in training activities, in selection of the contents for educational materials and interactive tools, as well as in choosing the presentation process for the aforementioned knowledge sharing instruments.

FINDINGS

From November 2014 to June 2018, 185 high school students and teachers were trained through the Asbestos Classroom. Through December 2018, they trained 3,241 classroom visitors. The Classroom relies on an inclusive participative process in which young people play a key role in the network of relationships within their community.

CONCLUSIONS

The paper corroborates the importance of engaging the educational system in communication efforts aimed at fostering collective awareness on environmental risk and health-related impacts for communities living in industrially contaminated sites. Considering the global dimension of the asbestos contamination and disease burden, this experience might be of relevance both in countries that banned asbestos and in those where asbestos is not yet prohibited.

Safe, Stable, and Nurtured: Protective Factors against Poor Physical and Mental Health Outcomes Following Exposure to Adverse Childhood Experiences (ACEs)

Protective factors can build resilience and potentially moderate the long-term impact of adverse childhood experiences (ACEs). To better understand the role of protective factors, this study examines the relationship of two protective factors focused on safe, stable and nurturing relationships, ACEs, and self-reported mental and physical health outcomes among a representative adult sample from the South Carolina Behavioral Risk Factor Surveillance System. Protective factors were assessed as potential moderators of ACEs and poor self-reported physical and mental health in multivariate logistic regression analyses. Respondents exposed to four or more ACEs who grew up with an adult who made them feel safe and protected were less likely to report frequent mental distress or poor health. The use of protective factors may be an effective prevention strategy for ACEs and its associated outcomes and may serve as a mechanism to "break the cycle" of childhood trauma.

The 14-item Resilience scale as a potential screening tool for depression/anxiety and quality of life assessment: a systematic review of current research

BACKGROUND

Due to the expensive and time-consuming diagnostics, most general physicians do not use a standardized psychodiagnostic tool to detect depression and anxiety and often rely on their own judgment. This often leads to inaccuracy of identification of patients with mental disorders.

OBJECTIVE

To systematically review the literature of the 14-item resilience scale (RS-14) and offer directions for future studies.

METHODS

Fourteen studies that included a translated/validated RS-14 regardless of the sample were included through Medline and CINAHL databases and the following questions were addressed: (i) What are the factor structure, internal consistency and repeatability of the RS-14? (ii) Is RS-14 concordant with other scales for measuring resilience, and what is the concurrent validity of this instrument? (iii) What are the critiques, conclusions and limitations of previous studies?

RESULTS

Most factor analyses demonstrated a one-factor solution and confirmed 14-item scale. Cronbach's α for was high (M = 0.88); the test-retest reliability was satisfactory in three (0.70 < r > 0.83) out of four studies (r = 0.49). Results of concurrent validity showed positive correlation with some variables, including quality of life and a negative correlation with depression and anxiety. Among other limitations, the biggest drawback was a non-representative sample.

CONCLUSIONS

RS-14 was found to perform well in clinical and non-clinical sample. Due to its wide use of population, time efficiency and good results on concurrent validity, we suggest future studies to examine whether RS-14 has a potential to serve as a first distress and quality of life screening tool in the family medicine practices.

Clinic and park partnerships for childhood resilience: A prospective study of park prescriptions

INTRODUCTION

Pediatricians need community resources for childhood stress. We examined the association of weekly park visits and resilience amongst children receiving a park prescription at a clinic for low-income families.

MATERIALS AND METHODS

A prospective longitudinal clinical trial was conducted amongst children ages 7-17 at a safety-net primary care clinic with measures at zero, one and three months out. Parents reported their child's park visits per week, baseline ACE score, their own stress (PSS10) and coping; children reported resilience (Brief Resiliency Scale) and stress (PSQ8-11 scale).

RESULTS

Enrolled children (N = 54; mean (sd) age 10.3 (2.4) years), had a median (IQR) ACE score of 2 (1, 4). Child resilience improved with each one-day increase in weekly park visits (0.04 points, 95% CI 0.01, 0.08) at every level of ACEs. Child stress partially mediated this relationship.

CONCLUSION

Parks are a community resource for pediatric resilience; park prescriptions may be a way to deal with pediatric stress.

Executive Function and Resilience as Mediators of Adolescents' Perceived Stressful Life Events and School Adjustment

This study investigated psychological mechanisms underlying the relationship between stressful life events and school adjustment in Chinese adolescents. The Adolescent Self-rating Life Events Checklist, the Adolescent Executive Function Scale, the Chinese version of the Resilience Scale, and the School-adjustment Scale were administered to 1101 Chinese adolescents (465 males, 636 females), aged 11–19 years, from three secondary schools. Results from serial mediation analysis revealed that perceived stressful life events could affect school adjustment through the mediation of executive function and resilience. The mediation effect contained three paths, the separate mediation effect of executive function, the separate mediation effect of resilience, and the serial mediation effect of executive function and resilience. These findings provide valuable insights into the effect of perceived stressful life events on school adjustment of Chinese adolescents, and suggest that, the researchers and educators could enhance school adjustment in vulnerable groups by improving their executive function and resilience.

Characteristics and components of children's and adolescents' resilience in disasters in Iran: a qualitative study

Children and adolescents are vulnerable in times of disaster and they will suffer more severely if neglected. The concept of resilience differs between cultures, and identifying the components of resilience is essential for decision making and interventions in disasters such as risk management. This study aimed to identify the components of children's resilience in disasters in Iran. This qualitative study took a content-analysis approach. Data were collected through semi-structured interviews with 23 people and three group meetings. Conventional content analysis was used for data analysis. MAXQDA 10 software was used for classification. The resilience components derived from the data were categorized into two main categories, internal and external, and eight subcategories covering psychological, emotional, cognitive, mental, spiritual, physical, social, and behavioral factors. The results also showed that the nature of resilience is both intrinsic and extrinsic. Recognizing the dimensions of children's resilience in disasters can lead to a new perspective for authorities and planners in disaster and emergency situations. The results of this study could be used by planners and policymakers to develop interventions to enhance children's and adolescents' resilience at the time of disasters, which is also underlined and highlighted by international documents.

Social and Emotional Learning Associated With Universal Curriculum-Based Interventions in Early Childhood Education and Care Centers: A Systematic Review and Meta-analysis

Importance

Social-emotional competence in early childhood influences long-term mental health and well-being. Interest in the potential to improve child health and educational outcomes through social and emotional learning (SEL) programs in early childhood education and care (ECEC) settings is increasing.

Objective

To conduct a systematic review and meta-analysis of studies examining the social, emotional, and early learning outcomes associated with universal curriculum-based SEL programs delivered to children aged 2 to 6 years in center-based ECEC settings.

Data Sources

Keyword searches of Education Resources Information Center (ERIC), MEDLINE Complete, PsycINFO, and Proquest Dissertations and Theses Global databases were conducted to identify all relevant studies published from January 1, 1995, through December 31, 2017.

Study Selection

Studies included in this review examined universal curriculum-based SEL intervention delivered to children aged 2 to 6 years in a center-based ECEC setting. All assessed individual-level social and/or emotional skill after the SEL intervention and used an experimental or quasi-experimental design (ie, studies that did not or were not able to randomly allocate participants to intervention and control groups) with a control group.

Data Extraction and Synthesis

A total of 13 035 records were screened, of which 362 were identified for full-text review. A systematic literature review was conducted on 79 studies. Multilevel random-effects meta-analyses were conducted on 63 eligible studies from October 2 through 18, 2018.

Main Outcomes and Measures

Social competence, emotional competence, behavioral self-regulation, behavior and emotional challenges, and early learning outcomes.

Results

This review identified 79 unique experimental or quasi-experimental studies evaluating the effect of SEL interventions on preschooler outcomes, including a total of 18 292 unique participants. Sixty-three studies were included in this meta-analysis. Compared with control participants, children in intervention conditions showed significant improvement in social competence (Cohen d [SE], 0.30; [0.06]; 95% CI, 0.18-0.42; P < .001), emotional competence (Cohen d [SE], 0.54 [0.16]; 95% CI, 0.22-0.86; P < .001), behavioral self-regulation (Cohen d [SE], 0.28 [0.09]; 95% CI, 0.11-0.46; P < .001), and early learning skills (Cohen d [SE], 0.18 [0.08]; 95% CI, 0.02-0.33; P = .03) and reduced behavioral and emotional challenges (Cohen d [SE], 0.19 [0.04]; 95% CI, 0.11-0.28; P < .001). Several variables appeared to moderate program outcomes, including intervention leader, type of assessment, informant, child age, and study quality.

Conclusions and Relevance

According to results of this study, social and emotional learning programs appeared to deliver at a relatively low intensity may be an effective way to increase social competence, emotional competence, behavioral self-regulation, and early learning outcomes and reduce behavioral and emotional difficulties in children aged 2 to 6 years. Social and emotional learning programs appear to be particularly successful at increasing emotional knowledge, understanding, and regulation.

Prevalence and correlates of common mental disorders among dental students in Brazil

This study aimed to estimate prevalence of common mental disorders (CMD) and associated factors among dental students. In this cross-sectional study, 230 students answered a questionnaire and instruments to assess CMD (Self Reporting Questionnaire-20), hazardous alcohol consumption (Alcohol Use Disorder Identification Test), social support (Social Support Scale), perceptions of academic life (Dundee Ready Education Environment Measure), coping (Ways of Coping Inventory) and resilience (Resilience Scale). Bivariate analysis was conducted using the Chi-Square and Mann-Whitney tests. Logistic regression included all explanatory variableswith p<0.20 in the bivariate analysis, besides sex and academic year. The explanatory variables were analyzed in five successive blocks (backward-stepwise), until all variables presented statistical significance in the final model (p<0.05). The prevalence of CMD was 45.2% (95%CI: 38.7–51.6), with no significant differences between sexes. Students with no extracurricular activities, who had negatively self- assessed their health status and their academic performance, were about four times more likely to present CMD, followed by receiving psychological or psychiatric treatment during university (AOR: 2.65; 95%CI: 1.1–6.1) and those with high scores for confrontive coping (AOR: 1.20; 95%CI: 1.0–1.4). Resilience was a protective factor for CMD among dental students (AOR: 0.93; 95%CI: 0.9–1.0). Aspects related to academic performance, health status and confrontive coping strategies were risk factors to students’ mental health. Individuals with high levels of resilience showed lower prevalence of CMD. Further prospective studies could contribute to understanding the role of resilience among this population.

Vulnerabilities in sequencing and task switching in healthy youth offspring of parents with mood disorders

INTRODUCTION

Visuospatial processing and task switching are impaired in individuals with mood disorders. It is unknown whether early deficits are present before mood symptom on set or are related to risk for a specific type of mood disorder. To investigate, we compared visual attention and task switching during sequencing among never-disordered youth with parental family histories of bipolar (BD) and major depressive disorders (MDD) and healthy controls (HC) with no personal or family history of psychopathology.

METHOD

8-17-year-old youth of parents with BD (n = 31, "BD-risk"), youth of parents with MDD (n = 49, "MDD-risk"), and demographically similar HC (n = 31, "HC") were examined using the Delis-Kaplan Executive Functioning System Trail Making Test. Seed-based resting-state functional connectivity (RSFC) was collected from a subset of 88 participants (25 BD-risk, 37 MDD-risk, 26 HC) to investigate group differences in RSFC related to visuospatial processing.

RESULTS

BD-risk and MDD-risk offspring had impaired sequencing and task switching, demonstrated by reduced scores on visual scanning, F(2, 108) = 4.12, p = .02, number sequencing, F(2, 88) = 4.75, p = .01, letter sequencing, F(2, 108) = 4.24, p = .02, and number-letter sequencing, F(2, 108) = 4.66, p = .01, compared to scores in HC. RSFC between the posterior cingulate (PCC) and clusters in the subcallosal cortex, amygdala, and hippocampus significantly differed among HC, BD-risk, and MDD-risk groups. PCC-subcallosal/limbic RSFC was positively coupled in the MDD-risk and BD-risk groups and negatively coupled in HCs.

CONCLUSIONS

Youth at familial risk for mood disorders demonstrate visuospatial deficits early in the processing stream. Improved methods for identifying at-risk children with the earliest possible neurocognitive impairments may inform remediation strategies that could prevent mood disorders.

Treatment Effects of Parent-Child Focused Evidence-Based Programs on Problem Severity and Functioning among Children and Adolescents with Disruptive Behavior

This study examined the treatment effects of manualized parent-child focused evidence-based programs (EBPs), characterized by an emphasis on parental involvement and engagement, on functioning and problem severity among a statewide sample of children and adolescents referred to outpatient psychiatric clinic for serious and persistent disruptive behavior. Propensity score matching was employed to account for baseline differences between children and adolescents (M_age = 8.4 years; 26% girls; 42% White, 10% Black, 42% Hispanic, 5% other) who received parent-child focused EBPs (treatment group; n = 220) and treatment-as-usual (comparison group; n = 2,543). Children and adolescents who received parent-child focused EBPs showed significantly greater reduction in problem severity compared to the comparison group, indicative of a drop below the clinical threshold for problem behavior. However, the pattern of improvement in problem severity was not paralleled by differential improvement in ratings of child functioning across treatment and comparison conditions. Finally, there were significant differences between the treatment and comparison groups pertaining to certain child and case characteristics that have potential implications for reaching high-risk populations of children and families. These findings support the potential of taking parent-child focused EBPs into scale to promote positive behavioral changes among children and adolescents. Parent-child focused EBPs may serve as an effective remedy that is less restrictive and more conducive to the healthy development of children and adolescents.

Social-emotional competence and early adolescents' peer acceptance in school: Examining the role of afternoon cortisol

The present study investigated the role of afternoon cortisol in social-emotional competence and peer acceptance in early adolescence. To date, research on basal cortisol activity and social development in childhood and adolescence has predominately focused on understanding maladjustment and dysfunction in development. The degree to which basal cortisol is also involved in positive adjustment and social functioning remains largely unexplored. A total of 154 early adolescents (46% female; Mean age = 11.26; SD = .65) from diverse ethnic backgrounds provided self-reports of perspective taking, peer reports of acceptance by classmates, peer reports of prosocial behaviors, and saliva samples to assess basal cortisol. As expected and in alignment with previous research, afternoon cortisol, perspective taking, prosocial behaviors, and peer acceptance were all positively correlated. Path analyses followed by bootstrapping analyses revealed that the direct path from higher afternoon cortisol to higher levels of prosocial behavior was fully mediated by perspective taking skills. The direct path from higher afternoon cortisol to peer acceptance was fully mediated by perspective taking skills and prosocial behavior. The findings are discussed within the broader context of previous research on cortisol and social adjustment in childhood and early adolescence. The practical relevance of the findings is considered.