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Koochakpour K, Nytrø Ø, Leventhal BL, Sverre Westbye O, Brox Røst T, Koposov R, Frodl T, Clausen C, Stien L, Skokauskas N. A review of information sources and analysis methods for data driven decision aids in child and adolescent mental health services. Int J Med Inform 2024; 188:105479. [PMID: 38761460 DOI: 10.1016/j.ijmedinf.2024.105479] [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] [Received: 03/03/2023] [Revised: 06/16/2023] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Clinical data analysis relies on effective methods and appropriate data. Recognizing distinctive clinical services and service functions may lead to improved decision-making. Our first objective is to categorize analytical methods, data sources, and algorithms used in current research on information analysis and decision support in child and adolescent mental health services (CAMHS). Our secondary objective is to identify the potential for data analysis in different clinical services and functions in which data-driven decision aids can be useful. MATERIALS AND METHODS We searched related studies in Science Direct and PubMed from 2018 to 2023(Jun), and also in ACM (Association for Computing Machinery) Digital Library, DBLP (Database systems and Logic Programming), and Google Scholar from 2018 to 2021. We have reviewed 39 studies and extracted types of analytical methods, information content, and information sources for decision-making. RESULTS In order to compare studies, we developed a framework for characterizing health services, functions, and data features. Most data sets in reviewed studies were small, with a median of 1,550 patients and 46,503 record entries. Structured data was used for all studies except two that used textual clinical notes. Most studies used supervised classification and regression. Service and situation-specific data analysis dominated among the studies, only two studies used temporal, or process features from the patient data. This paper presents and summarizes the utility, but not quality, of the studies according to the care situations and care providers to identify service functions where data-driven decision aids may be relevant. CONCLUSIONS Frameworks identifying services, functions, and care processes are necessary for characterizing and comparing electronic health record (EHR) data analysis studies. The majority of studies use features related to diagnosis and assessment and correspondingly have utility for intervention planning and follow-up. Profiling the disease severity of referred patients is also an important application area.
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Affiliation(s)
- Kaban Koochakpour
- Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Øystein Nytrø
- Department of Computer Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Computer Science, The Arctic University of Norway (UiT), Tromsø, Norway
| | | | - Odd Sverre Westbye
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| | | | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), The Arctic University of Norway (UiT), Tromsø, Norway
| | - Thomas Frodl
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Carolyn Clausen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Line Stien
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Koochakpour K, Sofie Solheim F, Nytrø Ø, Clausen C, Frodl T, Koposov R, Leventhal B, Pant D, Brox Røst T, Stien L, Sverre Westbye O, Skokauskas N. Challenges in Interpreting Norwegian Child and Adolescent Mental Health Records. Stud Health Technol Inform 2024; 310:845-849. [PMID: 38269928 DOI: 10.3233/shti231084] [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] [Indexed: 01/26/2024]
Abstract
The Electronic Health Record system BUPdata served Norwegian Child and Adolescent Mental Health Services (CAMHS) for over 35 years and is still an important source of information for understanding clinical practice. Secondary usage of clinical data enables learning and service quality improvement. We present some insights from explorative data analysis for interpreting the records of patients referred for hyperkinetic disorders. The major challenges were data preparation, pre-analysis, imputation, and validation. We summarize the main characteristics, spot anomalies, and detect errors. The results include observations about the patient referral diversity based on 12 different variables. We modeled the activities in an individual episode of care, described our clinical observations among data, and discussed the challenges of data analysis.
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Affiliation(s)
- Kaban Koochakpour
- Dept. Computer Science, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Frida Sofie Solheim
- Dept. Computer Science, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Bekk Consulting AS, Oslo, Norway
| | - Øystein Nytrø
- Dept. Computer Science, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Carolyn Clausen
- Reg. Centre for Child and Youth Mental Health and Child Welfare, NTNU, Trondheim, Norway
| | - Thomas Frodl
- Dept. of Psychiatry, Psychotherapy and -somatic, Univ. Hosp, RWTH Aachen, Germany
| | - Roman Koposov
- Reg. Centre for Child and Youth Mental Health and Child Welfare, Arctic Univ. of Norway
| | - Bennett Leventhal
- Dept. of Psychiatry, Division of Child and Adolescent Psychiatry, UCSF, USA
| | - Dipendra Pant
- Dept. Computer Science, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Line Stien
- Reg. Centre for Child and Youth Mental Health and Child Welfare, NTNU, Trondheim, Norway
| | - Odd Sverre Westbye
- Reg. Centre for Child and Youth Mental Health and Child Welfare, NTNU, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olav's Univ. Hosp, Trondheim, Norway
| | - Norbert Skokauskas
- Reg. Centre for Child and Youth Mental Health and Child Welfare, NTNU, Trondheim, Norway
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Ruchkin V, Stickley A, Koposov R, Sukhodolsky DG, Isaksson J. Depressive symptoms and anger and aggression in Russian adolescents. Child Adolesc Psychiatry Ment Health 2023; 17:130. [PMID: 37974287 PMCID: PMC10652468 DOI: 10.1186/s13034-023-00677-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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Research among adolescents exploring the association between depressive symptoms and aggression has produced inconsistent findings. This study investigated the prevalence of clinically significant (current major depressive episode) and subthreshold depressive symptoms in a general population sample of adolescents from Northern Russia and explored their association with aggression and anger, while controlling for comorbid mental health problems. The sample consisted of 2600 participants, aged 13-17 years (59.5% female; 95.7% ethnic Russian). Symptoms of a current major depressive episode, types of anger and aggression (anger rumination, trait anger, physical, verbal and social aggression) and comorbid problems (posttraumatic stress, alcohol use, anxiety, and hyperactivity/impulsivity) were assessed by means of self-reports. The prevalence of a clinically significant depressive episode in the past month was 3.5%, while for subthreshold depression it was 21.6%. All anger and aggression variables, as well as comorbid problems increased together with increasing levels of depression. The association between overt aggressive behavior and depression was primarily explained by comorbid mental health problems, whereas anger rumination and social aggression had more direct associations with depression, independent of comorbidity. Among adolescents with depression, boys reported higher levels of social and verbal aggression and of anger rumination than girls. The results of this study suggest that interventions aiming to reduce aggressive behavior in adolescents should consider depression and its comorbid conditions.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, S-751 85, Sweden.
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA.
| | - Andrew Stickley
- Department for Preventive Intervetion for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Epidemiology and Modern Technologies of Vaccination, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Denis G Sukhodolsky
- Child Study Center, Yale University Medical School, New Haven, CT, 06520, USA
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, S-751 85, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Isaksson J, Isaksson M, Stickley A, Vermeiren R, Koposov R, Schwab-Stone M, Ruchkin V. Community Violence Exposure and Eating Disorder Symptoms among Belgian, Russian and US Adolescents: Cross-Country and Gender Perspectives. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01590-1. [PMID: 37606867 DOI: 10.1007/s10578-023-01590-1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/23/2023]
Abstract
Community violence exposure (CVE) is one of the most common adverse childhood experiences worldwide. Despite this, its potential effect on disordered eating in adolescents from different cultures is underexplored. In the present cross-sectional study, self-reported data were collected from 9751 students (Mean age = 14.27) from Belgium, Russia and the US on CVE (witnessing violence and violence victimization), eating disorder (ED) symptoms (ED thoughts with associated compensatory behaviors), and comorbid symptoms of posttraumatic stress, depression and anxiety. Increased CVE (from no exposure to witnessing to victimization) was associated with more ED symptoms, and the associations remained significant after adjusting for comorbid conditions. The associations were similar for adolescents across the three countries. No gender differences were observed in the association between CVE and ED symptoms, even though girls in general reported more ED symptoms than boys. We conclude that CVE appears to be associated with ED symptoms in three culturally different samples of adolescents.
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Affiliation(s)
- Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Martina Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Robert Vermeiren
- Department of Child and Adolescent Psychiatry Curium, Leiden University Medical Center, Leiden, Netherlands
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsö, Norway
- Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
- Child Study Center, Yale University School of Medicine, New Haven, USA.
- Sala Forensic Psychiatric Clinic, Sala, Sweden.
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Koposov R, Stickley A, Sukhodolsky D, Ruchkin V. Bulimia symptoms and anger and aggression among adolescents. BMC Public Health 2023; 23:833. [PMID: 37147644 PMCID: PMC10161674 DOI: 10.1186/s12889-023-15664-1] [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] [Received: 11/15/2022] [Accepted: 04/12/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Previous research has indicated that anger and aggression may be elevated in adolescents with a bulimia nervosa (BN) diagnosis. However, as yet, little is known about whether bulimia symptoms are linked to anger and aggression in adolescents in the general population. To address this deficit this study aimed to explore the associations between a clinical level of bulimia symptoms (CLBS) and anger, anger rumination and aggression in community-based adolescents, and determine whether gender is important in this context. METHODS This study was conducted on a representative sample of youth from northwestern Russia (n = 2613, age 13-17 years old, 59.5% female) using self-report scales. A proxy variable for a CLBS was created using the Eating Disorder Diagnostic Scale. Aggression, anger and anger rumination were assessed by the Trait Anger Scale of the State Trait Anger Expression Inventory, the Anger Rumination Scale, and scales created to assess physically and verbally aggressive behavior. Multivariate analysis of covariance was used to examine the associations between the study variables. RESULTS A CLBS was more prevalent in girls than in boys (13.4% vs. 3.5%). The association with anger and aggression was stronger in both genders with a CLBS, compared to those adolescents without a CLBS. In the CLBS group, boys as compared to girls scored higher on verbal and physical aggression, anger rumination and social aggression. In both the CLBS and Non-CLBS groups higher anger and aggression scores were associated with increasing age. CONCLUSIONS Findings suggest that aggression and anger rumination are elevated in adolescents with BN symptoms, and that the associations between anger, aggression and BN symptoms may be stronger in boys. As previous research has indicated that the presence of aggressive behaviors may affect the prognosis of BN and complicate management of the disorder, clinician screening for these behaviors in adolescents with BN symptoms may facilitate the provision of more effective treatment, especially among boys.
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Affiliation(s)
- Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Denis Sukhodolsky
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, S-751 85, Sweden.
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Sala Forensic Psychiatric Clinic, Sala, Sweden.
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Pettersen SD, Martinussen M, Handegård BH, Rasmussen LMP, Koposov R, Adolfsen F. Beyond physical ability—predicting women’s football performance from psychological factors. Front Psychol 2023; 14:1146372. [PMID: 37063572 PMCID: PMC10090955 DOI: 10.3389/fpsyg.2023.1146372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
IntroductionEven though there is a clear agreement among researchers that psychological factors are a vital part of a football player’s performance, the topic has not been investigated thoroughly. The present study aimed to examine the predictive value of psychological factors on female football players’ match performance.MethodsA sample of 156 players from the top two leagues in Norway completed the following questionnaires: Perceived Motivational Climate in Sport Questionnaire 2 (PMCSQ-2), Big Five Inventory (BFI-20), Self-Regulated Learning questionnaire, and Grit-S and Sport Mental Toughness Questionnaire (SMTQ). Match performance data were collected from the online database of the performance analysis company InStat.ResultsResults from a linear mixed model analysis showed that perceived mastery climate and extraversion were the only significant predictors of performance. Other relevant indicators, such as mental toughness, self-regulated learning, and grit, did not predict performance.DiscussionThese findings suggest that the team climate facilitated by coaches may be more important for predicting match performance than individual psychological factors.
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Saunderson JM, Stickley A, Sturidsson K, Koposov R, Sukhodolsky DG, Ruchkin V. Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents. J Interpers Violence 2023; 38:3191-3214. [PMID: 35613735 PMCID: PMC9850389 DOI: 10.1177/08862605221104525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.
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Affiliation(s)
| | - Andrew Stickley
- Department of Preventive
Intervention for Psychiatric Disorders, National Institute of Mental
Health, National Center of Neurology
and Psychiatry, Kodaira, Tokyo, Japan
- Stockholm Center for Health and
Social Change (SCOHOST), Södertörn
University, Huddinge, Sweden
| | - Knut Sturidsson
- Department of Clinical
Neuroscience, Division of Psychology, Karolinska Institute,
Stockholm, Sweden
| | - Roman Koposov
- Regional Centre for Child and Youth
Mental Health and Child Welfare, Faculty of Health Sciences,
UiT The Arctic
University of Norway, Tromsø, Norway
- Sechenov First Moscow State Medical
University, Moscow, Russia
| | | | - Vladislav Ruchkin
- Child Study Center,
Yale University
Medical School, New Haven, CT, USA
- Department of Child and Adolescent
Psychiatry, Division of Neuroscience, Uppsala University,
Uppsala, Sweden
- Säter Forensic Psychiatric
Clinic, Säter, Sweden
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Clausen C, Leventhal B, Nytrø Ø, Koposov R, Røst TB, Westbye OS, Koochakpour K, Frodl T, Stien L, Skokauskas N. Usability of the IDDEAS prototype in child and adolescent mental health services: A qualitative study for clinical decision support system development. Front Psychiatry 2023; 14:1033724. [PMID: 36911136 PMCID: PMC9997712 DOI: 10.3389/fpsyt.2023.1033724] [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: 08/31/2022] [Accepted: 02/09/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Child and adolescent mental health services (CAMHS) clinical decision support system (CDSS) provides clinicians with real-time support as they assess and treat patients. CDSS can integrate diverse clinical data for identifying child and adolescent mental health needs earlier and more comprehensively. Individualized Digital Decision Assist System (IDDEAS) has the potential to improve quality of care with enhanced efficiency and effectiveness. METHODS We examined IDDEAS usability and functionality in a prototype for attention deficit hyperactivity disorder (ADHD), using a user-centered design process and qualitative methods with child and adolescent psychiatrists and clinical psychologists. Participants were recruited from Norwegian CAMHS and were randomly assigned patient case vignettes for clinical evaluation, with and without IDDEAS. Semi-structured interviews were conducted as one part of testing the usability of the prototype following a five-question interview guide. All interviews were recorded, transcribed, and analyzed following qualitative content analysis. RESULTS Participants were the first 20 individuals from the larger IDDEAS prototype usability study. Seven participants explicitly stated a need for integration with the patient electronic health record system. Three participants commended the step-by-step guidance as potentially helpful for novice clinicians. One participant did not like the aesthetics of the IDDEAS at this stage. All participants were pleased about the display of the patient information along with guidelines and suggested that wider guideline coverage will make IDDEAS much more useful. Overall, participants emphasized the importance of maintaining the clinician as the decision-maker in the clinical process, and the overall potential utility of IDDEAS within Norwegian CAMHS. CONCLUSION Child and adolescent mental health services psychiatrists and psychologists expressed strong support for the IDDEAS clinical decision support system if better integrated in daily workflow. Further usability assessments and identification of additional IDDEAS requirements are necessary. A fully functioning, integrated version of IDDEAS has the potential to be an important support for clinicians in the early identification of risks for youth mental disorders and contribute to improved assessment and treatment of children and adolescents.
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Affiliation(s)
- Carolyn Clausen
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bennett Leventhal
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Øystein Nytrø
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roman Koposov
- RKBU Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway
| | - Thomas Brox Røst
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Odd Sverre Westbye
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| | - Kaban Koochakpour
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Frodl
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
| | - Line Stien
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Norbert Skokauskas
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Bakken V, Koposov R, Røst TB, Clausen C, Nytrø Ø, Leventhal B, Westbye OS, Koochakpour K, Mandahl A, Hafstad H, Skokauskas N. Attitudes of Mental Health Service Users Toward Storage and Use of Electronic Health Records. Psychiatr Serv 2022; 73:1013-1018. [PMID: 35291817 DOI: 10.1176/appi.ps.202100477] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Electronic health records (EHRs) are used for both clinical practice and research. Because mental health service users' views are underrepresented in perspectives on EHR use, the authors examined service users' awareness, attitudes, and opinions about EHR data storage and sharing. METHODS A mixed-methods, cross-sectional design was used to examine attitudes of 253 Norwegian mental health service users who were recruited online to complete a quantitative and qualitative (free-text) survey about EHR utilization. RESULTS Most participants were aware that EHRs were stored (95%) and shared (58%). Most thought that patients benefited from EHR storage (84%), trusted authorities with EHR sharing (71%), were willing to share their EHRs to help others (75%), felt they benefited from EHR sharing (75%), and thought EHR sharing was ethical for health care and research (71%). Fewer were aware of EHR sharing for research (36%), and 62% were aware that shared data were anonymized. Of the participants, 69% recognized privacy risks associated with sharing. Lack of transparency and skepticism about anonymization and misuse of EHR data were concerns and perceived risks. Mental health service users thought that EHRs should be shared for policy development (81%), education and training (85%), improving care quality (89%), research (91%), and clinical decision support (81%). CONCLUSIONS Participants were aware of and supported EHR sharing for research and clinical care. They supported sharing to help others and were willing to fully participate in clinical care and research, as well as to share EHR information for their own care, research, and the care of others.
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Affiliation(s)
- Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Thomas Brox Røst
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Carolyn Clausen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Øystein Nytrø
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Bennett Leventhal
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Odd Sverre Westbye
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Kaban Koochakpour
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Arthur Mandahl
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Hege Hafstad
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences (Bakken, Clausen, Westbye, Skokauskas), and Department of Computer Science (Nytrø, Koochakpour), Norwegian University of Science and Technology, Trondheim, Norway; RKBU Northern Norway, Arctic University of Norway, Tromsø (Koposov); Sechenov First Moscow State Medical University, Moscow (Koposov); Vivit AS, Trondheim, Norway (Røst); Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Leventhal); Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway (Westbye); Vårres Regional User-Controlled Center of Central Norway, Trondheim, Norway (Mandahl, Hafstad)
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10
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Koochakpour K, Nytrø Ø, Westbye OS, Leventhal B, Koposov R, Bakken V, Clausen C, Røst TB, Skokauskas N. Success Factors of an Early EHR System for Child and Adolescent Mental Health: Lessons Learned for Future Practice Data-Driven Decision Aids. Stud Health Technol Inform 2022; 290:182-186. [PMID: 35672996 DOI: 10.3233/shti220057] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper recounts the successful BUPdata, a discontinued electronic health record (EHR) system for Child and Adolescent Mental Health Services (CAMHS) in Norway. It was developed and owned by the national association for CAMHS and fulfilled needs for collaborative care, practice insight, and service management. It aimed to unify the requirements of government, administration, clinicians, patients, and researchers alike, with the goal of providing uniform quality of care nationally. When CAMHS became integrated with specialist healthcare, BUPdata was replaced with more a general EHR system offering far less functionality and insight into CAMHS practice. We have studied BUPdata, and interviewed stakeholders in order to develop decision aids based on practice data analysis and give clinicians and patients insight into successful local practice, collaboration patterns, and overview of local resources.
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Affiliation(s)
- Kaban Koochakpour
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein Nytrø
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Odd Sverre Westbye
- Regional Centre for Child and Youth Mental Health and Child Welfare, Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| | - Bennett Leventhal
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, The Univ. of California San Francisco, CA, United States
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Northern Norway, UiT The Arctic University of Norway, Tromsø, Norway.,Sechenov First Moscow State Medical University, Moscow, Russia
| | - Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare, Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Carolyn Clausen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Thomas Brox Røst
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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11
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Kyrrestad H, Mabille G, Adolfsen F, Koposov R, Martinussen M. Gender differences in alcohol onset and drinking frequency in adolescents: an application of the theory of planned behavior. Drugs: Education, Prevention and Policy 2022. [DOI: 10.1080/09687637.2020.1865271] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Henriette Kyrrestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Geraldine Mabille
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Monica Martinussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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12
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Stickley A, Shirama A, Inagawa T, Ruchkin V, Koposov R, Isaksson J, Inoue Y, Sumiyoshi T. Attention-deficit/hyperactivity disorder symptoms, perceived stress, and suicidal ideation during the COVID-19 pandemic. Front Psychiatry 2022; 13:1008290. [PMID: 36440405 PMCID: PMC9682032 DOI: 10.3389/fpsyt.2022.1008290] [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: 07/31/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) symptoms have been linked to suicidal behavior. However, little is known about the mechanisms involved in this association. This study examined ADHD symptoms and suicidal ideation during the COVID-19 pandemic and the role of self-perceived stress in this association. METHOD Data were analyzed from an online sample of 1,452 Japanese individuals aged 18 to 89 obtained in February 2021. Information was collected on past-year suicidal ideation. ADHD symptoms were assessed with the Adult ADHD Self-Report Scale (ASRS) Screener while stress was measured with the Perceived Stress Scale (PSS-14). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9), while the Generalized Anxiety Disorder scale (GAD-7) was used to assess anxiety symptoms. Logistic regression was used to examine associations. RESULTS Fifty-one (3.5%) individuals had ADHD symptoms, while more than one in ten (11.7%) of the respondents reported past-year suicidal ideation. In an analysis adjusted for sociodemographic factors, ADHD symptoms were associated with eight times higher odds for past-year suicidal ideation. However, adjusting the analysis for mental health variables (anxiety and depressive symptoms) attenuated the association which became non-significant (odds ratio [OR]: 1.96, 95% confidence interval [CI]: 0.92-4.18). In contrast, in an analysis adjusted for mental health, individuals with ADHD symptoms and stress had significantly higher odds for suicidal ideation (OR: 3.72, 95%CI: 1.43-9.67) whereas, ADHD symptoms without stress were not linked to suicidal ideation (OR: 1.25, 95%CI: 0.38-4.18). CONCLUSIONS Self-perceived stress is important in the association between ADHD symptoms and suicidal ideation among individuals in Japan during the COVID-19 pandemic. Detecting and managing stress and its effects in individuals with ADHD/ADHD symptoms should be a therapeutic focus for improving health-related outcomes in this population both during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Department of Medical Sciences, Unit of Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.,Sala Forensic Psychiatric Clinic, Sala, Sweden
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.,M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Johan Isaksson
- Department of Medical Sciences, Unit of Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.,Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Tokyo, Japan
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13
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Stickley A, Koposov R, Koyanagi A, Oh H, Ruchkin V. Attention-Deficit/Hyperactivity Disorder Symptoms and Community Violence Exposure in Russian Adolescents. J Interpers Violence 2021; 36:NP9738-NP9756. [PMID: 31288607 DOI: 10.1177/0886260519861651] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A large body of research has shown that exposure to community violence is common for many children across the world. However, less is known about exposure in particular subgroups such as those children with developmental disorders. To address this research gap, the aim of this study was to examine community violence exposure (CVE) in adolescents with attention-deficit/hyperactivity disorder (ADHD) symptoms and the role of gender in this association. Data were analyzed from 2,782 adolescents aged 13 to 17 years from Arkhangelsk, Russia that were collected during the Social and Health Assessment (SAHA). ADHD status was assessed with the hyperactivity/inattention scale of the Strengths and Difficulties Questionnaire (SDQ). Information was obtained on past-year witnessing and violence victimization in the community. Results showed that CVE was more prevalent in children with ADHD symptoms. Specifically, 75.1% of children with ADHD symptoms had been exposed to any violence versus 62.3% in the non-ADHD group (χ2 = 18.65, p < .001). Multivariate analyses of covariance (MANCOVAs) revealed that CVE was significantly higher for adolescents with ADHD symptoms for both witnessing and victimization, while exposure was significantly higher for ADHD boys compared with girls. The findings of this study suggest that CVE may be elevated in adolescents with higher ADHD symptoms. Given that CVE has been associated with a variety of negative social and psychological outcomes in typically developing children, an important task for future research is to determine what factors are associated with CVE in adolescents with ADHD symptoms including those relating to such phenomena as comorbid psychopathology, the family, and peer relations, so that interventions can be designed and implemented to reduce CVE and its detrimental effects in this population.
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Affiliation(s)
- Andrew Stickley
- National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Södertörn University, Huddinge, Sweden
| | - Roman Koposov
- University of Tromsø-The Arctic University of Norway, Norway
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Hans Oh
- University of Southern California, Los Angeles, USA
| | - Vladislav Ruchkin
- Uppsala University, Sweden
- Yale University Medical School, New Haven, CT, USA
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14
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Koposov R, Isaksson J, Vermeiren R, Schwab-Stone M, Stickley A, Ruchkin V. Community Violence Exposure and School Functioning in Youth: Cross-Country and Gender Perspectives. Front Public Health 2021; 9:692402. [PMID: 34386472 PMCID: PMC8353073 DOI: 10.3389/fpubh.2021.692402] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Many children and adolescents experience violent events which can be associated with negative consequences for their development, mental health, school, and social functioning. However, findings between settings and on the role of gender have been inconsistent. This study aimed to investigate cross-country and gender differences in the relationship between community violence exposure (CVE) and school functioning in a sample of youths from three countries. Methods: A self-report survey was conducted among school students (12-17 years old) in Belgium (Antwerp, N = 4,743), Russia (Arkhangelsk, N = 2,823), and the US (New Haven, N = 4,101). Students were recruited from within classes that were randomly selected from within schools that had themselves been randomly selected (excepting New Haven, where all students were included). CVE was assessed with the Screening Survey of Exposure to Community Violence. School functioning was assessed with four measures: the Perceived Teacher Support scale, Negative Classroom Environment scale, and Academic Motivation and Perception of Safety at School scales. Multivariate Analyses of Covariance were performed to assess differences in the levels of school-related problem behaviors in boys and girls, who reported different degrees of CVE. Results: Participants in all three countries reported a relatively high prevalence of violence exposure (36.2% in Belgium, 39.3% in Russia and 45.2% in the US who witnessed violence), with a higher proportion of girls than boys witnessing violent events (varied from 37.4 to 51.6% between the countries), whereas boys reported more episodes of victimization by violence than girls (varied from 32.3 to 49.9% between the countries). Youths who experienced increased CVE (from no exposure to witnessing to victimization) reported an increase in all school functioning problems in all of the countries and this association was not gender-specific. Conclusions: Our findings suggest that regardless of differences in the level of CVE by country and gender, violence exposure is negatively associated with school functioning across countries. Nonetheless, even though reactions to community violence among adolescents may be expressed in a similar fashion, cross-country differences in social support systems should also be taken into account in order to provide culturally sensitive treatment modalities.
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Affiliation(s)
- Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | | | - Andrew Stickley
- Stockholm Center for Health and Social Change, Södertörn University, Stockholm, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,School of Medicine, Yale University, New Haven, CT, United States.,Sater Forensic Psychiatric Clinic, Sater, Sweden
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15
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Clausen CE, Leventhal BL, Nytrø Ø, Koposov R, Westbye OS, Røst TB, Bakken V, Koochakpour K, Thorvik K, Skokauskas N. Clinical Decision Support Systems: An Innovative Approach to Enhancing Child and Adolescent Mental Health Services. J Am Acad Child Adolesc Psychiatry 2021; 60:562-565. [PMID: 33068753 DOI: 10.1016/j.jaac.2020.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/07/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Carolyn E Clausen
- The Norwegian University of Science and Technology (NTNU), Faculty of Medicine & Health Sciences; Regional Center for Child and Youth Mental Health and Child Welfare-RKBU, Central Norway, Trondheim, Norway
| | | | - Øystein Nytrø
- The Norwegian University of Science and Technology (NTNU), Faculty of Information Technology and Electrical Engineering, Trondheim, Norway
| | - Roman Koposov
- UiT- The Arctic University of Norway, Regional Center for Child and Youth Mental Health and Child Welfare-RKBU, Northern Norway, Tromsø, Norway; and Sechenov First Moscow State Medical University, Moscow, Russia
| | - Odd Sverre Westbye
- The Norwegian University of Science and Technology (NTNU), Faculty of Medicine & Health Sciences; Regional Center for Child and Youth Mental Health and Child Welfare-RKBU, Central Norway, Trondheim, Norway; St. Olavs Hospital, Trondheim, Norway
| | - Thomas Brox Røst
- The Norwegian University of Science and Technology (NTNU), Faculty of Information Technology and Electrical Engineering, Trondheim, Norway
| | - Victoria Bakken
- The Norwegian University of Science and Technology (NTNU), Faculty of Medicine & Health Sciences; Regional Center for Child and Youth Mental Health and Child Welfare-RKBU, Central Norway, Trondheim, Norway
| | - Kaban Koochakpour
- The Norwegian University of Science and Technology (NTNU), Faculty of Information Technology and Electrical Engineering, Trondheim, Norway
| | - Ketil Thorvik
- Central Norway Regional Health Information Technology (HEMIT)
| | - Norbert Skokauskas
- The Norwegian University of Science and Technology (NTNU), Faculty of Medicine & Health Sciences; Regional Center for Child and Youth Mental Health and Child Welfare-RKBU, Central Norway, Trondheim, Norway.
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16
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Ruchkin V, Koposov R, Oreland L, af.Klinteberg B, Grigorenko EL. Dopamine-related receptors, substance dependence, behavioral problems and personality among juvenile delinquents. Personality and Individual Differences 2021. [DOI: 10.1016/j.paid.2020.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Koposov R, Stickley A, Ruchkin V. Non-Suicidal Self-Injury Among Incarcerated Adolescents: Prevalence, Personality, and Psychiatric Comorbidity. Front Psychiatry 2021; 12:652004. [PMID: 34093271 PMCID: PMC8170036 DOI: 10.3389/fpsyt.2021.652004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Incarcerated adolescents represent a risk group for non-suicidal self-injury (NSSI), but research on this population has been limited and no studies have been conducted in Russia. To address this deficit, this study examined NSSI and the factors associated with it among youth in a juvenile correctional facility in Russia. Methods: NSSI and psychopathology were assessed using a psychiatric interview and self-report questionnaire in 368 incarcerated male adolescents aged 14-19 years (mean age 16.4 years, S.D. 0.9) from Northern Russia. Results: 18.2% (N = 67) of the study participants had a history of NSSI and also had higher rates of anxiety, post-traumatic stress disorder (PTSD), depression, community violence exposure and scored higher on most of the Youth Self-Report problem scales. In addition, 31.3% of the NSSI group reported previous suicidal ideation and had thought about a specific suicide method compared to 12.0% in the No-NSSI group. Adolescents with NSSI also differed significantly from the No-NSSI group on self-directedness (lower) and self-transcendence (higher) personality traits. Conclusion: NSSI is common in incarcerated adolescents in Russia and is associated with extensive psychiatric comorbidity, suicidal ideation and specific personality traits.
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Affiliation(s)
- Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Center, Yale School of Medicine, New Haven, CT, United States.,Säter Forensic Psychiatric Clinic, Säter, Sweden
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18
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Isaksson J, Sukhodolsky DG, Koposov R, Stickley A, Ruchkin V. The Role of Gender in the Associations Among Posttraumatic Stress Symptoms, Anger, and Aggression in Russian Adolescents. J Trauma Stress 2020; 33:552-563. [PMID: 32384585 DOI: 10.1002/jts.22502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/21/2018] [Revised: 11/01/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022]
Abstract
Symptoms of posttraumatic stress disorder (PTSD) have been linked to anger and aggressive behavior in adult and veteran populations. However, research on the associations among anger, aggression, and PTSD in adolescents is lacking, particularly regarding differences between the sexes. To address this research gap, we used self-report data from Russian adolescents (N = 2,810; age range: 13-17 years) to perform a full path analysis examining the associations between PTSD symptoms and the emotional (anger traits) and cognitive (rumination) components of anger as well as physical/verbal and social aggression, after adjusting for depressive symptoms. We also examined the interaction effects between PTSD symptoms and sex on anger and aggression. The results indicated that girls scored higher on measures of anger and PTSD symptoms, ds = 0.20-0.32, whereas boys scored higher on measures of physical and verbal aggression, d = 0.54. Clinical levels of PTSD symptoms were associated with anger rumination, β = .16, and trait anger, β = .06, and an interaction effect for PTSD symptoms and sex was found for aggression, whereby boys with clinical levels of PTSD symptoms reported more physical/verbal and social aggression, βs = .05 and .20, respectively. Our findings suggest that PTSD symptoms may have an important impact on anger, anger rumination, and aggression during adolescence. In particular, boys seem to have an increased risk for aggressive behavior in the presence of PTSD symptoms. The present results highlight the importance of taking anger and aggression into account when evaluating PTSD.
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Affiliation(s)
- Johan Isaksson
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
| | - Denis G Sukhodolsky
- Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, The Arctic University of Norway, Tromsö, Norway
| | - Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Sodertorn University, Huddinge, Sweden.,Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Vladislav Ruchkin
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University School of Medicine, New Haven, Connecticut, USA.,Säter Psychiatric Clinic, Säter, Sweden
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Lindblad F, Isaksson J, Heiskala V, Koposov R, Ruchkin V. Comorbidity and Behavior Characteristics of Russian Male Juvenile Delinquents With ADHD and Conduct Disorder. J Atten Disord 2020; 24:1070-1077. [PMID: 25926630 DOI: 10.1177/1087054715584052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To test the previously suggested hypothesis that those with comorbid ADHD and Conduct Disorder (CD) diagnoses differ from other antisocially involved youth in terms of higher rates of violent behavior, impulsiveness, and psychopathic traits. Method: Three hundred eighty juvenile incarcerated delinquents from Northern Russia were assessed by means of semi-structured psychiatric interview and by student and teacher self-reports. Results: The study has demonstrated higher rates of psychiatric disorders and of comorbidity, as well as more complicated substance abuse and disruptive behaviors in those with combined ADHD-CD diagnosis, as compared with CD only, ADHD only, and no CD no ADHD groups. The results regarding psychopathic traits were inconclusive. Conclusion: The group with combined ADHD-CD diagnosis is more severely disturbed, both as concerns psychiatric comorbidity and more severe aggressive and disruptive behaviors. However, there is only limited evidence supporting a higher prevalence of psychopathic traits in this group.
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Røst TB, Clausen C, Nytrø Ø, Koposov R, Leventhal B, Westbye OS, Bakken V, Flygel LHK, Koochakpour K, Skokauskas N. Local, Early, and Precise: Designing a Clinical Decision Support System for Child and Adolescent Mental Health Services. Front Psychiatry 2020; 11:564205. [PMID: 33384621 PMCID: PMC7769803 DOI: 10.3389/fpsyt.2020.564205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/20/2020] [Accepted: 11/24/2020] [Indexed: 11/13/2022] Open
Abstract
Mental health disorders often develop during childhood and adolescence, causing long term and debilitating impacts at individual and societal levels. Local, early, and precise assessment and evidence-based treatment are key to achieve positive mental health outcomes and to avoid long-term care. Technological advancements, such as computerized Clinical Decision Support Systems (CDSSs), can support practitioners in providing evidence-based care. While previous studies have found CDSS implementation helps to improve aspects of medical care, evidence is limited on its use for child and adolescent mental health care. This paper presents challenges and opportunities for adapting CDSS design and implementation to child and adolescent mental health services (CAMHS). To highlight the complexity of incorporating CDSSs within local CAMHS, we have structured the paper around four components to consider before designing and implementing the CDSS: supporting collaboration among multiple stakeholders involved in care; optimally using health data; accounting for comorbidities; and addressing the temporality of patient care. The proposed perspective is presented within the context of the child and adolescent mental health services in Norway and an ongoing Norwegian innovative research project, the Individualized Digital DEcision Assist System (IDDEAS), for child and adolescent mental health disorders. Attention deficit hyperactivity disorder (ADHD) among children and adolescents serves as the case example. The integration of IDDEAS in Norway intends to yield significantly improved outcomes for children and adolescents with enduring mental health disorders, and ultimately serve as an educational opportunity for future international approaches to such CDSS design and implementation.
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Affiliation(s)
- Thomas Brox Røst
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Carolyn Clausen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Øystein Nytrø
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Northern Norway, The Arctic University of Norway (UiT), Tromsø, Norway.,Sechenov First Moscow State Medical University, Moscow, Russia
| | - Bennett Leventhal
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, The University of California San Francisco, San Francisco, CA, United States
| | - Odd Sverre Westbye
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| | - Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | - Kaban Koochakpour
- Department of Computer Science, The Norwegian University of Science and Technology, Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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21
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Stickley A, Koposov R, Koyanagi A, Inoue Y, Ruchkin V. ADHD and depressive symptoms in adolescents: the role of community violence exposure. Soc Psychiatry Psychiatr Epidemiol 2019; 54:683-691. [PMID: 30706080 DOI: 10.1007/s00127-019-01662-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 06/24/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Comorbid depression is common in adolescents with attention-deficit/hyperactivity disorder (ADHD). As yet, however, little is known about the factors associated with co-occurring depression in this population. To address this research gap, the current study examined the role of community violence exposure in the association between ADHD symptoms and depression. METHODS Data came from 505 Russian adolescents [mean age 14.37 (SD = 0.96)] who had teacher-reported information on ADHD symptoms that was collected in conjunction with the Social and Health Assessment (SAHA). Adolescent self-reports of witnessing and being a victim of community violence were also obtained while depressive symptoms were self-assessed with an adapted version of the Center for Epidemiologic Studies-Depression Scale (CES-D). Logistic regression analyses were performed to examine associations. RESULTS In univariable analyses, both witnessing and being a victim of violence were associated with significantly increased odds for depressive symptoms in adolescents with ADHD symptoms compared to non-ADHD adolescents who had not experienced community violence. However, in the multivariable analysis only being a victim of violence continued to be associated with significantly increased odds for depression [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.33-16.35]. CONCLUSION Exposure to community violence may be associated with depression in adolescents with ADHD symptoms. Clinicians should enquire about exposure to community violence in adolescents with ADHD/ADHD symptoms. Early therapeutic interventions to address the effects of violence exposure in adolescents with ADHD may be beneficial for preventing depression in this group.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 1878553, Japan. .,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden.
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsö, Norway
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029, Madrid, Spain
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, 123 West Franklin St, Chapel Hill, NC, 27516, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University Medical School, New Haven, CT, 06520, USA
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22
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Tingstedt O, Lindblad F, Koposov R, Blatný M, Hrdlicka M, Stickley A, Ruchkin V. Somatic symptoms and internalizing problems in urban youth: a cross-cultural comparison of Czech and Russian adolescents. Eur J Public Health 2019; 28:480-484. [PMID: 29373646 DOI: 10.1093/eurpub/cky001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Although the association between somatic complaints and internalizing problems (anxiety, somatic anxiety and depression) is well established, it remains unclear whether the pattern of this relationship differs by gender and in different cultures. The aim of this study was to examine cross-cultural and gender-specific differences in the association between somatic complaints and internalizing problems in youth from the Czech Republic and Russia. Methods The Social and Health Assessment, a self-report survey, was completed by representative community samples of adolescents, age 12-17 years, from the Czech Republic (N = 4770) and Russia (N = 2728). Results A strong association was observed between somatic complaints and internalizing psychopathology. Although the levels of internalizing problems differed by country and gender, they increased together with and largely in a similar way to somatic complaints for boys and girls in both countries. Conclusion The association between somatic symptoms and internalizing problems seems to be similar for boys and girls across cultures.
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Affiliation(s)
- Olga Tingstedt
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Frank Lindblad
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marek Blatný
- Institute of Psychology, Academy of Sciences of the Czech Republic, Brno, Czech Republic
| | - Michal Hrdlicka
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Centre, Yale University Medical School, New Haven, CT, USA.,Säter Forensic Psychiatric Clinic, Säter, Sweden
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23
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Adolfsen F, Strøm HK, Martinussen M, Handegård BH, Natvig H, Eisemann M, Koposov R. Parent participation in alcohol prevention: Evaluation of an alcohol prevention programme. Nordisk Alkohol Nark 2017; 34:456-470. [PMID: 32934505 PMCID: PMC7450848 DOI: 10.1177/1455072517732276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022] Open
Abstract
Aim: The main purpose of this study was to evaluate the effectiveness of the parental part of the Norwegian Unge & Rus (Youth and Alcohol) programme. The intervention was aimed at changing parents’ rules and attitudes towards adolescent alcohol use, and their ability to talk with their adolescents about alcohol, as well as improving parents’ relationships with and knowledge about their adolescents. These topics were addressed during parent meetings at school. Method: The effectiveness of the parent programme was tested using a longitudinal quasi-experimental control group design. Parents completed four online questionnaires N = 1166 at T1 in 2011 and N = 591 at T4 in 2013. Mixed models with observations nested in individuals were used to test the difference in rates of change between the groups. Results: Parents in both groups reported strict rules and attitudes towards alcohol use. There were no significant differences in the changes between the two parent groups in terms of rules and attitudes at the three follow-up time points. The parents in the intervention did not change significantly compared to the parents in the comparison group on other alcohol-related questions. Conclusions: Parents are important facilitators for the transmission of alcohol-related attitudes and rules. However, our study did not show significant differences between changes experienced by the intervention group and those of the comparison group for the main outcome variables, such as rules, attitudes and talking about alcohol with their adolescents.
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24
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Koposov R, Fossum S, Frodl T, Nytrø Ø, Leventhal B, Sourander A, Quaglini S, Molteni M, de la Iglesia Vayá M, Prokosch HU, Barbarini N, Milham MP, Castellanos FX, Skokauskas N. Clinical decision support systems in child and adolescent psychiatry: a systematic review. Eur Child Adolesc Psychiatry 2017; 26:1309-1317. [PMID: 28455596 DOI: 10.1007/s00787-017-0992-0] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/20/2017] [Indexed: 11/30/2022]
Abstract
Psychiatric disorders are amongst the most prevalent and impairing conditions in childhood and adolescence. Unfortunately, it is well known that general practitioners (GPs) and other frontline health providers (i.e., child protection workers, public health nurses, and pediatricians) are not adequately trained to address these ubiquitous problems (Braddick et al. Child and Adolescent mental health in Europe: infrastructures, policy and programmes, European Communities, 2009; Levav et al. Eur Child Adolesc Psychiatry 13:395-401, 2004). Advances in technology may offer a solution to this problem with clinical decision support systems (CDSS) that are designed to help professionals make sound clinical decisions in real time. This paper offers a systematic review of currently available CDSS for child and adolescent mental health disorders prepared according to the PRISMA-Protocols (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols). Applying strict eligibility criteria, the identified studies (n = 5048) were screened. Ten studies, describing eight original clinical decision support systems for child and adolescent psychiatric disorders, fulfilled inclusion criteria. Based on this systematic review, there appears to be a need for a new, readily available CDSS for child neuropsychiatric disorder which promotes evidence-based, best practices, while enabling consideration of national variation in practices by leveraging data-reuse to generate predictions regarding treatment outcome, addressing a broader cluster of clinical disorders, and targeting frontline practice environments.
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Affiliation(s)
- Roman Koposov
- Regional Centre for Children and Youth Mental Health and Welfare, Northern Norway, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019, Tromsø, Norway
| | - Sturla Fossum
- Regional Centre for Children and Youth Mental Health and Welfare, Northern Norway, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019, Tromsø, Norway
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Universitätsstr. 84, 93053, Magdeburg, Germany
| | - Øystein Nytrø
- Department of Computer and Information Science, Norwegian University of Science and Technology, Pb 8905, 7491, Trondheim, Norway
| | - Bennett Leventhal
- San Francisco School of Medicine, University of California, Parnassus Avenue 52, San Francisco, CA, 94143, USA
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Lemminkäisenkatu 3, 20014, Turku, Finland
| | - Silvana Quaglini
- Industrial and Information Engineering Department, Università degli Studi di Pavia, Via Ferrata 3, 27100, Pavia, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Hospital at Bosisio Parini, Via Alzate, 10, 22032, Albese Con Cassano, Italy
| | | | - Hans-Ulrich Prokosch
- Department of Medical Informatics, Friedrich-Alexander University, Schlossplatz 4, 91058, Erlangen, Germany
| | - Nicola Barbarini
- BIOMEdical Research Informatics Solutions, Via Ferrata 1, 27100, Pavia, Italy
| | - Michael Peter Milham
- Center for the Developing Brain, Child Mind Institute, 445 Park Avenue, New York, 10022, USA
| | | | - Norbert Skokauskas
- Regional Centre for Children and Youth Mental Health and Child Welfare - Central Norway, Norwegian University of Science and Technology, Pb 8905, 7491, Trondheim, Norway.
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Abstract
BACKGROUND Inhalant use by children and adolescents has been linked to an increased risk of multiple drug use, mental health problems and antisocial behavior. OBJECTIVES The purpose of this study was to examine the association between the frequency of inhalant use and psychiatric diagnoses among incarcerated delinquent youths in Russia. METHODS A total of 370 incarcerated delinquents from a juvenile correction center in Northern Russia were assessed by means of a semi-structured psychiatric interview and by self-reports. RESULTS Compared to non-users (N = 266), inhalant users (N = 104) reported higher rates of PTSD, early onset conduct disorder, ADHD, alcohol abuse and dependence, as well as higher levels of antisocial behavior, impulsiveness and more psychopathic traits. Frequent inhalant users also reported the highest rates of co-occurring psychopathology. CONCLUSIONS Our findings suggest that inhalant use in delinquents is frequent and may require additional clinical measures to address the issue of psychiatric comorbidity.
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Affiliation(s)
- Linnea Zachrison
- a Child and Adolescent Psychiatry Unit , Uppsala University , Uppsala , Sweden
| | - Vladislav Ruchkin
- a Child and Adolescent Psychiatry Unit , Uppsala University , Uppsala , Sweden.,b Child Study Center , Yale University Medical School , New Haven , Connecticut , USA.,c Säter Forensic Psychiatric Clinic , Säter , Sweden
| | - Andrew Stickley
- d Stockholm Center for Health and Social Change , Södertörn University , Huddinge , Sweden
| | - Roman Koposov
- e Regional Centre for Child and Youth Mental Health and Child Welfare , The Arctic University of Norway (UiT) , Tromsoe , Norway
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26
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Isaksson J, Stickley A, Koposov R, Ruchkin V. The danger of being inattentive - ADHD symptoms and risky sexual behaviour in Russian adolescents. Eur Psychiatry 2017; 47:42-48. [PMID: 29100171 DOI: 10.1016/j.eurpsy.2017.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/08/2017] [Accepted: 09/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Prior research has indicated that attention-deficit/hyperactivity disorder (ADHD) symptoms may be associated with an increased likelihood of engaging in risky sexual behaviour (RSB). However, research on this association among adolescents has been comparatively limited and mainly confined to North America. The aim of this study was to examine if inattention and hyperactivity/impulsivity symptoms were linked to RSB in a community cohort sample of Russian adolescents. METHODS The study was based on a group of 537 adolescents from Northern Russia. Information on inattention and hyperactivity/impulsivity as well as conduct problems was obtained through teacher ratings, while information on RSB (previous unprotected sex, number of sexual partners, sex while intoxicated and partner pregnancies), substance use, perception of risk, and parenting behaviour was based on students' self-reports. Binary logistic regression analysis was used to examine associations between the variables. RESULTS Teacher-rated inattention symptoms predicted RSB, independently of co-morbid conduct problems, substance use, risk perception, and different parenting styles (parental warmth, involvement and control). In addition, male sex, binge drinking and a lower assessment of perceived risk were all significantly associated with RSB in an adjusted model. Neither teacher-rated hyperactivity/impulsivity symptoms nor conduct problems were linked to RSB in the full model. CONCLUSIONS Deficits in planning and organizing behaviours, being easily distracted and forgetful seem to be of importance for RSB in Russian adolescents. This highlights the importance of discriminating between different ADHD symptoms in adolescence to prevent risk behaviours and their potentially detrimental outcomes on health and well-being.
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Affiliation(s)
- J Isaksson
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, 75185 Uppsala, Sweden; Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Centre for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, 11330 Stockholm, Sweden.
| | - A Stickley
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, 187-8553 Tokyo, Japan; The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 14189 Huddinge, Sweden
| | - R Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, The Arctic University of Norway, 9019 Tromsö, Norway
| | - V Ruchkin
- Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, 75185 Uppsala, Sweden; Child Study Centre, Yale University School of Medicine, New Haven, CT, 06520, USA; Säter Psychiatric Clinic, 78327 Säter, Sweden
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27
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Stickley A, Koyanagi A, Koposov R, Blatný M, Hrdlička M, Schwab-Stone M, Ruchkin V. Loneliness and its association with psychological and somatic health problems among Czech, Russian and U.S. adolescents. BMC Psychiatry 2016; 16:128. [PMID: 27146137 PMCID: PMC4857285 DOI: 10.1186/s12888-016-0829-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/25/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Loneliness is common in adolescence and has been linked to various negative outcomes. Until now, however, there has been little cross-country research on this phenomenon. The aim of the present study was to examine which factors are associated with adolescent loneliness in three countries that differ historically and culturally-the Czech Republic, Russia and the United States, and to determine whether adolescent loneliness is associated with poorer psychological and somatic health. METHODS Data from a school survey, the Social and Health Assessment (SAHA), were used to examine these relations among 2205 Czech, 1995 Russian, and 2050 U.S. male and female adolescents aged 13 to 15 years old. Logistic regression analysis was performed to examine if specific demographic, parenting, personal or school-based factors were linked to feeling lonely and whether lonely adolescents were more likely to report psychological (depression and anxiety) or somatic symptoms (e.g. headaches, pain). RESULTS Inconsistent parenting, shyness, and peer victimisation were associated with higher odds for loneliness in at least 4 of the 6 country- and sex-wise subgroups (i.e. Czech, Russian, U.S. boys and girls). Parental warmth was a protective factor against feeling lonely among Czech and U.S. girls. Adolescents who were lonely had higher odds for reporting headaches, anxiety and depressive symptoms across all subgroups. Loneliness was associated with other somatic symptoms in at least half of the adolescent subgroups. CONCLUSION Loneliness is associated with worse adolescent health across countries. The finding that variables from different domains are important for loneliness highlights the necessity of interventions in different settings in order to reduce loneliness and its detrimental effects on adolescent health.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden. .,Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. .,Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain ,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marek Blatný
- Institute of Psychology of the Czech Academy of Sciences, Veveří 97, 602 00 Brno, Czech Republic
| | - Michal Hrdlička
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Mary Schwab-Stone
- Child Study Centre, Yale University Medical School, New Haven, CT 06520 USA
| | - Vladislav Ruchkin
- Child Study Centre, Yale University Medical School, New Haven, CT 06520 USA ,Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, S-751 85 Sweden
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Rakhlin N, Hein S, Doyle N, Hart L, Koposov R, Macomber D, Ruchkin V, Strelina A, Tan M, Grigorenko EL. Sources of heterogeneity in developmental outcomes of children with past and current experiences of institutionalization in Russia: A four-group comparison. Am J Orthopsychiatry 2016; 87:242-255. [PMID: 27078048 DOI: 10.1037/ort0000146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present study sought to compare 4 groups of age- and gender-matched children-(a) those reared in institutions for children without parental care in Russia; (b) those raised by their biological parents in Russia; (c) those adopted to the United States from Russian institutions; and (d) those born in the United States and raised by their biological parents-on indicators of cognition, language, and early learning. In addition, we aimed to compare the effects of the length of time spent in an institution, the age of initial placement in an institution, the age at adoption, and pre-institutional risk factors (i.e., prenatal substance exposure and prematurity and low birth weight) on the above-mentioned outcomes in the 2 groups of children with institutionalization experiences. Our results confirm previous reports demonstrating negative consequences of institutionalization and substantial ameliorating effects of adoption. They also underscore the complexity of the effects of institutionalization and adoption, showing that they are intertwined with the effects of pre-institutional risk factors. (PsycINFO Database Record
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Affiliation(s)
- Natalia Rakhlin
- Department of Communication Sciences and Disorders, Wayne State University
| | | | - Niamh Doyle
- Department of Pediatrics, SUNY Upstate Medical University
| | | | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway
| | | | | | | | - Mei Tan
- Child Study Center, Yale University
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29
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Kornilov SA, Rakhlin N, Koposov R, Lee M, Yrigollen C, Caglayan AO, Magnuson JS, Mane S, Chang JT, Grigorenko EL. Genome-Wide Association and Exome Sequencing Study of Language Disorder in an Isolated Population. Pediatrics 2016; 137:peds.2015-2469. [PMID: 27016271 PMCID: PMC4811310 DOI: 10.1542/peds.2015-2469] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 01/26/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Developmental language disorder (DLD) is a highly prevalent neurodevelopmental disorder associated with negative outcomes in different domains; the etiology of DLD is unknown. To investigate the genetic underpinnings of DLD, we performed genome-wide association and whole exome sequencing studies in a geographically isolated population with a substantially elevated prevalence of the disorder (ie, the AZ sample). METHODS DNA samples were collected from 359 individuals for the genome-wide association study and from 12 severely affected individuals for whole exome sequencing. Multifaceted phenotypes, representing major domains of expressive language functioning, were derived from collected speech samples. RESULTS Gene-based analyses revealed a significant association between SETBP1 and complexity of linguistic output (P = 5.47 × 10(-7)). The analysis of exome variants revealed coding sequence variants in 14 genes, most of which play a role in neural development. Targeted enrichment analysis implicated myocyte enhancer factor-2 (MEF2)-regulated genes in DLD in the AZ population. The main findings were successfully replicated in an independent cohort of children at risk for related disorders (n = 372). CONCLUSIONS MEF2-regulated pathways were identified as potential candidate pathways in the etiology of DLD. Several genes (including the candidate SETBP1 and other MEF2-related genes) seem to jointly influence certain, but not all, facets of the DLD phenotype. Even when genetic and environmental diversity is reduced, DLD is best conceptualized as etiologically complex. Future research should establish whether the signals detected in the AZ population can be replicated in other samples and languages and provide further characterization of the identified pathway.
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Affiliation(s)
- Sergey A. Kornilov
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut;,Department of Psychology, University of Connecticut, Storrs, Connecticut;,Haskins Laboratories, New Haven, Connecticut;,Department of Psychology, Moscow State University, Moscow, Russia;,Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Natalia Rakhlin
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut;,Department of Communication Sciences and Disorders, Wayne State University, Detroit, Michigan
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maria Lee
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Carolyn Yrigollen
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ahmet Okay Caglayan
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut;,Department of Medical Genetics, Istanbul Bilim University, Istanbul, Turkey; and
| | - James S. Magnuson
- Department of Psychology, University of Connecticut, Storrs, Connecticut;,Haskins Laboratories, New Haven, Connecticut
| | - Shrikant Mane
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Joseph T. Chang
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut
| | - Elena L. Grigorenko
- Child Study Center, School of Medicine, Yale University, New Haven, Connecticut;,Haskins Laboratories, New Haven, Connecticut;,Department of Psychology, Saint Petersburg State University, Saint Petersburg, Russia;,Moscow State University for Psychology and Education, Moscow, Russia
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Strøm HK, Adolfsen F, Handegård BH, Natvig H, Eisemann M, Martinussen M, Koposov R. Preventing alcohol use with a universal school-based intervention: results from an effectiveness study. BMC Public Health 2015; 15:337. [PMID: 25879613 PMCID: PMC4404239 DOI: 10.1186/s12889-015-1704-7] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 03/27/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The effectiveness of the universal school-based alcohol prevention program "Unge & Rus" [Youth & Alcohol] was tested by an independent research group. The program aims to prevent alcohol use and to change adolescents' alcohol-related attitudes. The main outcome measure was frequency of monthly alcohol use, favorable alcohol attitudes, perceived behavioral control (PBC), positive alcohol expectancy and alcohol-related knowledge. METHODS Junior high school students (N = 2,020) with a mean age of 13.5 years participated in this longitudinal pre, post and one-year follow-up study with a quasi-experimental design, involving an intervention group and a comparison group recruited from 41 junior high schools in Norway. Multilevel analysis was used to account for the repeated observations (level 1) nested within students (level 2) who in turn were clustered within school classes (level 3). RESULTS Results showed an increased level of alcohol-related knowledge in the intervention group (p < .005) as compared to the comparison group at one-year follow-up. However, no significant difference in change was found between the intervention group and the comparison group in frequency of monthly alcohol use, alcohol-related attitudes, PBC or alcohol expectancy at one-year follow-up. CONCLUSIONS This study offers adequate data on the effectiveness of a school-based alcohol prevention program widely implemented in Norway. Under its current method of implementation, use of the program cannot be supported over the use of standard alcohol curriculum within schools.
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Affiliation(s)
- Henriette Kyrrestad Strøm
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT, the Arctic University of Norway, Tromsø, Norway.
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT, the Arctic University of Norway, Tromsø, Norway.
| | - Bjørn Helge Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT, the Arctic University of Norway, Tromsø, Norway.
| | - Henrik Natvig
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Martin Eisemann
- Department of Psychology, UiT, the Arctic University of Norway, Tromsø, Norway.
| | - Monica Martinussen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT, the Arctic University of Norway, Tromsø, Norway.
| | - Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT, the Arctic University of Norway, Tromsø, Norway.
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Stickley A, Koyanagi A, Koposov R, McKee M, Murphy A, Ruchkin V. Binge drinking and eating problems in Russian adolescents. Alcohol Clin Exp Res 2015; 39:540-7. [PMID: 25703623 DOI: 10.1111/acer.12644] [Citation(s) in RCA: 14] [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] [Received: 06/22/2014] [Accepted: 11/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Binge drinking may be linked to problematic eating behavior, although as yet, little research has been conducted on this association. The objective of this study was to examine the relationship between binge drinking and eating problems in Russian adolescents. METHODS Data were drawn from the Social and Health Assessment, a cross-sectional school-based survey of 6th to 10th grade students (aged 12 to 17 years old) carried out in Arkhangelsk, Russia. Information was collected on various eating problems (worries about weight, feeling fat, excessive eating, fasting and excessive exercise, and purging behaviors) and binge drinking (5 or more drinks in a row). Logistic regression analysis was used to examine the relationship between binge drinking and eating problems. RESULTS Among the 2,488 adolescents included in the statistical analysis, nearly 50% of girls expressed worries about their weight, while 35.0 and 41.5% of adolescent boys and girls reported excessive eating, respectively. The prevalence of purging behaviors (vomiting/using laxatives) was, however, much lower among both sexes (females—2.6%; males—3.3%). In a regression model adjusted for demographic factors and depressive symptoms, among girls, binge drinking was associated with 5 of the 6 eating problems with odds ratios (ORs) ranging from 1.21 (upset about weight gain) to 1.68 (excessive eating). For boys, binge drinking was linked to feeling overweight (OR: 1.47, confidence interval [CI]: 1.20 to 1.81) and vomiting/used laxatives (OR: 4.13, CI: 1.58 to 10.80). CONCLUSIONS Many adolescents in Russia report problematic eating attitudes and behaviors, and eating problems are associated with binge drinking. More research is now needed in this setting to better understand adolescent eating problems and their association with alcohol misuse, so that contextually suitable interventions can be implemented to reduce these behaviors and mitigate their potentially detrimental effects.
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Affiliation(s)
- Andrew Stickley
- Stockholm Center on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge, Sweden; Department of Human Ecology, University of Tokyo, Tokyo, Japan
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Stickley A, Koyanagi A, Koposov R, Blatný M, Hrdlička M, Schwab-Stone M, Ruchkin V. Correlates of weapon carrying in school among adolescents in three countries. Am J Health Behav 2015; 39:99-108. [PMID: 25290602 DOI: 10.5993/ajhb.39.1.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To determine the factors associated with weapon carrying in school among Czech, Russian, and US adolescents. METHODS Logistic regression was used to analyze data drawn from the Social and Health Assessment (SAHA). RESULTS Violent behavior (perpetration / victimization) was linked to adolescent weapon carrying in all countries. Substance use was associated with weapon carrying among boys in all countries. Greater parental warmth reduced the odds for weapon carrying among Czech and Russian adolescents. Associating with delinquent peers was important for weapon carrying only among US adolescents. CONCLUSIONS Factors associated with weapon carrying in school vary among countries although violent behavior and substance use may be associated with weapon carrying across countries.
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Affiliation(s)
- Andrew Stickley
- Stockholm Center on Health of Societies in Transition (SCOHOST), Södertörn University, Huddinge, Sweden.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Roman Koposov
- Regional Center for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Norway
| | - Marek Blatný
- Institute of Psychology, Academy of Sciences of the Czech Republic, Brno, Czech Republic
| | - Michal Hrdlička
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
| | - Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT, USA
| | - Vladislav Ruchkin
- Department of Child and Adolescent Psychiatry, Division of Neuroscience, Uppsala University, Uppsala, Sweden
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Adolfsen F, Strøm HK, Martinussen M, Natvig H, Eisemann M, Handegård BH, Koposov R. Early drinking onset: a study of prevalence and determinants among 13-year-old adolescents in Norway. Scand J Psychol 2014; 55:505-12. [PMID: 25070139 DOI: 10.1111/sjop.12151] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 01/23/2014] [Accepted: 05/21/2014] [Indexed: 11/28/2022]
Abstract
Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth-graders with a mean age of 13.5 years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30 days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.
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Affiliation(s)
- Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT The Arctic University of Norway, Norway
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Stickley A, Koyanagi A, Koposov R, Schwab-Stone M, Ruchkin V. Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study. BMC Public Health 2014; 14:366. [PMID: 24735570 PMCID: PMC4020347 DOI: 10.1186/1471-2458-14-366] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 03/24/2014] [Indexed: 11/10/2022] Open
Abstract
Background For some adolescents feeling lonely can be a protracted and painful experience. It has been suggested that engaging in health risk behaviours such as substance use and sexual behaviour may be a way of coping with the distress arising from loneliness during adolescence. However, the association between loneliness and health risk behaviour has been little studied to date. To address this research gap, the current study examined this relation among Russian and U.S. adolescents. Methods Data were used from the Social and Health Assessment (SAHA), a school-based survey conducted in 2003. A total of 1995 Russian and 2050 U.S. students aged 13–15 years old were included in the analysis. Logistic regression was used to examine the association between loneliness and substance use, sexual risk behaviour, and violence. Results After adjusting for demographic characteristics and depressive symptoms, loneliness was associated with a significantly increased risk of adolescent substance use in both Russia and the United States. Lonely Russian girls were significantly more likely to have used marijuana (odds ratio [OR]: 2.28; confidence interval [CI]: 1.17–4.45), while lonely Russian boys had higher odds for past 30-day smoking (OR, 1.87; CI, 1.08–3.24). In the U.S. loneliness was associated with the lifetime use of illicit drugs (excepting marijuana) among boys (OR, 3.09; CI, 1.41–6.77) and with lifetime marijuana use (OR, 1.79; CI, 1.26–2.55), past 30-day alcohol consumption (OR, 1.80; CI, 1.18–2.75) and past 30-day binge drinking (OR, 2.40; CI, 1.56–3.70) among girls. The only relation between loneliness and sexual risk behaviour was among Russian girls, where loneliness was associated with significantly higher odds for ever having been pregnant (OR, 1.69; CI: 1.12–2.54). Loneliness was not associated with violent behaviour among boys or girls in either country. Conclusion Loneliness is associated with adolescent health risk behaviour among boys and girls in both Russia and the United States. Further research is now needed in both settings using quantitative and qualitative methods to better understand the association between loneliness and health risk behaviours so that effective interventions can be designed and implemented to mitigate loneliness and its effects on adolescent well-being.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre on Health of Societies in Transition (SCOHOST), Södertörn University, 141 89 Huddinge, Sweden.
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Schwab-Stone M, Koposov R, Vermeiren R, Ruchkin V. Cross-cultural findings on community violence exposure and internalizing psychopathology: comparing adolescents in the United States, Russia, and Belgium. Child Psychiatry Hum Dev 2013; 44:516-24. [PMID: 23129249 DOI: 10.1007/s10578-012-0344-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [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: 11/28/2022]
Abstract
The study aimed to investigate cross-cultural differences in the relation between community violence and psychopathology. A self-report survey was conducted in a representative sample of 3,309 14-17 year old adolescents from urban communities in the US (N = 1,343), Belgium (N = 946) and Russia (N = 1,009). In all three countries, boys reported higher prevalences of violence exposure and more victimization by community violence than girls. Controlling for involvement in antisocial behavior, levels of psychopathology increased along with severity of exposure to community violence (from no exposure to witnessing to victimization). The associations between community violence and internalizing problems were similar across countries and gender. Current findings suggest that the relationships between community violence and adolescent mental health are not culture bound and that they follow similar dynamics in different populations. Clinical implications and directions are discussed.
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Affiliation(s)
- Mary Schwab-Stone
- Child Study Center, Yale University Medical School, New Haven, CT 06520, USA
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Stickley A, Koyanagi A, Koposov R, McKee M, Roberts B, Ruchkin V. Peer victimisation and its association with psychological and somatic health problems among adolescents in northern Russia. Child Adolesc Psychiatry Ment Health 2013; 7:15. [PMID: 23672615 PMCID: PMC3661367 DOI: 10.1186/1753-2000-7-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 05/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A growing body of evidence from countries around the world suggests that school-based peer victimisation is associated with worse health outcomes among adolescents. So far, however, there has been little systematic research on this phenomenon in the countries of the former Soviet Union. The aim of this study was to examine the relation between peer victimisation at school and a range of different psychological and somatic health problems among Russian adolescents. METHODS This study used data from the Social and Health Assessment (SAHA) - a cross-sectional survey undertaken in Arkhangelsk, Russia in 2003. Information was collected from 2892 adolescents aged 12-17 about their experiences of school-based peer victimisation and on a variety of psychological and somatic health conditions. Logistic regression analysis was used to examine the association between victimisation and health. RESULTS Peer victimisation in school was commonplace: 22.1% of the students reported that they had experienced frequent victimisation in the current school year (girls - 17.6%; boys - 28.5%). There was a strong relationship between experiencing victimisation and reporting worse health among both boys and girls with more victimisation associated with an increased risk of experiencing worse health. Girls in the highest victimisation category had odds ratios ranging between 1.90 (problems with eyes) and 5.26 (aches/pains) for experiencing somatic complaints when compared to their non-victimised counterparts, while the corresponding figures for boys were 2.04 (headaches) and 4.36 (aches/pains). Girls and boys who had the highest victimisation scores were also 2.42 (girls) and 3.33 (boys) times more likely to report symptoms of anxiety, over 5 times more likely to suffer from posttraumatic stress and over 6 times more likely to experience depressive symptoms. CONCLUSION Peer victimisation at school has a strong association with poor health outcomes among Russian adolescents. Effective school-based interventions are now urgently needed to counter the negative effects of victimisation on adolescents' health in Russia.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre on Health of Societies in Transition (Scohost), Södertörn University, Huddinge, Sweden.
| | - Ai Koyanagi
- Stockholm Centre on Health of Societies in Transition (Scohost), Södertörn University, Huddinge, Sweden
| | - Roman Koposov
- Centre for Child and Adolescent Mental Health and Child Welfare, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
| | - Martin McKee
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Bayard Roberts
- European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Vladislav Ruchkin
- Department of Child and Adolescent Psychiatry, Institute of Neuroscience, Uppsala University, Uppsala 75185, Sweden
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Stickley A, Koyanagi A, Koposov R, McKee M, Roberts B, Murphy A, Ruchkin V. Binge drinking among adolescents in Russia: prevalence, risk and protective factors. Addict Behav 2013; 38:1988-95. [PMID: 23384452 DOI: 10.1016/j.addbeh.2012.12.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 09/22/2012] [Accepted: 12/07/2012] [Indexed: 11/25/2022]
Abstract
Despite evidence that alcohol misuse has been having an increasingly detrimental effect on adolescent wellbeing in Russia in recent years this phenomenon has been little researched. Using data from 2112 children from the Arkhangelsk Social and Health Assessment (SAHA) 2003, this study examined which factors acted as 'risk' or 'protective' factors for adolescent binge drinking within three domains we termed the 'family environment', the 'alcohol environment' and 'deviant behaviour'. The results showed that in the presence of comparatively moderate levels of binge drinking among both boys and girls, being able to access alcohol easily, being unaware of the risks of binge drinking and having peers who consumed alcohol increased the risk of adolescent binge drinking - as did playing truant, smoking and marijuana use, while parental warmth was protective against binge drinking for girls. Our finding that risk and protective factors occur across domains suggests that any interventions targeted against adolescent binge drinking may need to simultaneously focus on risk behaviours in different domains, while at the same time, broader social policy should act to limit the availability of alcohol to adolescents in Russia more generally.
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Koposova N, Eriksen HM, Widström E, Handegård BH, Pastbin M, Koposov R. Caries prevalence and determinants among 12-year-olds in North-West Russia and Northern Norway. Stomatologija 2013; 15:3-11. [PMID: 23732824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. METHODS The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child's oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. RESULTS The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p<0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child's dental caries (χ(2)=87; p<0.001). Among parent's variables showing the strongest association with child's dental caries were country of origin (OR=2.4) and oral health problems during the past two years (OR=1.8) (χ(2)=60; p<0.001). CONCLUSIONS Dental caries prevalence was higher among the Russian than the Norwegian children. The overall regression models were significant for both the child and parental variables. The results indicate different impact on child's oral health from children and parental determinants.
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Affiliation(s)
- Natalia Koposova
- Institute of Clinical Dentistry, Faculty of Health Sciences, University of Tromsø, 9037, Tromsø, Norway.
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Ruchkin V, Koposov R, Vermeiren R, Schwab-Stone M. The Strength and Difficulties Questionnaire: Russian validation of the teacher version and comparison of teacher and student reports. J Adolesc 2011; 35:87-96. [PMID: 21737131 DOI: 10.1016/j.adolescence.2011.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 05/10/2011] [Accepted: 06/08/2011] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To confirm factor structure of the teacher Strengths and Difficulties Questionnaire (SDQ) and to compare teacher and student reports in Russian youth. METHOD The SDQ and psychopathology measures were completed by teachers in a representative sample of urban adolescents (N = 528). The factor structure was examined on two randomly selected split-halves of the sample, and using a gender split. The functional impairment score was predicted by the SDQ problem scales. RESULTS The fit for all models was acceptable. The fit did not decrease when applying increasing constraints in the random-split model, but became significantly worse for the gender model, suggesting lack of measure invariance. SDQ problem scales explained 37% of functional impairment variance. Significant scale interaction (emotional problems*peer problems and conduct problems*hyperactivity) suggest that combination of these problems produces an additional impact on functioning. CONCLUSIONS The SDQ teacher report may represent a potentially useful screener for children and youth.
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Affiliation(s)
- Vladislav Ruchkin
- Department of Social and Forensic Psychiatry, Division of Neuroscience, Karolinska Institute, Stockholm, Sweden.
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Koposova N, Widström E, Eisemann M, Koposov R, Eriksen HM. Oral health and quality of life in Norwegian and Russian school children: A pilot study. Stomatologija 2010; 12:10-16. [PMID: 20440091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To document the oral health status, to study oral health determinants and oral health-related quality of life among 12-year-olds from the Barents Euro-Arctic Region. MATERIAL AND METHODS The study was conducted in Severodvinsk (North-West Russia) and Tromsø (Northern Norway). Two schools representing each region were selected and all 12-year-old pupils having obtained their parents' written consent were included (Severodvinsk n=48, Tromsø n=36). Background factors were collected by questionnaires. Oral health conditions, i.e. caries (DMFT/S), oral hygiene (OHI-S) and satisfaction with their own dental appearance were recorded under field conditions and possible associations between background factors and the children's oral health status were studied. RESULTS Oral health was better among Norwegian than Russian participants. The most important factors explaining variation in oral health were country of origin and treatment (filling/no filling) received at the last dental visit. Among parental factors, education and oral health status were of importance. Oral health related quality of life (OHRQoL) was found to be related to oral health conditions. CONCLUSIONS Norwegian 12 year old pupils presented with better oral health than their Russian counterparts. Oral health is of importance for self-perceived quality of life.
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Renberg ES, Hjelmeland H, Koposov R. Building models for the relationship between attitudes toward suicide and suicidal behavior: based on data from general population surveys in Sweden, Norway, and Russia. Suicide Life Threat Behav 2008; 38:661-75. [PMID: 19152297 DOI: 10.1521/suli.2008.38.6.661] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [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: 11/20/2022]
Abstract
Our aim was to build a model delineating the relationship between attitudes toward suicide and suicidal behavior and to assess equivalence by applying the model on data from different countries. Representative samples from the general population were approached in Sweden, Norway, and Russia with the Attitudes Toward Suicide (ATTS) questionnaire. Data on experience of suicidal behavior among significant others and self-reported suicidal expressions were also collected. Structural equation modeling resulted in gender and country specific models where experience of suicidal behavior among significant others and self-reported suicidal expressions earlier in life predicted attitudes, and attitudes predicted current suicidal expressions. The models included the attitude factors acceptance of suicide, condemnation, and preventability; age and level of education were also incorporated. The different models reveal possible ways to better understand gender and culture-specific paths between attitudes and suicidal behaviors, and their relevance in a suicide prevention context is considered.
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Väfors Fritz M, Ruchkin V, Koposov R, Af Klinteberg B. Antisocial process screening device: validation on a Russian sample of juvenile delinquents with the emphasis on the role of personality and parental rearing. Int J Law Psychiatry 2008; 31:438-446. [PMID: 18790536 DOI: 10.1016/j.ijlp.2008.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The objectives of the present study were 1) to validate the Antisocial Process Screening Device (APSD) in a sample of Russian juvenile delinquents; 2) to examine subgroups of delinquents with higher versus lower levels of childhood problem behaviors with respect to the APSD subscales, personality traits, and parental rearing; and 3) to attempt to replicate the previous finding that the APSD subscale measuring callous/unemotional traits can differentiate subgroups of delinquents with different precursors for problem behaviors (predominantly biological versus predominantly social). A group of 250 Russian juvenile inmates (mean age=16.4) was examined by means of the APSD completed by the staff at the correctional institution. The inmates completed several self-reports assessing their current and childhood behavior problems, personality traits and experienced parental rearing practices. A factor structure of the APSD was obtained that is similar, albeit not identical, to that from the original studies by Frick and colleagues [Frick, P.J., O'Brien, B.S., Wootton, J.M., McBurnett, K., (1994). Psychopathy and conduct problems in children. Journal of Abnormal Psychology, 103, 700-707]; [Frick, P.J., Barry, C.T., Bodin, S.D., (1999). Applying the concept of psychopathy to children: Implications for the Assessment of antisocial youth. In Gacono, C.B. (Ed), The clinical and forensic assessment of psychopathy: A practitioners guide. Hillsdale, NJ: Erlbaum]; [Frick, P.J., Lilienfeld, S.O., Ellis, M., Loney, B., Silverthorn, P., (1999). The association between anxiety and psychopathy dimensions in children. Journal of Abnormal Child Psychology, 27, 383-392]; callous unemotional traits in the present sample were expressed in manipulative behavior. Results further disclosed higher levels of antisocial and aggressive activities, higher levels of personality attributes such as narcissism and novelty seeking, as well as lower cooperativeness, and negatively perceived parental rearing in a subgroup with higher (versus lower) number of childhood symptoms of conduct disorder and oppositional disorder. The juvenile delinquents with higher levels as compared to lower levels of callous unemotional traits also perceived their parents as using more negative rearing strategies. The findings are discussed in terms of interactional processes between personality of the juvenile delinquents and parental rearing in the development of antisocial behavior.
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Ruchkin V, Lorberg B, Koposov R, Schwab-Stone M, Sukhodolsky DG. ADHD symptoms and associated psychopathology in a community sample of adolescents from the European north of Russia. J Atten Disord 2008; 12:54-63. [PMID: 17712166 DOI: 10.1177/1087054707305169] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the prevalence of ADHD symptoms and their relationship to psychopathology in adolescents from the European North of Russia. METHOD The prevalence of ADHD symptoms is assessed by teacher reports in 536 adolescents. Internalizing and externalizing problems are assessed by teacher ratings and student self-reports. RESULTS Prevalence of individual ADHD symptoms ranges between 3.3% and 35%. Only 8.9% of boys and 3.6% of girls have positive ratings on six items in either inattention or hyperactivity subtype. These adolescents fare significantly worse regarding externalizing but not internalizing problems. Compared to girls with ADHD, boys with ADHD report higher levels of violent and nonviolent delinquency and are described by teachers as having more conduct problems. Possible ADHD status is associated with depressive symptoms in boys but not in girls. CONCLUSION The estimates of ADHD prevalence rates obtained in this study are similar to those of other countries, suggesting the need for identification and treatment of the disorder. Evaluation of associated disruptive behavior disorders and depression, particularly in boys, is warranted.
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Affiliation(s)
- Vladislav Ruchkin
- Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
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The study aimed at confirming factor structure of the Strength and Difficulties Questionnaire (SDQ) in a general population of Russian adolescents. The SDQ and other psychopathology measures were administered to a representative sample of 13-18-year-old adolescents from Arkhangelsk, Russia (N = 2892). The original factor structure was examined on two randomly selected split-halves of the sample, using structural equation modeling techniques. The fit for all models was good, and when applying increasing constraints across the models, there was not a significant decrease in fit for the random split model. However, the factor loadings and, correspondingly, the scale reliabilities were low. The study concluded that although the Russian SDQ scales do conform reasonably well to a five-factor oblique model, the scales are unsatisfactory in other respects; in its present form, the Russian version of the instrument has inadequate psychometric characteristics. Future research is needed for further scale development.
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Ruchkin V, Schwab-Stone M, Jones S, Cicchetti DV, Koposov R, Vermeiren R. Is posttraumatic stress in youth a culture-bound phenomenon? A comparison of symptom trends in selected U.S. and Russian communities. Am J Psychiatry 2005; 162:538-44. [PMID: 15741471 DOI: 10.1176/appi.ajp.162.3.538] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The cross-cultural applicability of the concept of posttraumatic stress was investigated by assessing symptom frequency and levels of comorbid psychopathology in adolescents from the United States and Russia. METHOD A self-report survey was conducted in representative samples of 2,157 adolescents 14 to 17 years old from urban communities of the United States (N=1,212) and Russia (N=945). RESULTS In both countries, the levels of all three major clusters of posttraumatic symptoms (reexperiencing, avoidance, and arousal), as well as of internalizing psychopathology, increased along with the level of posttraumatic stress. Expectations about the future had a tendency to decrease with increasing posttraumatic stress. No differences between countries in significant interaction effects for symptom levels were found. CONCLUSIONS The current findings suggest that posttraumatic symptoms and their associations with other adolescent mental health problems are not culture bound and that the psychological consequences of trauma follow similar dynamics cross-culturally.
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Affiliation(s)
- Vladislav Ruchkin
- Yale Child Study Center, 230 South Frontage Rd., New Haven, CT 06520-7900, USA.
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BACKGROUND This study aimed to assess psychopathology among incarcerated Russian juvenile delinquents in relation to the onset of conduct problems. METHOD 358 male juvenile delinquents were interviewed from January to September 1999, using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Early behavior problems, current antisocial behavior, and psychopathology were also assessed through self-reports. The presence of conduct disorder (CD) and other diagnoses was determined according to DSM-IV criteria. RESULTS 73.2% of the incarcerated youths met criteria for CD. 23.5% of the total sample reported at least 1 criterion for CD being present before the age of 10 years. All participants from this early-onset group fulfilled the criteria for CD. This group also had significantly higher rates of psychopathology, and particularly of externalizing behaviors, as compared with youths whose conduct problems began at or after the age of 10 years. CONCLUSION Poor psychosocial adaptation and future prognosis in juvenile delinquents with early-onset conduct problems may be related to their greater degree of psychiatric disturbance compared with later-onset delinquent youths. Need for psychiatric treatment should be carefully considered in prevention and rehabilitation efforts for troubled youths.
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Affiliation(s)
- Vladislav Ruchkin
- Yale Child Study Center, Yale University School of Medicine, New Haven, Conn., USA.
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OBJECTIVE To assess posttraumatic stress and its relationship to comorbid psychopathology, violence exposure, and personality traits in Russian male juvenile delinquents. METHOD Posttraumatic stress and comorbid psychopathology were assessed by a semistructured psychiatric interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version) in 370 delinquent youths during winter-spring of 1999. In addition, violence exposure, personality, and psychopathology were assessed by self-reports. RESULTS Most delinquents reported some degree of posttraumatic stress: 156 subjects (42%) fulfilled partial criteria and 87 (25%) fulfilled full DSM-IV criteria for posttraumatic stress disorder (PTSD). Violence-related experiences (witnessing and victimization) were the most common types of trauma. Higher levels of posttraumatic stress were accompanied by higher rates of comorbid psychopathology, with the most striking differences occurring between the groups with full versus partial PTSD criteria. Violence exposure was related to temperamental behavior activation (novelty seeking), whereas PTSD symptom scores were predominantly related to behavior inhibition and poor coping (high harm avoidance and low self-directedness). CONCLUSIONS Similar to findings from American samples, Russian juvenile delinquents represent a severely traumatized population, mainly due to high levels of violence exposure. Those with full PTSD are the most severely traumatized and have highest rates of psychopathology, as compared to those with no or partial PTSD, and they require the most clinical attention and rehabilitation. Both exposure to violence and levels of posttraumatic stress are related to personality traits, which influence degree of exposure and individual perception of stress. The latter should be considered in individualized approaches to rehabilitation.
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Affiliation(s)
- Vladislav V Ruchkin
- Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
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