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Ashworth E, Jarman I, McCabe P, McCarthy M, Provazza S, Crosbie V, Quigg Z, Saini P. Suicidal Crisis among Children and Young People: Associations with Adverse Childhood Experiences and Socio-Demographic Factors. Int J Environ Res Public Health 2023; 20:1251. [PMID: 36674021 PMCID: PMC9858613 DOI: 10.3390/ijerph20021251] [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: 12/05/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Suicide is a major public health issue and a leading cause of death among children and young people (CYP) worldwide. There is strong evidence linking adverse childhood experiences (ACEs) to an increased risk of suicidal behaviours in adults, but there is limited understanding regarding ACEs and suicidal crises in CYP. This study aims to examine the ACEs associated with CYP presenting at Emergency Departments for suicidal crises, and specifically the factors associated with repeat attendances. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in a paediatric Emergency Department in England between March 2019 and March 2021 (n = 240). The dataset was subjected to conditional independence graphical analysis. Results revealed a significant association between suicidal crisis and several ACEs. Specifically, evidence of clusters of ACE variables suggests two distinct groups of CYP associated with experiencing a suicidal crisis: those experiencing "household risk" and those experiencing "parental risk". Female sex, history of self-harm, mental health difficulties, and previous input from mental health services were also associated with repeat hospital attendances. Findings have implications for early identification of and intervention with children who may be at a heightened risk for ACEs and associated suicidal crises.
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Affiliation(s)
- Emma Ashworth
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Ian Jarman
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Philippa McCabe
- Faculty of Engineering and Technology, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Molly McCarthy
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Serena Provazza
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Vivienne Crosbie
- Alder Hey Children’s NHS Foundation Trust, Liverpool L14 5AB, UK
| | - Zara Quigg
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Pooja Saini
- Faculty of Health, Liverpool John Moores University, Liverpool L3 3AF, UK
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Ashworth E, Provazza S, McCarthy M, Saini P. Children and Young People Presenting in a Pediatric Emergency Department in North-West England in Suicidal Crisis: An Exploratory Case Series Study. Front Psychiatry 2022; 13:892939. [PMID: 35546930 PMCID: PMC9081675 DOI: 10.3389/fpsyt.2022.892939] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is a leading cause of death among children and young people (CYP) worldwide, and rates have been increasing in recent years. However, while evidence exists regarding factors associated with suicide and self-harm, there is limited information publicly available on the CYP who present in suicidal crisis. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in an Emergency Department at a pediatric hospital in North-West England between March 2019 and March 2021 (n = 240). Clinical records were extracted and audited to explore demographic data, methods of recording patient attendance, the clinical pathways available and the patterns of pathway usage, and differences in CYP presentations before and after the COVID-19 pandemic. Attendees were mostly White females, with a mean age of 13.5 years, and 24% had a diagnosed special educational need. "Social/social problems" was the most commonly used code for recording attendance (38%), and pathways varied depending on code used. A range of parental and familial factors were also identified. There were more CYP presenting with self-harm in addition to suicide ideation after the pandemic began (43 vs 27% pre-pandemic). This study provides the first clear insight into CYP who seek help at a North-West Emergency Department for suicidal crisis, and work is now needed to develop effective prevention strategies tailored toward the groups most at-risk.
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Affiliation(s)
- Emma Ashworth
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
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Provazza S, Carretti B, Giofrè D, Adams AM, Montesano L, Roberts D. Shallow or deep? The impact of orthographic depth on visual processing impairments in developmental dyslexia. Ann Dyslexia 2022; 72:171-196. [PMID: 35286579 PMCID: PMC8942915 DOI: 10.1007/s11881-021-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
The extent to which impaired visual and phonological mechanisms may contribute to the manifestation of developmental dyslexia across orthographies of varying depth has yet to be fully established. By adopting a cross-linguistic approach, the current study aimed to explore the nature of visual and phonological processing in developmental dyslexic readers of shallow (Italian) and deep (English) orthographies, and specifically the characterisation of visual processing deficits in relation to orthographic depth. To achieve this aim, we administered a battery of non-reading visual and phonological tasks. Developmental dyslexics performed worse than typically developing readers on all visual and phonological tasks. Critically, readers of the shallow orthography were disproportionately impaired on visual processing tasks. Our results suggest that the impaired reading and associated deficits observed in developmental dyslexia are anchored by dual impairments to visual and phonological mechanisms that underpin reading, with the magnitude of the visual deficit varying according to orthographic depth.
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Affiliation(s)
- Serena Provazza
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Barbara Carretti
- Department of General Psychology, University of Padova, Padua, Italy
| | - David Giofrè
- School of Psychology, Liverpool John Moores University, Liverpool, UK
- Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Anne-Marie Adams
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - Daniel Roberts
- Centre for Cognitive Neuroscience, Division of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
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Provazza S, Adams AM, Giofrè D, Roberts DJ. Double Trouble: Visual and Phonological Impairments in English Dyslexic Readers. Front Psychol 2020; 10:2725. [PMID: 31920790 PMCID: PMC6927912 DOI: 10.3389/fpsyg.2019.02725] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/10/2019] [Accepted: 11/18/2019] [Indexed: 11/13/2022] Open
Abstract
Developmental dyslexia is a reading disorder characterized by problems in accurate or fluent reading. A deficiency in phonological processing is thought to underpin the reading difficulties of individuals with developmental dyslexia and a variety of explanations have been proposed including deficits in phonological awareness and verbal memory. Recent investigations have begun to suggest that developmental deficits in the acquisition of reading may also co-occur with visual processing deficits, which are particularly salient for visually complex stimuli, yet these deficits have received relatively little attention from researchers. To further explore the nature of phonological and visual processing in developmental dyslexia, we administered a series of non-reading tasks tapping both domains. Unsurprisingly, individuals with developmental dyslexia performed worse than typically developing readers in phonological tasks. More intriguingly, they also struggled with visual tasks, specifically when discriminating between novel visual patterns, and in visuo-spatial working memory, which requires greater attentional control. These findings highlight that individuals with developmental dyslexia present not only with phonological impairments but also difficulties in processing visual materials. This aspect has received limited attention in previous literature and represents an aspect of novelty of this study. The dual phonological and visual impairments suggest that developmental dyslexia is a complex disorder characterized by deficits in different cognitive mechanisms that underpin reading.
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Affiliation(s)
- Serena Provazza
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Anne-Marie Adams
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - David Giofrè
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom.,Department of Educational Sciences, University of Genoa, Genoa, Italy
| | - Daniel John Roberts
- Division of Psychology, Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
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Abstract
In reading, length effects (LEs) are defined as an increment in the time taken to read as a function of word length and may indicate whether reading is proceeding in an efficient whole word fashion or by serial letter processing. LEs are generally considered to be a pathognomonic symptom of developmental dyslexia (DD) and predominantly have been investigated in transparent orthographies where reading impairment is characterized as slow and effortful. In the present study a sample of 18 adult participants with DD were compared to a matched sample of typical developing readers to investigate whether the LE is a critical aspect of DD in an opaque orthography, English. We expected that the DD group would present with marked LEs, in both words and non-words, compared to typical developing readers. The presence of LEs in the DD group confirmed our prediction. These effects were particularly strong in low frequency words and in non-words, as observed in reading speed. These preliminary findings may have important theoretical implications for current understanding of DD.
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Affiliation(s)
- S. Provazza
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - D. Giofrè
- Department of Education Sciences, School of Social Sciences, University of Genoa, Genoa, Italy
| | - A.-M. Adams
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - D. J. Roberts
- Division of Psychology, Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
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Giofrè D, Toffalini E, Provazza S, Calcagnì A, Altoè G, Roberts DJ. Are children with developmental dyslexia all the same? A cluster analysis with more than 300 cases. Dyslexia 2019; 25:284-295. [PMID: 31332875 PMCID: PMC6771784 DOI: 10.1002/dys.1629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/17/2019] [Revised: 05/09/2019] [Accepted: 06/20/2019] [Indexed: 06/10/2023]
Abstract
Reading is vital to every aspect of modern life, exacerbated by reliance of the internet, email, and social media on the written medium. Developmental dyslexia (DD) characterizes a disorder in which the core deficit involves reading. Traditionally, DD is thought to be associated with a phonological impairment. However, recent evidence has begun to suggest that the reading impairment in some individuals is provoked by a visual processing deficit. In this paper, we present WISC-IV data from more than 300 Italian children with a diagnosis of DD to investigate the manifestation of phonological and visual subtypes. Our results indicate the existence of two clusters of children with DD. In one cluster, the deficit was more pronounced in the phonological component, while both clusters were impaired in visual processing. These data indicate that DD may be an umbrella term that encompasses different profiles. From a theoretical perspective, our results demonstrate that dyslexia cannot be explained in terms of an isolated phonological deficit alone; visual impairment plays a crucial role. Moreover, general rather than specific accounts of DD are discussed.
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Affiliation(s)
- David Giofrè
- Department of Educational SciencesUniversity of GenoaGenoaItaly
| | | | - Serena Provazza
- Natural Sciences and PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Antonio Calcagnì
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Gianmarco Altoè
- Department of Developmental and Social PsychologyUniversity of PadovaPadovaItaly
| | - Daniel J. Roberts
- Centre for Cognitive Neuroscience, Division of Psychology, College of Health and Life SciencesBrunel University LondonUxbridgeUK
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Giofrè D, Provazza S, Angione D, Cini A, Menazza C, Oppi F, Cornoldi C. The intellectual profile of children with autism spectrum disorders may be underestimated: A comparison between two different batteries in an Italian sample. Res Dev Disabil 2019; 90:72-79. [PMID: 31082681 DOI: 10.1016/j.ridd.2019.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/05/2019] [Accepted: 04/12/2019] [Indexed: 06/09/2023]
Abstract
Intelligence measures are typically used in the assessment of children with autism spectrum disorders (ASD), but there is a paucity of research on the implications of such testing. In the present study, we examined children with ASD using two of the most largely adopted instruments, i.e., the WISC-IV, arguably the most utilized scale in the world; and the Leiter-3, a nonverbal scale that also excludes, from the IQ calculation, working memory and processing speed, which are points of weakness in ASD. Results showed that IQ and indices of these two batteries are strongly correlated. However, the WISC-IV IQ might underestimates the potential of children with ASD, particularly in children with a low functioning profile. These hold true for both the full scale IQ and three out of four indices of the WISC-IV, with remarkable implications for both assessment and treatment of these children. Practitioners working with children with ASD should be aware that the battery that they are using might severely affect the estimation of these children's potential.
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Affiliation(s)
- D Giofrè
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK.
| | - S Provazza
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
| | - D Angione
- Department of General Psychology, University of Padova, Padova, Italy
| | - A Cini
- Diagnosis and Research Center in Autism (CDCRA), ULSS 9, Scaligera, Italy
| | - C Menazza
- Center for Developmental Age and Autism, Polo Blu, Padova, Italy
| | - F Oppi
- Diagnosis and Research Center in Autism (CDCRA), ULSS 9, Scaligera, Italy
| | - C Cornoldi
- Department of General Psychology, University of Padova, Padova, Italy
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