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Butler W, Lewis KL, Benheim TS, Arauz Boudreau A, Brigham KS, Feldman M, Jellinek M, Murphy JM. Screening and Follow-Up Treatment Practices for Suicide Risk in Adolescent Primary Care: A Retrospective Chart Review. Clin Pediatr (Phila) 2024:99228241253158. [PMID: 38742439 DOI: 10.1177/00099228241253158] [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: 05/16/2024]
Abstract
Universal depression screening in adolescent primary care often encompasses questions about suicide risk. We conducted a retrospective chart review of well-child visits where adolescents (ages 13-17.9) had endorsed self-injurious thoughts and behaviors or suicidal ideation. The goal was to investigate primary care providers' follow-up actions, including documentation, further assessment, and referrals. Over 3-quarters of the progress notes showed evidence of further assessment, and two-thirds documented same-day actions, including mental health referrals, emergency department referrals, safety plans, medication changes, primary-care follow-up, and talking to parents. Actions varied by depression severity. Cases without interventions often had justifications. Owing to the variety of possible meanings and severity underlying positive screens, providers implemented an array of interventions, using clinical judgment to tailor actions to patients' individual needs and preferences. From these observations, we propose that standardized guidelines for suicide risk screening and follow-up should involve a clinical assessment and individualized treatment planning.
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Affiliation(s)
- William Butler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kristina L Lewis
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Talia S Benheim
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alexy Arauz Boudreau
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kathryn S Brigham
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mitchell Feldman
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael Jellinek
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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2
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Hosozawa M, Ando S, Yamaguchi S, Yamasaki S, DeVylder J, Miyashita M, Endo K, Stanyon D, Knowles G, Nakanishi M, Usami S, Iso H, Furukawa TA, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Sex Differences in Adolescent Depression Trajectory Before and Into the Second Year of COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2024; 63:539-548. [PMID: 37805069 DOI: 10.1016/j.jaac.2023.08.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/21/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE Evidence on the impact of the COVID-19 pandemic on adolescent mental health is mixed and does not disentangle natural age-related changes. We compared depressive symptoms among 16-year-olds surveyed, at a fourth wave, before or during the pandemic, while accounting for expected trajectories of within-person change based on 3 prior waves. METHOD In this longitudinal cohort of 3,171 adolescents in Tokyo, Japan, adolescents were grouped based on their age 16 survey timing: pre-pandemic (February 2019 to February 2020) and during-pandemic (March 2020 to September 2021). Depressive symptoms were self-reported using the Short Mood and Feelings Questionnaire. Mixed-effect models were fitted to assess group differences while controlling for previous trends. Variations by sex, household income, and pandemic phase (early, late first-year, and second-year) were examined. RESULTS Of 2,034 eligible adolescents, 960 (455 girls) were assessed before and 1,074 (515 girls) during the pandemic. Overall, depressive symptoms increased by 0.80 points (95% CI 0.28-1.31, 0.15 SD of the population average). This increase varied by sex and pandemic phase. For boys the increase emerged in the late first-year phase and enlarged in the second-year phase (mean difference from pre-pandemic: 1.69, 0.14-3.24), whereas for girls it decreased in the early school-closure phase (mean difference: -1.98, -3.54 to -0.41) and returned to the pre-pandemic level thereafter, with no additional increases during the pandemic. CONCLUSION Into the second year of the COVID-19 pandemic, depressive symptoms of 16-year-olds worsened above the expected age-related change only in boys. Continuous monitoring and preventive approaches for adolescents at the population level are warranted. DIVERSITY & INCLUSION STATEMENT We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
- Mariko Hosozawa
- National Center for Global Health and Medicine, Tokyo, Japan.
| | | | | | - Syudo Yamasaki
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jordan DeVylder
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Fordham University, New York
| | | | - Kaori Endo
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daniel Stanyon
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Gemma Knowles
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; King's College London, London, United Kingdom
| | - Miharu Nakanishi
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Tohoku University Graduate School of Medicine, Miyagi, Japan; Leiden University Medical Center, Leiden, the Netherlands
| | | | - Hiroyasu Iso
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Kiyoto Kasai
- The University of Tokyo, Tokyo, Japan; The University of Tokyo Institutes for Advanced Study, Tokyo, Japan
| | - Atsushi Nishida
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Smith KE, Acevedo-Duran R, Lovell JL, Castillo AV, Cardenas Pacheco V. Youth Are the Experts! Youth Participatory Action Research to Address the Adolescent Mental Health Crisis. Healthcare (Basel) 2024; 12:592. [PMID: 38470702 PMCID: PMC10930985 DOI: 10.3390/healthcare12050592] [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: 11/30/2023] [Revised: 02/19/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health.
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Affiliation(s)
- Kimberly E. Smith
- Department of Health, Human Services, and Public Policy, California State University Monterey Bay, Seaside, CA 93955, USA;
| | - Rosa Acevedo-Duran
- Department of Psychology, California State University Monterey Bay, Seaside, CA 93966, USA;
| | - Jennifer L. Lovell
- Department of Psychology, California State University Monterey Bay, Seaside, CA 93966, USA;
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Zhang L, Liu Y, Jonson-Reid M. Early Childhood Income Instability and Mental Health in Adolescence: Parenting Stress and Child Maltreatment as Mediators. Child Maltreat 2024:10775595241236389. [PMID: 38437737 DOI: 10.1177/10775595241236389] [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] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Ample research has examined how point-in-time or static measures of economic deprivation are associated with children's mental health outcomes. Less is known about the relationship between early childhood unstable income and mental health outcomes. Using the Future of Families and Child Wellbeing Study, this study examined (1) the latent patterns of early childhood economic well-being, predicted by income level and instability (i.e., direction and frequency of income change); (2) the association of income deprivation patterns with subsequent anxiety and depression symptoms, paying particular attention to the mediating roles of parenting stress and child maltreatment risk. The latent class analysis results suggested four distinct groups representing different combinations of income level and instability. Structural equation modeling results indicated indirect links between income deprivation patterns and mental health outcomes, through parenting stress and physical and psychological abuse. Findings indicated the importance of policies and programs promoting economic stability over the long run.
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Affiliation(s)
- Liwei Zhang
- School of Social Work, University of Georgia, Athens, GA, USA
| | - Yuerong Liu
- Sanford School of Public Policy, Center for Child and Family Policy, Duke University, Durham, NC, USA
| | - Melissa Jonson-Reid
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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5
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Riddleston L, Shukla M, Lavi I, Saglio E, Fuhrmann D, Pandey R, Singh T, Qualter P, Lau JYF. Identifying characteristics of adolescents with persistent loneliness during COVID-19: A multi-country eight-wave longitudinal study. JCPP Adv 2024; 4:e12206. [PMID: 38486960 PMCID: PMC10933679 DOI: 10.1002/jcv2.12206] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/26/2023] [Indexed: 03/17/2024] Open
Abstract
Background Elevated loneliness experiences characterise young people. While loneliness at this developmental juncture may emerge from age-typical upheaval in social relationships, there is little data on the extent to which young people experience high and persistent levels of loneliness, and importantly, who is most vulnerable to these experiences. Using the widespread social restrictions associated with the COVID-19 pandemic, which precipitated loneliness in many, we aimed to examine adolescents' loneliness profiles across time and the demographic predictors (age, sex, and country) of more severe trajectories. Methods Participants aged 12-18 years, recruited into a multi-wave study (N = 1039) across three sites (UK, Israel, and India) completed a 3-item loneliness measure fortnightly across 8 timepoints during the pandemic. Results Latent class growth analysis suggested 5 distinct trajectories: (1) low stable (33%), (2) low increasing (19%), (3) moderate decreasing (17%), (4) moderate stable (23%), and (5) high increasing (8%). Females and older adolescents were more likely to experience persistently high loneliness. Conclusions These findings indicate a need for interventions to reduce loneliness in adolescents as we emerge from the pandemic, particularly for those groups identified as being at highest risk.
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Affiliation(s)
- Laura Riddleston
- Department of PsychologyKing’s College LondonInstitute of Psychiatry, Psychology & Neuroscience (IoPPN)LondonUK
| | | | - Iris Lavi
- Department of PsychologyUniversity of BathBathUK
- School of Social WorkUniversity of HaifaHaifaIsrael
| | - Eloise Saglio
- Department of PsychologyKing’s College LondonInstitute of Psychiatry, Psychology & Neuroscience (IoPPN)LondonUK
| | - Delia Fuhrmann
- Department of PsychologyKing’s College LondonInstitute of Psychiatry, Psychology & Neuroscience (IoPPN)LondonUK
| | - Rakesh Pandey
- Department of PsychologyBanaras Hindu UniversityVaranasiIndia
| | - Tushar Singh
- Department of PsychologyBanaras Hindu UniversityVaranasiIndia
| | - Pamela Qualter
- Manchester Institute of EducationThe University of ManchesterSchool of Environment, Education and DevelopmentManchesterUK
| | - Jennifer Y. F. Lau
- Youth Resilience UnitCentre for Psychiatry and Mental HealthWolfson Institute of Population Health, Queen Mary University of LondonLondonUK
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Gimbrone C, Packard SE, Finsaas MC, Sprague NL, Jacobowitz A, Leventhal AM, Rundle AG, Keyes KM. Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017. JAACAP Open 2024; 2:55-65. [PMID: 38469457 PMCID: PMC10927262 DOI: 10.1016/j.jaacop.2023.10.001] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Objective After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.
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Affiliation(s)
- Catherine Gimbrone
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Samuel E Packard
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Megan C Finsaas
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Nadav L Sprague
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Ahuva Jacobowitz
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Adam M Leventhal
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Andrew G Rundle
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
| | - Katherine M Keyes
- Ms. Gimbrone, Mr. Packard, Mr. Sprague, Ms. Jacobowitz, Dr. Rundle, and Dr. Keyes are with Columbia the Mailman School of Public Health, Columbia University. Dr. Leventhal is with the Institute for Addiction Science, University of Southern California. Dr. Finsaas is with the City College of New York
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7
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Fitch MI. Editorial: Reproductive health and mental health in LMICs: adolescent health. Front Reprod Health 2024; 6:1383170. [PMID: 38496789 PMCID: PMC10940534 DOI: 10.3389/frph.2024.1383170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
- Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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8
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Hickling LM, Dabrowski J, Williams S. Expanding the early intervention offer: A new care pathway for children's wellbeing practitioners in a south London child and adolescent mental health service. Clin Child Psychol Psychiatry 2024; 29:155-167. [PMID: 37688480 PMCID: PMC10748444 DOI: 10.1177/13591045231201195] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
Child and Adolescent Mental Health Services (CAMHS) have been under recent increased demand, with increasingly limited resources, contributing to longer waiting lists, and a growing proportion of rejected referrals due to limited capacity and increasing thresholds. Child and Wellbeing Practitioners (CWPs) provide an opportunity to meet the needs of rejected referrals. We aimed to determine the feasibility of a new and direct referral route within a South London CAMHS. All referrals rejected to the local CAMHS in one year were assessed for inclusion to an embedded child and youth wellbeing in schools team (CYWS), and data collected on reasons for rejection, demographics and eligibility for the CYWS team. Of the 1,322 referrals made to CAMHS in this period, 317 were rejected. The most common reason for referral rejection was not meeting the severity threshold. One third of rejected referrals were judged to be eligible for inclusion to the CYWS team. Therefore, a significant number of children and young people (CYP) being rejected by CAMHS would be eligible for assessment and possible treatment under the CYWS team, making a new referral route potentially feasible, allowing more CYP to access mental health support and have a positive impact on waiting times.
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Affiliation(s)
- Lauren M Hickling
- Department of Psychology, King’s College London, Institute of Psychiatry Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Julia Dabrowski
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Sadie Williams
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
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Zulkefly NS, Dzeidee Schaff AR, Zaini NA, Mukhtar F, Dahlan R. A pilot randomized control trial on the feasibility, acceptability, and initial effects of a digital-assisted parenting intervention for promoting mental health in Malaysian adolescents. Digit Health 2024; 10:20552076241249572. [PMID: 38665881 PMCID: PMC11044793 DOI: 10.1177/20552076241249572] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Objective Online parenting interventions for enhancing child development, specifically mental health is relatively new in Malaysia. This pilot study tests the feasibility, acceptability, and initial effects of a universal digital-assisted parenting intervention (DaPI) in promoting mental health in adolescents by improving parental behaviors and self-efficacy. Methods A two-arm pilot randomized controlled trial was conducted. Twenty-four mothers of adolescent aged 10 to 14 years from a non-clinical sample were recruited online and randomly allocated into two groups (intervention [DaPI] and waitlist-control [WLC]). Eight weekly sessions were delivered online via technological devices. Feasibility outcomes were based on the participants' engagement in DaPI and study retention. Primary (parental behaviors and self-efficacy) and secondary (adolescent mental health) outcomes were assessed using an online survey at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). Data were analyzed using descriptive and inferential statistics and an intention-to-treat approach. Results The DaPI was well received by the mothers. Retention was high (81.8%) in both groups and intervention adherence was excellent (91.6%). Within-group analyses showed a significant decrease in physical control at T2 and an increase in parental self-efficacy at T1 and T2 among the DaPI mothers. No significant differences were observed in adolescents' mental health at any time point. As for the WLC group, there were no significant differences in all the outcome variables across the three assessment moments. Between groups analyses revealed DaPI mothers had significant differences in proactive parenting at T1, and in positive reinforcement and lax control at T2. There were no significant differences in adolescents' mental health between the groups at any time point. Discussion The DaPI is feasible and acceptable in the Malaysian context. Findings show promise regarding the initial effects of the DaPI. However, a larger RCT is needed to determine its effectiveness in promoting mental health of adolescents. Trial registration https://www.irct.ir/; identifier: IRCT20211129053207N1.
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Affiliation(s)
- Nor Sheereen Zulkefly
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Anis Raihan Dzeidee Schaff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nur Arfah Zaini
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rahima Dahlan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Mathur S, Weiss HA, Neuman M, Leurent B, Field AP, Shetty T, J. JE, Nair P, Mathews R, Malik K, Michelson D, Patel V. Developing knowledge-based psychotherapeutic competencies in non-specialist providers: A pre-post study with a nested randomised controlled trial of a coach-supported versus self-guided digital training course for a problem-solving psychological intervention in India. Glob Ment Health (Camb) 2023; 10:e87. [PMID: 38161749 PMCID: PMC10755375 DOI: 10.1017/gmh.2023.81] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants were 18 or older; fluent in Hindi or English; able to access digital training; and had no prior experience of delivering structured psychotherapies. 277 participants were enrolled from 31 March 2022 to 19 June 2022 of which 230 (83%) completed the study. There was a significant increase in competency score from pre-training (Mean = 7.01, SD = 3.29) to post-training (Mean = 8.88, SD = 3.80), 6 weeks after the pre-training assessment. Knowledge competency scores showed larger increase among participants randomised to the coaching arm (AMD = 1.09, 95% CI 0.26-1.92, p = 0.01) with an effect size (d) of 0.33 (95% CI 0.08-0.58). More participants completed training in the coaching arm (n = 96, 69.6%) compared to the self-guided training arm (n = 56, 40.3%). In conclusion, a coach-supported remote digital training intervention is associated with enhanced participation by learners and increased psychotherapeutic knowledge competencies.
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Affiliation(s)
| | - Helen A. Weiss
- Medical Research Council International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Melissa Neuman
- Medical Research Council International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Baptiste Leurent
- Department of Statistical Science, University College London, London, UK
| | - Andy P. Field
- School of Psychology, University of Sussex, Brighton, UK
| | | | | | | | | | - Kanika Malik
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, India
| | - Daniel Michelson
- School of Psychology, University of Sussex, Brighton, UK
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Vanderwood K, Joyner J, Little V. The effectiveness of collaborative care delivered via telehealth in a pediatric primary care population. Front Psychiatry 2023; 14:1240902. [PMID: 38025414 PMCID: PMC10679399 DOI: 10.3389/fpsyt.2023.1240902] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The prevalence of mental health conditions among children and adolescents in the United States has become a pressing concern, exacerbated by the COVID-19 pandemic. Collaborative care is an evidence-based model for identifying and treating depression and anxiety in healthcare settings, with additional promise for remote healthcare delivery. This study aims to evaluate the impact of a telehealth collaborative care model for adolescents with depression and anxiety in pediatric and primary care settings. Methods Secondary analysis was conducted using de-identified national data from Concert Health, a behavioral health medical group offering remote collaborative care across 17 states. Baseline, 90-day, and 120-day assessments of the PHQ-9 and GAD-7 were collected, along with baseline covariates. Stepwise regression analysis was performed to determine the contribution of select covariates to improvement rates. Results Among the analyzed data, 263 participants had complete PHQ-9 data, and 230 had complete GAD-7 data. In both the PHQ-9 and GAD-7 groups, over 50% of patients experienced treatment success based on success at discharge, as well as 90- and 120-day improvement rates. Predictors of success at discharge for the GAD-7 group included age at enrollment (OR 1.2258, 95% CI 1.01-1.496), clinical touchpoints (OR 1.1469, 95% CI 1.086-1.218), and lower baseline GAD-7 score (OR 0.9319, 95% CI 0.874-0.992). For the PHQ-9 group, Medicaid was significantly associated with not achieving a 50% reduction in PHQ-9 score at 120 days (OR 0.5874, 95% CI 0.349-0.979). Discussion Collaborative care has demonstrated its effectiveness in treating adolescent populations, providing an opportunity to expand access to evidence-based behavioral health treatment for young individuals. Notably, collaborative care is already integrated into the Medicaid fee schedule for 22 states and accepted by all commercial payers. Given that individuals often turn to their trusted primary care providers for behavioral health care, offering collaborative care to adolescents can play a crucial role in addressing the ongoing mental health crisis.
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Affiliation(s)
| | - Jian Joyner
- Concert Health, San Diego, CA, United States
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12
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Stuenkel M, Koob C, Richardson E, Griffin SF, Sease KK. School-Based Mental Health Service Utilization Through the COVID-19 Pandemic and Beyond. J Sch Health 2023; 93:1000-1005. [PMID: 37525409 DOI: 10.1111/josh.13384] [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] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND We examined trends in mental health service utilization before, during, and in the immediate return to in-person learning throughout the COVID-19 pandemic. METHODS Retrospective chart review was assessed for changes in odds of any visit being a mental health encounter from five school-based health centers from the 2018-2019 to the 2021-2022 school years. Data are limited to the in-person school year from mid-August to early June. RESULTS Data were assessed from 1239 students seen through 2256 visits over the 4 school years (Mage = 12.93). The odds of any visit being related to a mental health encounter increased each school year, with the 2020 to 2021 and 2021 to 2022 school years having significant increases in odds (both compared to the first and to the antecedent school year). In addition, during the 2019 to 2020 and 2020 to 2021 school years, the odds of a repeated mental health encounter significantly increased from year to year. CONCLUSIONS Findings indicate a steadily increasing number of mental health service utilization needs among adolescent students that was significantly exponentiated throughout the COVID-19 pandemic.
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Affiliation(s)
- Mackenzie Stuenkel
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Caitlin Koob
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Emily Richardson
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Kerry K Sease
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
- Pediatrics, University of South Carolina School of Medicine, Greenville, SC
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13
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Mudiam KR, Sheeber LB, Leve C, Pfeifer JH, Allen NB. Maternal depression, parental attributions, and adolescent psychopathology: An evaluation using observational and video-mediated recall methods. J Res Adolesc 2023; 33:1023-1037. [PMID: 37165702 DOI: 10.1111/jora.12855] [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] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 03/07/2023] [Accepted: 04/10/2023] [Indexed: 05/12/2023]
Abstract
Parenting styles associated with maternal depression are a risk factor for adolescent psychopathology, and maternal attributional styles may be a key mechanism in this relationship. Mother-adolescent dyads (N = 180; 96 male; ages 10-15) completed in-person interactions and then the mothers participated in a video-mediated recall procedure to assess maternal attributions. Maternal depression was associated with negative attributions. Negative attributions were associated with low parental acceptance, aggressive parenting, and low positive parenting. Positive maternal attributions were associated with less aggressive parenting, and more positive parenting during one interaction task. Adolescent externalizing behaviors were associated with negative attributions. Future research should evaluate whether maternal attributions mediate the association between maternal depression and both parenting behaviors and adolescent mental health.
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Affiliation(s)
- Kavya R Mudiam
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | | | - Craig Leve
- Oregon Research Institute, Eugene, Oregon, USA
| | | | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
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14
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DuPont-Reyes MJ, Villatoro AP, Datzman J, Phelan JC, Painter K, Barkin K, Link BG. Inequities Gone or Enduring? Evaluating the Effects of a School-Based Antistigma Intervention on Race/Ethnic and Gender Intersectional Disparities in Mental Illness Stigma. Stigma Health 2023; 8:381-392. [PMID: 37636031 PMCID: PMC10454522 DOI: 10.1037/sah0000406] [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] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
While significant mental illness stigma disparities across race/ethnicity and gender exist, little is known about the efficacy of anti-stigma interventions in reducing these intersectional disparities. We examine the two-year effects of school-based anti-stigma interventions on race/ethnic and gender intersectional stigma disparities among adolescents. An ethnically and socioeconomically diverse sixth grade sample (N = 302) self-completed surveys assessing stigma before randomly receiving an anti-stigma curriculum and/or contact intervention versus no intervention. Surveys were also self-completed two-years post-intervention. Stigma measures assessed general mental illness knowledge/attitudes, awareness/action, and social distance. Stigma towards peers with specific mental illnesses were examined using vignettes-two adolescent characters were described as having bipolar (Julia) and social anxiety (David) disorder. Race/ethnicity and gender were cross-classified into six intersectional groups (Latina/o, Non-Latina/o Black, and Non-Latina/o White girls and boys). Linear regressions adjusting for poverty and mental illness familiarity examined anti-stigma intervention effects across intersectional groups in sixth and eighth grade. The school-based anti-stigma intervention reduced intersectional stigma disparities over the two-year study period. While Non-Latino Black boys and Latino boys/girls reported greater disparities in stigma at baseline compared to Non-Latina White girls, these disparities (14 total) were predominantly eliminated in the two-year follow-up following receipt of the curriculum and contact components to just one remaining disparity post-intervention among Non-Latino Black boys. By identifying differences in how school-based anti-stigma interventions reduce mental illness stigma for unique race/ethnic and gender intersectional groups, we can better understand how to shape future anti-stigma interventions for diverse intersectional populations.
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Affiliation(s)
- Melissa J. DuPont-Reyes
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
- Department of Epidemiology, Columbia University Mailman School of Public Health
| | | | - Jared Datzman
- Department of Epidemiology and Biostatistics, Texas A&M University
| | - Jo C. Phelan
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
| | - Kris Painter
- School of Social Work, The University of Texas in Arlington
| | | | - Bruce G. Link
- School of Public Policy, University of California, Riverside
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15
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Makwana H, Vaghia KK, Solanki V, Desai V, Maheshwari R. Impact of Parenting Styles and Socioeconomic Status on the Mental Health of Children. Cureus 2023; 15:e43988. [PMID: 37746514 PMCID: PMC10516328 DOI: 10.7759/cureus.43988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background The relationship parents share with their children is unique and very important for their overall growth and development. Parenting is classified into the following four types: authoritarian, authoritative, permissive, and uninvolved. This study aimed to understand the relationship between socioeconomic status and parenting styles adopted by parents and compare various factors affecting the mental health status of children. Methodology An observational cross-sectional study was conducted among 480 students from four different schools in Valsad, Gujarat, India. The chief parenting style of both parents was determined, and the Pediatric Symptom Checklist (PSC) scores were calculated for the students. Data were analyzed and various tests of significance were performed. Results There was a highly significant association between various parenting styles adopted by both parents and the PSC score of children. Interparental consistency showed a lower score on the PSC scale. There was a moderate positive correlation between an authoritarian parent and the poor mental health status of the child. As age advanced, children were seen to experience more emotional and psychological troubles. The education of the mother had a significant association with the well-being of the child. However, there was no impact of socioeconomic status on parenting style and PSC score. Conclusions Poor parenting technique contributes to various psychological problems in children with advancing age. The involvement of healthcare facilities in this field at the earliest will ensure a better environment for the child to grow and learn.
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Affiliation(s)
- Hemal Makwana
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
| | - Kiran Kumar Vaghia
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
| | - Viren Solanki
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
- Psychiatry, Government Medical College, Baroda, Valsad, IND
| | - Vedant Desai
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
| | - Rithik Maheshwari
- Psychiatry, Gujarat Medical Education and Research Society (GMERS) Medical College and Hospital, Valsad, IND
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16
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Dolp R, Wardle DP, Khalid-Khan S. The role of psychiatry in diagnosis and treatment of paediatric chronic fatigue syndrome - a scoping literature review. Int J Adolesc Med Health 2023; 0:ijamh-2023-0030. [PMID: 37336592 DOI: 10.1515/ijamh-2023-0030] [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: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Paediatric Chronic Fatigue Syndrome (pCFS) is a common condition that significantly disrupts a healthy psychosocial development. Psychiatric symptoms associated with pCFS are conceptualized as either part of its complex etiology, its consequence, or as a comorbidity. However, patients with this condition are rarely seen by psychiatrists. This scoping review aims to explore the role of psychiatry in the diagnosis and treatment of pCFS. CONTENT A scoping review of literature was conducted using MEDLINE, EMBASE, Cochrane and PsycINFO. Databases were searched for articles describing psychiatric involvement in the diagnosis or treatment of children and adolescents (age ≤ 18) with pCFS. A grey literature search was also conducted to identify additional guidelines and national recommendations to identify the role of psychiatry in the diagnosis and treatment of pCFS. SUMMARY The search provided 436 articles of which 16 met inclusion criteria. Grey literature search identified 12 relevant guidelines. Most studies and guidelines did not include any psychiatric involvement in the care of patients with pCFS. If psychiatry was mentioned, it was used interchangeably with psychological interventions or in the context of treating distinct psychiatric comorbidities and suicidal ideation. OUTLOOK The role of psychiatry in diagnosis and treatment of pCFS is poorly defined. Future research is required to understand how psychiatrists can contribute to the care of patients with pCFS.
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Affiliation(s)
- Reinhard Dolp
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
- North Bay Regional Health Centre, North Bay, ON, Canada
- Northern Ontario School of Medicine, Sudbury, ON, Canada
| | - David Pr Wardle
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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17
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Rajapakshe OBW, Mohan M, Singh SP. Development of adolescent mental health services in Sri Lanka. BJPsych Int 2023; 20:41-43. [PMID: 38414998 PMCID: PMC10895478 DOI: 10.1192/bji.2022.32] [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: 06/15/2022] [Revised: 09/19/2022] [Accepted: 11/07/2022] [Indexed: 01/12/2023] Open
Abstract
Sri Lanka has faced two major catastrophes in recent history: the civil war (1983-2009) and the tsunami (2004). Furthermore, there is a continuously changing socioeconomic situation which is becoming ever more challenging. Nearly a quarter of the Sri Lankan population is a youth or adolescent, and this age group is particularly vulnerable to adversity. Over the past decade Sri Lanka has acknowledged the need to support these young people and embarked on developing adolescent mental health services, but they require further expansion. This article provides a critical review of the state of current adolescent mental health services in our country and makes suggestions for improvement.
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Affiliation(s)
- Onali Bimalka Wickramaseckara Rajapakshe
- MBBS, MSc, MD, Consultant Community Physician, National Programme for Tuberculosis Control and Chest Diseases, Ministry of Health, Public Health Complex, Narahenpita, Western Province, Sri Lanka. Email
| | - Mohapradeep Mohan
- PhD, Research Fellow, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Swaran Preet Singh
- MBBS, MD, DM, FRCPsych, Director, Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK
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18
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Huang S, Lai X, Li Y, Cui Y, Wang Y. Beyond Screen Time: The Different Longitudinal Relations between Adolescents' Smartphone Use Content and Their Mental Health. Children (Basel) 2023; 10:children10050770. [PMID: 37238318 DOI: 10.3390/children10050770] [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] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/07/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023]
Abstract
Purpose: Previous studies focusing on the relationship between adolescents' screen time and mental health have uncovered contradictory results. By focusing on smartphone use content (SUC), this study uses specification curve analysis to explore the different effects of SUCs on mental health-based on longitudinal data. Methods: A total of 2552 adolescents were surveyed in the first (July 2020) and second year (April 2021). A total of 2049 eligible participants (average age = 14.39 ± 2.27, female = 1062) are included in the analysis. Participants reported 20 types of content used by them during smartphone use and their mental health (depression, anxiety, and somatization). Specification curve analysis was used to examine the longitudinal relationship between SUCs and their mental health. Results: Smartphone use for listening to music (median β = 0.18, p < 0.001, NSRPD = 25/27, p < 0.05), chatting online (median β = 0.15, p < 0.001, NSRPD = 24/27, p < 0.05), watching TV (median β = 0.14, p < 0.001, NSRPD = 24/27, p < 0.05), and playing games (median β = 0.09, p < 0.001, NSRPD = 19/27, p < 0.05) produce high to medium negative effects on subsequent mental health. Only using smartphones for online courses exerts no effect on their subsequent mental health (median β = 0.01, p > 0.05, NSRPD = 0/27, p > 0.05). The left 15 types of smartphone content showed unstable effects on future mental health. Depending on the types of content used, these effects ranged from high, medium, and small to none. The relatively descending order of effect on mental health is listening to music, chatting online, watching TV, playing games, and types of content (e.g., browsing social media, making payments, reading online novels) with high but unstable effects, types of content with medium (e.g., browsing news and posting/sharing) but unstable effects, types of content (e.g., using the camera, obtaining life information, and making calls) with small but unstable effects, such as finishing homework and taking online courses. Conclusions: This study enlightens researchers and policymakers to update their understanding of adolescents' technology use, especially to adopt a differentiated attitude towards different media use content. As nutritionists often do, a "nutritionally balanced" digital diet for young people should be recommended to the public, rather than just suggesting limits on the amount of time they can spend using digital media.
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Affiliation(s)
- Shunsen Huang
- State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Xiaoxiong Lai
- State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yajun Li
- Guangming Institute of Education Sciences, Shenzhen 518107, China
| | - Yang Cui
- State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
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19
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Leung JTY, Shek DTL, To SM, Ngai SW. Maternal Distress and Adolescent Mental Health in Poor Chinese Single-Mother Families: Filial Responsibilities-Risks or Buffers? Int J Environ Res Public Health 2023; 20:5363. [PMID: 37047977 PMCID: PMC10093977 DOI: 10.3390/ijerph20075363] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Single motherhood and poverty have a significant, negative impact on mothers and their children. When their mothers experience maternal distress, adolescent children have to take up more instrumental and emotional filial responsibilities to comfort their mother and adapt to related changes. Based on 325 mother-child dyads of Chinese single-mother families experiencing economic disadvantage, this study examined the relationship between maternal distress and adolescent mental health problems (indexed by anxiety and depression) and the moderating roles of instrumental and emotional filial responsibilities. Results indicated that maternal distress was positively associated with anxiety and depression in adolescent children. In addition, instrumental filial responsibility intensified the associations of maternal distress with adolescent anxiety and depression. Moreover, the moderating role of emotional filial responsibility in the predictive relationship between maternal distress and adolescent anxiety was different in boys and girls. Adolescent girls with more emotional filial responsibility reported higher adolescent anxiety than did those who shouldered less emotional filial responsibility when their mother exhibited more distress, whereas the relationship between maternal distress and adolescent anxiety was stable in boys, regardless of emotional filial responsibility. In short, the present study showed that parentification was likely to occur in poor Chinese single-mother families, and adolescent children who took up a more caregiving role in the family exhibited poorer mental health. Family counselling and tangible support for single-mother families experiencing economic disadvantage are urged.
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Affiliation(s)
- Janet T. Y. Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Daniel T. L. Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Siu-Ming To
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - So-Wa Ngai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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20
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Girela-Serrano B, Miguélez C, Porras-Segovia AA, Díaz C, Moreno M, Peñuelas-Calvo I, Roselló R, Baca-García E, Carballo JJ. Predictors of mental health service utilization as adolescents with attention deficit hyperactivity disorder transition into adulthood. Early Interv Psychiatry 2023; 17:252-262. [PMID: 35706409 DOI: 10.1111/eip.13322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/01/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) symptoms may persist into adulthood and are likely to cause great problems in young adults. To date, few studies have explored the characteristics of patients diagnosed with ADHD that might influence the utilization of adult mental health services (AMHS). We aimed to examine and identify predictive symptoms of AMHS. METHODS We analysed data from 114 participants diagnosed with ADHD from a cohort of adolescents recruited at the age of 12-17 years, who, at the time of data analysis, were over 18 years old. RESULTS Among AMHS users, hyperactivity/impulsivity measures were significantly more severe (t = 2.668, df = 112, p < .001), ADHD combined subtype diagnosis (χ2 = 4.66, df = 1, p = .031) was more frequent and dysregulation profile in the SDQ-P was also significantly higher (t = -2.497, df = 109, p = .014). However, the dysregulation profile did not remain statistically significant after controlling for type of AMHS contact. CONCLUSIONS Our findings suggest that adolescents with ADHD are more likely continue their care under AMHS if they present more severe symptoms of hyperactivity/impulsivity and emotional dysregulation. The better characterization of the patient profile will help clinicians to early identify groups at-risk and to tailor interventions and prevention strategies.
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Affiliation(s)
- Braulio Girela-Serrano
- Westminster Child & Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, UK
- Division of Psychiatry, Imperial College, London, UK
| | - Carolina Miguélez
- Department of Child and Adolescent Psychiatry, Hospital Niño Jesús, Madrid, Spain
| | - Alejandro Albán Porras-Segovia
- Division of Psychiatry, Imperial College, London, UK
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | | | - Manon Moreno
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | | | - Rocio Roselló
- Division of Psychiatry, Imperial College, London, UK
- Department of Psychiatry, University Hospital Doctor Peset of Valencia & University of Valencia, Valencia, Spain
| | - Enrique Baca-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Infanta Elena, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Central de Villalba, Madrid, Spain
- Department of Psychiatry, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Universidad Católica del Maule, Talca, Chile
- Université de Nîmes, Nîmes, France
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21
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Perkins AM, Meiser-Stedman R, Spaul SW, Bowers G, Perkins AG, Pass L. The effectiveness of third wave cognitive behavioural therapies for children and adolescents: A systematic review and meta-analysis. Br J Clin Psychol 2023; 62:209-227. [PMID: 36443910 PMCID: PMC10100516 DOI: 10.1111/bjc.12404] [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: 01/25/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Third wave cognitive behavioural therapies are increasingly used with children and adolescents. This meta-analysis aimed to determine the effectiveness of four third-wave interventions (acceptance and commitment therapy, compassion focused therapy, mindfulness-based cognitive therapy, and metacognitive therapy) for youth. METHODS Four electronic databases were used to identify randomized controlled trials, which tested effects related to health, well-being and functioning. Sensitivity analyses considering study quality were conducted and moderators were explored. RESULTS The results based on 50 RCTs meeting inclusion criteria indicated emotional symptoms/internalizing problems (g = -.68, 95% CI -.98 to -.37, k = 43, N = 3265), behavioural difficulties/externalizing problems (g = -.62, 95% CI -1.01 to -.22, k = 23, N = 1659), interference from difficulties (g = -.46, 95% CI -.87 to -.05, k = 21, N = 1786), third wave processes (g = .39, 95% CI .17 to .62, k = 22, N = 1900), wellbeing/flourishing (g = .76, 95% CI .35 to 1.17, k = 21, N = 1303) and physical health/pain (g = .72, 95% CI .01 to 1.44, k = 9, N = 1171) yielded significant effects. Effect for quality of life (g = .62, 95% CI -.08 to 1.31, k = 12, N = 1271) was non-significant. When analysing only those studies rated moderate-high quality, third wave interventions yielded significant superiority effects compared to controls for emotional symptoms/internalizing problems (g = -.55, 95% CI -.82 to -.27, k = 28, N = 2110), interference from difficulties (g = -.48, 95% CI -.90 to -.05, k = 21, N = 1605), third wave processes (g = .27, 95% CI .11 to .43, k = 18, N = 1692), well-being/flourishing (g = .50, 95% CI .18 to .81, k = 16, N = 1063), and quality of life (g = .32, 95% CI .04 to .60, k = 10, N = 1212). Behavioural difficulties/externalizing problems (g = -.38, 95% CI -.86 to .10, k = 15, N = 1351) and physical health/pain (g = .52, 95% CI -.14 to 1.17, k = 8, N = 1139) ceased to be significant. Widespread heterogeneity raised concerns about generalizability and follow-up data was relatively sparse. CONCLUSIONS This meta-analysis finds promising results for use of third wave CBT with youth, though the review has limitations.
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Affiliation(s)
- Amorette M Perkins
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norfolk, UK.,Norfolk and Suffolk NHS Foundation Trust, Mary Chapman House, Norfolk, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norfolk, UK
| | - Samuel W Spaul
- Norfolk and Suffolk NHS Foundation Trust, Mary Chapman House, Norfolk, UK
| | - Gemma Bowers
- Norfolk and Suffolk NHS Foundation Trust, Mary Chapman House, Norfolk, UK
| | - Abigail G Perkins
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norfolk, UK
| | - Laura Pass
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norfolk, UK
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22
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Luttenberger K, Najem C, Rosenbaum S, Sifri C, Kind L, Baggenstos B. A Climbing (Bouldering) Intervention to Increase the Psychological Well-Being of Adolescents in the Bekaa Valley in Lebanon-Study Protocol for a Controlled Trial. Int J Environ Res Public Health 2023; 20:4289. [PMID: 36901303 PMCID: PMC10002189 DOI: 10.3390/ijerph20054289] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Adolescent refugees in Lebanon and Lebanese youth are both at high risk of suffering from reduced psychological well-being. Sport is an evidence-based strategy for improving mental and physical health, and climbing is a type of sport that may positively impact both. The aim of this study is to test the effect of a manualized, psychosocial group climbing intervention on the well-being, distress, self-efficacy, and social cohesion of adolescents in Lebanon. In addition, the mechanisms behind psychological changes will be investigated. (2) Methods: In this mixed-methods waitlist-controlled study, we are allocating a minimum of 160 participants to an intervention (IG) or a control group (CG). The primary outcome is overall mental well-being (WEMWBS) after the 8-week intervention. Secondary outcomes include distress symptoms (K-6 Distress Scale), self-efficacy (General Self-Efficacy Scale; GSE), and social cohesion. Potential mechanisms of change and implementation factors are being investigated through qualitative interviews with a subgroup of 40 IG participants. (3) Conclusions: The results may contribute to knowledge of sports interventions and their effects on psychological well-being and will provide insights regarding low-intensity interventions for supporting adolescent refugees and host populations in conflict-affected settings. The study was prospectively registered at the ISRCTN platform (current-controlled trials). ISRCTN13005983.
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Affiliation(s)
- Katharina Luttenberger
- Department Medical Psychology and Medical Sociology, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Charbel Najem
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9052 Ghent, Belgium
- Department of Physiotherapy, Faculty of Public Health, Antonine University, Baabda, Lebanon
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW, Sydney 2052, Australia
| | - Charles Sifri
- ClimbAID Lebanon, Branch of ClimbAID, 8048 Zurich, Switzerland
| | - Leona Kind
- Department Medical Psychology and Medical Sociology, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Beat Baggenstos
- ClimbAID Lebanon, Branch of ClimbAID, 8048 Zurich, Switzerland
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Tort-Nasarre G, Artigues-Barberà E, Pollina-Pocallet M, Espart A, Roca J, Vidal-Alaball J. Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Positive Body Image among Adolescents Scale (PBIAS) into Spanish and Catalan. Int J Environ Res Public Health 2023; 20:4017. [PMID: 36901026 PMCID: PMC10001491 DOI: 10.3390/ijerph20054017] [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] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The Positive Body Image among Adolescents Scale (PBIAS) explores the factors that bolster and interfere with developing and maintaining a positive body image during adolescence. The aim of this study was to translate, adapt, and validate the PBIAS into Spanish and Catalan. A cross-sectional study was conducted for the instrument's translation, cross-cultural adaptation, and psychometric validation. A process of translation, back-translation, expert consultation, and piloting was followed. The reliability and statistical validity were evaluated. The Cronbach's alpha was 0.95 in both the Spanish and Catalan versions. Pearson's correlation coefficients were statistically significant (r > 0.087) for all items analyzed. The resulting values of the Spanish and Catalan versions indicate a good level of concordance (p < 0.001) with the original questionnaire, the comparative fit index being 0.914 and 0.913, the Tucker-Lewis index being 0.893 and 0.892, the root mean square error of approximation being 1.31 and 1.28, and the standardized root mean square residual being 0.051 and 0.060, respectively. The instrument presents a good level of internal consistency, a high level of reliability, and statistical validity compared to the original instrument. The PBIAS in Spanish and Catalan can be a useful assessment instrument for educators and health professionals in the context of adolescent mental health literacy. This work contributes to the Sustainable Development Goals (Goal 3) of the United Nations 2030 Agenda.
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Affiliation(s)
- Glòria Tort-Nasarre
- SAP ANOIA, Gerència Territorial Catalunya Central, Institut Català de la Salut (ICS), 08700 Igualada, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- AFIN, Research Group and Outreach Centre, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Eva Artigues-Barberà
- Balàfia Primary Care Center, Gerència Territorial Lleida, Institut Català de la Salut (ICS), 25005 Lleida, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
| | - Mercè Pollina-Pocallet
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Bellpuig Primary Care Center, Gerència Territorial Lleida, Institut Català de la Salut (ICS), 25250 Lleida, Spain
| | - Anna Espart
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- Development of Healthy and Sustentable Organizations and Territories (DOTSS), Serra Húnter Lecturer, 25001 Lleida, Spain
- Research Group of Health Care (GRECS), Lleida Institute for Biomedical Research, Dr. Pifarré Foundation, IRBLleida, 25198 Lleida, Spain
| | - Judith Roca
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25198 Lleida, Spain
- Research Group of Health Care (GRECS), Lleida Institute for Biomedical Research, Dr. Pifarré Foundation, IRBLleida, 25198 Lleida, Spain
| | - Josep Vidal-Alaball
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut (ICS), 08272 Sant Fruitós del Bages, Spain
- Department of Medicine, University of Vic-Central University of Catalonia, 08500 Vic, Spain
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Demkowicz O, Panayiotou M, Qualter P, Humphrey N. Longitudinal relationships across emotional distress, perceived emotion regulation, and social connections during early adolescence: A developmental cascades investigation. Dev Psychopathol 2023:1-16. [PMID: 36734229 DOI: 10.1017/s0954579422001407] [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] [Indexed: 02/04/2023]
Abstract
Early adolescence is a vulnerable period for emotional distress. Both emotion regulation and social connection to peers and family adults are understood to be associated with distress. However, existing longitudinal work has not explored these constructs jointly in a way that estimates their reciprocal relationships over adolescence. We present a three-wave random-intercepts cross-lagged panel model of reciprocal relationships between emotional distress, perceived emotion regulation, and social connections during early adolescence, among 15,864 participants from education settings in disadvantaged areas of England, over three annual waves (at ages 11/12, 12/13, and 13/14 years). Findings showed that emotional distress and perceived emotion regulation share a negative relationship over time, and that higher perceived emotion regulation predicts greater family connection in the initial stages of early adolescence (from age 11-12 to 12-13 years). Findings also indicated that connection to peers is positively associated with family connection, but also positively predicts slightly greater distress in the later stages of early adolescence (from age 12-13 to 13-14 years). Findings indicate a risk of negative spiral between emotional distress and perceived emotion regulation in early adolescence, and that social connection may not necessarily play the role we might expect in reducing distress.
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Affiliation(s)
- Ola Demkowicz
- Manchester Institute of Education, The University of Manchester, UK
| | | | - Pamela Qualter
- Manchester Institute of Education, The University of Manchester, UK
| | - Neil Humphrey
- Manchester Institute of Education, The University of Manchester, UK
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Hua J, Zhou YX. Personality assessment usage and mental health among Chinese adolescents: A sequential mediation model of the Barnum effect and ego identity. Front Psychol 2023; 14:1097068. [PMID: 36818085 PMCID: PMC9932533 DOI: 10.3389/fpsyg.2023.1097068] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Adolescence is a crucial period for establishing ego identity and becoming a social individual. However, numerous adolescents suffer from mental health problems, especially after the conditions surrounding the COVID-19 outbreak. Personality assessments are often used when adolescents look for psychological self-help services. However, the meaning and mechanism of these personality assessments remain unknown. Taking the increasingly popular MBTI personality assessment as an entry point, the current study examined the potential sequential mediation relationship of Barnum effect - ego identity on the link between personality assessment usage and mental health. Methods The current study surveyed 308 Chinese high school students, including 109 males and 199 females. MBTI use, Barnum effect, ego-identity, and mental health (subjective well-being, depression, and anxiety) were measured by seven questionnaires, respectively. Sequential mediation models were constructed to analyze the relationship. Results The results indicate that the Barnum effect and ego identity together function as a sequential mediation path between personality assessment use and teenagers' mental health, including subjective well-being, depression, and anxiety. Specifically, a higher level of MBTI use triggers a stronger Barnum effect. The Barnum effect then promotes adolescents' ego identity, ultimately increasing subjective well-being levels and reducing anxiety and depression. Discussion Our findings suggest that by properly using personality assessment and stimulating the Barnum effect, we can enhance adolescents' mental health. The theoretical and practical implications of our findings are discussed.
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Lee JO, Duan L, Lee WJ, Rose J, Oxford ML, Cederbaum JA. Developmental inflection point for the effect of maternal childhood adversity on children's mental health from childhood to adolescence: Time-varying effect of gender differences. Dev Psychopathol 2023; 35:447-58. [PMID: 35249575 DOI: 10.1017/S0954579421001486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Childhood adversities have a well-established dose-response relationship with later mental health. However, less attention has been given to intergenerational influences. Further, it is unknown how intergenerational influences intersect with children's developmental stages and gender. The current study examined whether a developmental inflection point exists when the intergenerational influences of childhood adversities gain salience and explored differences by children's gender. Data were from the Young Women and Child Development Study (n = 361). Time-varying effect models (TVEMs) and moderation TVEMs by child's gender were evaluated. Our findings reveal that ages 5-8, the period of transition into primary schools, may represent a developmental inflection point when the intergenerational influences of maternal childhood adversity start emerging substantially. The results from gender interaction TVEMs reveal that maternal childhood adversity was a statistically significant predictor of internalizing problems until age 11, regardless of child's gender, and remained statistically significant for girls' internalizing problems until age 16.7. For externalizing problems, maternal childhood adversity was a statistically significant predictor until age 13, regardless of gender.
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Phoa PKA, Ab Razak A, Kuay HS, Ghazali AK, Ab Rahman A, Husain M, Bakar RS, Abdul Gani F. Predictors of Mental Health Literacy among Parents, Guardians, and Teachers of Adolescents in West Malaysia. Int J Environ Res Public Health 2023; 20:825. [PMID: 36613147 PMCID: PMC9819300 DOI: 10.3390/ijerph20010825] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/07/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
Parents, guardians, and teachers are the informal sources of mental health support that adolescents rely on. Nevertheless, limited mental health knowledge limits their ability and confidence in providing appropriate assistance. This study aims to (1) evaluate the relationship between the roles of parents/guardians and teachers and their responses to discover the common misconceptions on mental health among those providing informal support to adolescents and (2) determine which demographic factors would act as the strongest predictor influencing their mental health literacy (MHL) status. The cross-sectional study recruited 867 parents, guardians, and teachers of adolescents from 24 government secondary schools' parent-teacher associations via multistage stratified random sampling. Parents, guardians, and teachers' MHL were evaluated using the Mental Health Knowledge Schedule-Malay Version (MAKS-M). The collected data were analyzed using Pearson's Chi-squared test to investigate the association between the respondents' roles and responses. Multiple Regression analysis was used to determine the predictors of MHL. The score of MAKS-M for the current study sample is 73.03% (M = 43.82, SD = 4.07). Most respondents responded incorrectly on Items 1 (employment), 6 (help-seeking), 8 (stress), and 12 (grief). Teachers provided more favorable responses on several items than parents and guardians. Finally, younger age, higher income, knowing someone with mental disorders, and having experience of attending formal training on mental health first aid were the significant predictors of MHL. MHL interventions in Malaysia should cater to older adults of lower socioeconomic status and lesser experience in mental health, specifically highlighting the stigmas on mental health help-seeking behaviors, treatment, and employment concerns, plus the recognition of various mental health diagnoses.
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Affiliation(s)
- Picholas Kian Ann Phoa
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Asrenee Ab Razak
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Hue San Kuay
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Anis Kausar Ghazali
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Maruzairi Husain
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Raishan Shafini Bakar
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Kelantan, Malaysia
| | - Firdaus Abdul Gani
- Department of Psychiatry and Mental Health, Sultan Haji Ahmad Shah Hospital, Temerloh 28000, Pahang, Malaysia
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Marçal KE. Intimate Partner Violence Exposure and Adolescent Mental Health Outcomes: The Mediating Role of Housing Insecurity. J Interpers Violence 2022; 37:NP19310-NP19330. [PMID: 34496695 DOI: 10.1177/08862605211043588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/13/2023]
Abstract
The present study investigated pathways from childhood exposure to mothers' intimate partner violence (IPV) to adolescent depression and anxiety. Further, the study examined whether housing insecurity mediated the link from IPV exposure to mental health outcomes. Data came from the Years 5, 9 and 15 interviews of the Fragile Families and Child Well-being Study; the analytic sample was limited to mothers with at least partial custody of children (N = 2,425). Structural equation modeling with latent variables investigated research questions. Confirmatory factor analysis (CFA) identified observed indicators for latent constructs, and a path analysis tested direct and indirect pathways from IPV exposure to adolescent depression and anxiety. IPV exposure at age five was associated with increased housing insecurity at age nine, which was associated with increased adolescent depression and anxiety at age 15. Although IPV exposure was not directly associated with either mental health outcome, housing insecurity mediated the link from IPV exposure to adolescent depression. Findings point to the long-term consequences of exposure to intimate partner violence in childhood, highlighting pathways to mental disorder in adolescence. The present study emphasizes the need for policies that protect survivors of IPV from eviction and homelessness, empower them to leave abusers without fear of losing their housing, and promote healthy child development in the wake of family violence.
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Abstract
Dissociative/conversion disorders affect almost 31% of children and adolescents in a clinical setting. These children experience significant impairments in their academics, and daily functioning, with high chances of developing other psychiatric comorbidities such as anxiety and depression. However, there are no studies that explore the experiences of suffering from dissociative/conversion disorders from perspective of the sufferer. Therefore, the paper has aimed at exploring the subjective experiences of dissociative and conversion disorders among adolescents in the Indian context by examining their understanding about the illness and the reason they ascribe to the cause of their illness. The study used a qualitative semi-structured interview to understand their illness. In total, 10 adolescents of age group between 12 and 16 years participated. Eight out of the 10 participants were female and the mean age was 12 years. All of them were in-patients in the department of Child and Adolescent Psychiatry, NIMHANS, which is the tertiary mental health care Institute India and pioneer Institute of mental health in Asia. All participants have had at least one or more consultation history either with a traditional healer or/and physician. Thematic analysis identified vital themes such as (1) Adolescents' attributing factors of the illness, (2) Cognitive and emotional appraisal of stressful situation/s, (3) Adolescents' appraisal of different explanatory model, (4) Living with the Impact of the illness. This analysis about dissociative/conversion disorders from adolescents' perspective has a major contribution in enhancing the clinical knowledge and practice in planning and managing children/adolescents diagnosed with dissociative/conversion disorders.
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Affiliation(s)
- R Shangmi Moyon
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Bino Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Satish C Girimaji
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Overstreet K, Derouin A. Improving Interprofessional Collaboration Between Behavioral Mental Health and Pediatric Primary Care Providers Through Standardized Communication. J Pediatr Health Care 2022; 36:582-588. [PMID: 35945101 DOI: 10.1016/j.pedhc.2022.07.001] [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: 06/08/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pediatric mental health crisis increases demand for integrated behavioral health and pediatric primary care providers (PPCP). Communication is key to successful integrated pediatric behavioral-mental health, but studies demonstrate gaps between existing and desired communication practices. Project aims to improve PPCP factors and patient outcomes by implementing standardized communication tool in the Electronic Health Record (EHR). METHOD Pre-post 20-week intervention. SETTING AND SAMPLE Pediatric primary care and affiliated pediatric behavioral-mental health clinic of academic health system. PBMH patients and referring PPCPs. MEASURES PPCP satisfaction with communication, comfort and confidence continuing mental health care pre-post PBMH consult, and patient appointment attendance. RESULTS PPCP confidence and comfort treating mental health in primary care increased. No significant change in PPCP satisfaction after implementing standardized communication. Identified factors associated with patient appointment continuity. DISCUSSION Standardized EHR communication tools and enhancing PPCP confidence in managing common pediatric mental health conditions are effective collaboration strategies.
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Affiliation(s)
- Kari Overstreet
- Kari Overstreet, Pediatric Nurse Practitioner, Department of Psychiatry and Behavioral Sciences, Child Division, Duke University Health System, Durham, NC; Anne Derouin, Professor & Assistant Dean Master of Science in Nursing Program, Duke University School of Nursing, Durham, NC.
| | - Anne Derouin
- Kari Overstreet, Pediatric Nurse Practitioner, Department of Psychiatry and Behavioral Sciences, Child Division, Duke University Health System, Durham, NC; Anne Derouin, Professor & Assistant Dean Master of Science in Nursing Program, Duke University School of Nursing, Durham, NC
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Kvamme LS, Waaler P, Helland SS, Kjøbli J. Striving for Happily Ever After: Supportive Interventions for Youth Leaving Residential Placement. A Systematic Review of Reviews. Child Adolesc Ment Health 2022; 27:389-398. [PMID: 34472685 DOI: 10.1111/camh.12507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Youth who reenter communities after forensic or residential care are overrepresented in prevalence rates for mental disorders, delinquency, incarceration, low academic achievement, and unemployment. Supportive interventions that aid youth in the reentry to their communities can be crucial for successful reintegration. In systematic reviews (SR) on this topic, only specific interventions or programs are described. Therefore, a summary of evidence about transitional interventions for various groups of reentry youth is needed. METHOD This overview of SRs was preregistered in PROSPERO. We searched PsycINFO, Ovid MEDLINE, Cochrane Library, Campbell Library, Web of Science, Sociological Abstracts, Criminal Justice Abstracts, Social Care Online, and Epistemonikos. SRs that fit the search criteria were evaluated using the AMSTAR checklist for methodological quality and the GRADE tool for assessing confidence in effect estimates. RESULTS We screened 2,349 publications for eligibility. Eight SRs were included for analysis. The methodological quality of five SRs was critically low, two were of low quality, and one was of moderate quality. Recidivism was reported as the only outcome in five SRs. Detrimental outcomes were reported in five SRs. Confidence in effect estimates was low or very low for all outcomes. Ninety-five percent of primary study populations were from the United States. CONCLUSION We offer a rigorous appraisal of SRs on transitional interventions. The gaps of knowledge are vast regarding what works, how it works, and for whom. Development of a knowledge base should include defining the term 'recidivism', systematic reporting of demographics, and identifying effective common elements.
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Affiliation(s)
- Line Solheim Kvamme
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Pamela Waaler
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Siri Saugestad Helland
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - John Kjøbli
- Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.,Department of Education, University of Oslo, Oslo, Norway
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Marçal KE, Maguire-Jack K. Informal supports, housing insecurity, and adolescent outcomes: Implications for promoting resilience. Am J Community Psychol 2022; 70:178-196. [PMID: 35156209 DOI: 10.1002/ajcp.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/09/2021] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
Adolescents in low-income, marginalized families are vulnerable to behavior problems that impede healthy functioning and threaten long-term well-being. Informal supports may fill an important gap for these households as they navigate financial and social stressors. Instrumental support from social networks and neighborhood cohesion may promote family stability and youth well-being; further, these informal supports may promote resilience to housing insecurity, which is linked with a range of adverse adolescent outcomes. The present study utilized data from a large sample of at-risk families with children (N = 2425) to investigate whether instrumental support and neighborhood cohesion predicted adolescent behavior problems over 10 years and whether these links were mediated by housing insecurity. Results of structural equation modeling with latent variables showed direct links from instrumental support to anxious/depressed behaviors and from neighborhood cohesion to aggressive behaviors, as well as an indirect link from instrumental support to aggressive behavior via housing insecurity. Findings suggest informal supports are an important source of resilience for low-income families who may be excluded from or are reluctant to engage with formal social systems. Further, stable, connected communities with highly embedded social networks can promote housing stability and youth well-being in a virtuous cycle.
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Affiliation(s)
- Katherine E Marçal
- Greenspun College of Urban Affairs, University of Nevada, Las Vegas, Nevada, USA
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McRell AS, Fram MS, Frongillo EA. Adolescent-Reported Household Food Insecurity and Adolescents' Poor Mental and Physical Health and Food Insufficiency in Kenya. Curr Dev Nutr 2022; 6:nzac117. [PMID: 35957739 PMCID: PMC9362762 DOI: 10.1093/cdn/nzac117] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 12/01/2022] Open
Abstract
Background Assessing adolescents' experiences of food insecurity in households is important for promoting healthy development. Although parental reports have been traditionally used, emerging research highlights the importance of child and adolescent reports of the household food environment. Objectives Extending research from high- and upper-middle-income countries, this study of adolescent compared with adult reports of household food insecurity in Kenya, a lower-middle-income country, examined 1) prevalence of and correspondence between adolescent and adult reports of household food insecurity, and 2) associations of adolescent and adult reports of household food insecurity with adolescent nonnutritional and nutritional outcomes. Methods Using data from the Kenya Violence Against Children Surveys (n = 1182), we assessed prevalence of household food insecurity reported by adolescents (ages 13-17 y) and adults, with McNemar χ2 and κ analysis of correspondence between reports. Ordinal and binary logistic regression assessed associations between adolescent and adult reports and adolescent mental health and self-rated physical health and food sufficiency outcomes. Results Household food insecurity was reported by 36% of adolescents and 63% of adults; 36% of adult reports were discordant with adolescent reports (κ = 0.333). Odds of adolescent mental health difficulties were highest with adolescent-only report (OR = 2.11, P = 0.02), followed by adult and adolescent (OR = 1.83, P = 0.001) and adult-only (OR = 1.06, P = 0.77) report. Odds of poor adolescent self-rated physical health were highest with adult and adolescent report (OR = 2.47, P < 0.001) followed by adolescent-only (OR = 2.04, P = 0.08) and adult-only (OR = 1.37, P = 0.20) report. Odds of adolescents eating ≤1 meals the previous day were highest with adult and adolescent (OR = 21.38, P < 0.001) followed by adult-only (OR = 7.44, P = 0.01) and adolescent-only (OR = 2.31, P = 0.34) report. Conclusions Measuring household food insecurity with both adolescent report and adult report is important for having a comprehensive understanding of household resources and needs and of the nonnutritional (mental and physical health) and nutritional (diet and food) outcomes of household food insecurity for adolescents.
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Affiliation(s)
- Amanda S McRell
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Maryah S Fram
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Edward A Frongillo
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Crowter L, Banerjee R, Berry C, Fowler D. Schematic beliefs, negative affect and paranoia in at-risk youth. Br J Clin Psychol 2022; 61:1038-1051. [PMID: 35762490 DOI: 10.1111/bjc.12373] [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: 09/15/2021] [Revised: 03/08/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Attenuated symptoms of psychosis are a core feature of At-Risk Mental States. However, subthreshold levels of paranoia are also common among nonpsychosis populations. At present, little is known about whether the processes underpinning the experience of paranoid ideation in high-risk youth differ as a consequence of meeting At-Risk Mental States (ARMS) for psychosis criteria. METHODS This study utilized path analysis techniques to examine the relationships between schematic beliefs, negative affect and the experience of paranoia for two groups: a group meeting criteria for ARMS (n = 133) and a group presenting with emerging complex mental health difficulties who did not meet the criteria for ARMS (n = 137). RESULTS While the ARMS group displayed significantly greater maladaptive schematic beliefs and more severe symptomatology, the associations between schematic beliefs, symptoms of negative affect and paranoia did not differ as a consequence of ARMS status. CONCLUSIONS While meeting the ARMS criteria is associated with experiencing more maladaptive cognitions and more negative symptomatology among at-risk youth, the associations between these cognitive beliefs and symptoms may be similar for youth who do not meet ARMS. These findings have implications for broadening the scope of at-risk/high-risk and for developing effective interventions for young people presenting with emerging difficulties.
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Affiliation(s)
| | | | - Clio Berry
- Brighton and Sussex Medical School, Sussex, UK
| | - David Fowler
- University of Sussex, Sussex, UK.,Sussex Partnership NHS Foundation Trust, Sussex, UK
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35
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Turner AL, Brokamp C, Wolfe C, Reponen T, Brunst KJ, Ryan PH. Mental and Physical Stress Responses to Personal Ultrafine Particle Exposure in Adolescents. Int J Environ Res Public Health 2022; 19:ijerph19127509. [PMID: 35742759 PMCID: PMC9223710 DOI: 10.3390/ijerph19127509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023]
Abstract
Incidence rates of mental health disorders among adolescents is increasing, indicating a strong need for effective prevention efforts at a population level. The etiology of mental health disorders includes genetic, social, and environmental factors. Ultrafine particles (UFPs; particles less than 0.1 μm in diameter) have been shown to exert neurotoxic effects on the brain; however, epidemiologic evidence on the relationship between UFPs and childhood mental health outcomes is unclear. The objective of this study was to determine if exposure to UFPs was associated with symptoms of mental health in adolescents. Adolescents completed personal UFP monitoring for one week as well as a series of validated Patient-Reported Outcomes Measurement Information System (PROMIS) assessments to measure five domains of mental and physical stress symptoms. Multivariable linear regression models were used to estimate the association between PROMIS domain T-scores and median weekly personal UFP exposure with the inclusion of interactions to explore sex differences. We observed that median weekly UFP exposure was significantly associated with physical stress symptoms (β: 5.92 per 10-fold increase in UFPs, 95% CI [0.72, 11.13]) but no other measured domains. Further, we did not find effect modification by sex on any of the PROMIS outcomes. The results of this study indicate UFPs are associated with physical symptoms of stress response among adolescents, potentially contributing to mental health disorders in this population.
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Affiliation(s)
- Ashley L. Turner
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (C.B.); (C.W.); (P.H.R.)
- Correspondence: ; Tel.: +1-630-306-2259
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (C.B.); (C.W.); (P.H.R.)
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Chris Wolfe
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (C.B.); (C.W.); (P.H.R.)
| | - Tiina Reponen
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (T.R.); (K.J.B.)
| | - Kelly J. Brunst
- Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA; (T.R.); (K.J.B.)
| | - Patrick H. Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (C.B.); (C.W.); (P.H.R.)
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
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36
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Prencipe L, Houweling TAJ, van Lenthe FJ, Kajula L, Palermo T. Effects of Adolescent-Focused Integrated Social Protection on Depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania's Cash Plus Intervention. Am J Epidemiol 2022; 191:1601-1613. [PMID: 35581169 PMCID: PMC9437816 DOI: 10.1093/aje/kwac093] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 09/29/2021] [Revised: 03/29/2022] [Accepted: 05/12/2022] [Indexed: 01/29/2023] Open
Abstract
We assessed the impacts of Tanzania's adolescent-focused Cash Plus intervention on depression. In this pragmatic cluster-randomized controlled trial, 130 villages were randomly allocated to an intervention or control arm (1:1). Youth aged 14-19 years living in households receiving governmental cash transfers were invited to participate. The intervention included an intensive period (a 12-session course) and an aftercare period (9 months of mentoring, productive grants, and strengthened health services). We examined intervention impacts on a depressive symptoms scale (10-item Center for Epidemiologic Studies Depression Scale score (range, 0-30)) and rates of depressive symptomatology (score ≥10 points on the scale), recorded at study baseline (April-June 2017), midline (May-July 2018), and endline (June-August 2019). Using intention-to-treat methodology, we employed logistic and generalized linear models to estimate effects for binary and continuous outcomes, respectively. Quantile regression was used to estimate effects across the scale. From 2,458 baseline participants, 941 intervention and 992 control adolescents were reinterviewed at both follow-ups. At endline, the intervention reduced the odds of depressive symptomatology (adjusted odds ratio = 0.67, 95% confidence interval: 0.52, 0.86), with an undetectable mean scale difference (risk difference = -0.36, 95% confidence interval: -0.84, 0.11). Quantile regression results demonstrated an intervention effect along the upper distribution of the scale. Integration of multisectoral initiatives within existing social protection systems shows potential to improve mental health among youth in low-resource settings.
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Affiliation(s)
- Leah Prencipe
- Correspondence to Leah Prencipe, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands (e-mail: )
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Moe CA, Villaveces A, Rivara FP, Rowhani-Rahbar A. Self-harming behavior in relation to exposure to inter-personal violence among youth and young adults in Colombia. Int J Inj Contr Saf Promot 2022; 29:76-85. [PMID: 34775916 PMCID: PMC9942612 DOI: 10.1080/17457300.2021.2001830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The effects of violence exposure on the risk of self-harming behaviors of youth in low- and middle-income countries is not well-understood. Using household survey data from one nationally representative sample and one sample from conflict-affected areas, we examined violence exposure and self-harm among Colombian youth aged 13-24. Survey-weighted prevalence ratios comparing self-harming behaviors by exposure to violence were estimated with Poisson log-linear models, controlling for age, sex, education and food insecurity. Compared to unexposed youth, those exposed to violence in both home and community settings were 7.97 (95% confidence interval [CI]:2.72-23.36) times more likely in the conflict-affected sample, and 21.05 (95% CI: 8.80-50.34) times more likely in the national sample to report having attempted suicide. Among Colombian youth, exposure to violence as either witness or victim was associated with greater prevalence of self-harming behaviors. Youth suicide prevention programs can address exposures to violence as a risk factor for self-harm.
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Affiliation(s)
- Caitlin A. Moe
- Department of Epidemiology, University of Washington, Seattle, WA,Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA
| | - Andrés Villaveces
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Frederick P. Rivara
- Department of Epidemiology, University of Washington, Seattle, WA,Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA,Department of Pediatrics, University of Washington, Seattle, WA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, University of Washington, Seattle, WA,Harborview Injury Prevention & Research Center, University of Washington, Seattle, WA,Department of Pediatrics, University of Washington, Seattle, WA
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38
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Thorup AAE, Hemager N, Bliksted VF, Greve AN, Ohland J, Wilms M, Rohd SB, Birk M, Bundgaard AF, Laursen AF, Jefsen OH, Steffensen NL, Andreassen AK, Veddum L, Knudsen CB, Enevoldsen M, Nymand M, Brandt JM, Søndergaard A, Carmichael L, Gregersen M, Krantz MF, Burton BK, Dietz M, Nudel R, Johnsen LK, Larsen KM, Meder D, Hulme OJ, Baaré WFC, Madsen KS, Lund TE, Østergaard L, Juul A, Kjær TW, Hjorthøj C, Siebner HR, Mors O, Nordentoft M. The Danish High-Risk and Resilience Study-VIA 15 - A Study Protocol for the Third Clinical Assessment of a Cohort of 522 Children Born to Parents Diagnosed With Schizophrenia or Bipolar Disorder and Population-Based Controls. Front Psychiatry 2022; 13:809807. [PMID: 35444571 PMCID: PMC9013818 DOI: 10.3389/fpsyt.2022.809807] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children born to parents with severe mental illness have gained more attention during the last decades because of increasing evidence documenting that these children constitute a population with an increased risk of developing mental illness and other negative life outcomes. Because of high-quality research with cohorts of offspring with familial risk and increased knowledge about gene-environment interactions, early interventions and preventive strategies are now being developed all over the world. Adolescence is a period characterized by massive changes, both in terms of physical, neurologic, psychological, social, and behavioral aspects. It is also the period of life with the highest risk of experiencing onset of a mental disorder. Therefore, investigating the impact of various risk and resilience factors in adolescence is important. METHODS The Danish High-Risk and Resilience Study started data collection in 2012, where 522 7-year-old children were enrolled in the first wave of the study, the VIA 7 study. The cohort was identified through Danish registers based on diagnoses of the parents. A total of 202 children had a parent diagnosed with schizophrenia, 120 children had a parent diagnosed with bipolar disorder, and 200 children had parents without these diagnoses. At age 11 years, all children were assessed for the second time in the VIA 11 study, with a follow-up retention rate of 89%. A comprehensive assessment battery covering domains of psychopathology, neurocognition, social cognition and behavior, motor development and physical health, genetic analyses, attachment, stress, parental functioning, and home environment was carried out at each wave. Magnetic resonance imaging scans of the brain and electroencephalograms were included from age 11 years. This study protocol describes the third wave of assessment, the VIA 15 study, participants being 15 years of age and the full, 3-day-long assessment battery this time including also risk behavior, magnetoencephalography, sleep, and a white noise paradigm. Data collection started on May 1, 2021. DISCUSSION We will discuss the importance of longitudinal studies and cross-sectional data collection and how studies like this may inform us about unmet needs and windows of opportunity for future preventive interventions, early illness identification, and treatment in the future.
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Affiliation(s)
- Anne Amalie Elgaard Thorup
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Vibeke Fuglsang Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Martin Wilms
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Merete Birk
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Faurskov Bundgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Andreas Færgemand Laursen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Oskar Hougaard Jefsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Lawaetz Steffensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Enevoldsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Marie Nymand
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Julie Marie Brandt
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Anne Søndergaard
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Carmichael
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Maja Gregersen
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Roskilde, Denmark
| | - Martin Dietz
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Ron Nudel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Korsgaard Johnsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kit Melissa Larsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Oliver James Hulme
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - Torben Ellegaard Lund
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Leif Østergaard
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Anders Juul
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, Section 5064, University of Copenhagen, Copenhagen, Denmark
| | | | - Carsten Hjorthøj
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Neurology, Hospital Bispebjerg, Copenhagen University, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
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Gellatly R, Knudsen K, Boustani MM, Michelson D, Malik K, Mathur S, Nair P, Patel V, Chorpita BF. A qualitative analysis of collaborative efforts to build a school-based intervention for multiple common adolescent mental health difficulties in India. Front Psychiatry 2022; 13:1038259. [PMID: 36506442 PMCID: PMC9731107 DOI: 10.3389/fpsyt.2022.1038259] [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: 09/06/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In low- and middle-income countries (LMICs), the gap between need for mental health (MH) treatment and access to services is stark, particularly among children and adolescents. In service of addressing this treatment gap, the current study provides an in-depth illustration of later-stage collaborative design of a school-based, transdiagnostic MH intervention in New Delhi and Goa, India, using a combination of contextual insights from local stakeholders and knowledge derived from the global evidence base. METHODS Using an inductive-deductive approach to qualitative thematic analysis, we examined coded data from qualitative sources related to experiences of developing and implementing an intervention prototype. These sources included notes from meetings attended by treatment development team members and providers, written feedback on protocol materials (e.g., provider manual, student handouts), field notes reflecting researcher observations, and minutes from weekly clinical supervision meetings. RESULTS Results revealed that codes involving cultural/contextual considerations, protocol material and content, and intervention complexity arose consistently throughout treatment development and across document types, illustrating their central role in finalizing protocol design. DISCUSSION These findings have implications for the future of mental health treatment development and implementation globally.
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Affiliation(s)
- Resham Gellatly
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States.,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kendra Knudsen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Maya M Boustani
- Department of Psychology, Loma Linda University, Loma Linda, CA, United States
| | - Daniel Michelson
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Kanika Malik
- Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, India.,Sangath, Porvorim, Goa, India
| | | | | | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Bruce F Chorpita
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
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40
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Eugene DR. Connectedness to Family, School, and Neighborhood and Adolescents' Internalizing Symptoms. Int J Environ Res Public Health 2021; 18:12602. [PMID: 34886328 PMCID: PMC8656744 DOI: 10.3390/ijerph182312602] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/27/2021] [Accepted: 11/27/2021] [Indexed: 11/17/2022]
Abstract
In the U.S., there is a strong national interest in social connectedness as a key determinant in promoting positive well-being in adolescents through building strong bonds and creating protective relationships that support adolescent mental health. To this end, this study examined whether, and to what extent, specific types of connectedness to family, school, and neighborhood were associated with internalizing symptoms (i.e., depression and anxiety) among a diverse sample of adolescents from disadvantaged backgrounds. The sample (n = 2590) was majority male (51%), with an average age of 15.6 years, and identified as Black (49%) and Hispanic/Latino (26%). The results revealed that adolescents who reported strong connections to their parent (β = -0.128, p < 0.001), school (β = -0.222, p < 0.001), and neighborhood (β = -0.116, p = 0.003) were more likely to report lower levels of depressive symptomology, with school connectedness exerting a greater influence. In addition, parent connectedness (β = -0.157, p < 0.001) and school connectedness (β = -0.166, p < 0.001) were significantly related to teen anxiety; however, neighborhood connectedness was not (β = -0.123, p = 0.087). The findings have important implications, which are discussed.
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Affiliation(s)
- Danielle R Eugene
- School of Social Work, University of Texas at Arlington, Arlington, TX 76019, USA
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41
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Black M, Barnes A, Strong M, Brook A, Ray A, Holden B, Foster C, Taylor-Robinson D. Relationships between Child Development at School Entry and Adolescent Health-A Participatory Systematic Review. Int J Environ Res Public Health 2021; 18:11613. [PMID: 34770127 PMCID: PMC8582847 DOI: 10.3390/ijerph182111613] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
Abstract
The relationship between child development and adolescent health, and how this may be modified by socio-economic conditions, is poorly understood. This limits cross-sector interventions to address adolescent health inequality. This review summarises evidence on the associations between child development at school starting age and subsequent health in adolescence and identifies factors affecting associations. We undertook a participatory systematic review, searching electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) for articles published between November 1990 and November 2020. Observational, intervention and review studies reporting a measure of child development and subsequent health outcomes, specifically weight and mental health, were included. Studies were individually and collectively assessed for quality using a comparative rating system of stronger, weaker, inconsistent or limited evidence. Associations between child development and adolescent health outcomes were assessed and reported by four domains of child development (socio-emotional, cognitive, language and communication, and physical development). A conceptual diagram, produced with stakeholders at the outset of the study, acted as a framework for narrative synthesis of factors that modify or mediate associations. Thirty-four studies were included. Analysis indicated stronger evidence of associations between measures of socio-emotional development and subsequent mental health and weight outcomes; in particular, positive associations between early externalising behaviours and later internalising and externalising, and negative associations between emotional wellbeing and later internalising and unhealthy weight. For all other domains of child development, although associations with subsequent health were positive, the evidence was either weaker, inconsistent or limited. There was limited evidence on factors that altered associations. Positive socio-emotional development at school starting age appears particularly important for subsequent mental health and weight in adolescence. More collaborative research across health and education is needed on other domains of development and on the mechanisms that link development and later health, and on how any relationship is modified by socio-economic context.
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Affiliation(s)
- Michelle Black
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - Amy Barnes
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - Mark Strong
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - Anna Brook
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - Anna Ray
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK;
| | - Ben Holden
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - Clare Foster
- School of Health and Related Research, The University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; (A.B.); (M.S.); (A.B.); (B.H.); (C.F.)
| | - David Taylor-Robinson
- Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool L69 3GL, UK;
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Alonzo D, Popescu M, Zubaroglu-Ioannides P. Training non-mental health professionals to assess and manage suicide risk: Community level intervention for suicide prevention in Guatemala. Int J Soc Psychiatry 2021; 67:705-712. [PMID: 33148098 DOI: 10.1177/0020764020970237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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
BACKGROUND Domestic violence, childhood physical and sexual abuse, and gang violence are prevalent and growing problems for Guatemalan youth, particularly in low socioeconomic (SES) areas. Resources in the community for psychosocial support are greatly lacking. Schools often serve as the main source of support for these highly vulnerable adolescents. Yet, many teachers lack the training to manage the psychological distress of their at-risk students and to properly engage, assess, and manage the psychological needs of their students. We developed a brief risk assessment and management training for teachers to address this gap. AIMS We present the acceptability and preliminary effectiveness of the training at increasing teacher's knowledge and understanding of how to engage and work with their at-risk students around their thoughts and feelings of suicide. METHOD Twenty-two teachers from a school in a low SES community in Guatemala participated in the training program. Mixed methods were used to explore effectiveness, acceptability, and satisfaction with the training. Primary outcomes assessed were changes in self-reported knowledge and understanding of engaging and working with students at risk of suicide. RESULTS Participants reported increased knowledge and understanding of all training targets (p < .05). Acceptability was high as no participants dropped out and all participants rated the training as useful for their professional development, meeting their expectations, and as highly satisfying. CONCLUSION Brief, focused training on suicidality can be effective and is acceptable to lay professionals. Further examination of the effectiveness of the training in a larger sample is required to assess the long-term impact of the training and its transportability to other communities.
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Affiliation(s)
- Dana Alonzo
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
| | - Marciana Popescu
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
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Abstract
Adolescents are constantly connected to their devices, and concerns have been raised that this connectivity is damaging their development more generally, and their mental health in particular. Recent narrative reviews and meta-analyses do not support a strong linkage between the quantity of adolescents' digital technology engagement and mental health problems. Instead, it appears that offline vulnerabilities tend to mirror and shape online risks in ways that may further amplify mental health inequalities among youth. New approaches for supporting youth mental health, especially for vulnerable youth and those typically excluded from traditional services, are now both possible and required.
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Affiliation(s)
- Candice L Odgers
- Department of Psychological Science, University of California-Irvine, Irvine, California, US
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Sung JY, Mumper E, Schleider JL. Empowering Anxious Parents to Manage Child Avoidance Behaviors: Randomized Control Trial of a Single-Session Intervention for Parental Accommodation. JMIR Ment Health 2021; 8:e29538. [PMID: 34255718 PMCID: PMC8292931 DOI: 10.2196/29538] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A majority of youth who need anxiety treatment never access support. This disparity reflects a need for more accessible, scalable interventions-particularly those that may prevent anxiety in high-risk children, mitigating future need for higher-intensity care. Self-guided single-session interventions (SSIs) may offer a promising path toward this goal, given their demonstrated clinical utility, potential for disseminability, and low cost. However, existing self-guided SSIs have been designed for completion by adolescents already experiencing symptoms, and their potential for preventing anxiety in children-for instance, by mitigating known anxiety risk factors-remains unexplored. OBJECTIVE This trial evaluated the acceptability and proximal effects of project EMPOWER: a web-based, self-guided SSI designed to reduce parental accommodation, a parenting behavior known to increase the risk of anxiety in offspring. METHODS In total, 301 parents who reported elevated anxiety symptoms with children aged 4-10 years received either project EMPOWER or an informational control (containing psychoeducational materials and resources); parents self-reported their accommodation of child anxiety and overall distress tolerance at baseline and 2-week follow-up. RESULTS Relative to control-group parents, those who received the intervention outlined in project EMPOWER reported significant reductions in their accommodation of child anxiety (ds=0.61; P<.001) and significant increases in their distress tolerance (ds=0.43; P<.001) from baseline to 2-week follow-up. Additionally, parents rated project EMPOWER as highly acceptable (ie, easy to use, helpful, and engaging) in accordance with preregistered benchmarks. CONCLUSIONS Project EMPOWER is an acceptable self-guided SSI for parents of children at-risk for anxiety, which yields proximal reductions in clinically relevant targets. TRIAL REGISTRATION ClinicalTrials.gov NCT04453865; https://tinyurl.com/4h84j8t9.
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Affiliation(s)
- Jenna Y Sung
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Emma Mumper
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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45
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Lu W, Xu L, Hart D. Editorial: Minority Adolescent Mental Health and Health Care Disparities. Front Public Health 2021; 9:704765. [PMID: 34222192 PMCID: PMC8249763 DOI: 10.3389/fpubh.2021.704765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Wenhua Lu
- Department of Community Health and Social Medicine, School of Medicine, City University of New York, New York, NY, United States
| | - Lei Xu
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, United States
| | - Daniel Hart
- Department of Psychology, School of Arts and Sciences, Rutgers, The State University of New Jersey, Camden, NJ, United States
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Abstract
Background The long-term negative consequences of mental health problems during adolescence highlight the need for effective treatments. Compassion-focused therapy (CFT) aims to help individuals to enhance their ability to support and care for themselves and to alleviate shame and self-stigmatization. Objective This non-randomized controlled trial examined the effectiveness of group-based CFT on perceived stress and the extent of self-compassion in a clinical sample of adolescents receiving psychiatric care for complex mental health difficulties and their parents. Method The participants were 43 adolescents (ages 14-17; 83.7 % female) under treatment at a child and adolescent psychiatric outpatient clinic in Sweden and their parents (n = 77; 61 % female). The adolescents volunteered for group-based CFT (n = 19); if they did not want to participate, they were asked to join the control group receiving treatment as usual (TAU, n = 24). The CFT parents were given the same treatment as their children in parallel parent groups. The participants completed questionnaires measuring self-compassion and perceived stress before and after treatment. Paired samples t-tests and independent samples t-tests assessed the within-group and between-group differences via change scores. Results The fathers scored highest on self-compassion and had less perceived stress at both times than the adolescents or mothers. There were no significant differences between the CFT and TAU groups in self-compassion or perceived stress at either time, and the effect sizes were small (g ≤ 0.25). The TAU mother group was the only group with a significantly changed mean self-compassion score post-treatment. Conclusions Some patients seem to benefit from group-based CFT in ways similar to the benefits of specialized therapeutic approaches. Further research into the utility of CFT for adolescents with MH problems and their parents, as well as the long-term clinical effects of CFT for this group is needed.
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Affiliation(s)
- Anna Sofia Bratt
- Linnaeus University, Faculty of Health and Life Sciences, Växjö, Kronoberg, Sweden
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenbrg, Sweden.,Region Västra Götaland, Södra Ävlsborg Hospital, Dep. of Research, Borås, Sweden
| | - Idor Svensson
- Linnaeus University, Faculty of Health and Life Sciences, Växjö, Kronoberg, Sweden
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Reeson M, Polzin W, Pazderka H, Agyapong V, Greenshaw AJ, Hnatko G, Wei Y, Szymanski L, Silverstone PH. A Novel 2-week Intensive Multimodal Treatment Program for Child Sexual Abuse (CSA) Survivors is Associated with Mental Health Benefits for Females aged 13-16. J Can Acad Child Adolesc Psychiatry 2020; 29:165-176. [PMID: 32774399 PMCID: PMC7391871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 02/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the psychiatric outcomes for the first cohorts of adolescent female Child Sexual Abuse (CSA) survivors after two-weeks in an intensive multimodal treatment program designed for this population. METHODS Baseline data was collected at intake and again immediately prior to discharge. Data collected included demographic information, as well as measurement of standardized scales for PTSD, depression, anxiety, quality of life, self-esteem, and resilience. Mean scores at baseline and discharge were statistically analyzed to assess for changes following the treatment program on these measures. RESULTS From the first twenty-seven (27) adolescent female CSA survivors, who completed two-weeks of the multimodal treatment program, all three symptomatic scales showed statistically significant improvements from baseline. There were decreases in mean questionnaire scores for Depression (-23.8%, p = 0.001), Anxiety (-20.6%, p = 0.006), and PTSD (-20.3%, p = 0.002), as well as decrease of nearly 50% in the number of participants who were having active suicidal thoughts. In keeping with this, there were also statistically significant improvements in ratings for Quality of Life (17.6%, p = 0.022), Self-Esteem (22.9%, p = 0.010), and Resilience (6.9%, p = 0.019). CONCLUSION This study presents preliminary findings from an intensive two-week multimodal treatment program specifically designed to help survivors of child sexual abuse (CSA). The highly positive short-term findings suggest that further longer-term follow-up in larger groups is appropriate. These preliminary results also support ongoing research for such intensive multimodal programs.
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Affiliation(s)
- Matthew Reeson
- Department of Psychiatry, University of Alberta, Edmonton, Alberta
| | - Wanda Polzin
- Little Warriors Be Brave Ranch, Edmonton, Alberta
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, Alberta
| | - Vincent Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, Alberta
| | | | - Gary Hnatko
- CASA Child Treatment facility, Edmonton, Alberta
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, Alberta
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Liverpool S, Mota CP, Sales CMD, Čuš A, Carletto S, Hancheva C, Sousa S, Cerón SC, Moreno-Peral P, Pietrabissa G, Moltrecht B, Ulberg R, Ferreira N, Edbrooke-Childs J. Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review of Modes of Delivery, Facilitators, and Barriers. J Med Internet Res 2020; 22:e16317. [PMID: 32442160 PMCID: PMC7381028 DOI: 10.2196/16317] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/15/2020] [Accepted: 03/12/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible. OBJECTIVE This review aimed to (1) identify modes of delivery used in CYP digital MH interventions, (2) explore influencing factors to usage and implementation, and (3) investigate ways in which the interventions have been evaluated and whether CYP engage in DHIs. METHODS A literature search was performed in the Cochrane Library, Excerpta Medica dataBASE (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and PsycINFO databases using 3 key concepts "child and adolescent mental health," "digital intervention," and "engagement." Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least two reviewers. The selected articles were assessed for quality using the mixed methods appraisal tool, and data were extracted to address the review aims. Data aggregation and synthesis were conducted and presented as descriptive numerical summaries and a narrative synthesis, respectively. RESULTS This study identified 6 modes of delivery from 83 articles and 71 interventions for engaging CYP: (1) websites, (2) games and computer-assisted programs, (3) apps, (4) robots and digital devices, (5) virtual reality, and (6) mobile text messaging. Overall, 2 themes emerged highlighting intervention-specific and person-specific barriers and facilitators to CYP's engagement. These themes encompassed factors such as suitability, usability, and acceptability of the DHIs and motivation, capability, and opportunity for the CYP using DHIs. The literature highlighted that CYP prefer DHIs with features such as videos, limited text, ability to personalize, ability to connect with others, and options to receive text message reminders. The findings of this review suggest a high average retention rate of 79% in studies involving various DHIs. CONCLUSIONS The development of DHIs is increasing and may be of interest to CYP, particularly in the area of MH treatment. With continuous technological advancements, it is important to know which modalities may increase engagement and help CYP who are facing MH problems. This review identified the existing modalities and highlighted the influencing factors from the perspective of CYP. This knowledge provides information that can be used to design and evaluate new interventions and offers important theoretical insights into how and why CYP engage in DHIs.
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Affiliation(s)
- Shaun Liverpool
- Evidence-Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Catarina Pinheiro Mota
- Center for Psychology, University of Porto, Porto, Portugal
- University of Trás-os-Montes and Alto Douro, Porto, Portugal
| | - Célia M D Sales
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Anja Čuš
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Sara Carletto
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Camellia Hancheva
- Faculty of Philosophy, General, Experimental, Developmental, and Health Psychology, Sofia University, Sofia, Bulgaria
| | - Sónia Sousa
- School of Digital Technologies, Tallinn University, Tallinn, Estonia
| | | | | | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Bettina Moltrecht
- Evidence-Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Randi Ulberg
- Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
| | | | - Julian Edbrooke-Childs
- Evidence-Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, London, United Kingdom
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49
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Harder VS, Barry SE, French S, Consigli AB, Frankowski BL. Improving Adolescent Depression Screening in Pediatric Primary Care. Acad Pediatr 2019; 19:925-933. [PMID: 30858080 DOI: 10.1016/j.acap.2019.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Received: 08/09/2018] [Revised: 01/17/2019] [Accepted: 02/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Depression among adolescents is a leading public health problem. Although screening for adolescent depression in primary care is strongly recommended, screening rates remain low. Effective quality improvement (QI) initiatives can facilitate change. This study aims to assess the impact of a QI learning collaborative on adolescent depression screening and initial plans of care in primary care. METHODS Seventeen pediatric-serving practices in Vermont participated in a QI learning collaborative aimed at improving practitioner knowledge and office systems around adolescent depression screening. Monthly medical record reviews provided monitoring of adolescent depression screening and initial plans of care over 7 months for QI. Randomly sampled annual medical record review data allowed comparison of screening and initial plans of care after the QI learning collaborative between participating and 21 control practices. RESULTS As practices improved their office systems around adolescent depression screening and initial plans of care, data showed marked improvement in depression screening at all 17 practices, from 34% to 97% over 7 months. Adolescents at participating practices had 3.5 times greater odds (95% confidence interval [CI], 1.14-10.98, P = .03) of being screened for depression and 37.5 times greater odds (95% CI, 7.67-183.48, P < .0005) of being screened with a validated tool than adolescents at control practices, accounting for patient characteristics. CONCLUSIONS There were significant within practice increases in adolescent depression screening after a QI learning collaborative, as well as in comparison with control practices 1 year later.
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Affiliation(s)
- Valerie S Harder
- Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski); Psychiatry (VS Harder), Vermont Child Health Improvement Program, University of Vermont, Burlington.
| | - Sara E Barry
- Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski)
| | - Sarah French
- Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski)
| | - Alyssa B Consigli
- Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski)
| | - Barbara L Frankowski
- Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski)
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50
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Bratt AS, Svensson I, Rusner M. Finding confidence and inner trust as a parent: experiences of group-based compassion-focused therapy for the parents of adolescents with mental health problems. Int J Qual Stud Health Well-being 2019; 14:1684166. [PMID: 31662062 PMCID: PMC6830276 DOI: 10.1080/17482631.2019.1684166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Indexed: 10/25/2022] Open
Abstract
Purpose: Compassion-focused therapy (CFT) can alleviate the stress and challenges faced by the parents of adolescents with mental health (MH) problems. Although CFT interventions have shown promising results, few studies have examined its effectiveness in adolescent psychiatric settings. Therefore, this study examined the participant experiences of group-based CFT for the parents of adolescents with MH problems.Methods: The reflective lifeworld research (RLR) approach was used to conduct in-depth interviews with eleven parents, focusing on participant experiences of group-based CFT. Meaning-oriented data analysis was undertaken.Results: The essential meaning of the phenomenon of participating in group-based CFT was understood as finding confidence and inner trust as a parent, characterized by an understanding of one's own needs, which provided parents with the confidence to support their children. The phenomenon is further explicated with its three constituents: (a) taking care of oneself and one's child; (b) being open and sharing experiences; and (c) acceptance and hope for the future.Conclusions: The CFT intervention enabled parents to find their agency and strengthened their relationships with their children. The findings underscore the need to acknowledge the supportive role parents play in the recovery of children who receive psychiatric care.
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Affiliation(s)
- Anna Sofia Bratt
- Faculty of Health and Life Sciences, Department of Psychology, Linnaeus University, Växjö, Sweden.,Child & Adolescent Psychiatric Clinic, Södra Älvsborg Hospital, Region Västra Götaland, Borås, Sweden
| | - Idor Svensson
- Faculty of Health and Life Sciences, Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Region Västra Götaland, Södra Älvsborg Hospital, Borås, Sweden
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