Difficulties Questionnaire Scores Research Articles

Association between Family Functioning, Child Emotional and Behavioral Problems, and Parental Stress during the COVID-19 Pandemic in Thailand.

The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children's difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children's difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.

Measurement invariance of the parent-reported Strengths and Difficulties Questionnaire in autistic adolescents.

Autistic people are more likely than non-autistic people to experience mental health difficulties. The Strengths and Difficulties Questionnaire is often used to screen for these difficulties and to otherwise make important decisions about mental health treatment and research in populations of autistic people. However, this study suggests that parent-reported Strengths and Difficulties Questionnaire scores may not be useful for comparing autistic and non-autistic adolescents at 11, 14 and 17 years old, as well as screening for mental health conditions in autistic adolescents. In addition, several items may be more likely to be endorsed by parents of autistic 17-year-olds than by parents of non-autistic 17-year-olds (and vice versa), which might suggest caution is needed when comparing groups on specific items.

Relationship between physical activity and behaviour challenges of adolescents in South Africa.

Four out of five adolescents worldwide are physically inactive based on recommended standards. We determined whether physical activity is associated with lower behavioural challenges in adolescents to promote buy-in from stakeholders. KwaZulu-Natal province, South Africa, from January 2020 to March 2020. A cross-sectional study was conducted among 187 adolescent learners (12-18 years) from three government schools in KwaZulu-Natal Province, South Africa, from January to March 2020. We fitted linear regression models between the Strengths and Difficulties Questionnaire scores (total, internalising, externalising, and prosocial) and hours of physical activity exposure, adjusting for demographic covariates, and depression history. The median age was 14.4 years (interquartile range = 1.36) and 75.9% of the participants were females. Overall average and weekday physical activity were each associated with lower total and externalising but higher pro-social scores. Depression was associated with higher inactivity scores (total, internalising and externalising). The article shows that physical activity can reduce the behavioural and emotional problems in adolescents. Physical activity is critical for a healthy adolescent hood and needs to be actively included in childhood development.

Recurrent otitis media and behaviour problems in middle childhood: A longitudinal cohort study.

To investigate the long-term effects of early-life recurrent otitis media (OM) and subsequent behavioural problems in children at the age of 10 years. Data from the Raine Study, a longitudinal pregnancy cohort, were used to categorise children into those with three or more episodes of OM (rOM group) and those without a history of recurrent OM in the first 3 years of life (reference group). The parent report Strengths and Difficulties Questionnaire was used to assess child behaviour at the age of 10 years. Parental questionnaires were used to report past and present diagnoses of various mental health and developmental conditions, including attention, anxiety, depression, learning, and speech-language problems. Multiple linear and logistic models were used to analyse the data and were adjusted for a fixed set of key confounding variables. The linear regression analysis revealed significant, independent associations between a history of recurrent OM and higher Strengths and Difficulties Questionnaire scores, including total, internalising, externalising, emotional, attention/hyperactivity and peer problems subscales. Logistic regression analyses revealed an independent increased likelihood for children in the rOM group to have a diagnosis of attention, anxiety, learning and speech-language problems. Children at 10 years of age with an early history of recurrent OM are more likely to exhibit attentional and behavioural problems when compared to children without a history of recurrent OM. These findings highlight the association between early-life recurrent OM and later behavioural problems that may require professional allied health-care interventions.

Association between Children's Difficulties, Parent-Child Sleep, Parental Control, and Children's Screen Time: A Cross-Sectional Study in Japan.

Children's screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children's screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children's screen time based on their sleep, difficulties, and parental control among Japanese elementary and junior high school students. A cross-sectional survey was conducted among parents in Japan. Data on screen time duration, parent-child background, strengths and difficulties, sleep variables, and parental control types were collected from 225 households. A regression analysis revealed that high Strengths and Difficulties Questionnaire (SDQ) scores (β = 0.166, p = 0.008), sleep duration (β = -0.281, p < 0.001), and parental control (β = -0.204, p = 0.001) were significantly related to children's screen time. Additionally, it was found that parents' late bedtimes affect children's screen time by mediating children's sleep duration. This study, together with previous research, provides comprehensive insights into design interventions to decrease the screen time of children in the Japanese context.

Wachttijden op de polikliniek kinder- en jeugdpsychiatrie van het UZ Brussel: hoe sneller patiënten identificeren die minder kans hebben op doorstromen naar diagnostisch onderzoek?

Waiting times at the outpatient clinic for child and adolescent psychiatry at the University Hospital of Brussels: which factors are related to waiting times and the risk of being admitted for diagnostics? Long waiting lists are a major problem in mental health care for minors. In Flanders (Belgium), concrete data about waiting lists are limited. Gaining more insight into this problem and exploring possibilities to reduce waiting times are essential. This exploratory study of a retrospective cohort mapped the waiting times and population characteristics of all registered patients in the period of May 1, 2020 to April 30, 2021 who were placed on the waiting list for intake at the outpatient clinic for child and adolescent psychiatry of the University Hospital of Brussels. A logistic regression analysis was conducted to determine factors associated with the likelihood of rejection. Based on the data, a template for an online questionnaire was developed to help identify patients at high risk of being rejected more quickly. Half of the 382 registered patients moved on for further assessment. The median waiting time until intake was 17 weeks. The likelihood of being rejected increased as the parents’ total Strengths and Difficulties Questionnaire (SDQ) score decreased and with current involvement of psychological/psychiatric services. This study confirms the long waiting time for ambulatory multidisciplinary child psychiatric assessment within a university hospital. A significant proportion of the patients does not proceed for further assessment, which makes fast identification of these patients important. A proposal for an online questionnaire was developed for this purpose. Patients with an increased risk of rejection can be screened in the short term. Follow-up research with practical implementation and evaluation of the impact on waiting times is necessary.

Machine learning-based prediction for self-harm and suicide attempts in adolescents

This study aimed to use machine learning (ML) models to predict the risk of self-harm and suicide attempts in adolescents. We conducted secondary analysis of cross-sectional data from the Longitudinal Study of Australian Children dataset. Several key variables at the age of 14–15 years were used to predict self-harm or suicide attempt at 16-17 years. Random forest classification models were used to select the optimal subset of predictors and subsequently make predictions. Among 2809 participants, 296 (10.54%) reported an act of self-harm and 145 (5.16%) reported attempting suicide at least once in the past 12 months. The area under the receiver operating curve was fair for self-harm (0.7397) and suicide attempt (0.7220), which outperformed the prediction strategy solely based on prior suicide or self-harm attempt (AUC: 0.6). The most important factors identified were similar, and included depressed feelings, strengths and difficulties questionnaire scores, perceptions of self, and school- and parent-related factors. The random forest classification algorithm, an ML technique, can effectively select the optimal subset of predictors from hundreds of variables to forecast the risks of suicide and self-harm among adolescents. Further research is needed to validate the utility and scalability of ML techniques in mental health research.

A Shared Multivariate Brain-Behavior Relationship in a Transdiagnostic Sample of Adolescents

BackgroundInternalizing and externalizing psychopathology typically present in early childhood and can have negative implications on general functioning and quality of life. Prior work has linked increased psychopathology symptoms with altered brain structure. Multivariate analysis such as partial least squares correlation can help identify patterns of covariation between brain regions and psychopathology symptoms. This study examined the relationship between gray matter volume (GMV) and psychopathology symptoms in adolescents with various psychiatric diagnoses. MethodsStructural magnetic resonance imaging data were collected from 490 participants with various internalizing and externalizing diagnoses (197 female/293 male; age = 14.68 ± 2.35 years; IQ = 104.05 ± 13.11). Cortical and subcortical volumes were parcellated using the Desikan-Killiany atlas. Partial least squares correlation was used to identify multivariate linear relationships between GMV and the Strength and Difficulties Questionnaire difficulties domains (emotional, peer, conduct, and hyperactivity issues). Resampling approaches were used to determine significance (permutation test), stability (bootstrap resampling), and reproducibility (split-half resampling) of identified relationships. ResultsWe found a significant, stable, and largely reproducible dimension that linked lower Strength and Difficulties Questionnaire scores (less impairment) across all difficulties domains with greater widespread GMV (singular value = 1.17, accounts for 87.1% of the covariance; p < .001). This dimension emphasized the relationship between lower conduct problems and greater GMV in frontotemporal regions. ConclusionsOur results indicate that the most significant and stable brain-behavior relationship in a transdiagnostic sample is a domain-general relationship, linking lower psychopathology symptom scores to greater global GMV. This finding suggests that a shared brain-behavior relationship may be present across adolescents with and without clinically significant psychopathology symptoms.

Integrating EMDR Standard Treatment Protocol into Child Psychotherapy at a Primary School with a 5‐year‐old Boy Who Suffered Complex Trauma: A Single Case Study

Schools are making an important contribution to providing access to professional counselling for young people and their families. The population of children who access school counselling includes young people who have experienced severe and complex trauma in their early life, which presents itself as post‐traumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) therapy is a recommended method of intervention for PTSD, with effective results in a short time. However, school counsellors are rarely specifically trained to work with complex trauma or PTSD. This article presents a case study exploring the integration of the EMDR eight‐phase protocol into child psychotherapy in an English primary school setting with a 5‐year‐old boy who suffered complex trauma. Following treatment, the Strengths and Difficulties Questionnaire (SDQ) score and Generalized Anxiety Disorder Assessment (GAD‐7) score—filled in by the child's parent and schoolteacher because of the child's age—decreased to non‐clinical levels. The six‐month follow‐up assessment confirmed the improvement in the emotional well‐being of the client. The promising results suggest the value of having adequately qualified child psychotherapists linked to primary schools to support emotionally vulnerable pupils.

Plasma proteomics discovery of mental health risk biomarkers in adolescents

An estimated 10–20% of adolescents experience mental health conditions, and most of them remain underdiagnosed and undertreated. Discovering new susceptibility biomarkers is therefore important for identifying individuals at high risk of developing mental health problems, and for improving early prevention. Here we aimed to discover plasma protein-based susceptibility biomarkers in children/adolescents aged 11–16 years at risk of developing mental health issues. Risk was evaluated on the basis of self-reported Strengths and Difficulties Questionnaire (SDQ) scores, and plasma proteomic data were obtained for individuals participating in the Spanish WALNUTs cohort study by liquid chromatography–tandem mass spectrometry. Bioinformatic analyses were performed to identify the biological processes and pathways in which the identified biomarker candidates are involved; 58 proteins were significantly associated with the SDQ score. The most prominent enriched pathways related to these proteins included immune responses, blood coagulation, neurogenesis and neuronal degeneration. This exploratory study revealed several alterations of plasma proteins associated with the SDQ score in adolescents, which opens a new avenue to develop novel susceptibility biomarkers to improve early identification of individuals at risk of mental health problems.

Internal Consistency of the Serbian Translation of the Stanford Social Dimensions Scale and Association to Strengths and Difficulties Questionnaire Scores in Male and Female Individuals on the Autism Spectrum and Non-autistic Individuals.

We aimed to evaluate the internal consistency of Stanford Social Dimensions Scale (SSDS) translated to Serbian and to test it against the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 200 patients (32% ASD) of the Institute of Mental Health in Belgrade, Serbia (68 females, 132 males, Mage=9.61, SDage=4.06). Internal consistency coefficients were within good/acceptable range for Social Motivation, Affiliation, Recognition and Unusual Approach subscales and below acceptable for Expressive Social Communication subscale. The non-autistic group scored higher on all subscales compared to the ASD group. All SSDS subscales positively correlated with SDQ Prosocial Behaviors scale. The SSDS is a valuable instrument for accessing sociobehavioral phenotype in both individuals on the autism spectrum and non-autistic individuals.

Prediction of School Dropout Outside School Setting: Potential for Early risk Stratification by Youth Health Care Services in the Netherlands. Results from a Retrospective Cohort Study

BackgroundEarly school dropout is an economic, social, and individual problem. School dropout is a result of cumulative processes that occur over many childhood years. Despite the influence of level of education on health outcomes, primary prevention of dropout outside of the school setting is rare. In the Netherlands, the Youth Health Care (YHC) service may play a role in primary prevention of school dropout.ObjectiveWe hypothesized that data collected by YHC on family background and Strength and Difficulties Questionnaire (SDQ) scores at ages 10 and 14 is predictive of school dropout.MethodsWe analyzed Dutch YHC data from 24,988 children born in 1996 − 200. Early school dropout was defined as having left school without diploma by the age of 17. Two multilevel logistic regression models were built with predictors measured at the ages of 10 and 14. The model performance was assessed using ROC curve.ResultsA child’s SDQ was a strong predictor of early school dropout, in addition to gender and parents’ socio-economic status at age 10 and age 14. Models showed moderate prediction performance (ROC value 0.70/0.69, respectively).ConclusionsThe proposed prediction models are based on only few routinely collected socio-demographic factors and SDQ scores. We found these models can contribute to risk stratification by YHC as early as age of ten. This provides a window of opportunity for interventions that aim to strengthen school engagement. Further research and practical efforts to expand the set of predictors available to YHC (e.g., school performance) are expected to improve the quality of this prediction.

Tobacco Usage and Its Association With Mental Health Status of School-Going Adolescents Near Patna, Bihar: A Community-Based Cross-Sectional Study in Eastern India.

Background Of all the adolescents in India, 7.3% are suffering from some form of mental disorder. They frequently use tobacco to cope with these problems, but get stuck in a vicious cycle of deteriorating mental health. Our study aimed to determine the effect of tobacco on the mental health status of adolescents studying in the 9th to 12th standards in 10 high schools in urban and rural areas near Patna, Bihar. Methodology An analytical cross-sectional study was conducted among 360 school-going adolescents recruited using stratified random sampling. Selected adolescents were given the Indian Adolescent Health Questionnaire. The mental health status was calculated from the Strengths and Difficulties Questionnaire (SDQ) score. Information on sociodemographic characteristics and tobacco use was also obtained. Independent t-test, analysis of variance, and multiple linear regression analysis were used for predicting the significant factors. Significance was set at p-values <0.05. Results In this study, 40 (11.1%) adolescents had abnormal whereas 55 (15.3%) had borderline overall SDQ scores. The majority of those affected had peer problems (40%) and conduct problems (24.7%). All SDQ components of conduct (F = 2.94, p = 0.013), hyperactivity (F = 2.90, p = 0.014), emotional problems (F = 1.14, p = 0.001), and peer pressure (F = 3.06, p = 0.010), as well as the overall SDQ score (F = 5.74, p < 0.001), were significantly associated with increasing age. The adolescents attending rural schools (13.28 ± 5.22, p = 0.047) had significantly higher SDQ scores than those attending urban schools (12.08 ± 5.60). Hyperactivity scores were significantly higher in those studying in class 10 compared to other classes and in those attending rural rather than urban schools. Emotional problems score was significantly higher in 16-17-year-old students than in 14-15-year-old students, in females than in males, and in class 10 than in class 9 students. Only 24 (6.7%) adolescents had a history of tobacco consumption at least once which was significantly associated with the SDQ score (17.71 ± 5.69; t = 4.95, df = 358, p < 0.001). Around 79.4% of adolescents were exposed to passive smoking from close friends which deteriorated their overall mental health status (14.50 ± 5.99; F = 6.29, df = 2,357, p = 0.002). Those who had smoked for more than 10 days had significantly greater conduct problems and lesser pro-social behavior. Overall, 96.1% agreed that tobacco is harmful to health, and 76.1% had seen anti-smoking messages in the media. Female gender, increasing class and age, and history of smoking or chewing tobacco at least once also led to a significant increase in emotional problems. Age, area of the school, history of tobacco consumption, and exposure to cigarette smoke by either a close friend or male guardian had a significant impact on the conduct, hyperactivity, peer problems, and overall mental health status of school-going adolescents. Conclusions Predicting risk factors such as age, area of the school, and the history of tobacco consumption by self or by close friends is important for decision-making by school administration regarding counseling for mental health and preventing tobacco use.

Mental Wellbeing among Children with Cancer during COVID-19 Pandemic in Indonesia: A Cross-sectional Study

Abstract Introduction Coronavirus disease 2019 (COVID-19) has affected both physical and mental aspect of people worldwide, especially the high-risk group such as pediatric cancer patients. Children with cancer were considered both clinically and mentally vulnerable during this pandemic. They were also affected by the self-isolation, quarantine, and social distancing policy taken as a respond to public threat. Objectives To evaluate the impact of social distancing and health protocol during COVID-19 on the mental health profile of children with cancer in Indonesia. Methods A cross-sectional study evaluating the mental health of children with cancer during COVID-19 pandemic was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from June to September 2020. An online questionnaire was used to collect demographics of parents and children, children's Strength and Difficulties Questionnaire (SDQ) score, and parents' Self-Reporting Questionnaire (SRQ). SDQ score consists of five subscales, including the emotional symptoms, conduct problems, hyperactivity, peer relationships problems and prosocial behavior. Cancer types were grouped into retinoblastoma, nonretinoblastoma (other solid tumors), and leukemia. Results There were 156 valid responses, consisting of 42 patients with retinoblastoma, 34 patients with nonretinoblastoma (other solid tumors), and 80 patients with leukemia. Pandemic-related lifestyle changes did not significantly impact emotional or behavioral problems. Children with normal total SDQ (odds ratio [OR]: 473, p = 0.001) and emotional scores (OR: 3.19, p = 0.07) had parents with normal SRQ scores (&lt;6). Leukemia patients with shorter diagnosis period had worse hyperactivity score (p = 0.01). On the contrary, leukemia inpatients had better prosocial scores than outpatients (p = 0.03). More bilateral retinoblastoma patients (p = 0.04) with longer duration of cancer diagnosis (p = 0.03) faced peer problems. Conclusions Our study revealed that lifestyle changes during early COVID-19 pandemic were not major factors impacting emotional and behavioral problems in children with cancer. However, disease-related factors pose great challenges; thus, a holistic mental health support system should be available to both children and parents.

Hearing outcomes in children with single sided deafness: Our experience at a tertiary paediatric otorhinolaryngology unit.

Hearing rehabilitation options for single sided deafness (SSD) include contralateral routing of sound (CROS) aids and bone conduction devices (BCDs). This study aimed to review the management of children with SSD at our tertiary paediatric otolaryngology unit over the last 15 years. A retrospective cohort study was performed. Primary hearing outcomes were measured using the Children's Home Inventory for Listening Difficulties (CHILD) questionnaire score and secondary hearing outcomes were measured using hearing thresholds for speech in noise. Outcomes were measured pre and post bone conduction device (BCD) trial. 49 patients with SSD were identified. 20 children had trial of a BCD. 16 patients had pre- and post- BCD trial CHILD scores available for analysis. There was a statistically significant improvement in CHILD scores and speech in noise testing at +5dB and +0dB following amplification with a BCD. The mean use of BCD was 1.3h per day. We have described the management of children with SSD in our unit. This study demonstrated a statistically significant benefit of BCD use on hearing outcomes. However, device compliance is low suggesting hearing advice choice in the population is complex and further research is warranted.

Secondary data analysis of social care records to examine theprovision of mental health support for young people in care.

Young people in care are much more likely to experience mental health difficulties than the general population, yet little is known about the provision of mental health support for this group in the United Kingdom. Using routinely collected social care data, we explored the provision of mental health support for 112 young people in care in the UK. We identified young people experiencing elevated internalising or externalising difficulties in their first year in care (based on strengths and difficulties questionnaire scores) and extracted data on mental health referrals and provision. We generated descriptive statistics relating to provision of mental health support and used regressions to examine predictors of mental health provision, and associations between support and mental health outcomes one and 2years later. Eighty-one percent of the children (n=79) were referred to mental health services in their first year of being in care. Referrals were usually for emotional or conduct problems. Those with higher externalising symptoms were more likely to be referred than those with higher internalising symptoms (OR=1.2, (95% confidence interval (CI): 1.01, 1.38)). Females were more likely to access support than males (OR=3.82 (95% CI: 1.2, 13.3)). Sixty-eight percent of children (n=66) accessed mental health services in their first year of being in care. Of those who accessed services, support ended prematurely for 29 (44%) of them, often due to placement instability or disengagement. Accessing support in the first year of care was not associated with changes in mental health 1year (OR: 2.14 (95% CI: 0.62,7.29)), or 2years after entering care (OR: 0.72-8.57, (95% CI: 0.72, 8.57)), although methodological limitations are noted. Mental health difficulties for children in care are recognised quickly, but mental health support may be difficult to access, with issues evident in retention and engagement.

Types of greenspace and adolescent mental health and well-being in metropolitan London

ABSTRACT The evidence suggests a link between greenspace and adolescent mental health. One limitation is the typically crude measure of greenspace quantity or greenness. We explored the roles of different types of greenspace in the mental health of 10- to 15-year-old adolescents living in London, using data from Understanding Society, a UK household longitudinal study. We used data on 1,879 adolescents from waves 1-8 (2009-2018). As some adolescents had observations at multiple waves, 4,217 observations were included. Mental health and well-being measures were Strengths and Difficulties Questionnaire scores, self-esteem, and happiness. Proportions of green land cover, parks & gardens, natural & semi-natural urban greenspaces, outdoor sports facilities, and total green land use were measured in 500 m around postcodes. We ran linear regressions, stratified by age, adjusted for confounders, and accounting for Understanding Society’s complex sampling design. We did not find consistent results across analyses, but we identified patterns worth exploring further: older adolescents (13-15 years) seemed to ‘benefit’ more from greenspace than younger adolescents (10-12 years); and parks & gardens and outdoor sports facilities seemed to be most ‘beneficial’. Overall, however, no clear conclusions can be drawn, and findings need to be confirmed in future studies.

Lone parents' employment policy and adolescents’ socioemotional development: Quasi-experimental evidence from a UK reform

Studies suggest that welfare-to-work programmes increase lone mother's employment, but their impact on child and adolescent socioemotional development is unclear. The lone parent obligation (LPO) reform introduced a requirement for lone mothers entitled to unconditional Income Support (IS) to seek paid work actively as a condition to receive benefits. We use data from the UK Millennium Cohort Study to examine the impact of work search requirements for lone parents on child and adolescent socioemotional development. We apply a difference-in-differences approach that exploits gradual changes from 2008 to 2017 in children's maximum eligibility age to receive IS and assess effects on child and adolescent Strengths and Difficulties Questionnaire (SDQ) scores. We find that the LPO reform led to a ten-percentage point increase in lone mothers' employment but no change in the risk of family poverty. The reform led to a small but statistically significant increase in adolescents' SDQ scores, which indicated worse mental health and was largely driven by increased emotional problems. It also led to an increase in mothers' distress and poor self-rated health, and mothers' reports that time spent with children was insufficient. Our findings highlight the need to consider trade-offs between employment gains and child and adolescent socioemotional development in assessing the net impact of welfare-to-work policies targeting lone parents.

Urban factors and mental health symptoms in children of the Tokyo Early Adolescence Survey; impact of proximity to railway stations

IntroductionThere is an evolving literature on the association of the proximity of place of residence to specific urban features with mental health symptoms or diagnoses, although few studies have examined these associations in children. This study tested the hypothesis that proximity of home to railway stations is a positive predictor of mental health at age 10 years. MethodsWe used data from a large population-based survey conducted in three municipalities in Tokyo, Japan, the Tokyo Early Adolescence Survey. We examined relationships between distance from home to the nearest railway station and Strengths and Difficulties Questionnaire (SDQ) scores for hyperactivity/inattention, prosocial behaviour and emotional symptoms. We undertook unadjusted analyses and then adjusted for urban, child and parental co-variates. Analyses were performed both in the whole sample and after stratification by child gender. Multiple Imputation with Chained Equations was used for missing data analyses. ResultsGreater distance to the nearest railway station was associated with higher SDQ-derived hyperactivity/inattention scores (i.e. more symptoms) in the unadjusted analysis across all 4052 analyzable children (β = 0.144, 95% C.I. 0.013 to 0.276, p = 0.031), and in the fully adjusted analysis in boys (β = 0.186, 95% C.I. 0.001 to 0.372, p = 0.049) but not in girls (β = 0.020, 95% C.I. −0.146 to 0.185, p = 0.817). There were no associations with the other SDQ-based outcomes of prosocial behaviour and emotional symptoms. ConclusionsThese findings suggest that access to high-frequency rail transit may be associated with improved hyperactivity/inattention outcomes in children living in urban environments, raising the possibility that an additional benefit of transit-oriented developments in urban settings may be a positive impact on this important aspect of children's mental health.

Impact of high‐intensity interval training including Indigenous narratives on adolescents’ mental health: a cluster‐randomised controlled trial

ObjectivesWe investigated the efficacy of teacher‐delivered high‐intensity interval training (HIIT) with Indigenous narrative options on the mental health of school students in low–mid socioeconomic areas, compared to standard curriculum physical education practice. MethodsA cluster‐randomised controlled trial was conducted in eight schools (N=368, age range 11–13 years) over 16 weeks. The primary outcome was the Strengths and Difficulties Questionnaire (SDQ) score. Generalised linear mixed models, controlling for the SDQ at baseline were applied, expressed as β, 95% confidence intervals, standardised effect, and p‐value. Focus groups elicited experiences with participating in and delivering the intervention. ResultsThere were no clear effects for SDQ total score (β ‐0.15, CI ‐0.98 ‐ 0.67, SE 0.42, p=0.714). Teachers did not deliver the Indigenous narrative options consistently owing to the perceived preparation needed and lack of confidence. ConclusionsHIIT delivered in this manner had no effect on self‐perceived psychological difficulty or mental wellbeing in a cohort of young adolescents. Implications for public healthFuture research should continue to explore opportunities to improve mental wellbeing via physical activity, but HIIT should not be implemented as a universal intervention for mental health gains alone. Teachers need more support to utilise Indigenous narratives as part of HIIT delivery.