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Kim S. Editorial: Placing Parenting in Context: Neighborhood Crime, Early Brain Development, and Socioemotional Outcomes. J Am Acad Child Adolesc Psychiatry 2024; 63:678-680. [PMID: 38461892 DOI: 10.1016/j.jaac.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
The past decade has seen scientific advances that have provided an unprecedented window into the earliest years of human brain development.1 These discoveries have corroborated what many have long hypothesized: the human brain does not develop in isolation, but through close interactions with its environment. Evidence converges to support the critical importance of the parent-child relationship-the immediate caregiving environment that comprises foundational building blocks of the child's early socioemotional development.2-4 Attention is being increasingly directed to the role of the broader environment,5,6 the surrounding context in which immediate caregiving takes shape. Much remains to be understood as to how the broader environment intersects with the immediate caregiving environment to shape early developmental trajectories, especially in the face of adversities known to undermine early development (eg, poverty, crime, pollution, racism). The need for such work is timely, with growing public recognition of the deeply embedded inequities that our socioeconomically disadvantaged children face.
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Affiliation(s)
- Sohye Kim
- Eunice Kennedy Shriver Center, Departments of Psychiatry, Pediatrics, and Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA.
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2
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Yildiz NG, Aydin HZ, Aydin K, Yildiz H, Sambo G, Mwamulima B, Zonda JM, Phiri D, Phiri YVA. Understanding adverse childhood experiences and the call for trauma-informed healthcare system in Turkey: a review. Health Res Policy Syst 2024; 22:63. [PMID: 38816817 PMCID: PMC11140905 DOI: 10.1186/s12961-024-01137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/30/2024] [Indexed: 06/01/2024] Open
Abstract
Over the past four decades, research has underscored the significance of approaching and preventing trauma from a systemic standpoint. Trauma-informed care (TIC) methodologies offer a structure for healthcare practices, striving to convert organizations into trauma-informed systems that employ trauma-specific interventions. This review employs epidemiological and household data from Turkey to underscore the importance of integrating trauma-informed care as a means of prevention and intervention. Through a desk review, the study examines the role of adverse childhood experiences (ACEs), delving into their origin from family dynamics, migration, violence, exposure to violence, juvenile delinquency, and child maltreatment. The research highlights innovative healthcare approaches that leverage data to address complex patient health issues while considering mental health needs. In contemporary times, healthcare organizations acknowledge the value of a data-driven approach to make informed clinical decisions, enhance treatment procedures, and improve overall healthcare outcomes. The reviewed research and empirical data furnish proof of the importance of effective and efficient treatment methods that prioritize trauma prevention and treatment, integrating the role of ACEs. This paper seeks to contribute to discussions on transforming the healthcare system to meet the healthcare needs of Turkish households, all the while taking into account the evolving sociopolitical factors that shape Turkey's population characteristics.
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Affiliation(s)
- Nadire Gülçin Yildiz
- Department of Educational Sciences, Faculty of Education, Boğaziçi University, Bebek, Istanbul, 34342, Turkey.
- Faculty of Education, Department of Guidance and Counseling, Istanbul Medipol University, Istanbul, Turkey.
| | - Halide Z Aydin
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kemal Aydin
- Faculty of Economics and Administrative Sciences, Amasya University, Amasya, Turkey
| | - Hatice Yildiz
- Health Sciences Institute, Istanbul Medipol University, Istanbul, Turkey
| | - Grace Sambo
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Bwanalori Mwamulima
- Directorate of Health and Social Services, Rumphi District Council, Rhumpi, Malawi
| | - Joe Maganga Zonda
- Department of Economics, National Cheng Kung University, Tainan, Taiwan
| | - Doreen Phiri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan
| | - Yohane Vincent Abero Phiri
- Department of Epidemiology and Environmental Health (EEH), University at Buffalo, Buffalo, NY, USA.
- Charis Professional and Academic Research Consultants (CPARC), C/O P.O. Box 132, Mchinji, Malawi.
- Malawi Environmental Health Association (MEHA), P.O. Box 381, Lilongwe 3, Malawi.
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3
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Van den Bergh BRH, Antonelli MC, Stein DJ. Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation. Curr Opin Psychiatry 2024; 37:237-250. [PMID: 38415742 DOI: 10.1097/yco.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health. RECENT FINDINGS (1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse. SUMMARY During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.
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Affiliation(s)
| | - Marta C Antonelli
- Laboratorio de Programación Perinatal del Neurodesarrollo, Instituto de Biología Celular y Neurociencias "Prof.E. De Robertis", Facultad de Medicina. Universidad de Buenos Aires, Buenos Aires, Argentina
- Frauenklinik und Poliklinik, Klinikum rechts der Isar, Munich, Germany
| | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
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McCord M, Fierman A, Sisco S, Canfield C, Manjunath S, Cohen N, Havens J, Wilcox W, Tomopoulos S, Albert MS, Abraham T, Charney A, Acri M, Piwnica-Worms K. A Two-Generation, Early Childhood Advanced Primary Care Model. Pediatrics 2024; 153:e2023062567. [PMID: 38444349 DOI: 10.1542/peds.2023-062567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 03/07/2024] Open
Abstract
It is well recognized that early experiences produce long-term impacts on health outcomes, yet many children are at risk of not achieving their full potential because of health and service disparities related largely to poverty and racism. Although many pediatric primary care (PPC) models address these needs, most are isolated, add-on efforts that struggle to be scalable and sustainable. We describe 3-2-1 IMPACT (Integrated Model for Parents and Children Together), an initiative to transform the model of PPC delivered within New York City Health + Hospitals, the largest public hospital system in the United States, to address the full range of child and family needs in early childhood. Taking advantage of the frequent contact with PPC in the early years and linking to prenatal services, the model assesses family mental, social, and physical health needs and offers evidence-based parenting supports and integrated mental health services. Launching and sustaining the model in our large health system has required coalition building and sustained advocacy at the state, city, and health system levels. Long-term sustainability of the IMPACT model will depend on the implementation of early childhood-focused advanced payment models, on which we have made substantial progress with our major contracted Medicaid managed care plans. By integrating multiple interventions into PPC and prenatal care across a large public-healthcare system, we hope to synergize evidence-based and evidence-informed interventions that individually have relatively small effect sizes, but combined, could substantially improve child and maternal health outcomes and positively impact health disparities.
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Affiliation(s)
| | - Arthur Fierman
- New York University, Grossman School of Medicine, New York, New York
| | | | - Caitlin Canfield
- New York University, Grossman School of Medicine, New York, New York
| | - Sanjana Manjunath
- New York University, Grossman School of Medicine, New York, New York
| | | | - Jennifer Havens
- New York University, Grossman School of Medicine, New York, New York
| | | | - Suzy Tomopoulos
- New York University, Grossman School of Medicine, New York, New York
| | | | | | | | - Mary Acri
- New York University, Grossman School of Medicine, New York, New York
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5
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Masten AS. Emergence and evolution of developmental resilience science over half a century. Dev Psychopathol 2024:1-9. [PMID: 38456302 DOI: 10.1017/s0954579424000154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This reflection on the history and future of developmental resilience science (DRS) highlights its co-emergence with developmental psychopathology (DP), as well as the roles of this journal and its founding editor, Dante Cicchetti, in the evolution of these intertwined domains of scholarship. A remarkable constellation of scholars at the University of Minnesota shaped the course of both conceptual frameworks and their dissemination. I describe fundamental assumptions common to DP and DRS frameworks that reflect their common roots and the pervasive influence of systems theory on developmental science. I describe four waves of DRS and key principles of DRS at the present time. In conclusion, I consider the possibility that a fifth wave of DRS is emerging with a focus on understanding patterns of multisystem, multilevel processes of resilience and their implications for interventions in the context of interacting, interdependent, and complex adaptive systems. I close this commentary with questions for future research and a hopeful outlook on the future of human resilience.
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Affiliation(s)
- Ann S Masten
- University of Minnesota Twin Cities, Minneapolis, MN, USA
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6
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Shah PE, Poehlmann J, Weeks HM, Spinelli M, Richards B, Suh J, Kaciroti N. Developmental trajectories of late preterm infants and predictors of academic performance. Pediatr Res 2024; 95:684-691. [PMID: 37626121 DOI: 10.1038/s41390-023-02756-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/08/2023] [Accepted: 06/08/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The trajectories of late preterm development from infancy to kindergarten reading and math, and predictors of academic resilience and risk are unknown. METHODS Sample included 1200 late preterm infants (LPIs) from the Early Childhood Longitudinal Study, Birth Cohort. Objective measurements of development at 9 and 24 months (Bayley-SFR) and reading and math academic achievement at preschool and kindergarten were standardized; trajectories of late preterm development from 9 months to kindergarten reading and math were identified using latent class growth analysis. Multinomial logistic regression [aOR, 95% CI] identified predictors of academic resilience and risk. RESULTS Four trajectory groups were observed for reading and three for math. More optimal trajectories (in reading and math) and academic resilience were associated with experiencing sensitive parenting and preschool attendance. Suboptimal (at-risk) trajectories (in reading or math) and an increased odds of academic risk were associated with CONCLUSIONS LPI trajectories varied from infancy to kindergarten. More sensitive parenting and preschool attendance predicted academic resilience, and should be encouraged. Select risk factors (prenatal smoking, twin/multiple gestation, male sex, IMPACT Late preterm infants (LPIs) have developmental risks compared to full terms. LPI trajectories of early reading and math varied from infancy to kindergarten. We identified predictors of academic resilience and risk, which can help inform anticipatory guidance provided to LPIs prior to kindergarten. Promotive factors (sensitive parenting and preschool enrollment) predicted academic resilience. Select maternal and neonatal characteristics (
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Affiliation(s)
- Prachi E Shah
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, USA.
| | - Julie Poehlmann
- Department of Human Development and Family Studies, University of Wisconsin, Madison, WI, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maria Spinelli
- Department of Neurosciences, Imaging and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Blair Richards
- Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA
| | - Joohee Suh
- Research Foundation for Mental Hygiene, New York, NY, USA
| | - Niko Kaciroti
- Department of Biostatistics, School of Public of Health, University of Michigan, Ann Arbor, MI, USA
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7
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Dutta DJ, Sasaki J, Bansal A, Sugai K, Yamashita S, Li G, Lazarski C, Wang L, Sasaki T, Yamashita C, Carryl H, Suzuki R, Odawara M, Imamura Kawasawa Y, Rakic P, Torii M, Hashimoto-Torii K. Alternative splicing events as peripheral biomarkers for motor learning deficit caused by adverse prenatal environments. Proc Natl Acad Sci U S A 2023; 120:e2304074120. [PMID: 38051767 PMCID: PMC10723155 DOI: 10.1073/pnas.2304074120] [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: 03/13/2023] [Accepted: 10/25/2023] [Indexed: 12/07/2023] Open
Abstract
Severity of neurobehavioral deficits in children born from adverse pregnancies, such as maternal alcohol consumption and diabetes, does not always correlate with the adversity's duration and intensity. Therefore, biological signatures for accurate prediction of the severity of neurobehavioral deficits, and robust tools for reliable identification of such biomarkers, have an urgent clinical need. Here, we demonstrate that significant changes in the alternative splicing (AS) pattern of offspring lymphocyte RNA can function as accurate peripheral biomarkers for motor learning deficits in mouse models of prenatal alcohol exposure (PAE) and offspring of mother with diabetes (OMD). An aptly trained deep-learning model identified 29 AS events common to PAE and OMD as superior predictors of motor learning deficits than AS events specific to PAE or OMD. Shapley-value analysis, a game-theory algorithm, deciphered the trained deep-learning model's learnt associations between its input, AS events, and output, motor learning performance. Shapley values of the deep-learning model's input identified the relative contribution of the 29 common AS events to the motor learning deficit. Gene ontology and predictive structure-function analyses, using Alphafold2 algorithm, supported existing evidence on the critical roles of these molecules in early brain development and function. The direction of most AS events was opposite in PAE and OMD, potentially from differential expression of RNA binding proteins in PAE and OMD. Altogether, this study posits that AS of lymphocyte RNA is a rich resource, and deep-learning is an effective tool, for discovery of peripheral biomarkers of neurobehavioral deficits in children of diverse adverse pregnancies.
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Affiliation(s)
- Dipankar J. Dutta
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Junko Sasaki
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo160-8402, Japan
| | - Ankush Bansal
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Keiji Sugai
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo160-8402, Japan
| | - Satoshi Yamashita
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Guojiao Li
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo160-8402, Japan
| | - Christopher Lazarski
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC20010
| | - Li Wang
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Toru Sasaki
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo160-8402, Japan
| | - Chiho Yamashita
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Heather Carryl
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
| | - Ryo Suzuki
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo160-8402, Japan
| | - Masato Odawara
- Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University, Tokyo160-8402, Japan
| | - Yuka Imamura Kawasawa
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Hershey, PA17033
| | - Pasko Rakic
- Kavli Institute for Neuroscience, Yale School of Medicine, New Haven, CT06520
| | - Masaaki Torii
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
- Department of Pediatrics, Pharmacology and Physiology, George Washington University, Washington, DC20010
| | - Kazue Hashimoto-Torii
- Center for Neuroscience Research, Children’s National Hospital,Washington, DC20010
- Department of Pediatrics, Pharmacology and Physiology, George Washington University, Washington, DC20010
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8
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Dumitriu D, Lavallée A, Riggs JL, Frosch CA, Barker TV, Best DL, Blasingame B, Bushar J, Charlot-Swilley D, Erickson E, Finkel MA, Fortune B, Gillen L, Martinez M, Ramachandran U, Sanders LM, Willis DW, Shearman N. Advancing early relational health: a collaborative exploration of a research agenda. Front Pediatr 2023; 11:1259022. [PMID: 38143537 PMCID: PMC10748603 DOI: 10.3389/fped.2023.1259022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/07/2023] [Indexed: 12/26/2023] Open
Abstract
Here, we introduce the Early Relational Health (ERH) Learning Community's bold, large-scale, collaborative, data-driven and practice-informed research agenda focused on furthering our mechanistic understanding of ERH and identifying feasible and effective practices for making ERH promotion a routine and integrated component of pediatric primary care. The ERH Learning Community, formed by a team of parent/caregiver leaders, pediatric care clinicians, researchers, and early childhood development specialists, is a workgroup of Nurture Connection-a hub geared toward promoting ERH, i.e., the positive and nurturing relationship between young children and their parent(s)/caregiver(s), in families and communities nationwide. In response to the current child mental health crisis and the American Academy of Pediatrics (AAP) policy statement promoting ERH, the ERH Learning Community held an in-person meeting at the AAP national headquarters in December 2022 where members collaboratively designed an integrated research agenda to advance ERH. This agenda weaves together community partners, clinicians, and academics, melding the principles of participatory engagement and human-centered design, such as early engagement, co-design, iterative feedback, and cultural humility. Here, we present gaps in the ERH literature that prompted this initiative and the co-design activity that led to this novel and iterative community-focused research agenda, with parents/caregivers at the core, and in close collaboration with pediatric clinicians for real-world promotion of ERH in the pediatric primary care setting.
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Affiliation(s)
- Dani Dumitriu
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
- Division of Developmental Neuroscience, Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Andréane Lavallée
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Jessica L. Riggs
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, United States
| | - Cynthia A. Frosch
- Department of Human Development and Family Science, Auburn University, Auburn, AL, United States
| | - Tyson V. Barker
- Science and Innovation Strategy, Institute for Child Success, Greenville, SC, United States
| | - Debra L. Best
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | | | - Jessica Bushar
- HealthySteps, ZERO TO THREE, Washington, DC, United States
| | | | - Elizabeth Erickson
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | - Morgan A. Finkel
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Bryn Fortune
- Fortune Consulting, Early Relational Health-Family Network Collaborative, Royal Oak, MI, United States
| | - Leah Gillen
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
| | - Marty Martinez
- Chief Executive Officer, Reach Out and Read, Boston, MA, United States
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Lee M. Sanders
- Department of Pediatrics, Division of General Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - David W. Willis
- Center for the Study of Social Policy, Washington, DC, United States
| | - Nikki Shearman
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
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9
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Bates EJS, Berny LM, Ganiban JM, Natsuaki MN, Neiderhiser JM, Shaw DS, Leve LD. Examination of promotive and protective effects on early adolescent prosocial behavior through a bioecological lens. Front Psychol 2023; 14:1280346. [PMID: 38046108 PMCID: PMC10690822 DOI: 10.3389/fpsyg.2023.1280346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Prosocial behavior during childhood has been associated with numerous positive developmental and behavioral outcomes in adolescence and adulthood. Prosocial behavior, which includes cooperation and helping others, develops within a bioecological context. Considering it through such a lens enhances the understanding of the roles of different bioecological factors in its development. Methods Using data from a longitudinal study of adopted children and children reared with their biological parents, this paper examined if positive aspects of a child's bioecological system at age 7 predict prosocial behavior in early adolescence (age 11), and whether these bioecological factors could offset risk due to biological family psychopathology and/or maternal prenatal substance use. The analyses incorporated variables from different levels of Bronfenbrenner's bioecological model (the individual, microsystem, exosystem, and macrosystem) and examined the promotive, and potentially protective, effect of each contextual factor, while also considering their interplay with biological family psychopathology and prenatal substance use. Results Results from linear regression models indicated that the microsystem variable of parental warmth at age 7 had a promotive effect on age 11 prosocial behavior. Further, in addition to its main effect, parental warmth was protective against maternal substance use during pregnancy when children were raised with their biological parent (s). Household type (biological family) and biological family internalizing psychopathology were the only other significant predictors in the model, with each associated with lower prosocial behavior at age 11. Discussion Study results extend prior work on the benefits of parental warmth on child outcomes by employing a strength-based, bioecological approach to the development of prosocial behavior during early adolescence and examining "for whom" the effects of parental warmth are most protective.
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Affiliation(s)
- Elizabeth J. S. Bates
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Lauren M. Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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10
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Wang M, Perzynski A, Ronis S. Bringing community oriented primary care into an academic training setting: A qualitative study. Prev Med Rep 2023; 35:102313. [PMID: 37752984 PMCID: PMC10518791 DOI: 10.1016/j.pmedr.2023.102313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 09/28/2023] Open
Abstract
Objectives Identify patient-informed strategies through which an urban resident continuity clinic can implement the principles of community oriented primary care (COPC). Methods As part of a larger sequential mixed methods study supporting implementation evaluation of a new urban academic medical center in Cleveland, Ohio, semi-structured telephone interviews using a descriptive phenomenological approach were conducted spring 2021 with patients to explore perspectives regarding community involvement by healthcare providers and what they want clinicians to know about their community. A constant comparative analysis of emerging themes was used to analyze the thematic contents of interviews. Results Twenty-one participants completed interviews. Almost all thought clinicians' community involvement is important. Thematic guidance from participants highlighted that clinicians should be: (1) knowledgeable about the Black experience, (2) seen in the community outside the clinic, and (3) aware that "knowing my community is knowing me." Conclusions Design with a target community in mind is a necessary but not sufficient step to implement COPC in practice. The visibility of clinicians in community settings is essential for COPC.
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Affiliation(s)
- Mia Wang
- Case Western Reserve School of Medicine, Department of Population and Quantitative Health Sciences, Cleveland, OH, United States
| | - Adam Perzynski
- Case Western Reserve School of Medicine, Department of Population and Quantitative Health Sciences, Cleveland, OH, United States
| | - Sarah Ronis
- University Hospitals, Rainbow Center for Child Health and Policy, Cleveland, OH, United States
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Bürgin D, Clemens V, Witt A, Sachser C, Jud A, Brähler E, Strauß B, Petrowski K, Schmid M, Fegert JM. Adverse childhood experiences increase the risk for low perceived social participation and health-related quality of life in a large-scale population-based study in Germany. CHILD ABUSE & NEGLECT 2023; 144:106382. [PMID: 37527561 DOI: 10.1016/j.chiabu.2023.106382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/17/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are highly prevalent and increase the risk for long-term adverse health outcomes. Next to well-known ACE-associated risks for morbidity, recent research is increasingly invested in exploring pathways towards health, overall functioning, and partaking in society following early adversity. OBJECTIVES Thus, this study aims to assess the association between latent classes of ACEs with perceived social participation and health-related Quality of Life (QoL) in a large population-based sample and to explore potential moderators of these associations. METHOD A representative sample of the German population (N = 2531; Mage = 48.7; 51 % women) was cross-sectionally investigated for ACEs, social participation (KsT-5), and health-related QoL (EuroQol-5D-5L). Latent Class Analysis (LCA) was performed to derive groups with similar ACE patterns. Multiple regression analyses were used to investigate the association of latent classes of ACEs with social participation and health-related QoL and to explore potential moderators. RESULTS Four distinct latent classes of ACEs were identified; "no/low ACEs" (N = 1968, 77.8 %); "household-dysfunction" (N = 259, 10.2 %), "child abuse and neglect" (N = 188, 7.4 %), and "polyadversity" (N = 116, 4.6 %). Compared to participants in the no/low ACE class, those in the ACE-exposed classes showed overall lower levels of perceived social participation and health-related QoL. The polyadversity class showed lower levels of social participation compared to the two other ACE-exposed classes. Chronic stress, living with a partner, education, current job/educational involvement, and gender were found to moderate these associations in exploratory analyses. CONCLUSIONS This study shows people exposed to ACEs to have a higher risk for lower perceived social participation and lower health-related QoL - an increased risk, however, is not a deterministic uninventable fortune. Reduction of chronic stress, fostering of social support, and educational and vocational paths as interventional targets are discussed to enable those with precarious starting conditions to partake in society.
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Affiliation(s)
- David Bürgin
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland.
| | - Vera Clemens
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Witt
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany
| | - Andreas Jud
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
| | - Elmar Brähler
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center of Johannes Gutenberg University of Mainz, Mainz, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases-Behavioral Medicine, Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Marc Schmid
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of Basel, Basel, Switzerland
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Ulm, Ulm, Germany; Competence Center Child Abuse and Neglect in Medicine Baden-Wurttemberg com.can, Ulm, Germany
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de Mendonça Filho EJ, Pokhvisneva I, Maalouf CM, Parent C, Mliner SB, Slopen N, Williams DR, Bush NR, Boyce WT, Levitt P, Nelson CA, Gunnar MR, Meaney MJ, Shonkoff JP, Silveira PP. Linking specific biological signatures to different childhood adversities: findings from the HERO project. Pediatr Res 2023; 94:564-574. [PMID: 36650307 PMCID: PMC10382309 DOI: 10.1038/s41390-022-02415-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/23/2022] [Accepted: 11/02/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although investigations have begun to differentiate biological and neurobiological responses to a variety of adversities, studies considering both endocrine and immune function in the same datasets are limited. METHODS Associations between proximal (family functioning, caregiver depression, and anxiety) and distal (SES-D; socioeconomic disadvantage) early-life adversities with salivary inflammatory biomarkers (IL-1β, IL-6, IL-8, and TNF-α) and hair HPA markers (cortisol, cortisone, and dehydroepiandrosterone) were examined in two samples of young U.S. children (N = 142; N = 145). RESULTS Children exposed to higher SES-D had higher levels of TNF-α (B = 0.13, p = 0.011), IL-1β (B = 0.10, p = 0.033), and DHEA (B = 0.16, p = 0.011). Higher family dysfunction was associated with higher cortisol (B = 0.08, p = 0.033) and cortisone (B = 0.05, p = 0.003). An interaction between SES-D and family dysfunction was observed for cortisol levels (p = 0.020) whereby children exposed to lower/average levels of SES-D exhibited a positive association between family dysfunction and cortisol levels, whereas children exposed to high levels of SES-D did not. These findings were partially replicated in the second sample. CONCLUSIONS Our results indicate that these biological response systems may react differently to different forms of early-life adversity. IMPACT Different forms of early-life adversity have varied stress signatures, and investigations of early-life adversities with inflammation and HPA markers are lacking. Children with higher socioeconomic disadvantage had higher TNF-α, IL-1β, and DHEA. Higher family dysfunction was associated with higher hair cortisol and cortisone levels, and the association between family dysfunction and cortisol was moderated by socioeconomic disadvantage. Biological response systems (immune and endocrine) were differentially associated with distinct forms of early-life adversities.
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Affiliation(s)
- Euclides José de Mendonça Filho
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | - Christina Maria Maalouf
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | - Carine Parent
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
| | - Shanna B Mliner
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, San Francisco, CA, USA
- Division of Developmental Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - William Thomas Boyce
- Division of Developmental Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Pat Levitt
- Department of Pediatrics and Program in Developmental Neuroscience and Developmental Neurogenetics, The Saban Research Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Charles A Nelson
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Megan R Gunnar
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Michael J Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, Singapore, Republic of Singapore
| | - Jack P Shonkoff
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
- Center on the Developing Child, Harvard University, Cambridge, MA, USA
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Hospital Research Center, Montreal, QC, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
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Trachtman R, Samuels J, Wojtal E, Feldman BM. Resilience and its associations in children with Systemic Lupus Erythematosus and Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2023; 21:67. [PMID: 37420184 DOI: 10.1186/s12969-023-00854-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/01/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Resilience has been shown to be associated with better psychological outcomes and ability to cope with negative and traumatic events in the healthcare setting. Therefore, in this study, we aimed to evaluate resilience and its association with disease activity and health-related quality of life (HRQOL) in children with Systemic Lupus Erythematosus (SLE) and Juvenile Idiopathic Arthritis (JIA). FINDINGS Patients with diagnoses of SLE or JIA were recruited. We collected: demographic data, medical history and physical examination, physician and patient global health assessments, Patient Reported Outcome Measurement Information System questionnaires, Connor Davidson Resilience Scale 10 (CD-RISC 10), Systemic Lupus Erythematosus Disease Activity Index, and clinical Juvenile Arthritis Disease Activity Score 10. Descriptive statistics were calculated, and PROMIS raw scores were converted to T-scores. Spearman's correlations were performed, with statistical significance set to p < 0.05. 47 study subjects were recruited. The average CD-RISC 10 score in SLE was 24.4, and in JIA was 25.2. In children with SLE, CD-RISC 10 was correlated with disease activity and inversely correlated with anxiety. In children with JIA, resilience was inversely associated with fatigue, and positively correlated with mobility and peer relationships. CONCLUSIONS In children with SLE and JIA, resilience is lower than in the general population. Further, our results suggest that interventions to increase resilience may improve the HRQOL of children with rheumatic disease. Ongoing study of the importance of resilience in this population, as well as interventions to increase resilience, will be an important area of future research in children with SLE and JIA.
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Affiliation(s)
- Rebecca Trachtman
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, 10029, New York, NY, USA.
- Mindich Child Health and Development Institute, New York, NY, USA.
| | - Julie Samuels
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, 10029, New York, NY, USA
| | - Emma Wojtal
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, 10029, New York, NY, USA
| | - Brian M Feldman
- The Hospital for Sick Children, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
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Ronis S, Guyon-Harris KL, Burkhart K, Gabriel M, Cipolla K, Riggs JL, Huth-Bocks A. Profiles of Early Childhood Adversity in an Urban Pediatric Clinic: Implications for Pediatric Primary Care. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1023. [PMID: 37371255 DOI: 10.3390/children10061023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/27/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019-January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%). Among those who also completed the Adverse Childhood Experiences Questionnaire (ACE-Q, n = 1373) and the Protective and Compensatory Experiences Scale (PACES, n = 1377), belonging to the L class was associated with lower ACE-Q and higher PACES scores. For parent-respondents only, ACE-Q scores were significantly greater for the CSD class compared to the CS and L classes. Pediatricians should attend to the needs of caregivers reporting both stress and depression, as these families may face especially high levels of adversity and low levels of protective factors.
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Affiliation(s)
- Sarah Ronis
- UH Rainbow Center for Child Health and Policy, Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH 44106, USA
| | - Katherine L Guyon-Harris
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Kimberly Burkhart
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH 44106, USA
| | - Mary Gabriel
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Kristin Cipolla
- Department of Pediatrics, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Jessica L Riggs
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alissa Huth-Bocks
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Merrill Palmer Skillman Institute, Division of Research, Wayne State University, Detroit, MI 48202, USA
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Bisagno E, Cadamuro A, Serafine D, Dima BM, Anne G, Zane LO, Annija K, Dóra VS, Dorottya M, Noémi L, Monika R, Andrea G, Giovanna Laura DF, Johanna Maria Catharina B. The Development of a Screening Tool for Childcare Professionals to Detect and Refer Infant and Toddler Maltreatment and Trauma: A Tale of Four Countries. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050858. [PMID: 37238406 DOI: 10.3390/children10050858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Child maltreatment is considered a pressing social question, compromising the present and future mental and physical health of one in four children in Europe. While children younger than three years of age are especially vulnerable, few screening instruments are available for the detection of risk in this age group. The purpose of this research was to develop a screening tool for childcare professionals working in public and private daycare settings to support them in the early identification and referral of infants and toddlers exposed to emotional and physical abuse and neglect by primary caregivers, to be used in different settings across four European countries: Belgium, Italy, Latvia, and Hungary. METHOD A stratified process was used to create the screening tool: We started by using Living lab methodology to co-create the screening tool with its final users, which was followed by testing the tool with a total of 120 childcare professionals from the four participating countries. RESULTS During the Living Lab phase, a screening tool with three layers was developed. The initial layer includes five "red flags" that signal particular concern and require immediate action. The second layer is a quick screener with twelve items focused on four areas: neglect of basic needs, delays in development, unusual behaviors, and interaction with caregivers. The third layer is an in-depth questionnaire that aids in formalizing a thorough observation of twenty-five items within the same four areas as the quick screener. After a one-day training session, 120 childcare professionals caring for children aged 0-3 from four countries assessed the screening tool and their overall training experience. Childcare professionals reported great satisfaction with the three-layered structure, which made the tool versatile, and agreed on its content, which was considered helpful in the daycare setting for the regular evaluation of the behavior of children and their primary caregivers, thus improving the early observation of change from the normal behavior of the infant or toddler. CONCLUSION The three-layered screening tool was reported as feasible, practical, and with great content validity by childcare professionals working in four European countries.
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Affiliation(s)
- Elisa Bisagno
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Alessia Cadamuro
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Dierickx Serafine
- Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium
| | - Bou Mosleh Dima
- Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium
| | - Groenen Anne
- Expertise Centre Resilient People, University Colleges Leuven-Limburg (UCLL), 3001 Leuven, Belgium
| | - Linde-Ozola Zane
- Department of Anthropology, Faculty of Humanities, University of Latvia, LV-1586 Riga, Latvia
| | | | | | - Morva Dorottya
- Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary
| | - László Noémi
- Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary
| | - Rozsa Monika
- Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary
| | - Gruber Andrea
- Pressley Ridge Hungary Foundation, 1142 Budapest, Hungary
| | | | - Blom Johanna Maria Catharina
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41121 Modena, Italy
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Lavallée A, Warmingham JM, Reimers MA, Kyle MH, Austin J, Lee S, Barker T, Hussain M, Ettinger S, Dumitriu D. Factor Structure of the Postpartum Bonding Questionnaire in a US-Based Cohort of Mothers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.09.23288334. [PMID: 37131748 PMCID: PMC10153319 DOI: 10.1101/2023.04.09.23288334] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
As research efforts in the field of pediatrics are oriented toward a better understanding of the synergistic relationship between different facets of early relational health (ERH) and child development and wellbeing, it is essential to focus on the quality of research instruments available for measuring different components of ERH. This study investigates the measurement characteristics of a widely used parent/caregiver-reported measure of bonding, the Postpartum Bonding Questionnaire (PBQ), in a US-based sample (n=610) of English-speaking biological mothers who completed the PBQ at 4 months postpartum. To evaluate the factor structure of the PBQ, confirmatory and exploratory statistical techniques were employed. The current study failed to replicate the PBQ's original 4-factor structure. Exploratory factor analysis results supported the creation of a 14-item abbreviated measure, the PBQ-14. The PBQ-14 showed evidence of good psychometric properties, including high internal consistency (ω=.87) and correlation with depression (r=.44, p<.001) assessed using the Patient Health Questionnaire (PHQ-9), as would be expected. The new unidimensional PBQ-14 is suitable for use in the US as a measure of general postnatal parent/caregiver-to-infant bonding.
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Affiliation(s)
- Andréane Lavallée
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA
| | - Jennifer M. Warmingham
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA
| | - Mark A. Reimers
- Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Margaret H. Kyle
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA
| | - Judy Austin
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Seonjoo Lee
- Mental Health Data Science, New York State Psychiatric Institute, New York, NY 10032, USA.Department of Biostatistics and Psychiatry, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Tyson Barker
- Institute for Child Success, Greenville, SC 29601, USA
| | - Maha Hussain
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA
| | - Sharon Ettinger
- Department of Psychological and Brain Sciences, Drexel University College of Arts and Sciences, Philadelphia, PA 19104, USA
| | - Dani Dumitriu
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA
- Division of Developmental Neuroscience, Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
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Mølland E, Haraldstad K, Abildsnes E, Håland ÅT, Köpp UMS, Fegran L, Westergren T. Use of the Strengths and Difficulties Questionnaire in child and school health services among children aged 4 and 6 years in Southern Norway: clinical considerations. BMC Pediatr 2023; 23:30. [PMID: 36658563 PMCID: PMC9850695 DOI: 10.1186/s12887-023-03837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Parent reported mental health can be assessed by the Strengths and Difficulties Questionnaire (SDQ). Currently, Norwegian norms for parent-reported SDQ do not exist, whereas Swedish, Danish, and United Kingdom (UK) norms have been published. We aimed to (1) describe parent-reported SDQ among children aged 4 and 6 years in Southern Norway, (2) evaluate empirical cutoff values within the context of the Starting RightTM project in relation to the Swedish, Danish, and UK cutoffs, and (3) evaluate the representativeness of the study sample with regard to parental socioeconomic status. METHODS This study included parent-reported observations for 665 children (63% consent rate). Means and standard deviations were calculated for the domains of SDQ, and gender differences were assessed. Based on the Swedish, Danish, and UK cutoffs and the 80th and 90th percentile cutoff values within the study, we calculated the total number of children with borderline and abnormal scores. RESULTS Boys had higher mean total difficulties (7.3 vs 5.6) and impact scores (0.3 vs 0.1) and lower prosocial scores (8.3 vs 8.8) than girls. The differences in means were largest in the case of externalizing symptoms (5.0 vs 3.6) and hyperactivity subscore (3.2 vs 2.3). Using the UK cutoff values, 28 and 25 children had borderline and abnormal total difficulties scores, respectively. The corresponding numbers using the within study or Scandinavian cutoff values were 84-99 and 54-79, respectively. Overall, our study sample was well representative of the target population. CONCLUSIONS Our findings consistently indicated that girls had better SDQ scores than boys among children aged 4 and 6 years. Fewer children would be identified as having mental health difficulties using the UK cutoff values than using the Scandinavian age- and gender-relevant cutoff values.
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Affiliation(s)
- Eirin Mølland
- grid.23048.3d0000 0004 0417 6230Department of Economics and Finance, School of Business and Law, University of Agder, PO Box 422, 4604 Kristiansand, Norway ,grid.509009.5NORCE, Kristiansand, Norway
| | - Kristin Haraldstad
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Eirik Abildsnes
- grid.458169.70000 0004 0474 7697Kristiansand Municipality, Kristiansand, Norway ,grid.23048.3d0000 0004 0417 6230Department of Psychosocial Health, Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Åshild Tellefsen Håland
- grid.23048.3d0000 0004 0417 6230Department of Psychosocial Health, Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway ,grid.417290.90000 0004 0627 3712Department of Children and Adolescents Mental Health (ABUP), Sørlandet Hospital HF, Kristiansand, Norway
| | - Unni Mette Stamnes Köpp
- grid.417290.90000 0004 0627 3712Department of Peadiatrics, Sørlandet Hospital HF, Kristiansand, Norway
| | - Liv Fegran
- grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- grid.509009.5NORCE, Kristiansand, Norway ,grid.23048.3d0000 0004 0417 6230Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Uccellini O, Benlodi A, Caroppo E, Cena L, Esposito G, Fernandez I, Ghazanfar M, Imbasciati A, Longo F, Mazza M, Marano G, Nacinovich R, Pignatto A, Rolnick A, Trivelli M, Spada E, Vanzini C. 1000 Days: The "WeCare Generation" Program-The Ultimate Model for Improving Human Mental Health and Economics: The Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16741. [PMID: 36554625 PMCID: PMC9779238 DOI: 10.3390/ijerph192416741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The COVID-19 pandemic stressed the necessity of a new resilience of the human population and health system. The "WeCare Generation" program is a new proposal of territorial intervention, with a new paradigm, on the diseases of the human body and mind. BACKGROUND In recent decades, the independent strands of investigation on brain plasticity and early trauma consequences have demonstrated that traumatic experiences in the period from pregnancy to the age of 3 years have an enormous impact on an individual's future development, and both physical and mental health. Research shows that adverse child experiences (ACEs) are associated with a strong risk of conditions such as: harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular diseases, stroke respiratory diseases and, as a consequence, to a high financial cost in Italy and also across Europe (1-9% GDP) and the USA (total annual costs estimated to be USD 581 billion in Europe and USD 748 billion in North America). All this suggests that an early intervention on that traumatized-slice of population leads to multiplied savings. METHODS A multi-center, randomized, controlled trial was designed. The parents of the future neonatal population (from pregnancy to delivery) with trauma will be enrolled, and randomized to treatment, or control arm. The article describes in detail how the primary outpoint (cost to the national health system), and some secondary outpoints, will be collected. DISCUSSION An overall rate of return on investment (ROI) statistically significant 13.0% per annum with an associated benefit/cost ratio (BCR) of 6.3 is expected as the primary outcome of the "WeCare Generation" program. Our proposed model predicts a new medical paradigm aiming to empower new generations, with a strong return on economy and health.
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Affiliation(s)
| | - Andrea Benlodi
- Clinical Psychology Unit Carlo Poma Hospital, ASST Mantova, 46100 Mantua, Italy
| | - Emanuele Caroppo
- Department of Mental Health, Local Health Authority Roma 2, 00159 Rome, Italy
| | - Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38122 Trent, Italy
| | | | - Maria Ghazanfar
- Maternal and Child Department, ASST Brianza, 20871 Vimercate, Italy
| | - Antonio Imbasciati
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Francesco Longo
- Cergas Center for Research on Health and Social Care Management, SDA Bocconi University, 20136 Milan, Italy
| | - Marianna Mazza
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe Marano
- Department of Geriatrics, Neuroscience and Orthopedics, Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Universita’ Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Renata Nacinovich
- Child and Adolescent Neuropsichiatry, ASST Monza, NeuroMI—Milan Center for Neuroscience, University of Milano Bicocca, 20126 Milan, Italy
| | - Antonio Pignatto
- Department of Psychology, IUSTO—Salesian University Institute Torino Rebaudengo, 10155 Turin, Italy
| | - Arthur Rolnick
- Department of Economics, Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN 55455, USA
| | - Marco Trivelli
- General and Economic Direction, ASST Brianza, 20871 Vimercate, Italy
| | | | - Cinzia Vanzini
- Training Sector Management, ASST Brianza, 20871 Vimercate, Italy
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19
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The Use of Psychotropic Medication in Pediatric Oncology for Acute Psychological and Psychiatric Problems: Balancing Risks and Benefits. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121878. [PMID: 36553324 PMCID: PMC9777172 DOI: 10.3390/children9121878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
Severe acute behavioral and emotional problems represent one of the most serious treatment-related adverse effects for children and adolescents who have cancer. The critical and severe nature of these symptoms often makes necessary the use of psychotropic drugs. A working group composed of experts in multiple disciplines had the task of creating an agreement regarding a management plan for severe acute behavioral and emotional problems (SABEPs) in children and adolescents treated for cancer. To obtain global information on the use of psychotropic drugs in pediatric oncology, the working group first developed and mailed a 15-item questionnaire to many Italian pediatric oncology centers. Overall, an evident lack of knowledge and education regarding the use of psychotropic medications for the treatment of SABEPs was found. Thus, by referring to an adapted version of the Delphi method of consensus and standard methods for the elaboration of clinical questions (PICOs), the working group elaborated evidence-based recommendations for psychotropic drugs in the pediatric oncology setting. Furthermore, based on a thorough multivariate analysis of needs and difficulties, a comprehensive management flow was developed to optimize therapeutic interventions, which allows more accurate and efficient matching of the acute needs of patients while guiding treatment options.
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20
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Jablonka O, Palusci VJ. Role of Psychologists in Child Abuse Pediatrics. Pediatr Clin North Am 2022; 69:879-893. [PMID: 36207099 DOI: 10.1016/j.pcl.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article describes the extent of the problem and the medical evaluation of child maltreatment, focusing on the outpatient interdisciplinary assessment of suspected child physical and sexual abuse. Separate from their role as clinicians, the roles of the child psychologist before, during, and after the medical assessment are highlighted. The child psychologist is an important member of the interdisciplinary team who helps the team prepare for the evaluation (before), assists in screening and determining immediate psychological safety during the medical evaluation (during), and communicating the need for further treatment and follow-up (after).
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Affiliation(s)
- Olga Jablonka
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, 462 First Avenue, GC-65, New York, NY 10016, USA.
| | - Vincent J Palusci
- Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, GC-65, New York, NY 10016, USA
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21
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Bechtiger L, Steinhoff A, Dollar JM, Calkins SD, Keane SP, Shriver L, Wideman L, Shanahan L. Maternal Depressive Symptoms and Adolescents' Unhealthy Behavior: A 15-year Longitudinal Study. Pediatrics 2022; 150:e2022056562. [PMID: 36127316 PMCID: PMC9647587 DOI: 10.1542/peds.2022-056562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES First, to leverage 15 years of longitudinal data, from child ages 2 to 17, to examine whether maternal depressive symptoms in early and middle childhood and in adolescence predict their child's unhealthy behaviors during adolescence. Second, to examine whether the timing of maternal depressive symptoms or specific unhealthy behaviors matter and whether child depressive symptoms and body mass index explain these associations. METHODS Data came from a prospective-longitudinal community sample with multi-informant data (N = 213) from child ages 2 to17. A cumulative adolescent unhealthy behavior index was calculated, summing the presence of poor sleep, poor diet, physical inactivity, sedentary behavior, and smoking. Regression analyses examined associations of maternal depressive symptoms in early childhood (ages 2 to 5), middle childhood (ages 7 to 10), and adolescence (age 15) with adolescents' unhealthy behaviors (ages 16 to17). Indirect effects of child depressive symptoms and body mass index were tested using a path model. RESULTS Adolescents' unhealthy behaviors were common (eg, 2 out of 3 engaged in at least 1 unhealthy behavior). Higher levels of maternal depressive symptoms in middle childhood and adolescence were associated with adolescent engagement in more unhealthy behaviors at ages 16 to 17. Maternal depressive symptoms in early childhood were associated with adolescent unhealthy behaviors through indirect effects involving children's depressive symptoms and continuity of maternal depressive symptoms. CONCLUSIONS Maternal depressive symptoms are associated with the number of adolescent unhealthy behaviors, both directly and indirectly. Promoting mothers' mental health can be crucial for promoting children's health behaviors and health.
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Affiliation(s)
| | | | | | - Susan D. Calkins
- Office of Research and Engagement, University of North Carolina at Greensboro, Greensboro, North Carolina
| | | | | | | | - Lilly Shanahan
- Jacobs Center for Productive Youth Development
- Department of Psychology, University of Zurich, Zurich, Switzerland
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22
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Monk C, Dimidjian S, Galinsky E, Gregory KD, Hoffman MC, Howell EA, Miller ES, Osborne C, Rogers CE, Saxbe DE, D'Alton ME. The Transition to Parenthood in Obstetrics: Enhancing Prenatal Care for Two Generation Impact. Am J Obstet Gynecol MFM 2022; 4:100678. [PMID: 35728782 DOI: 10.1016/j.ajogmf.2022.100678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022]
Abstract
Obstetrics, the specialty overseeing infant and parent health before birth, could be expanded to address the inter-related areas of parents' prenatal impact on children's brain development and their own psychosocial needs during a time of immense change and neuroplasticity. Obstetrics is primed for the shift that is happening in pediatrics, which is moving from its traditional focus on physical health to a coordinated, whole child, two or multi-generation approach. Pediatric care now includes developmental screening, parenting education, parent coaching, access to developmental specialists, brain-building caregiving skills, linkages to community resources, and tiered interventions with psychologists. Drawing on decades of Developmental Origins of Health and Disease research highlighting the prenatal beginnings of future health and new studies on the transition to parenthood describing adult development from pregnancy to early postpartum, we propose that, similar to pediatrics, the integration of education and intervention strategies into the prenatal care ecosystem should be tested for its potential to improve child cognitive and social-emotional development and parental mental health. Pediatric care programs can serve as models of change for the systematic development, testing and, incorporation of new content into prenatal care as universal, first-tier treatment as well as evidenced-based, triaged interventions according to level of need. To promote optimal beginnings for the whole family, we propose an augmented prenatal care ecosystem that aligns with, and could build on, current major efforts to enhance perinatal care individualization through consideration of medical, social, and structural determinants of health.
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Affiliation(s)
- Catherine Monk
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY; Department of Psychiatry, Columbia University Irving Medical Center, New York, NY.
| | - Sona Dimidjian
- Department of Psychology and Neuroscience, University Colorado, Boulder
| | | | | | - M Camille Hoffman
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora; Department of Psychiatry, University of Colorado School of Medicine, Aurora
| | - Elizabeth A Howell
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Emily S Miller
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL; Department of Psychiatry and Behavioral Health Sciences, Northwestern University, Chicago, IL
| | - Cynthia Osborne
- Department of Leadership, Policy, and Organizations, Peabody College, Vanderbilt University, Nashville, TN
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, Los Angeles
| | - Mary E D'Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY
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23
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Robstad N, Westergren T, Mølland E, Abildsnes E, Haraldstad K, Stamnes Köpp UM, Håland ÅT, Fegran L. Experiences of Norwegian child and school health nurses with the "Starting Right™" child health assessment innovation: a qualitative interview study. BMC Health Serv Res 2022; 22:728. [PMID: 35650581 PMCID: PMC9157476 DOI: 10.1186/s12913-022-08088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although child health services are well established in Norway, the use of information technology for the systematic collection of evidence-based child- and proxy-reported health measures may be beneficial in the early identification of child development problems. The Norwegian “Starting Right™” health service innovation consists of parent- and child-reported online structured health assessments tools, including practical routines for child and school health assessments. The aim of this study was to explore the experiences of child and school health nurses with the Starting Right innovation. Methods We used a qualitative design and conducted three focus group interviews with 18 child and school health nurses from three child health centres one year after the implementation of the innovation. Results The experiences of professionals with the Starting Right innovation were captured by three themes: (1) the digital innovation could be used to obtain a good overview of a child’s health and development; (2) interpreting the questionnaires was a challenge; and (3) implementing the new digital innovation was time-consuming. Conclusions Overall, the child and school health nurses experienced that the Starting Right innovation was useful for providing a comprehensive overview of child development and health. The challenges related to interpreting the parents’ scores and follow-up of children, as well as providing the questionnaires in relevant foreign languages, should be addressed to allow all children and families to be reached.
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Affiliation(s)
- Nastasja Robstad
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
| | - Thomas Westergren
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,NORCE, Universitetsveien 19, 4630, Kristiansand, Norway
| | - Eirin Mølland
- NORCE, Universitetsveien 19, 4630, Kristiansand, Norway.,Department of Economics and Finance, School of Business and Law, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Eirik Abildsnes
- Kristiansand municipality, P.O. Box 4, 4685, Nodeland, Norway.,Department of Psychosocial Health, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
| | - Unni Mette Stamnes Köpp
- Department of Pediatrics, Sørlandet Hospital, P.O. Box 416, Lundsiden, 4604, Kristiansand, Norway
| | - Åshild Tellefsen Håland
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.,Department of Pediatrics, Sørlandet Hospital, P.O. Box 416, Lundsiden, 4604, Kristiansand, Norway
| | - Liv Fegran
- Department of Health and Nursing Science, Faculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway
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24
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Nelson HJ, Munns A, Ong S, Watson L, Burns S. Identification of models, theoretical design and formal evaluation of integrated specialist community health service provision for the first 2000 days: a protocol for a scoping review. BMJ Open 2022; 12:e054807. [PMID: 35296481 PMCID: PMC8928289 DOI: 10.1136/bmjopen-2021-054807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The first 2000 days of a child's life (during pregnancy up to age 5 years) represent a critical period, in which early interventions reduce risk associated with developmental delay, disability and intergenerational disadvantage. The risk is exacerbated by barriers to specialised early intervention for children and families. This scoping review seeks to contribute to the evidence for sustaining integrated community-based specialist care in these earliest years of a child's life. METHODS AND ANALYSIS The Joanna Briggs Institute scoping review framework will be followed. Inclusion and exclusion criteria for screening of literature is predefined, guided by the criteria of population, concept and context. The review will identify models of care delivery, and will identify quality of care outcomes that have been measured, including evidence of reliability and validity. Sources of evidence will include CINAHL, Cochrane databases, Medline, PsycINFO and Scopus. ETHICS AND DISSEMINATION In a three-part study, evidence synthesis from the scoping review of the literature; mapping of existing specialist early years services in one community and a consumer consultation (Curtin University Human Research Ethics approval HRE2021-0546) in the same community will inform a model of integrated care that accounts for the context of the community it seeks to serve. Results will be disseminated by peer-reviewed publications and conference presentations, contributing to the evidence base for delivering sustainable community-based integrated care in the context of the first 2000 days. This protocol is specific to the scoping review.
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Affiliation(s)
| | - Ailsa Munns
- School of Nursing, Curtin University, Perth, Western Australia, Australia
- Child and Adolescent Health Service, Nedlands, Western Australia, Australia
| | - Sarah Ong
- Child and Adolescent Health Service, Nedlands, Western Australia, Australia
| | - Leanne Watson
- Carey Community Resources, Harrisdale, Western Australia, Australia
- East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Sharyn Burns
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Western Australia, Australia
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25
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Fuller MG, Cavanaugh N, Green S, Duderstadt K. Climate Change and State of the Science for Children's Health and Environmental Health Equity. J Pediatr Health Care 2022; 36:20-26. [PMID: 34493406 DOI: 10.1016/j.pedhc.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/19/2021] [Accepted: 08/10/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Climate change is impacting the physical and mental health of children and families. This is a state of the science update regarding the impacts of climate change for pediatric-focused health care providers and advanced practice registered nurses. METHOD Using an equity lens, the authors reviewed and synthesized current literature regarding the adverse impacts of climate change. RESULTS The poor and communities of color are disproportionately impacted by climate change. Physical health impacts include increased vector and water-born infectious diseases, increases in asthma and respiratory infections, and undernutrition. Social disruptions lead to human trafficking. Climate change is associated with mental health concerns, including anxiety and posttraumatic stress after natural disasters. DISCUSSION As clinicians, pediatric-focused providers, and advanced practice registered nurses should use multipronged and interdisciplinary approaches to address or prevent the adverse impacts of climate change. Advocacy at all government levels is necessary to safeguard children and vulnerable populations.
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26
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MacNeill LA, Allen NB, Poleon RB, Vargas T, Osborne KJ, Damme KSF, Barch DM, Krogh-Jespersen S, Nielsen AN, Norton ES, Smyser CD, Rogers CE, Luby JL, Mittal VA, Wakschlag LS. Translating RDoC to Real-World Impact in Developmental Psychopathology: A Neurodevelopmental Framework for Application of Mental Health Risk Calculators. Dev Psychopathol 2021; 33:1665-1684. [PMID: 35095215 PMCID: PMC8794223 DOI: 10.1017/s0954579421000651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The National Institute of Mental Health Research Domain Criteria's (RDoC) has prompted a paradigm shift from categorical psychiatric disorders to considering multiple levels of vulnerability for probabilistic risk of disorder. However, the lack of neurodevelopmentally-based tools for clinical decision-making has limited RDoC's real-world impact. Integration with developmental psychopathology principles and statistical methods actualize the clinical implementation of RDoC to inform neurodevelopmental risk. In this conceptual paper, we introduce the probabilistic mental health risk calculator as an innovation for such translation and lay out a research agenda for generating an RDoC- and developmentally-informed paradigm that could be applied to predict a range of developmental psychopathologies from early childhood to young adulthood. We discuss methods that weigh the incremental utility for prediction based on intensity and burden of assessment, the addition of developmental change patterns, considerations for assessing outcomes, and integrative data approaches. Throughout, we illustrate the risk calculator approach with different neurodevelopmental pathways and phenotypes. Finally, we discuss real-world implementation of these methods for improving early identification and prevention of developmental psychopathology. We propose that mental health risk calculators can build a needed bridge between RDoC's multiple units of analysis and developmental science.
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Affiliation(s)
- Leigha A MacNeill
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Norrina B Allen
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Roshaye B Poleon
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL
| | | | | | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Sheila Krogh-Jespersen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
| | - Ashley N Nielsen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Elizabeth S Norton
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Christopher D Smyser
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Vijay A Mittal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
- Department of Psychology, Northwestern University, Evanston, IL
- Department of Psychiatry, Northwestern University, Chicago, IL
- Institute for Policy Research, Northwestern University, Evanston, IL
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL
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27
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Shonkoff JP, McCoy DC. Raising the Bar for Evaluating Effectiveness of Early Childhood Interventions. Pediatrics 2021; 148:peds.2021-052326. [PMID: 34544848 DOI: 10.1542/peds.2021-052326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jack P Shonkoff
- Center on the Developing Child at Harvard University, Cambridge, Massachusetts .,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts.,Harvard Medical School, Harvard University, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts.,Massachusetts General Hospital, Boston, Massachusetts.,Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Dana Charles McCoy
- Center on the Developing Child at Harvard University, Cambridge, Massachusetts.,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts
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28
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McDonald SE, Tomlinson CA, Applebaum JW, Moyer SW, Brown SM, Carter S, Kinser PA. Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10114. [PMID: 34639416 PMCID: PMC8508333 DOI: 10.3390/ijerph181910114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022]
Abstract
There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals' relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human-animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI-HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.
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Affiliation(s)
- Shelby E. McDonald
- Children, Families, and Animals Research (CFAR) Group, LLC, Richmond, VA 23223, USA
| | - Camie A. Tomlinson
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Jennifer W. Applebaum
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL 32611, USA;
| | - Sara W. Moyer
- School of Nursing, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.W.M.); (P.A.K.)
| | - Samantha M. Brown
- School of Social Work, Colorado State University, Fort Collins, CO 80523, USA;
| | - Sue Carter
- The Kinsey Institute, Indiana University, Bloomington, IN 47405, USA;
| | - Patricia A. Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, VA 23298, USA; (S.W.M.); (P.A.K.)
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29
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Abstract
Most children will experience some type of trauma during childhood, and many children suffer from significant adversities. Research in genetics, neuroscience, and epidemiology all provide evidence that these experiences have effects at the molecular, cellular, and organ level, with consequences on physical, emotional, developmental, and behavioral health across the life span. Trauma-informed care translates that science to inform and improve pediatric care and outcomes. To practically address trauma and promote resilience, pediatric clinicians need tools to assess childhood trauma and adversity experiences as well as practical guidance, resources, and interventions. In this clinical report, we summarize current, practical advice for rendering trauma-informed care across varied medical settings.
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Affiliation(s)
- Heather Forkey
- Department of Pediatrics, University of Massachusetts, Worcester, Massachusetts
| | - Moira Szilagyi
- Divisions of General and Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Erin T Kelly
- Ambulatory Health Services, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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30
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Garner A, Yogman M. Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health. Pediatrics 2021; 148:peds.2021-052582. [PMID: 34312296 DOI: 10.1542/peds.2021-052582] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
By focusing on the safe, stable, and nurturing relationships (SSNRs) that buffer adversity and build resilience, pediatric care is on the cusp of a paradigm shift that could reprioritize clinical activities, rewrite research agendas, and realign our collective advocacy. Driving this transformation are advances in developmental sciences as they inform a deeper understanding of how early life experiences, both nurturing and adverse, are biologically embedded and influence outcomes in health, education, and economic stability across the life span. This revised policy statement on childhood toxic stress acknowledges a spectrum of potential adversities and reaffirms the benefits of an ecobiodevelopmental model for understanding the childhood origins of adult-manifested disease and wellness. It also endorses a paradigm shift toward relational health because SSNRs not only buffer childhood adversity when it occurs but also promote the capacities needed to be resilient in the future. To translate this relational health framework into clinical practice, generative research, and public policy, the entire pediatric community needs to adopt a public health approach that builds relational health by partnering with families and communities. This public health approach to relational health needs to be integrated both vertically (by including primary, secondary, and tertiary preventions) and horizontally (by including public service sectors beyond health care). The American Academy of Pediatrics asserts that SSNRs are biological necessities for all children because they mitigate childhood toxic stress responses and proactively build resilience by fostering the adaptive skills needed to cope with future adversity in a healthy manner.
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Affiliation(s)
- Andrew Garner
- Partners in Pediatrics, Westlake, Ohio.,School of Medicine, Case Western Reserve University, Cleveland, Ohio
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31
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Levitt P. Progressions on the Coexistence of Neuronal and Glial Precursor Cells in the Cerebral Ventricular Zone. J Neurosci 2021; 41:3301-3306. [PMID: 33597270 PMCID: PMC8051679 DOI: 10.1523/jneurosci.3190-20.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
Heterogeneity is defined as the quality or state of being diverse in character or content. This article summarizes the natural progression from my studies, reported in the first issue of the Journal of Neuroscience, that identified molecular heterogeneity in precursor cells of the developing primate cerebral cortex to the current state in which differences defined at the molecular, cellular, circuit, and systems levels are building data encyclopedias. The emphasis on heterogeneity has impacted many contributors in the field of developmental neuroscience, who have led a quest to determine the extent to which there is diversity, when it appears developmentally, and what heritable and nonheritable factors mediate nervous system assembly and function. Since the appearance of the article on progenitor cell heterogeneity in the inaugural issue of the Journal of Neuroscience, there have been continuous advances in technologies and data analytics that are contributing to a much better understanding of the origins of neurobiological and behavioral heterogeneity.
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Affiliation(s)
- Pat Levitt
- Program in Developmental Neuroscience and Neurogenetics, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California 90027
- Department of Pediatrics, Keck School of Medicine of University of Southern California, Los Angeles, California 90027
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32
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Boyce WT, Levitt P, Martinez FD, McEwen BS, Shonkoff JP. Genes, Environments, and Time: The Biology of Adversity and Resilience. Pediatrics 2021; 147:peds.2020-1651. [PMID: 33495368 DOI: 10.1542/peds.2020-1651] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/24/2022] Open
Abstract
Exposures to adverse environments, both psychosocial and physicochemical, are prevalent and consequential across a broad range of childhood populations. Such adversity, especially early in life, conveys measurable risk to learning and behavior and to the foundations of both mental and physical health. Using an interactive gene-environment-time (GET) framework, we survey the independent and interactive roles of genetic variation, environmental context, and developmental timing in light of advances in the biology of adversity and resilience, as well as new discoveries in biomedical research. Drawing on this rich evidence base, we identify 4 core concepts that provide a powerful catalyst for fresh thinking about primary health care for young children: (1) all biological systems are inextricably integrated, continuously "reading" and adapting to the environment and "talking back" to the brain and each other through highly regulated channels of cross-system communication; (2) adverse environmental exposures induce alterations in developmental trajectories that can lead to persistent disruptions of organ function and structure; (3) children vary in their sensitivity to context, and this variation is influenced by interactions among genetic factors, family and community environments, and developmental timing; and (4) critical or sensitive periods provide unmatched windows of opportunity for both positive and negative influences on multiple biological systems. These rapidly moving frontiers of investigation provide a powerful framework for new, science-informed thinking about health promotion and disease prevention in the early childhood period.
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Affiliation(s)
- W Thomas Boyce
- Departments of Pediatrics and Psychiatry, University of California, San Francisco, San Francisco, California
| | - Pat Levitt
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California.,Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Fernando D Martinez
- Asthma and Airway Disease Research Center, The University of Arizona, Tucson, Arizona
| | - Bruce S McEwen
- The Rockefeller University, New York, New York.,Deceased
| | - Jack P Shonkoff
- Center on the Developing Child and .,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts.,Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health and.,Harvard Medical School and Boston Children's Hospital, Harvard University, Boston, Massachusetts.,Boston Children's Hospital, Boston, Massachusetts; and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
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Shonkoff JP, Slopen N, Williams DR. Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health. Annu Rev Public Health 2021; 42:115-134. [PMID: 33497247 DOI: 10.1146/annurev-publhealth-090419-101940] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Inequalities in health outcomes impose substantial human and economic costs on all societies-and the relation between early adversity and lifelong well-being presents a rich scientific framework for fresh thinking about health promotion and disease prevention broadly, augmented by a deeper focus on how racism influences disparities more specifically. This review begins with an overview of advances in the biology of adversity and resilience through an early childhood lens, followed by an overview of the unique effects of racism on health and a selective review of findings from related intervention research. This article presents a framework for addressing multiple dimensions of the public health challenge-including institutional/structural racism, cultural racism, and interpersonal discrimination-and concludes with the compelling need to protect the developing brain and other biological systems from the physiological disruptions of toxic stress that can undermine the building blocks of optimal health and development in the early childhood period.
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Affiliation(s)
- Jack P Shonkoff
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , , .,Harvard Graduate School of Education, Harvard University, Cambridge, Massachusetts 02138, USA.,Harvard Medical School, Harvard University, Boston, Massachusetts 02115, USA
| | - Natalie Slopen
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , ,
| | - David R Williams
- Center on the Developing Child, Harvard University, Cambridge, Massachusetts 02138, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; , , .,Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
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