Child Mental Health Research Articles

Parental domestic violence and abuse, mental ill-health, and substance misuse and the impact on child mental health: a secondary data analysis using the UK Millennium Cohort Study

BackgroundParental domestic violence and abuse (DVA), mental ill-health (MH), and substance misuse (SU) can have a negative impact on both parents and children. However, it remains unclear if and how parental DVA, MH, and SU cluster and the impacts this clustering might have. We examined how parental DVA, MH, and SU cluster during early childhood, the demographic/contextual profiles of these clusters, and how these clusters relate to child MH trajectories.MethodsWe examined data from 15,377 families in the UK Millennium Cohort Study. We used: (1) latent class analysis to create groups differentially exposed to parental DVA, MH, and SU at age three; (2) latent growth curve modelling to create latent trajectories of child MH from ages 3–17; and (3) a case-weight approach to relate latent classes to child MH trajectories.ResultsWe identified three latent classes: high-frequency alcohol use (11.9%), elevated adversity (3.5%), and low-level adversity (84.6%). Children in the elevated adversity class had higher probabilities of being from low-socioeconomic backgrounds and having White, younger parents. Children exposed to elevated adversity displayed worse MH at age three (intercept = 2.274; p < 0.001) compared the low-level adversity (intercept = 2.228; p < 0.001) and high-frequency alcohol use class (intercept = 2.068; p < 0.001). However, latent growth factors (linear and quadratic terms) of child MH did not differ by latent class.ConclusionsParental DVA, MH, and SU cluster during early childhood and this has a negative impact on children’s MH at age three, leading to similar levels of poor MH across time. Intervening early to prevent the initial deterioration, using a syndemic-approach is essential.

The Role of Resilience as a Mediating Factor between Adverse Childhood Experience and Mental Health in Adolescents Receiving Child Welfare Services in Nova Scotia

The Role of Resilience as a Mediating Factor between Adverse Childhood Experience and Mental Health in Adolescents Receiving Child Welfare Services in Nova Scotia

Telementoring to Strengthen Child and Youth Mental Health Care Capacity in Primary Care Providers: Session Duration and Learning Outcomes.

Primary care providers (PCPs) report insufficient capacity for child and youth mental health care (CYMH). The telementoring program Project ECHO (Extension for Community Healthcare Outcomes) can build capacity, but 75- to 120-minute sessions are a participation barrier. Using a Lean health care paradigm, we designed a 60-minute session, and compared self-reported CYMH capacity strengthening (10 constructs) and satisfaction between 60- and 90-minute sessions. Pre-post (n = 139) and post-cycle (n = 146) survey data were analyzed using generalized linear mixed-effects logistic regression. Capacity strengthening was demonstrated when analyzing both groups together (all Ps ≤ .002). Session duration did not affect capacity strengthening for 9/10 constructs (all Ps > .05), but medication management development was higher with 90-minute sessions (P = .002). Satisfaction was high in both groups. The 60-minute ECHO CYMH sessions can be used without negative learning outcomes, but more mentoring may be needed to build capacity for psychopharmacologic treatment.

Trauma exposure among young children in rural Pakistan: Associations with gender, mental health, and cognitive skills

BackgroundThe burden of childhood trauma (violence, injury/illness, loss) in low-resource settings is high, although the effect of trauma on children’s mental and cognitive health is under-researched. Child gender may moderate the association between trauma and outcomes; boys are more likely to experience trauma, but girls are more likely to show distress following trauma.MethodsWe draw on data from the Bachpan cohort (n = 888), a sample of mother-child dyads in rural Pakistan, to investigate these associations among 6-year-old children in a South Asian, low-resource setting. Mothers reported on children’s lifetime exposure to 15 possible traumas and their current mental health. In addition, children were assessed for their verbal skills, working memory, and inhibitory control. We estimated trauma prevalence and used generalized estimating equations to test the association between number of traumatic events and child mental health and cognitive skills in the overall sample and by gender.Results90.5% of children experienced at least one trauma. The most common traumas were death of a loved one (47%) and hearing about war/terrorism on the TV/radio (48%). On average, boys experienced more traumas (M = 3.00) than girls (M = 2.67). Specifically, boys were more likely than girls to experience an injury or hospitalization (30% vs. 21%, p < .05) and to hear about war/terrorism on the TV/radio (52% vs. 43%, p < .05). Trauma was associated with increased mental health difficulties and increased anxiety scores. There was little evidence that trauma exposure was associated with child cognitive skills. The strength of association between trauma and outcomes was similar for boys and girls.ConclusionsFindings show that childhood trauma exposure is common in this setting and associated with worse mental health problems among young boys and girls. Results suggest that trauma-informed interventions are important for supporting child mental health in South Asia.

Health research priorities in Pakistan: A Child Health and Nutrition Research Initiative (CHNRI) exercise.

The National Health Vision of Pakistan 2016-2025 is to provide affordable health services through a resilient and responsive health system for achieving health-related Sustainable Development Goals (SDGs) and universal health coverage (UHC) targets. Through this study, we wanted to identify the research priorities at the national level that would help to provide the necessary evidence for achieving this vision through essential package of health services (EPHS). We followed World Health Organization (WHO) guidance for undertaking research priority-setting exercises and the Child Health and Nutrition Research Initiative (CHNRI) methodology in conducting this national exercise. The proposed research options for the next three to five years were identified in five thematic research areas: communicable diseases; non-communicable diseases (NCDs) and injuries; reproductive, maternal, newborn, child, and adolescent health (RMNCAH); mental health; and health systems and services. We assessed these research options against five priority-setting criteria: feasibility, public health importance, sustainability, equity, and community involvement. Forty-three experts proposed 272 research ideas, which were consolidated into a list of 155 research options and sent back to the experts for scoring. The top 10 research priorities in each of the five research areas were identified based on the weighted research priority scores (wRPS) rankings. Tuberculosis and antimicrobial resistance; NCD screening and prevention; maternal and neonatal mortality; mental health of children, adolescents, and youth; and human resource management were the issues that were most frequently reflected in the list of research priorities. Most research priorities aimed to identify barriers to the implementation of interventions. Through this exercise, we identified the top 50 national health research priorities, which also have a strong correlation with EPHS interventions. To realise the findings of this exercise, funding agencies should establish funding mechanisms to support the undertaking of the identified research priorities, and academic researchers should actually utilise them in future studies. Such activities could hopefully contribute to achieving the national health goals.

The direct effect of basic need services, and social support on positive mental health among institutionalized children: the mediating role of psychological capital

Previous research in Ethiopia mainly contemplated studying children’s mental distress and the negative effects of orphanages. However, there is a dearth of documented evidence on how positive psychological resources, social support, basic needs services, and mental health impact the well-being of children in childcare institutions and how care centers can benefit vulnerable children. This study aimed to investigate the direct impact of perceived social support (PSS), basic need services (BNS), and Psychological Capital (PsyCap) on the mental health of children in childcare settings. Additionally, the study sought to explore the mediating role of PsyCap between PSS, BNS, and children’s positive mental health (PMH). A total of 420 institutionalized Ethiopian children, comprising 187 females and 233 males, were selected by using a stratified multistage random sampling approach. Validated and standardized measures of psychological well-being (PWB), PsyCap, BNS, and PSS were employed to collect data from the study participants. The findings from the structural equation modeling (SEM) analysis revealed that BNS and PsyCap directly and significantly predicted the PMH of children. Moreover, both BNS and PSS exhibited a positive and significant effect on the higher-order PsyCap construct. Although PSS did not directly influence positive mental health, it indirectly predicted mental health outcomes through the presence of PsyCap. Furthermore, PsyCap played a mediating role between BNS and positive mental health outcomes. It is recommended that future research replicate and expand upon the current study’s findings to gain insights into the positive mental health of institutionalized children.

Duration of exposure to compound daytime-nighttime high temperatures and changes in population exposure in China under global warming

Global warming has led to the enhancement of diurnal (daytime-nighttime) compound heat waves, which can severely affect the population’s physical health and productive life; this is particularly the case for vulnerable populations that are more susceptible to psychological and physiological harm with the future normalization of heatwave scenarios. In this study, we attributed the changes in population exposure under diurnal compound high temperatures (HTs) and extremely high temperatures (EHTs) to the influence of climatic (exposure duration) and population factors and their combined influence to determine the relationship between exposure duration and the changes in exposure of vulnerable populations. Diurnal compound HT and EHT covered a land area of 4,016,800 and 1,984,200 km2, respectively. The heat-exposed area spread step-like in all directions, centering on the 24-h high-exposure area with a strong gradient effect. The area of prolonged exposure shifted from the Yellow-Huai-Huai Plain across the geographical boundary between the south and the north to the middle and lower reaches of the Yangtze River Plain. Meanwhile, the average maximum value of vulnerable population exposure reached 186,800 and 93,100 person-h, with high values in Zhengzhou, Chongqing, Wuhan, Chengdu, Beijing, and other cities. Changes in vulnerable population exposure were dominated first by demographic factors and then by climatic factors, with the dominance of climatic factors evident in areas of prolonged exposure. Under prolonged exposure to daytime-nighttime compound EHT, changes in the exposure of child and older populations were dominated by climatic factors with a contribution rate of 87.16% and 87.43%, respectively. Therefore, suitable cooling measures should be proposed for vulnerable populations under prolonged exposure, focusing more on the physical and mental health of children and older adults exposed to compound EHT.

A replication and extension of adverse and benevolent childhood experiences along with contemporaneous social support and sociodemographic stress for perinatal mental health problems.

This study replicated and extended Narayan and colleagues' (2018) original benevolent childhood experiences (BCEs) study. We examined associations between adverse and positive childhood experiences and mental health problems in a second sample of low-income, ethnically diverse pregnant individuals (replication). We also examined effects of childhood experiences on perinatal mental health problems while accounting for contemporaneous support and stress (extension). Participants were 175 pregnant individuals (M = 28.07 years, SD = 5.68, range = 18-40; 38.9% White, 25.7% Latina, 16.6% Black, 12.0% biracial/multiracial, 6.8% other) who completed standardized instruments on BCEs, childhood maltreatment and exposure to family dysfunction, sociodemographic stress, and perinatal depression and post-traumatic stress disorder (PTSD) symptoms. They completed the Five-Minute Speech Sample at pregnancy and postpartum to assess social support from the other biological parent. Higher family dysfunction predicted higher prenatal depression symptoms, while higher BCEs and prenatal social support predicted lower prenatal PTSD symptoms. Prenatal depression and prenatal PTSD symptoms were the most robust predictors of postnatal depression and PTSD symptoms, respectively, although higher postnatal social support also predicted lower postnatal PTSD symptoms. Findings replicated many patterns found in the original BCEs study and indicated that contemporaneous experiences are also associated with perinatal mental health problems.

Development of a Digital Platform to Support Child Mental Health Care.

Childhood mental health problems are a leading cause of disability and frequently go untreated. Barriers to children receiving the most effective care available include shortfalls in three areas: identification, referral to specialists, and delivery of evidence-based treatment (EBT). The current paper details an effort to develop a digital health intervention, the Mental Health Advisor (MHA), to increase the number of children with mental health problems who receive optimal care through identification, specialty referral, and fidelity to EBT. We present this pilot as a case example to help guide other efforts to improve mental health care through technology.

Unlocking Potential: Contribution of Sports in Improving Mental Health in Children

Unlocking Potential: Contribution of Sports in Improving Mental Health in Children

Co-producing an intervention to prevent mental health problems in children and young people in contact with child welfare services

BackgroundChildren and young people (CYP) in contact with child welfare services are at high risk of developing mental health problems. There is a paucity of evidenced-based preventative interventions provided to this population.ObjectiveThis project worked in partnership with CYP, their parents/caregivers and the professionals who support them to co-produce a preventative mental health intervention for CYP in contact with child welfare services.Participants and settingWe recruited a purposive sample of CYP in contact with child welfare services (n = 23), parents/caregivers (n = 18) and practitioners working within child welfare services and mental health services (n = 25) from the North East of England and convened co-production workshops (n = 4).MethodsThis project followed the established principles for intervention development, applying the six steps to quality intervention development (6SQUID) approach. The mixed method research consisted of four work packages with continuous engagement of stakeholders throughout the project. These were: a systematic review of reviews; focus groups with practitioners; interviews with parents/caregivers and CYP; co-production workshops.ResultsWe identified that the primary risk factor affecting CYP in contact with child welfare services is the experience of childhood adversity. The quality of relationships that the CYP experiences with both their parent/caregivers and the professionals involved in their care are considered to be the main factors amenable to change.ConclusionsWe found that a trauma-informed, activity-based intervention with an embedded family-focused component provided to CYP who have experienced adversity is most likely to prevent mental health problems in those in contact with child welfare services.

Prevalence of Common Child Mental Health Disorders Using Administrative Health Data and Parent Report in a Prospective Community-Based Cohort from Alberta, Canada: Prévalence des troubles communs de santé mentale de l'enfant à l'aide des données de santé administratives et des rapports des parents dans une cohorte prospective communautaire d'Alberta, Canada.

Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age. Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data"). Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources. The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood. Prevalence of child mental health disorders according to different data sources in Canada.

Air pollution and children’s mental health in rural areas: compositional spatio-temporal model

Air pollution stands as an environmental risk to child mental health, with proven relationships hitherto observed only in urban areas. Understanding the impact of pollution in rural settings is equally crucial. The novelty of this article lies in the study of the relationship between air pollution and behavioural and developmental disorders, attention deficit hyperactivity disorder (ADHD), anxiety, and eating disorders in children below 15 living in a rural area. The methodology combines spatio-temporal models, Bayesian inference and Compositional Data (CoDa), that make it possible to study areas with few pollution monitoring stations. Exposure to nitrogen dioxide (NO2), ozone (O3), and sulphur dioxide (SO2) is related to behavioural and development disorders, anxiety is related to particulate matter (PM10), O3 and SO2, and overall pollution is associated to ADHD and eating disorders. To sum up, like their urban counterparts, rural children are also subject to mental health risks related to air pollution, and the combination of spatio-temporal models, Bayesian inference and CoDa make it possible to relate mental health problems to pollutant concentrations in rural settings with few monitoring stations. Certain limitations persist related to misclassification of exposure to air pollutants and to the covariables available in the data sources used.

MELANGKAH TANPA PENUNTUN: MENGEKSPLORASI DAMPAK KEHILANGAN AYAH TERHADAP KESEHATAN MENTAL DAN EMOSIONAL ANAK-ANAK

The role and function of parents towards children are very important in the family. The absence of one person, especially the father, in guiding and supporting the development of the child will have a direct, unknown impact on a family, as it has a significant impact on the child's health and emotional well-being. Most children unconsciously have problems with the role of a lost father or fatherless in their lives; even Indonesia occupies the third place in the roles of a missing father or fatherless. The study explores the impact of father loss on the child's mental and emotional health, factors that cause fatherlessness, and adaptive strategies to cope with the difficulties that arise after the loss of a father. This research uses a library study method, or literature review, which involves collecting books, articles, and previous research that supports research with a qualitative approach. The results point to the fact that losing a father can have a significant impact on a child's mental and emotional health. This study provides insight into the importance of the father's role in the family and the importance of social support to cope with the impact fatherless.

Protocol of the Nutritional, Psychosocial, and Environmental Determinants of Neurodevelopment and Child Mental Health (COINCIDE) study

Background Over 250 million children are developing sub-optimally due to their exposure to early life adversities. While previous studies have examined the independent effects of nutritional status, psychosocial adversities, and environmental pollutants on children’s outcomes, little is known about their interaction and cumulative effects. Objectives This study aims to investigate the independent, interaction, and cumulative effects of nutritional, psychosocial, and environmental factors on children’s cognitive development and mental health in urban and rural India. It also seeks to explain pathways leading to inequities in child development outcomes at the individual, household, and neighbourhood levels. Methods A mixed-methods prospective cohort study will be conducted on 1600 caregiver-child dyads (child age 3–9 years) in urban and rural India. Nutritional status, psychosocial adversities, environmental pollutants, and child mental health outcomes will be assessed using parent-report questionnaires. Performance-based measures will be used to assess cognitive outcomes. Venous blood and urine samples will be used to measure nutritional and pesticide biomarkers in 500 children. Indoor air pollution will be monitored in 200 households twice, during two seasons. Multilevel regression, weighted quantile sum regression, and Bayesian kernel machine regression will assess the individual and combined effects of exposures on child outcomes. Thematic analysis of in-depth interviews and focus group discussions will explore pathways to early childhood development inequities. Discussion The data will be used to formulate a Theory of Change (ToC) to explain the biological, psychosocial, and environmental origins of children’s cognitive and mental health outcomes across the first decade of life in diverse Indian settings, which will then inform context-specific intervention targets for promoting children’s outcomes beyond the first 1000 days, potentially generalizable to similar under-resourced global settings. The COINCIDE research infrastructure will comprise a valuable global health resource, including prospective cohort data, validated study tools, and stored biological and environmental samples for future studies.

Development of Internalizing Mental Health Symptoms from Early Childhood to Late Adolescence.

Children's mental health symptoms' development can be characterized by both continuity and discontinuity. However, existing studies ignore the potential discontinuity in children's internalizing symptoms' development. Hence, the current study examines continuous and discontinuous developmental trajectories using representative data from a sample of 2792 children (49.10% females) from the Growing Up in Australia cohort assessed seven times (ages 4, 6, 8, 10, 12, 14, 16). Longitudinal measurement invariance analyses revealed that internalizing symptoms were comparable over time. Linear, quadratic, and piecewise latent growth curve models were deployed to estimate the trajectory of internalizing symptoms from early childhood to late adolescence. The analyses showed that internalizing symptoms were characterized by a quadratic-quadratic piecewise growth curve comprising two distinct phases of upward concave growth. Internalizing scores reduced steadily between ages 4 and 8 years but exhibited a slight upward curvature between ages 8 and 10 years. By age 14 years, the trajectory remained relatively stable but spiked between age 14 and 16 years. The two phases of internalizing symptoms' development were largely unrelated. Overall, the study adds to the knowledge about the development of internalizing mental health from early childhood to late adolescence and highlights the need for additional support in late adolescence.

Effect of Universal Credit on young children’s mental health: quasi-experimental evidence from understanding society

BackgroundChild mental health has become an increasingly important issue in the UK, especially in the context of significant welfare reforms. Universal Credit (UC) has introduced substantial changes to the UK’s...

Barriers to and enablers of the transition from child and adolescent to adult mental health services for autistic young people and/or those with attention deficit hyperactivity disorder: protocol for a scoping review

IntroductionAutistic young people and/or those with attention deficit hyperactivity disorder (ADHD) who have co-occurring mental health conditions experience significant challenges when transitioning from child and adolescent mental health services (CAMHS)...

Adverse event assessment in a parenting programme: experiences from a multisite randomised controlled trial

BackgroundClinicians and researchers should consider the expected benefits and potential harms of an intervention. Parenting programmes are a widely used evidence-based intervention for child behaviour problems. However, few data are available on potential negative effects. The aims of this paper were to increase systematic knowledge of adverse event (AE) assessment in parenting programmes and to provide an AE assessment tool.MethodsAs part of the RISE project (prevention of child mental health problems in South-eastern Europe—adapt, optimise, test and extend parenting for lifelong health), we developed and tested an AE assessment procedure in three sequential studies for parents of children with child behaviour problems aged 2 to 9 years in North Macedonia, Republic of Moldova, and Romania. This paper reports on the development of the assessment tool in phase 1 (N = 140), phase 2 (N = 835), and the final experiences with using the optimised procedures in phase 3 (multisite randomised controlled trial, N = 823) in which AEs were assessed before, three times during intervention delivery, and at 1 year follow-up. At each time point, the participants completed a 12-item AE checklist. If moderate-to-severe problems of parent or child were reported, a structured follow-up interview was conducted.ResultsThe response rate on the AE assessment tool increased from 6% (phase 1) to 100% (phase 3) indicating improvement in collecting these data based on the experiences of each phase. Results of the RCT (phase 3) showed generally low (S)AE frequencies with the finally optimised procedure: During the intervention, no serious adverse events (SAE) were registered; at least one AE was reported by 10% (after the first session), 7% (after the third session), and 4% (after the last fifth session) of participants. None of the identified (S)AEs was causally related to the study or intervention. Cost–benefit considerations are needed to determine the best way to ensure participant safety in parenting programmes.ConclusionThe applied active AE assessment procedure provides a comprehensive AE assessment tool that can be used by others—with adaptations for the specific context, if needed. Based on our experiences, we outline recommendations for future studies.Trial registrationClinicalTrials.gov, registration number phase 1: NCT03552250; phase 2: NCT03865485, phase 3: NCT04721730. Registered on 13 January 2021.

Trends, risk factors and interventions for some mental health problems in the US children and adolescents: evidence from the National Survey of Children’s Health, 2016-2022

PurposeThe purpose of this study is threefold: Determine recent trends in several mental health problems in the USA, identify risk factors that may be responsible for the trends and evaluate intervention policies to reduce the consequences of these problems.Design/methodology/approachThis study used data from the National Survey of Children's Health (NSCH), a nationally representative survey of children under the age of 17 that was conducted between 2016 and 2022. Prevalence rates in the data take into account the probability of selection and nonresponse. Because of the possible correlation in the longitudinal responses in the data, an appropriate extension of the generalized linear models (the marginal models) was used. Marginal models, also known as population-average models, do not require distributional assumptions for the observations, only a regression model for the mean response. The avoidance of distributional assumptions leads to the use of the generalized estimating equations (GEE) method.FindingsThe author found that the odds of children and adolescents experiencing mental health problems in the USA changed over a seven-year period, from 2016 to 2022. Anxiety and depression, in particular, have both increased, with anxiety increasing faster than depression; however, behavioral issues and attention deficit disorder/attention deficit hyperactivity disoder (ADD/ADHD) remained stable until 2020 (the start of COVID-19), when they began to rise. This paper also found a link between increased social media use and increased mental health problems, and bullying has a negative impact on the mental health of children and adolescents.Originality/valueThe NSCH, an annual representative survey, was used in this study to assess mental health problems among children and adolescents in the USA. Marginal models, which enable the capture of potential correlations among observations of the same subject, were used in conjunction with the GEE method. This study differs from previous research, which used other surveys, pre-COVID-19 data points and logistic regressions that assumed independence in repeated observations.