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Neville RD, Hopkins WG, McArthur BA, Draper CE, Madigan S. Associations Between Changes in 24-Hour Movement Behaviors in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Mediation-Based Meta-Analysis. J Phys Act Health 2024; 21:323-332. [PMID: 38194951 DOI: 10.1123/jpah.2023-0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic. METHODS We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression. RESULTS This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47-0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38-1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62-0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00-1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42-0.67). We observed no further mediational associations. CONCLUSION Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior.
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Affiliation(s)
- Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
| | - Catherine E Draper
- South African Medical Research Council Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
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Browne DT, McArthur BA, Racine N. Editorial: Multilevel social determinants of individual and family well-being: national and international perspectives. Front Epidemiol 2024; 4:1381516. [PMID: 38596205 PMCID: PMC11002224 DOI: 10.3389/fepid.2024.1381516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/27/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Dillon T. Browne
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | | | - Nicole Racine
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
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Hassan A, Brooks BL, McArthur BA, Beauchamp MH, Craig W, Doan Q, Zemek R, Yeates KO. Dynamic Relations Between Psychological Resilience and Post-Concussion Symptoms in Children With Mild Traumatic Brain Injury Versus Orthopedic Injury: An A-CAP Study. J Neurotrauma 2024; 41:135-146. [PMID: 37485612 DOI: 10.1089/neu.2023.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Higher psychological resilience is correlated with less severe post-concussion symptoms (PCS) after mild traumatic brain injury (mTBI) in children, but the directional nature of this relationship remains uncertain. Although traditionally regarded as a stable, trait-like construct, resilience may be malleable and potentially influenced by mTBI and post-concussive symptoms. The current study sought to examine the stability of resilience, elucidate the dynamic nature of the resilience-PCS relation, and determine whether resilience-symptom associations are specific to mTBI or applicable to traumatic injury in general. Participants were children aged 8-16.99 years with either mTBI (n = 633) or orthopedic injury (OI; n = 334) recruited to participate in a prospective cohort study after presenting acutely to five Canadian pediatric emergency departments (EDs). Symptoms and psychological resilience were assessed at 1 week, 3 months, and 6 months post-injury. Group differences in resilience over time were examined using a mixed linear model, and associations between resilience and symptoms over time were examined using random intercepts cross-lagged panel modeling (RI-CLPM). The mTBI group reported significantly lower resilience than the OI group, but the difference was significantly larger 1 week post-injury (d = 0.50) than at 3 months (d = 0.08) and 6 months (d = 0.10). Cross-lagged panel models indicated that resilience had both stable and dynamic aspects, and both affected and was affected by PCS, although their association varied by time post-injury, symptom measure, and reporter (parent vs. child). Higher parent-reported cognitive symptom severity at 1 week was significantly associated with higher resilience at 3 months (β = 0.23, p = 0.001). Higher resilience at 3 months was associated with lower levels of parent-reported somatic symptom severity (β = -0.14, p = 0.004) and fewer total symptoms (β = -0.135, p = 0.029) at 6 months. Higher resilience at 3 months was associated with fewer child-reported symptoms at 6 months (β = -0.11, p = 0.030) and, reciprocally, fewer child-reported symptoms at 3 months were associated with higher resilience at 6 months (β = -0.22, p = 0.001). Notably, injury group was not a significant moderator in cross-lagged models, suggesting that resilience-symptom associations are not specific to mTBI. Psychological resilience and symptoms have bidirectional relationships after injury. Interventions designed to foster resilience have the potential to promote recovery after mTBI specifically and injury more generally.
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Affiliation(s)
- Ali Hassan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Brian L Brooks
- Departments of Pediatrics, Clinical Neurosciences, and Psychology, and Alberta Children's Hospital Research Institute, University of Calgary, Alberta Children's Hospital, Neurosciences Program, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Departments of Psychology and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal and Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - William Craig
- Department of Pediatrics, University of Alberta, and Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Quynh Doan
- Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Roger Zemek
- Department of Pediatrics and Emergency Medicine, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Keith Owen Yeates
- Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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4
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Kautz MM, McArthur BA, Moriarity DP, Ellman LM, Klugman J, Coe CL, Abramson LY, Alloy LB. The Impact of Early and Recent Life Stress on Trajectories of Inflammatory Biomarkers in a Diverse Sample of Adolescents. Res Child Adolesc Psychopathol 2023; 51:1883-1894. [PMID: 36786893 PMCID: PMC10642298 DOI: 10.1007/s10802-023-01026-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/15/2023]
Abstract
Elevated inflammatory activity is one possible pathway through which exposure to childhood adversity engenders risk for physical and psychiatric illnesses. Limited research has investigated the compounding effects of childhood and adolescent stress exposure on changes in circulating levels of inflammatory biomarkers. This study assessed whether childhood adversity interacted with chronic or acute stress during adolescence to affect the temporal trajectories of five inflammatory biomarkers across at least three blood draws in a diverse sample of adolescents (N = 134; observations = 462). Using multilevel modeling, the interaction of childhood adversity, time, and within-person variance of acute stressors significantly predicted trajectories of higher interleukin-10 levels, controlling for demographics, medication use, and body mass index. Adolescents with high levels of childhood adversity who were exposed to a higher frequency of acute stressors compared to their own average rate of stress exposure consistently had higher levels of IL-10 as they got older, but those with average and below frequency of acute stressors had decreasing trajectories of log IL-10 as they matured. The results demonstrate how events early in life shape biological responses to the adolescent environment. This study also highlights the importance of developmental timing on the body's enhanced reactivity to acute and sustained stressors following childhood adversity.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | | | - Daniel P Moriarity
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Joshua Klugman
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Wisconsin, USA
| | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, Wisconsin, USA
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA.
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Racine N, Plamondon A, McArthur BA, Hetherington E, McDonald S, Edwards S, Tough S, Madigan S. Changes and predictors of maternal depressive and anxiety symptoms during the COVID-19 pandemic. Arch Womens Ment Health 2023:10.1007/s00737-023-01339-8. [PMID: 37382647 DOI: 10.1007/s00737-023-01339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
Longitudinal changes in maternal depressive and anxiety symptoms and predictors of symptom variation among a group of middle-to-upper income Canadian women (n = 2152) were examined prior to the pandemic (2017-2019) and at three pandemic timepoints (May-July 2020, March-April 2021, November-December 2021). Mean maternal depression and anxiety scores were elevated throughout the pandemic. Pre-pandemic depressive symptoms were associated with greater increases in depressive symptoms. Coping and relationship quality were protective factors. Supporting the development of coping strategies may mitigate mental health concerns among mothers.
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Affiliation(s)
- Nicole Racine
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier 4087, Ottawa, Ontario, K1N 6N5, Canada.
| | - André Plamondon
- Département des fondements et pratiques en éducation, Université Laval, Québec, QC, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sheila McDonald
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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6
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Madigan S, Racine N, Vaillancourt T, Korczak DJ, Hewitt JMA, Pador P, Park JL, McArthur BA, Holy C, Neville RD. Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:567-581. [PMID: 37126337 PMCID: PMC10152379 DOI: 10.1001/jamapediatrics.2023.0846] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/04/2023] [Indexed: 05/02/2023]
Abstract
Importance There is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased. Objective To synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic. Data Sources Medline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022. Study Selection Included studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal. Data Extraction and Synthesis In total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included. Main Outcomes and Measures Standardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic. Results The analysis included 40 807 children and adolescents represented in pre-COVID-19 studies and 33 682 represented in during-COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income. Conclusions This systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Tracy Vaillancourt
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Counselling Psychology, Faculty of Education University of Ottawa, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Jackson M. A. Hewitt
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Joanne L. Park
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Celeste Holy
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ross D. Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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7
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Plamondon A, McArthur BA, Eirich R, Racine N, McDonald S, Tough S, Madigan S. Changes in Children's Recreational Screen Time During the COVID-19 Pandemic. JAMA Pediatr 2023:2803664. [PMID: 37036711 PMCID: PMC10087086 DOI: 10.1001/jamapediatrics.2023.0393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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8
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McArthur BA, Racine N, McDonald S, Tough S, Madigan S. Child and family factors associated with child mental health and well-being during COVID-19. Eur Child Adolesc Psychiatry 2023; 32:223-233. [PMID: 34302530 PMCID: PMC8302979 DOI: 10.1007/s00787-021-01849-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/16/2021] [Indexed: 12/23/2022]
Abstract
Understanding the implications of the COVID-19 pandemic on the current generation of youth is critical for post-pandemic recovery planning. This study aimed to identify the most salient child (i.e., connectedness to caregivers, screen time, sleep, physical activity, peer relationships, and recreational activities) and family (i.e., COVID-19 financial impact, maternal depression and anxiety) factors associated with children's mental health and well-being during the COVID-19 pandemic, after controlling for pre-pandemic mental health. This study included 846 mother-child dyads (child age 9-11) from the All Our Families cohort. Mothers reported on the child's pre-pandemic mental health at age 8 (2017-2019) and during COVID-19 (May-July 2020), the family's financial impact due to COVID-19, and maternal depression and anxiety. During COVID-19 (July-August 2020), children reported on their screen time, sleep, physical activity, peer and family relationships, and recreational activities, as well as their happiness, anxiety and depression. After controlling for pre-pandemic anxiety, connectedness to caregivers (B - 0.16; 95% CI - 0.22 to - 0.09), child sleep (B - 0.11; 95% CI - 0.19 to - 0.04), and child screen time (B 0.11; 95% CI 0.04-0.17) predicted child COVID-19 anxiety symptoms. After controlling for pre-pandemic depression, connectedness to caregivers (B - 0.26; 95% CI - 0.32 to - 0.21) and screen time (B 0.09; 95% CI 0.02-0.16) predicted child COVID-19 depressive symptoms. After controlling for covariates, connectedness to caregivers (B 0.36; 95% CI 0.28-0.39) predicted child COVID-19 happiness. Fostering parent-child connections and promoting healthy device and sleep habits are critical modifiable factors that warrant attention in post-pandemic mental health recovery planning.
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Affiliation(s)
- Brae Anne McArthur
- Department of Psychology, Faculty of Arts, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Nicole Racine
- Department of Psychology, Faculty of Arts, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Sheila McDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Suzanne Tough
- Department of Pediatrics and Community Health Sciences, Cumming School of Medicine, Alberta Children’s Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB T2N 1N4 Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, University of Calgary, 2500 University Dr. NW., Calgary, AB, T2N 1N4, Canada.
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Madigan S, Eirich R, Pador P, McArthur BA, Neville RD. Assessment of Changes in Child and Adolescent Screen Time During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:1188-1198. [PMID: 36342702 PMCID: PMC9641597 DOI: 10.1001/jamapediatrics.2022.4116] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
IMPORTANCE To limit the spread of COVID-19, numerous restrictions were imposed on youths, including school closures, isolation requirements, social distancing, and cancelation of extracurricular activities, which independently or collectively may have shifted screen time patterns. OBJECTIVE To estimate changes in the duration, content, and context of screen time of children and adolescents by comparing estimates taken before the pandemic with those taken during the pandemic and to determine when and for whom screen time has increased the most. DATA SOURCES Electronic databases were searched between January 1, 2020, and March 5, 2022, including MEDLINE, Embase, PsycINFO, and the Cochrane Central Register of Controlled Trials. A total of 2474 nonduplicate records were retrieved. STUDY SELECTION Study inclusion criteria were reported changes in the duration (minutes per day) of screen time before and during the pandemic; children, adolescents, and young adults (≤18 years); longitudinal or retrospective estimates; peer reviewed; and published in English. DATA EXTRACTION AND SYNTHESIS A total of 136 articles underwent full-text review. Data were analyzed from April 6, 2022, to May 5, 2022, with a random-effects meta-analysis. MAIN OUTCOMES AND MEASURES Change in daily screen time comparing estimates taken before vs during the COVID-19 pandemic. RESULTS The meta-analysis included 46 studies (146 effect sizes; 29 017 children; 57% male; and mean [SD] age, 9 [4.1] years) revealed that, from a baseline prepandemic value of 162 min/d (2.7 h/d), during the pandemic there was an increase in screen time of 84 min/d (1.4 h/d), representing a 52% increase. Increases were particularly marked for individuals aged 12 to 18 years (k [number of sample estimates] = 26; 110 min/d) and for device type (handheld devices [k = 20; 44 min/d] and personal computers [k = 13; 46 min/d]). Moderator analyses showed that increases were possibly larger in retrospective (k = 36; 116 min/d) vs longitudinal (k = 51; 65 min/d) studies. Mean increases were observed in samples examining both recreational screen time alone (k = 54; 84 min/d) and total daily screen time combining recreational and educational use (k = 33; 68 min/d). CONCLUSIONS AND RELEVANCE The COVID-19 pandemic has led to considerable disruptions in the lives and routines of children, adolescents, and families, which is likely associated with increased levels of screen time. Findings suggest that when interacting with children and caregivers, practitioners should place a critical focus on promoting healthy device habits, which can include moderating daily use; choosing age-appropriate programs; promoting device-free time, sleep, and physical activity; and encouraging children to use screens as a creative outlet or a means to meaningfully connect with others.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Paolo Pador
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Ross D. Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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McArthur BA, Tough S, Madigan S. Screen time and developmental and behavioral outcomes for preschool children. Pediatr Res 2022; 91:1616-1621. [PMID: 34012028 DOI: 10.1038/s41390-021-01572-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/22/2021] [Accepted: 05/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND One pressing question in the field of pediatrics is whether a dose-response relation is observed between hours of screen time and child outcomes. This study examined the association between hours of screen time (≤1 vs 2 vs ≥3 h/day) and children's developmental and behavioral outcomes. METHODS This study included data from 1994 mothers and children in Calgary, Canada, drawn from the All Our Families cohort. At 36 months, children's screen time (h/day), behavior problems, developmental milestones, and vocabulary acquisition were assessed via maternal report. Socio-demographic factors and baseline levels of performance at 24 months were included as covariates. RESULTS Compared to ≤1 h/day (47%; n = 935), children using screens 2 h (36%; n = 725) or ≥3 h/day (17%; n = 333) had an increased likelihood of reported behavioral problems (adjusted odds ratio (AOR) 1.30-1.90), delayed achievement of developmental milestones (AOR 1.41-1.68), and poorer vocabulary acquisition (AOR 1.94). CONCLUSIONS At 36 months, an association was observed between screen time and children's developmental, language, and behavioral outcomes, suggesting that duration of screen time is associated with poor child development outcomes. Findings provide support for screen time guidelines and emphasize the need for childcare professionals to discuss screen time guidelines with families. IMPACT International guidelines recommend that preschoolers spend no more than 1 h/day viewing screens. Research is needed to determine if there is a relation between screen time levels and child developmental and behavioral outcomes. Compared to ≤1 h/day, children viewing screens 2 or ≥3 h/day had an increased likelihood of behavioral problems, delayed achievement of developmental milestones, and poorer vocabulary acquisition. Findings highlight the association between duration of screen time and factors of child development.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Suzanne Tough
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sheri Madigan
- University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
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Eirich R, McArthur BA, Anhorn C, McGuinness C, Christakis DA, Madigan S. Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis. JAMA Psychiatry 2022; 79:393-405. [PMID: 35293954 PMCID: PMC8928099 DOI: 10.1001/jamapsychiatry.2022.0155] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Importance Currently, there is a lack of consensus in the literature on the association between screen time (eg, television, video games) and children's behavior problems. Objective To assess the association between the duration of screen time and externalizing and internalizing behavior problems among children 12 years or younger. Data Sources For this systematic review and meta-analysis, MEDLINE, Embase, and PsycINFO databases were searched for articles published from January 1960 to May 2021. Reference lists were manually searched for additional studies. Study Selection Included studies measured screen time (ie, duration) and externalizing or internalizing behavior problems in children 12 years or younger, were observational or experimental (with baseline data), were available in English, and had data that could be transformed into an effect size. Studies conducted during the COVID-19 pandemic were excluded. Of 25 196 nonduplicate articles identified and screened for inclusion, 595 met the selection criteria. Data Extraction and Synthesis The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Extracted variables were child age, sex, and socioeconomic status; informants and measurement type for screen time and behavior problems; study publication year; and study design and quality. Data were extracted by 2 independent coders and were pooled using a random-effects model. Main Outcomes and Measures The primary outcome was the association of screen time duration with externalizing (eg, aggression, attention deficit/hyperactivity disorder symptoms) and internalizing (eg, depression, anxiety) behaviors or diagnoses. Results Of the 595 full-text articles assessed for eligibility, 87 studies met all inclusion criteria, comprising 98 independent samples and 159 425 participants (mean [SD] age, 6.07 [2.89] years; 83 246 [51.30%] male). Increased duration of screen time had a small but significant correlation with more externalizing problems (90 samples; r, 0.11; 95% CI, 0.10-0.12) and internalizing problems (43 samples; r, 0.07; 95% CI, 0.05-0.08) in children. Several methodological moderators explained between-study heterogeneity. There was evidence of significant between study heterogeneity (I2 = 87.80). Conclusions and Relevance This systematic review and meta-analysis found small but significant correlations between screen time and children's behavior problems. Methodological differences across studies likely contributed to the mixed findings in the literature.
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Affiliation(s)
- Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Ciana Anhorn
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Claire McGuinness
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Dimitri A Christakis
- Seattle Children's Hospital Research Institute, University of Washington, Seattle.,Editor, JAMA Pediatrics
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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12
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McArthur BA, Volkova V, Tomopoulos S, Madigan S. Global Prevalence of Meeting Screen Time Guidelines Among Children 5 Years and Younger: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:373-383. [PMID: 35157028 PMCID: PMC8845032 DOI: 10.1001/jamapediatrics.2021.6386] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Pediatric guidelines suggest that infants younger than 2 years avoid screen time altogether, while children aged 2 to 5 years receive no more than 1 hour per day. Although these guidelines have been adopted around the world, substantial variability exists in adherence to the guidelines, and precise estimates are needed to inform public health and policy initiatives. OBJECTIVE To derive the pooled prevalence via meta-analytic methods of children younger than 2 years and children aged 2 to 5 years who are meeting guidelines about screen time. DATA SOURCES Searches were conducted in MEDLINE, PsycINFO, and Embase up to March 2020. STUDY SELECTION Studies were included if participants were 5 years and younger and the prevalence of meeting (or exceeding) screen time guidelines was reported. DATA EXTRACTION AND SYNTHESIS Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates. MAIN OUTCOMES AND MEASURES Prevalence of meeting screen time guidelines. RESULTS From 63 studies, 95 nonoverlapping samples with a total of 89 163 participants were included. For children younger than 2 years, the pooled prevalence of meeting the screen time guideline (0 h/d) was 24.7% (95% CI, 19.0%-31.5%). Moderator analyses revealed that prevalence of meeting screen time guidelines varied as a function of year of data collection (increased over time), measurement method (higher when questionnaires compared with interview), and type of device use (higher when a combination of screen use activities compared with television/movies only). For children aged 2 to 5 years, the mean prevalence of meeting the screen time guideline (1 h/d) was 35.6% (95% CI, 30.6%-40.9%). Moderator analyses revealed that the prevalence of meeting screen time guidelines varied as a function of type of device use (higher when screen time was television/movies only compared with a combination of screen use activities). CONCLUSIONS AND RELEVANCE The findings of this meta-analysis indicate that only a minority of children 5 years and younger are meeting screen time guidelines. This highlights the need to provide support and resources to families to best fit evidence-based recommendations into their lives.
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Affiliation(s)
- Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Valeriya Volkova
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Suzy Tomopoulos
- Department of Pediatrics, New York University School of Medicine–Bellevue Hospital Center, New York
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
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13
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McArthur BA, Browne D, Racine N, Tough S, Madigan S. Screen Time as a Mechanism Through Which Cumulative Risk is Related to Child Socioemotional and Developmental Outcomes in Early Childhood. Res Child Adolesc Psychopathol 2022; 50:709-720. [PMID: 34997403 DOI: 10.1007/s10802-021-00895-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
Socio-demographic risks are associated with higher child screen time and higher screen time is associated with poor socioemotional and developmental health. Existing studies have not examined children's screen time as a mechanism through which distal risks may be associated with child outcomes. In the current study, we examined whether two proximal factors, screen time and parenting quality, mediate the relation between distal cumulative risk and child outcomes. Participants (N = 1992) were drawn from a birth cohort of mothers and their children (81% white; 46% female). Mothers reported on cumulative risk factors (maternal income, education, depression, stress, marital status, housing instability, unemployment, and maternal history of childhood adversity) during the prenatal period. Parenting quality (ineffective/hostile, positive interactions) and children's screen time (hours/week) were assessed when children were three years of age. Child socioemotional (internalizing and externalizing problems) and developmental (achievement of developmental milestones) outcomes were measured at five years of age. Path analysis revealed indirect effects from cumulative risk to internalizing symptoms and achievement of developmental milestones via screen time. Indirect effects were observed from cumulative risk to internalizing and externalizing behavior via hostile parenting behavior. Over and above the effects of parenting, screen time may be a factor that links structural forms of social disadvantage during the prenatal period to child socioemotional and developmental outcomes. Due to modest effect sizes of screen time, it remains the case that child socioemotional and developmental health should be conceptualized within the context of distal cumulative risk factors such as caregiver psychological and material resources.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | | | - Nicole Racine
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Suzanne Tough
- University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sheri Madigan
- University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
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14
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Neville RD, McArthur BA, Eirich R, Lakes KD, Madigan S. Bidirectional associations between screen time and children's externalizing and internalizing behaviors. J Child Psychol Psychiatry 2021; 62:1475-1484. [PMID: 33945153 DOI: 10.1111/jcpp.13425] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND While it has been purported that excessive screen time can lead to behavioral problems, it has also been suggested that children with behavioral dysregulation receive more access to screens to manage problematic behavior. In this study, both temporally stable and longitudinal associations between screen time and externalizing and internalizing behaviors across childhood are examined to directly address this issue of directionality. METHODS Data are from a prospective cohort of 10,172 Irish children, collected between 2010 and 2018 when children were ages 3, 5, 7, and 9. Children's screen time (hours/day) and externalizing and internalizing behaviors (Strengths and Difficulties Questionnaire) were assessed via caregiver report. Random-intercepts cross-lagged panel models were used to estimate longitudinal bidirectional associations while controlling for temporally stable (i.e., 'time-invariant' or 'trait-like') differences between children. RESULTS Temporally stable differences between children were observed for both screen time and behavior problems. Longitudinal trajectories for screen time lacked stability; however, and externalizing and internalizing behaviors stabilized increasingly during later childhood. Greater externalizing and internalizing behaviors at age 3 were directionally associated with increased screen time at age 5. Greater screen time at ages 3 and 5 was directionally associated with increased internalizing behaviors at ages 5 and 7, respectively. More screen time at age 7 was directionally associated with fewer internalizing behaviors at age 9. Screen time was not associated with later externalizing behaviors. CONCLUSIONS Bidirectional associations between screen time and internalizing behaviors were observed for preschoolers. Directional associations between screen time and internalizing difficulties were observed across childhood. These findings can inform screen use guidelines and family media planning at different ages and stages of development.
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Affiliation(s)
- Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Kimberley D Lakes
- Department of Psychiatry and Neuroscience, School of Medicine, University of California, Riverside, CA, USA
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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15
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Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr 2021; 175:1142-1150. [PMID: 34369987 PMCID: PMC8353576 DOI: 10.1001/jamapediatrics.2021.2482] [Citation(s) in RCA: 881] [Impact Index Per Article: 293.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature. OBJECTIVE To ascertain more precise estimates of the global prevalence of child and adolescent clinically elevated depression and anxiety symptoms during COVID-19; to compare these rates with prepandemic estimates; and to examine whether demographic (eg, age, sex), geographical (ie, global region), or methodological (eg, pandemic data collection time point, informant of mental illness, study quality) factors explained variation in prevalence rates across studies. DATA SOURCES Four databases were searched (PsycInfo, Embase, MEDLINE, and Cochrane Central Register of Controlled Trials) from January 1, 2020, to February 16, 2021, and unpublished studies were searched in PsycArXiv on March 8, 2021, for studies reporting on child/adolescent depression and anxiety symptoms. The search strategy combined search terms from 3 themes: (1) mental illness (including depression and anxiety), (2) COVID-19, and (3) children and adolescents (age ≤18 years). For PsycArXiv, the key terms COVID-19, mental health, and child/adolescent were used. STUDY SELECTION Studies were included if they were published in English, had quantitative data, and reported prevalence of clinically elevated depression or anxiety in youth (age ≤18 years). DATA EXTRACTION AND SYNTHESIS A total of 3094 nonduplicate titles/abstracts were retrieved, and 136 full-text articles were reviewed. Data were analyzed from March 8 to 22, 2021. MAIN OUTCOMES AND MEASURES Prevalence rates of clinically elevated depression and anxiety symptoms in youth. RESULTS Random-effect meta-analyses were conducted. Twenty-nine studies including 80 879 participants met full inclusion criteria. Pooled prevalence estimates of clinically elevated depression and anxiety symptoms were 25.2% (95% CI, 21.2%-29.7%) and 20.5% (95% CI, 17.2%-24.4%), respectively. Moderator analyses revealed that the prevalence of clinically elevated depression and anxiety symptoms were higher in studies collected later in the pandemic and in girls. Depression symptoms were higher in older children. CONCLUSIONS AND RELEVANCE Pooled estimates obtained in the first year of the COVID-19 pandemic suggest that 1 in 4 youth globally are experiencing clinically elevated depression symptoms, while 1 in 5 youth are experiencing clinically elevated anxiety symptoms. These pooled estimates, which increased over time, are double of prepandemic estimates. An influx of mental health care utilization is expected, and allocation of resources to address child and adolescent mental health concerns are essential.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Jessica E. Cooke
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Rachel Eirich
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Jenney Zhu
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada,Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
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16
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McArthur BA, Madigan S, Korczak DJ. Tweens are not teens: the problem of amalgamating broad age groups when making pandemic recommendations. Can J Public Health 2021; 112:984-987. [PMID: 34716572 PMCID: PMC8555731 DOI: 10.17269/s41997-021-00585-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/06/2021] [Indexed: 12/18/2022]
Abstract
Demarcating childhood into two distinct and broad 10-year age bands of over and under age 10 is a disservice to our tween population (9–12 years), and may be overlooking our role in understanding the negative impacts of SARS-CoV-2 (COVID-19) during a formative period of development. In this commentary, we discuss the importance of considering tweens as a unique population of youth who are differentially impacted by the COVID-19 pandemic. We first describe the distinctive progress of tweens across various facets of developmental health, followed by recommendations to improve understanding and address impact of the pandemic and its restrictions on tweens. The COVID-19 pandemic has had a large impact on the day-to-day lives of tweens and what we do now will have long-lasting effects on their lifelong trajectories.
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Affiliation(s)
- Brae Anne McArthur
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Calgary, AB, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, 1145 Burton Wing, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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17
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McArthur BA, Racine N, Browne D, McDonald S, Tough S, Madigan S. Recreational screen time before and during COVID-19 in school-aged children. Acta Paediatr 2021; 110:2805-2807. [PMID: 34076927 PMCID: PMC8222899 DOI: 10.1111/apa.15966] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/17/2021] [Accepted: 06/01/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Brae Anne McArthur
- University of Calgary Calgary AB Canada
- Alberta Children’s Hospital Research Institute Calgary AB Canada
| | - Nicole Racine
- University of Calgary Calgary AB Canada
- Alberta Children’s Hospital Research Institute Calgary AB Canada
| | | | - Sheila McDonald
- University of Calgary Calgary AB Canada
- Alberta Health Services Calgary AB Canada
| | - Suzanne Tough
- University of Calgary Calgary AB Canada
- Alberta Children’s Hospital Research Institute Calgary AB Canada
| | - Sheri Madigan
- University of Calgary Calgary AB Canada
- Alberta Children’s Hospital Research Institute Calgary AB Canada
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18
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McArthur BA, Hentges R, Christakis DA, McDonald S, Tough S, Madigan S. Cumulative Social Risk and Child Screen Use: The Role of Child Temperament. J Pediatr Psychol 2021; 47:171-179. [PMID: 34388254 DOI: 10.1093/jpepsy/jsab087] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES It is critical to understand what children, and in which context, are at risk for high levels of screen use. This study examines whether child temperament interacts with cumulative social risk to predict young children's screen use and if the results are consistent with differential susceptibility or diathesis-stress models. METHODS Data from 1,992 families in Calgary, Alberta (81% White; 47% female; 94% >$40,000 income) from the All Our Families cohort were included. Mothers reported on cumulative social risk (e.g., low income and education, maternal depression) at <25 weeks of gestation, child's temperament at 36 months of age (surgency/extraversion, negative affectivity, effortful control), and child's screen use (hours/day) at 60 months of age. Along with socio-demographic factors, baseline levels of screen use were included as covariates. RESULTS Children high in surgency (i.e., high-intensity pleasure, impulsivity) had greater screen use than children low in surgency as social risk exposure increased. In line with differential susceptibility, children high in surgency also had less screen use than children low in surgency in contexts of low social risk. Children with heightened negative affectivity (i.e., frequent expressions of fear/frustration) had greater screen use as social risk increased, supporting a diathesis-stress model. CONCLUSIONS Young children predisposed to high-intensity pleasure seeking and negative affectivity in environments characterized as high in social risk may be prone to greater durations of screen use. Findings suggest that an understanding of social risks and individual characteristics of the child should be considered when promoting healthy digital health habits.
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Affiliation(s)
- Brae Anne McArthur
- Psychology Department, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Rochelle Hentges
- Psychology Department, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | | | - Sheila McDonald
- Cummings School of Medicine, University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Calgary, AB, Canada
| | - Suzanne Tough
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Psychology Department, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
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19
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Letourneau N, McDonald S, MacKay LJ, Bell RC, Hetherington E, Deane AJ, Dewey D, Edwards S, Field CJ, Giesbrecht GF, Graham S, Lebel C, Leung B, Madigan S, McArthur BA, McMorris C, Racine N, Ross KM, Wu M, Tough SC. Cross-Sectional Study Protocol for the COVID-19 Impact Survey of Mothers and Their 7-11 Year Old Children in Alberta, Canada. Front Psychiatry 2021; 12:597759. [PMID: 34239455 PMCID: PMC8260076 DOI: 10.3389/fpsyt.2021.597759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Our aim is to understand the effect of the COVID-19 pandemic on families who have been followed longitudinally in two cohorts studied in Alberta, Canada. We will examine household infections during the COVID-19 pandemic, financial impact, domestic violence, substance use, child school and daily life and relationships in the home. We will identify risk and protective factors for maternal mental health outcomes using longitudinal data that can inform policy and government resource allocation in future disasters. Methods: Mothers who are currently participating in two longitudinal studies, Alberta Pregnancy Outcomes and Nutrition (APrON; N = 1,800) and All Our Families (AOF: N = 2,534) were eligible to participate. Mothers were invited to complete the baseline COVID-19 Impact Survey (20-30 min) within 4 months of March 15, 2020, which was when the province of Alberta, Canada, implemented school closures and physical-distancing measures to prevent the spread of COVID-19. Mothers were asked to report on their own, their child's and their family's functioning. Mothers were re-surveyed at 6 months after completion of the initial COVID-19 Impact Survey, and will be re-surveyed again at 12 months. Results: Responses from participants in both cohorts will be examined in harmonized analyses as well as separately. Descriptive, multivariable analysis will be undertaken to examine risk and resiliency over time and factors that predict mental health and well-being. Conclusions: This study will provide timely information on the impact of COVID-19 for Albertan families. It will identify risk and protective factors for mental health and well-being among contemporary urban families supported by a publicly funded health care system to inform allocation of resources to support those most vulnerable during a global pandemic.
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Affiliation(s)
- Nicole Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Rhonda C. Bell
- Faculty of Agricultural, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
| | - Erin Hetherington
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andrea J. Deane
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Deborah Dewey
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Catherine J. Field
- Faculty of Agricultural, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
| | - Gerald F. Giesbrecht
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan Graham
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brenda Leung
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Public Health Program, Faculty Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Brae Anne McArthur
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Kharah M. Ross
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
- Psychology, Centre for Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Muci Wu
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne C. Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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20
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McArthur BA, Browne D, McDonald S, Tough S, Madigan S. Longitudinal Associations Between Screen Use and Reading in Preschool-Aged Children. Pediatrics 2021; 147:peds.2020-011429. [PMID: 34031229 DOI: 10.1542/peds.2020-011429] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The home literacy environment has been identified as a key predictor of children's language, school readiness, academic achievement, and behavioral outcomes. With the increased accessibility and consumption of digital media, it is important to understand whether screen use impacts off-line enrichment activities such as reading or whether reading activities offset screen use. Using a prospective birth cohort, we examined reading and screen use at 24, 36, and 60 months to elucidate the directional association between screen use and reading over time. METHODS This study included data from 2440 mothers and children in Calgary, Alberta, drawn from the All Our Families cohort. Children's screen use and reading activities were assessed via maternal report at age 24, 36, and 60 months. Sociodemographic covariates were also collected. RESULTS Using a random-intercepts cross-lagged panel model, which statistically controls for individual-level confounds, this study revealed that greater screen use at 24 months was associated with lower reading at 36 months (β = -.08; 95% confidence interval: -0.13 to -0.02). In turn, lower reading at 36 months was associated with greater screen use at 60 months (β = -.11; 95% confidence interval: -0.19 to -0.02). Covariates did not modify the associations. CONCLUSIONS A reciprocal relationship between screen use and reading was identified. Early screen use was associated with lower reading activities, resulting in greater screen use at later ages. Findings emphasize the need for practitioners and educators to discuss screen use guidelines and encourage families to engage in device-free activities to foster early literacy exposure.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary, Calgary Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Dillon Browne
- University of Waterloo, Waterloo, Ontario, Canada; and
| | - Sheila McDonald
- University of Calgary, Calgary Alberta, Canada.,Alberta Health Services, Calgary, Alberta, Canada
| | - Suzanne Tough
- University of Calgary, Calgary Alberta, Canada.,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Contributed equally as joint senior authors
| | - Sheri Madigan
- University of Calgary, Calgary Alberta, Canada; .,Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.,Contributed equally as joint senior authors
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Racine N, Hetherington E, McArthur BA, McDonald S, Edwards S, Tough S, Madigan S. Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis. Lancet Psychiatry 2021; 8:405-415. [PMID: 33773109 PMCID: PMC8824360 DOI: 10.1016/s2215-0366(21)00074-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. METHODS In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. FINDINGS Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35·21%, 95% CI 32·48-38·04) and anxiety symptoms (31·39%, 28·76-34·15) than at all previous data collection timepoints. The mean depression score (8·31, 95% CI 7·97-8·65) and anxiety score (11·90, 11·66-12·13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5·05, 4·85-5·25; mean anxiety score 9·51, 9·35-9·66), 5-year timepoint (mean depression score 5·43, 5·20-5·66; mean anxiety score 9·49, 9·33-9·65), and 8-year timepoint (mean depression score 5·79, 5·55-6·02; mean anxiety score 10·26, 10·10-10·42). For the within-person comparisons, depression scores were a mean of 2·30 points (95% CI 1·95-2·65) higher and anxiety scores were a mean of 1·04 points (0·65-1·43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. INTERPRETATION Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress. FUNDING Alberta Innovates Health Solutions Interdisciplinary Team, Canadian Institutes of Health Research, Alberta Innovates, and Alberta Children's Hospital Foundation.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Brae Anne McArthur
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Affiliation(s)
- Brae Anne McArthur
- University of Calgary Calgary AB Canada
- Alberta Children's Hospital Research Institute Calgary AB Canada
| | | | - Sheila McDonald
- University of Calgary Calgary AB Canada
- Alberta Health Services Calgary AB Canada
| | - Suzanne Tough
- University of Calgary Calgary AB Canada
- Alberta Children's Hospital Research Institute Calgary AB Canada
| | - Sheri Madigan
- University of Calgary Calgary AB Canada
- Alberta Children's Hospital Research Institute Calgary AB Canada
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23
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Dunning EE, McArthur BA, Abramson LY, Alloy LB. Linking Maternal Depression to Adolescent Internalizing Symptoms: Transmission of Cognitive Vulnerabilities. J Youth Adolesc 2021; 50:324-335. [PMID: 33165756 PMCID: PMC7878334 DOI: 10.1007/s10964-020-01342-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
The mechanisms of the well-documented relationship between maternal depression and offspring psychopathology are not yet fully understood. Building upon cognitive theories of depression and the modeling hypothesis, path analyses tested whether maternal depression history predicted adolescent internalizing symptoms via the transmission of cognitive vulnerabilities within a sample of 635 adolescents (Mage = 13.1 years, range = 11.2-17.2 years; 53% female; 48% African American/Black) and their primary female caregivers. Maternal depression history did not directly predict adolescent symptoms. Two significant indirect effects were found; maternal depression history was associated with maternal negative cognitive style, which predicted greater adolescent negative generalization, which, in turn, predicted adolescents' greater depressive and anxiety symptoms. These findings suggest that the transmission of cognitive vulnerabilities may link maternal depression and offspring internalizing psychopathology.
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Affiliation(s)
- Erin E Dunning
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, USA.
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24
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Grupp RB, Murphy RJ, Hegeman RA, Alexander CP, Unberath M, Otake Y, McArthur BA, Armand M, Taylor RH. Fast and automatic periacetabular osteotomy fragment pose estimation using intraoperatively implanted fiducials and single-view fluoroscopy. Phys Med Biol 2020; 65:245019. [PMID: 32590372 DOI: 10.1088/1361-6560/aba089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Accurate and consistent mental interpretation of fluoroscopy to determine the position and orientation of acetabular bone fragments in 3D space is difficult. We propose a computer assisted approach that uses a single fluoroscopic view and quickly reports the pose of an acetabular fragment without any user input or initialization. Intraoperatively, but prior to any osteotomies, two constellations of metallic ball-bearings (BBs) are injected into the wing of a patient's ilium and lateral superior pubic ramus. One constellation is located on the expected acetabular fragment, and the other is located on the remaining, larger, pelvis fragment. The 3D locations of each BB are reconstructed using three fluoroscopic views and 2D/3D registrations to a preoperative CT scan of the pelvis. The relative pose of the fragment is established by estimating the movement of the two BB constellations using a single fluoroscopic view taken after osteotomy and fragment relocation. BB detection and inter-view correspondences are automatically computed throughout the processing pipeline. The proposed method was evaluated on a multitude of fluoroscopic images collected from six cadaveric surgeries performed bilaterally on three specimens. Mean fragment rotation error was 2.4 ± 1.0 degrees, mean translation error was 2.1 ± 0.6 mm, and mean 3D lateral center edge angle error was 1.0 ± 0.5 degrees. The average runtime of the single-view pose estimation was 0.7 ± 0.2 s. The proposed method demonstrates accuracy similar to other state of the art systems which require optical tracking systems or multiple-view 2D/3D registrations with manual input. The errors reported on fragment poses and lateral center edge angles are within the margins required for accurate intraoperative evaluation of femoral head coverage.
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Affiliation(s)
- R B Grupp
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States of America
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25
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Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA. Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:665-675. [PMID: 32202633 PMCID: PMC7091394 DOI: 10.1001/jamapediatrics.2020.0327] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/22/2020] [Indexed: 11/14/2022]
Abstract
Importance There is considerable public and scientific debate as to whether screen use helps or hinders early child development, particularly the development of language skills. Objective To examine via meta-analyses the associations between quantity (duration of screen time and background television), quality (educational programming and co-viewing), and onset of screen use and children's language skills. Data Sources Searches were conducted in MEDLINE, Embase, and PsycINFO in March 2019. The search strategy included a publication date limit from 1960 through March 2019. Study Selection Inclusion criteria were a measure of screen use; a measure of language skills; and statistical data that could be transformed into an effect size. Exclusion criteria were qualitative studies; child age older than 12 years; and language assessment preverbal. Data Extraction and Synthesis The following variables were extracted: effect size, child age and sex, screen measure type, study publication year, and study design. All studies were independently coded by 2 coders and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Main Outcomes and Measures Based on a priori study criteria, quantity of screen use included duration of screen time and background television, quality of screen use included co-viewing and exposure to educational programs, and onset of screen use was defined as the age children first began viewing screens. The child language outcome included assessments of receptive and/or expressive language. Results Participants totaled 18 905 from 42 studies included. Effect sizes were measured as correlations (r). Greater quantity of screen use (hours per use) was associated with lower language skills (screen time [n = 38; r = -0.14; 95% CI, -0.18 to -0.10]; background television [n = 5; r = -0.19; 95% CI, -0.33 to -0.05]), while better-quality screen use (educational programs [n = 13; r = 0.13; 95% CI, 0.02-0.24]; co-viewing [n = 12; r = 0.16; 95% CI, 0.07-.24]) were associated with stronger child language skills. Later age at screen use onset was also associated with stronger child language skills [n = 4; r = 0.17; 95% CI, 0.07-0.27]. Conclusions and Relevance The findings of this meta-analysis support pediatric recommendations to limit children's duration of screen exposure, to select high-quality programming, and to co-view when possible.
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Affiliation(s)
- Sheri Madigan
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Brae Anne McArthur
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Ciana Anhorn
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Rachel Eirich
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
| | - Dimitri A. Christakis
- Seattle Children’s Hospital Research Institute, University of Washington, Seattle
- Editor, JAMA Pediatrics
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26
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Kautz MM, Coe CL, McArthur BA, Mac Giollabhui N, Ellman LM, Abramson LY, Alloy LB. Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents. Brain Behav Immun 2020; 86:43-52. [PMID: 30822466 PMCID: PMC6710165 DOI: 10.1016/j.bbi.2019.02.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 11/23/2018] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology, Temple University, United States
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, United States
| | | | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Lauren B Alloy
- Department of Psychology, Temple University, United States.
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27
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Moriarity DP, Ng T, Curley EE, Anne McArthur B, Ellman LM, Coe CL, Abramson LY, Alloy LB. Reward Sensitivity, Cognitive Response Style, and Inflammatory Response to an Acute Stressor in Adolescents. J Youth Adolesc 2020; 49:2149-2159. [PMID: 32141010 DOI: 10.1007/s10964-020-01216-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/21/2020] [Indexed: 12/14/2022]
Abstract
Inflammation is gaining support as a biological mediator between stress and many negative outcomes that have heightened risk during adolescence (e.g., mood disorders). Thus, an important line of inquiry is evaluating whether risk factors for mood psychopathology also are associated with heightened inflammatory responses to stress during this developmental period. Two prominent risk factors that interact to predict mood psychopathology are reward sensitivity and perseverative cognitive response styles, which also have been associated with heightened inflammatory proteins. These factors could influence inflammation by synergistically amplifying stress reactivity. Ninety-nine late adolescents (Mage = 18.3 years, range = 15.6-21.9 years) completed measures of reward sensitivity, cognitive response style, and blood draws before and 60-min after a modified Trier Social Stress Task to determine levels of inflammation. Higher reward drive interacted with more perseverative response style ratios (rumination relative to distraction + problem-solving) to predict larger increases in interleukin-6 (a proinflammatory protein). Follow-up analyses found that reward drive interacted with all three components of the ratio to predict change in interleukin-6. Thus, these results suggest that high reward drive and perseverative cognitive response styles are associated with increased inflammatory response to social stress in adolescents, a potential physiological mechanism linking these risk factors to mood psychopathology during this developmental period.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Tommy Ng
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Erin E Curley
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Brae Anne McArthur
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
| | | | | | - Lauren B Alloy
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA.
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28
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Liu RT, McArthur BA, Burke TA, Hamilton JL, Mac Giollabhui N, Stange JP, Hamlat EJ, Abramson LY, Alloy LB. A Latent Structure Analysis of Cognitive Vulnerability to Depression in Adolescence. Behav Ther 2019; 50:755-764. [PMID: 31208685 PMCID: PMC6582994 DOI: 10.1016/j.beth.2018.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/25/2018] [Accepted: 11/27/2018] [Indexed: 01/28/2023]
Abstract
Whether cognitive vulnerability to depression exists along a continuum of severity or as a qualitatively discrete phenomenological entity has direct bearing on theoretical formulations of risk for depression and clinical risk assessment. This question is of particular relevance to adolescence, given that cognitive vulnerability appears to coalesce and rates of depression begin to rise markedly during this period of development. Although a dimensional view is often assumed, it is necessary to submit this assumption to direct empirical evaluation. Taxometric analysis is a family of statistical techniques developed directly to test such assumptions. The present study applied taxometric methods to address this question in a community sample of early adolescents (n = 485), drawing on three indices of cognitive vulnerability to depression (i.e., negative inferential style, ruminative response style, self-referent information processing). The results of three taxometric analyses (i.e., mean above minus below a cut [MAMBAC], maximum eigenvalue [MAXEIG], and latent mode [L-Mode]) were consistent in unambiguously supporting a dimensional conceptualization of this construct. The latent structure of the tested indices of cognitive vulnerability to depression in adolescence appears to exist along a continuum of severity rather than as a discrete clinical entity.
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29
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McArthur BA, Burke TA, Connolly SL, Olino TM, Lumley MN, Abramson LY, Alloy LB. A Longitudinal Investigation of Cognitive Self-schemas across Adolescent Development. J Youth Adolesc 2019; 48:635-647. [PMID: 30612293 PMCID: PMC6391197 DOI: 10.1007/s10964-018-00981-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/29/2018] [Indexed: 11/25/2022]
Abstract
Research in developmental psychology highlights youth's self-schemas as one possible pathway to improve adolescents' functioning and promote positive developmental outcomes. Despite this, the trajectory of positive and negative self-schemas is relatively understudied. This study addresses this limitation by empirically examining the trajectory of self-schemas in a community sample of 623 youth (M = 13.04 years; 54% female; 49% African American, 4% Biracial, 47% European American) who were followed over a seven-year period. Caregivers completed measures of parenting practices, maternal rumination and negative inferential style, and adolescents completed a computerized behavioral task assessing self-schemas (i.e., mental frameworks that guide attention, interpretation, and memory of one's experiences). Multilevel growth curve modeling results demonstrated a quadratic slope for negative self-schemas and no mean-level change for positive self-schemas. These trajectories did not vary by gender or racial group. However, parenting factors differentially influenced the trajectories. Specifically, higher levels of parental involvement at baseline, or an active interest and engagement in a child's experiences and activities, related to lower levels of negative self-schemas during adolescence. Additionally, higher levels of parental rumination and parental negative control at baseline related to lower levels of youth positive self-schemas at baseline. These findings contribute to models of youth cognitive development.
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Affiliation(s)
| | - Taylor A Burke
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Samantha L Connolly
- Center for Healthcare Organization & Implementation Research, VA Boston Health Care System, Boston, MA, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, USA
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30
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Moriarity DP, McArthur BA, Ellman LM, Coe CL, Abramson LY, Alloy LB. Immunocognitive Model of Depression Secondary to Anxiety in Adolescents. J Youth Adolesc 2018; 47:2625-2636. [PMID: 30088131 PMCID: PMC6246794 DOI: 10.1007/s10964-018-0905-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/18/2018] [Indexed: 01/15/2023]
Abstract
There is evidence that anxiety precedes the onset of depression and that rumination contributes to this risk pathway in adolescence. This study examined inflammatory biomarkers as mediators in a risk model of depressive symptoms secondary to anxiety symptoms among adolescents who ruminate. A sample of 140 adolescents (52% female, 54% African American, 40% Caucasian, 6% biracial, mean age at T1 = 16.5 years, SD = 1.2 years) provided blood samples on two visits (T1 and T2; mean time between T1 and T2 = 13.5 months, SD = 5.9 months). Self-report anxiety, depression, and rumination measures were given at T1 and the depression measure was given again at a third visit (T3, mean months since T1 = 26.0 months, SD = 9.0 months). Higher anxiety predicted more interleukin-6, but not more C-reactive protein, for adolescents with high levels of rumination. Moderated mediation analyses (N for analysis after removing cases with missing data and outliers = 86) indicated that interleukin-6, but not C-reactive protein, at T2 mediated the relationship between anxiety symptoms at T1 and depressive symptoms at T3, conditional on rumination. Anxiety and rumination interacted such that, as rumination increased, anxiety predicted greater inflammation and depressive symptoms. These results demonstrate that established cognitive vulnerabilities for the development of depressive symptoms secondary to anxiety symptoms in adolescence might indirectly operate though biological mechanisms such as inflammation. In addition to highlighting risk factors and potential treatment targets for depression, this study suggests a potential biological mechanism underlying the effects of psychotherapies that reduce rumination on negative affect (e.g., cognitive behavioral therapy).
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31
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Haas LM, McArthur BA, Burke TA, Olino TM, Abramson LY, Alloy LB. Emotional clarity development and psychosocial outcomes during adolescence. ACTA ACUST UNITED AC 2018; 19:563-572. [PMID: 29781646 DOI: 10.1037/emo0000452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Past research on emotional clarity (EC), the ability to identify and label one's own emotions, has illustrated an association between EC deficits and poor psychosocial outcomes during the adolescent years. Although past research has connected EC to psychosocial outcomes during adolescence in cross-sectional and longitudinal designs, no studies have traced the trajectory of EC over time to determine the developmental course of the construct during adolescence. Thus, this study investigated how EC developed over five years during adolescence and what factors were associated with the developmental trajectory of emotional clarity. Participants included a diverse sample of 640 adolescents (M age at Time 1 = 12.55 years; 53.0% female; 52.2% African American; 48.0% eligible for free school lunch). Results indicated that EC tended to decrease over adolescence, and females, on average, had a steeper decline of EC over time than males. The trajectory of EC predicted psychosocial outcomes, including depression and well-being. Results are discussed with the ultimate goal of informing novel prevention and intervention programs to promote adaptive emotional functioning during an influential time in human development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison
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32
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Shapero BG, Stange JP, McArthur BA, Abramson LY, Alloy LB. Cognitive reappraisal attenuates the association between depressive symptoms and emotional response to stress during adolescence. Cogn Emot 2018; 33:524-535. [PMID: 29637806 DOI: 10.1080/02699931.2018.1462148] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Depression is associated with increased emotional response to stress. This is especially the case during the developmental period of adolescence. Cognitive reappraisal is an effective emotion regulation strategy that has been shown to reduce the impact of emotional response on psychopathology. However, less is known about whether cognitive reappraisal impacts the relationship between depressive symptoms and emotional responses, and whether its effects are specific to emotional reactivity or emotional recovery. The current study examined whether cognitive reappraisal moderated the relationship between depressive symptoms and trait or state measures of emotional reactivity and recovery. A community sample of 127 adolescents (M-age = 15.28; 49% female, 47% Caucasian), at an age of risk for depression, completed self-report measures of trait emotional responding and depressive symptoms. In addition, they completed an in vivo social stress task and were assessed on state emotional reactivity and recovery from the stressor. Findings suggested that cognitive reappraisal was associated with an attenuated impact of depressive symptoms on trait and state emotional recovery. These results provide evidence that cognitive reappraisal may be an effective strategy for improving some aspects of emotional responding in relation to depressive symptoms among adolescents.
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Affiliation(s)
- Benjamin G Shapero
- a Department of Psychiatry , Massachusetts General Hospital , Boston , MA , USA.,b Harvard Medical School , Boston , MA , USA
| | - Jonathan P Stange
- c Department of Psychiatry , University of Illinois at Chicago , Chicago , IL , USA
| | - Brae Anne McArthur
- d Department of Psychology , Temple University , Philadelphia , PA , USA
| | - Lyn Y Abramson
- e Department of Psychology , University of Wisconsin , Madison , WI , USA
| | - Lauren B Alloy
- d Department of Psychology , Temple University , Philadelphia , PA , USA
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33
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Burke TA, McArthur BA, Daryanani I, Abramson LY, Alloy LB. Latent classes of trait affect and cognitive affective regulation strategies are associated with depression, non-suicidal self-injury, and well-being. J Affect Disord 2018; 225:180-187. [PMID: 28837951 PMCID: PMC5663635 DOI: 10.1016/j.jad.2017.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/19/2017] [Accepted: 08/10/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The present study sought to better understand the unique profiles of late adolescents' affective functioning by exploring patterns of trait affect and cognitive affective regulation strategies. The study also examined whether these unique profiles significantly predicted depressive symptoms, non-suicidal self-injury (NSSI), and well-being outcomes. METHODS Data from a sample of 590 late adolescents were examined (M = 19.14 years, SD = 1.41, 63% Female, 62% Caucasian, 38% African American/Biracial). Participants were followed for an average of 14 months (SD = 2.53) and completed measures of trait affect, cognitive affective regulation, depression, NSSI, and well-being. Data were examined using latent class analysis. RESULTS Five subgroups with unique patterns of affective functioning were identified. Late adolescents who reported above average levels of negative affect, dampening of positive affect, brooding, and reflection, coupled with below average levels of positive affect and positive rumination, were more likely to report having higher levels of depressive symptoms and greater engagement in NSSI during the one-year period prior to baseline. Similarly, the late adolescents fitting this profile also reported lower levels of well-being and were more likely to report engaging in NSSI at the follow-up. LIMITATIONS Limitations include a narrow exploration of affective regulation strategies and the addition of key variables after the initiation of the larger study. CONCLUSIONS These findings shed light on affective regulation factors relevant to the experience of depressive symptoms and NSSI, and the promotion of well-being.
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Affiliation(s)
- Taylor A. Burke
- Department of Psychology, Temple University, Philadelphia PA, USA
| | | | - Issar Daryanani
- Department of Psychology, Temple University, Philadelphia PA, USA
| | - Lyn Y. Abramson
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lauren B. Alloy
- Department of Psychology, Temple University, Philadelphia PA, USA
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McArthur BA, Cherry KM, Braimoh G, Lumley MN. An Exploration of Positive Parenting in Relation to Psychopathology for Youth with a Diagnosis of Bipolar Spectrum Disorder. J Can Acad Child Adolesc Psychiatry 2017; 26:224-232. [PMID: 29056985 PMCID: PMC5642462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 06/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Bipolar Spectrum Disorder (BSD) is a severe psychiatric disorder associated with a host of deleterious sequelae. While researchers have found a robust link between parenting variables and psychopathology for youth with BSD, few have examined positive parenting factors and associated psychopathology for these youth. Furthermore, conclusions from extant literature are hindered by a) exploring a limited range of parenting variables and b) employing retrospective reports of parenting with adult populations. This study addressed these gaps by examining how a range of contemporaneously-measured positive parenting variables were related to psychopathology among youth with a BSD diagnosis. METHODS One hundred fifty families with a youth aged 5-16 years participated in this study and completed screening for a mood disorder through a tertiary care facility. Participants completed measures of depression, mania, behavioural difficulties, and the parent-child relationship. RESULTS Parental characteristics (limit setting, autonomy granting, egalitarian views) were related to lower levels of psychopathology for youth screened for BSD. CONCLUSIONS Taken together, the results from this study contribute to our understanding of the relation between positive parenting characteristics and psychopathology for youth with a diagnosis of BSD.
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Affiliation(s)
| | | | - Gani Braimoh
- Child and Parent Resource Institute, London, Ontario
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Abstract
PURPOSE Research in the area of pediatric oncology has shown that although some children and youth diagnosed with this disease cope adaptively after their diagnosis, others continue to have long-term psychosocial difficulties. The potential mechanisms that may protect against the experience of psychopathology and poor quality of life within this population are not well known. The purpose of this pilot study was to utilize a new comprehensive measure of positive schemas to better understand the relationship between positive schemas, quality of life, and psychopathology, for children on active treatment for cancer. METHODS Participants were 22 patients, aged 8-18 years, being treated in a pediatric oncology clinic. Patients and parents completed measures of positive schemas, quality of life, and psychopathology. RESULTS The mean age at time of initial diagnosis of the patient sample was 11.6 years. Child-reported positive schemas were significantly related to child-reported child quality of life (r = 0.46, p = 0.03). CONCLUSIONS This is the first study to examine positive schemas within a pediatric oncology sample. Future research is needed to further explore facets of positive schemas that may be particularly relevant to child psychological functioning in a pediatric oncology population.
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Affiliation(s)
- Brae Anne McArthur
- a Department of Psychology , Temple University , Philadelphia , PA , USA
| | - Douglas Strother
- b Hematology, Oncology, and Transplant Program , Alberta Children's Hospital , Calgary , Canada
| | - Fiona Schulte
- b Hematology, Oncology, and Transplant Program , Alberta Children's Hospital , Calgary , Canada.,c Psychology Department , Alberta Children's Hospital , Calgary , Canada
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Morrongiello BA, McArthur BA, Spence JR. Understanding gender differences in childhood injuries: Examining longitudinal relations between parental reactions and boys' versus girls' injury-risk behaviors. Health Psychol 2015; 35:523-30. [PMID: 26348496 DOI: 10.1037/hea0000275] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this longitudinal study was to examine gender differences in children's hazard-directed behaviors when the parent was absent and determine whether parent reactions when present differentially influences boys' and girls' subsequent behaviors. METHOD Children and parents were video recorded in their home when a contrived burn hazard ('Gadget') was within view and reach of the child and the parent was sometimes present and absent. Videos were coded for teaching- and discipline-focused reactions by parents when children approached the Gadget in the parent's presence and children's hazard-directed behaviors when the parent was absent. Data were gathered monthly for a period of up to 6 months. RESULTS Multilevel regression analyses examining temporal relationships between parents' reactions (teaching, discipline) and children's hazard-directed behaviors when the parent was absent revealed significant gender differences. For boys, reductions in hazard-directed behaviors over time were predicted from high teaching or low discipline reactions, with low teaching and high discipline reactions maintaining injury-risk behaviors over time. For girls, reductions in hazard-directed behaviors over time were predicted from low teaching or high discipline reactions, with high teaching and low discipline reactions maintaining injury-risk behaviors over time. CONCLUSION To moderate young boys' injury-risk behaviors, caregivers should avoid frequent discipline-focused reactions in favor of frequent teaching when the child engages in injury-risk behaviors. For girls, however, frequent discipline-focused reactions reduced injury-risk behaviors over time more effectively than frequent teaching-focused reactions that sustained girls' interest in the hazard. Implications for injury prevention are discussed. (PsycINFO Database Record
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Morrongiello BA, McArthur BA, Bell M. Managing children's risk of injury in the home: does parental teaching about home safety reduce young children's hazard interactions? Accid Anal Prev 2014; 71:194-200. [PMID: 24929823 DOI: 10.1016/j.aap.2014.04.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 04/21/2014] [Accepted: 04/22/2014] [Indexed: 06/03/2023]
Abstract
Past research confirms that parents extend much effort to teach their young children about safety, but little is known about this process. The present study examined mothers' use of teaching as a strategy to manage young children's risk of home injury and how this impacts children's hazard interactions. Mothers of three-year-olds completed an in-home room-by-room interview in which they identified injury hazards that concern them, reported on use of teaching to manage risk of injury from these hazards, rated children's understanding of these safety issues and compliance with behavioral guidelines regarding these safety issues, and reported on children's recent interactions with these hazards. They also completed questionnaire measures of how difficult the child is to manage and the child's typical level of risk taking. Results revealed that children's understanding of safety impacted both their compliance and hazard interactions, moderating the impact of risk taking on compliance and also the impact of children's difficult-to-manage score on hazard interactions. These findings demonstrate that teaching strategies need to effectively enhance children's understanding of the safety issue in order to reduce children's risk of hazard interactions.
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Affiliation(s)
| | | | - Melissa Bell
- Psychology Department University of Guelph, Guelph, ON, N1G 2W1 Canada
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Morrongiello BA, McArthur BA, Goodman S, Bell M. Don’t Touch the Gadget Because It’s Hot! Mothers’ and Children’s Behavior in the Presence of a Contrived Hazard at Home: Implications for Supervising Children. J Pediatr Psychol 2014; 40:85-95. [DOI: 10.1093/jpepsy/jsu056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Morrongiello BA, McArthur BA, Kane A, Fleury R. Only kids who are fools would do that! Peer social norms influence children's risk-taking decisions. J Pediatr Psychol 2013; 38:744-55. [PMID: 23629147 DOI: 10.1093/jpepsy/jst019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The current research examined the impact of peer social norms on the physical risk-taking decisions of elementary-school children. METHOD Children 6-12 years of age completed a novel video-viewing decision task in which they observed risk and non-risk child behaviors on a playground and, after each behavior, indicated their willingness to model each of the behaviors in their own video, both before and after exposure to peer-communicated social norms (encouragement, discouragement). RESULTS Exposure to peer social norms resulted in significant changes in risk taking, with changes predicted from ratings of perceived social norms and appraisals of injury vulnerability and severity. CONCLUSION Exposure to peer social norms can provide another means by which injury prevention programs can aim to reduce injury-risk behaviors among school-age children.
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Abstract
BACKGROUND Intervention fidelity has important implications for the interpretation of intervention outcomes. Reviews on fidelity implementation for psychosocial interventions targeting children and adolescents with comorbid mental health problems are scarce. The purpose of this study was to systematically review reported fidelity of psychosocial interventions for children with comorbid mental health conditions. METHOD Fidelity and quality ratings were calculated based on an analysis of articles resulting from a previously reported systematic search of the literature (using PsycINFO, MEDLINE and ERIC databases between 1994 and 2009), using the Intervention Fidelity Assessment Checklist for the fidelity measure and the Cochrane Collaboration's tool for assessing risk of bias for the quality measure. RESULTS Overall, few studies were found to have a high level of fidelity adherence. Only 1 of the 10 studies met the 'high' intervention fidelity cutoff. CONCLUSIONS Findings suggest that current psychosocial interventions for children and adolescents with comorbid mental health disorders must be interpreted with caution, given many studies either do not measure intervention fidelity or have variable levels of fidelity adherence. Including fidelity components in future studies would aid in determining the effectiveness and generalizability of interventions targeted at children with comorbid disorders.
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Affiliation(s)
| | | | - Michèle Preyde
- University of Guelph, Guelph, ONT N1G 2W1, Canada. E-mail:
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Abstract
BACKGROUND Comorbidity is common among child clinical samples. Reviews on effective intervention for comorbid problems are lacking. METHOD Based on a literature search of three databases (PsycINFO, MEDLINE and ERIC), initial data analysis was carried out on 865 studies; of these,10 randomised trials fully met study inclusion criteria and were subject to final analysis, with quality assessments and effect sizes calculated. RESULTS Overall, effect sizes for externalising (M = 1.12) and internalising (M = 1.09) outcomes were large. Effect sizes were large for family-based (M = 1.80) compared to individual (M = 0.78) and group-based (M = 0.54) interventions. Studies with homotypic comorbidity (M= 1.18) displayed larger treatment effect sizes than ones with heterotypic comorbidity (M = 0.54). CONCLUSIONS While the overall quality ratings of the reviewed studies varied from mediocre to good, with a variety of measures used across studies to assess the same outcomes, findings suggest that current interventions are effective for reducing internalising and externalising problems in children with comorbidity. More substantive evidence for the beneficial effects of psychosocial interventions for children with comorbid problems may arise as more robust studies, which more explicitly address and describe comorbidity, become available.
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Affiliation(s)
| | | | - Michèle Preyde
- University of Guelph, Guelph, Ontario N1G 2W1, Canada. E-mail:
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Morrongiello BA, Walpole B, McArthur BA. Brief report: Young children's risk of unintentional injury: a comparison of mothers' and fathers' supervision beliefs and reported practices. J Pediatr Psychol 2009; 34:1063-8. [PMID: 19276175 DOI: 10.1093/jpepsy/jsp011] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE There is increasing interest in understanding how parent supervision influences young children's risk of injury, but nearly all of this research has been conducted with mothers. The present study compared first-time mothers' and fathers' supervisory beliefs and reported practices, and related these scores to parental reports of their child's history of injuries. METHODS Mothers and fathers of children 2-5 years each independently completed a telephone interview and previously validated questionnaires about their supervisory beliefs and practices and their child's history of injuries. RESULTS Mothers and fathers provided similar reports of their child's injuries (minor, medically attended) and scored similarly on various supervision indices. Despite these similarities, the way mothers' and fathers' supervision indices related to children's injury history scores differed. Children's frequency of minor and medically attended injuries was predicted from maternal supervisory scores but not from paternal scores. CONCLUSIONS Maternal supervision has more impact on children's risk of injury than paternal supervision, possibly because mothers spend more time with children than fathers.
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