Search Results

Longitudinal associations between changes in screen-time and mental health outcomes in adolescents.

Introduction: The primary aim was to examine longitudinal associations between changes in screen-time and mental health outcomes among adolescents. Methods: Adolescents (N = 322, 65.5% females, mean age = 14.4 +/- 0.6 years) reported screen-time and mental health at two time points over a school year. Multi-level linear regression analyses were conducted after adjusting for covariates. Results: Changes in total recreational screen-time (beta = -0.09 p = 0.048) and tablet/mobile phone use (beta = -0.18, p < 0.001) were negatively associated with physical self-concept. Changes in total recreational screen-time (beta = -0.20, p = 0.001) and computer use (beta = -0.23, p = 0.003) were negatively associated with psychological well-being. A positive association was found with television/DVD use and psychological difficulties (beta = 0.16, p = 0.015). No associations were found for non-recreational screen-time. Conclusion: Changes in recreational screen-time were associated with changes in a range of mental health outcomes.

Keywords: Screen-time; Mental health; Adolescents; Longitudinal

Self-regulatory speech during planning and problem-solving in children with SLI and their typically developing peers.

Background: Past research with children with specific language impairment (SLI) has shown them to have poorer planning and problem-solving ability, and delayed self-regulatory speech (SRS) relative to their typically developing (TD) peers. However, the studies are few in number and are restricted in terms of the number and age range of participants, which limits our understanding of the nature and extent of any delays. Moreover, no study has examined the performance of a significant subset of children with SLI, those who have hyperactive and inattentive behaviours. Aims: This cross-sectional study aimed to compare the performance of young children with SLI (aged 4-7 years) with that of their TD peers on a planning and problem-solving task and to examine the use of SRS while performing the task. Within each language group, the performance of children with and without hyperactive and inattentive behaviours was further examined. Methods & Procedures: Children with SLI (n = 91) and TD children (n = 81), with and without hyperactive and inattentive behaviours across the three earliest school years (Kindergarten, Preprimary and Year 1) were video-taped while they completed the Tower of London (TOL), a planning and problem-solving task. Their recorded speech was coded and analysed to look at differences in SRS and its relation to TOL performance across the groups. Main Contribution: Children with SLI scored lower on the TOL than TD children. Additionally, children with hyperactive and inattentive behaviours performed worse than those without hyperactive and inattentive behaviours, but only in the SLI group. This suggests that children with SLI with hyperactive and inattentive behaviours experience a double deficit. Children with SLI produced less inaudible muttering than TD children, and showed no reduction in social speech across the first three years of school. Finally, for children with SLI, a higher percentage performed better on the TOL when they used SRS than when they did not. Conclusions & Implications: The results point towards a significant delay in the development and internalization of SRS in the SLI group, which should be taken into account when considering the planning and problem-solving of young children with SLI.

Keywords: self-regulation; self-talk; private speech; specific language impairment (SLI); planning; hyperactive and inattentive behaviours

Influence maternal background has on children’s mental health.

BACKGROUND: In this paper, we aim to discern how a mother’s health and her socioeconomic determinants may influence her children’s mental health. In addition to this, we also evaluate the influence of other household characteristics and whether or not the economic downturn has heightened the effect a parent’s social gradient has on their children’s mental health. METHODS: We use samples comprised of 4-14-year-old minors from the 2006 Spanish National Health Survey (SNHS), undertaken prior to the crisis, and the 2011 SNHS, carried out during the crisis. The participating children’s mental health is assessed using the Strengths and Difficulties Questionnaire (SDQ). Mixed models are used to evaluate the influence a mother’s health and her socioeconomic status may have on her children’s mental health. We also add interactions to observe the effect specific socioeconomic determinants may have had during the economic downturn. RESULTS: The risk of a child suffering from mental health disorders increases when their mother has mental health problems. Socioeconomic determinants also play a role, as a low socioeconomic status (SES) increases the risk of a child exhibiting behavioural problems, being hyperactive or antisocial, whereas when a mother has attained a high level of education, this significantly reduces the probability of a child having mental health problems. ‘Homemaker’ is the activity status most positively related to children’s mental health. The findings show that the Spanish economic downturn has not significantly changed children’s mental health problems and the negative effects of low maternal SES are no greater than they were before the crisis. The main difference in 2011, with respect to 2006, is that the risk of children suffering from mental health problems is higher when their parents are (long or short-term) unemployed. CONCLUSIONS: In conclusion, both a mother’s health and her socioeconomic status, as well as other household characteristics, are found to be related to her children’s mental well-being. Although the crisis has not significantly changed mental health disorders in children or the social gradient of parents in general, at-risk children are the most negatively affected in the Spanish economic downturn.

Keywords: Maternal factors; Children; Mental health; SDQ; Spain

Status of mental-health services for adolescents with psychiatric morbidity in youth correctional institutions in Lagos.

Background: High prevalence rates of psychiatric morbidity have been documented among adolescents within youth correctional institutions in Nigeria. However, there has not been prior investigation to determine the capacity for and nature of mental health services being provided in these institutions. Objectives: To assess psychiatric morbidity among adolescents within youth correctional institutions in Lagos, while simultaneously examining the capacity for and the scope of mental health services. Methods: Psychiatric morbidity and alcohol/substance use disorder were assessed among 165 respondents using the Strengths and Difficulties Questionnaire, and the CRAFFT screening tool for adolescent substance use disorder. Availability of mental-health services in the institutions was examined using an ‘audit protocol’. Results: We found prevalence rates of 18.2% and 15.8% of general psychiatric morbidity and alcohol/ substance use disorder, respectively, among the adolescents. Only about a third (34.3%; n = 20) of the operational staff at the institutions had educational backgrounds relevant to psycho-social services for children/adolescents, while less than a quarter (22.4%, n = 13) has ever received any training in child mental health services. There was no evidence of mental health screening and intervention in the service framework within the institutions. Conclusions: We concluded that there was evidence for significant mental health service gaps within the youth correctional services in Lagos.

Keywords: [none]

Psychological Profile of Children Who Require Repetitive Surgical Procedures for Early Onset Scoliosis: Is a Poorer Quality of Life the Cost of a Straighter Spine?

STUDY DESIGN: Cross-sectional study. OBJECTIVE: Assess the psychosocial status of children with early-onset scoliosis (EOS) undergoing multiple procedures and evaluate associations with other variables. SUMMARY OF BACKGROUND DATA: EOS may require repetitive surgical procedures to control deformity and preserve growth. These procedures impact patients’ psychosocial status because of the repetitive surgeries. METHODS: EOS patients 6-18 years, undergoing traditional growing rod treatment with more than 5 surgical procedures, and neurologically/mentally intact were included. Patients were screened for psychiatric disorders before inclusion. The Quality of Life Scale for Children (PedsQL), Strengths and Difficulties Questionnaire (SDQ) self-report form, Beck Depression Inventory, Children Depression Inventory (CDI), Beck Anxiety Inventory (BAI), and the Self-Report for Childhood Anxiety Related Disorders (SCARED) were completed by the children. PedsQL Parental Form and SDQ Parent Form were completed by their parents. RESULTS: Twenty-one patients (9 male, 12 female) met the inclusion criteria. Average age was 6.4 years (4-10.5) at index surgery, and 13.5 years (8-17) at final follow-up. The mean number of procedures was 13 (6-18). Mean follow-up was 83.9 months (36-122). Depression was observed in 23.8% of patients, and generalized anxiety disorder in 42.8%. Patients in the study group were more likely than the general population to have a psychiatric diagnosis. Number of procedures undergone was found to correlate negatively with BAI, SCARED, and the behavioral difficulties domain of SDQ parent form score and positively with emotional functioning, psychosocial health summary score, PedsQL total score, and increased social and physical functioning. Nonidiopathic etiology was found to be related to increased behavioral difficulties and lower functioning. CONCLUSION: A higher prevalence of depressive and anxiety symptoms was observed in patients with EOS along with dysfunctional areas of daily life. Other comorbidities may also contribute to dysfunction and difficulties. Determination of the aspects of EOS treatment that have a negative impact on psychosocial functioning may allow for more competent help for these patients.

Keywords: Early-onset scoliosis; Growing rods; Traditional growing rod; Psychosocial; Psychology; Behavior; Repetitive surgery

The SIGHT questionnaire: A novel assessment tool for Satisfaction In Genital Hypospadias Treatment.

PURPOSE: Psychosexual development is currently underrepresented in hypospadias outcome research. The aim of this study was to develop and validate a questionnaire addressing psychosexual long-term satisfaction, specifically of adolescent patients, after hypospadias repair. MATERIALS AND METHODS: In a multistep participative design we identified key interests of adolescent patients with hypospadias. Next, a questionnaire addressing specifically the psychosexual satisfaction of adolescents after hypospadias repair was established. A population of 109 former patients with hypospadias was then assessed using this questionnaire. Furthermore, functional and cosmetic aspects, behavioural anomalies, and sexual activity were investigated. Age-matched patients undergoing circumcision served as control patients. Possible influence factors on patient satisfaction were investigated. Clinical trial registry site: German Registry of Clinical Trials DRKS, Freiburg, Germany (Reference: DRKS00003432). RESULTS: Key interests of adolescent patients were ‘normal appearance of the penis’, ‘normal function of the penis regarding voiding and sexual activity’, ‘no limitations regarding cosmetic appearance to others’, ‘no limitations to sexual activity’, and an ‘unimpaired masculine identity’. The ‘Satisfaction In Genital Hypospadias Treatment’ (SIGHT) questionnaire was developed using these items and using previously published evaluation systems. Nine questions address psychosexual aspects and two additional questions address current sexual activity. Internal consistency was high and retest reliability acceptable. The patient population showed a normal strength and difficulties score (SDQ). Overall satisfaction was high and similar to that of the control group. In a Spearman correlation a high SDQ value, erectile problems, and complications correlated negatively with satisfaction. CONCLUSION: To date, few studies have examined patients’ satisfaction and psychosexuality. To our knowledge, the SIGHT questionnaire is the first to be developed participatively and in a stepwise fashion in collaboration with a paediatric psychologist and an open approach to determine items specifically important for adolescents. The SIGHT questionnaire can thus offer a relevant assessment of patients’ psychosexual satisfaction. It is most suitable to supplement current strategies that so far mostly neglect the impact on psychosexual wellbeing.

Keywords: Hypospadias; SDQ; Psychosexual development; Adolescence

Students’ oppositional behaviors and engagement in school: The differential role of the student-teacher relationship.

Students presenting oppositional behaviors often display lower behavioral and emotional engagement in class as compared to their peers. Moreover, children in general are known to be deeply affected by their relationships with teachers while in school. It is therefore possible that such relationships could also influence the engagement of students presenting higher levels of oppositional behavior. As a way of verifying this hypothesis, the present study investigated the contribution of students’ levels of oppositional behavior to their behavioral and emotional engagement in literacy. Furthermore, it examined whether these relationships were different for boys and girls, or changed as a function of two components of student-teacher relationships: closeness and conflict. Three hundred and eighty five third and fourth grade students and their teachers participated in the study. Two series of linear regressions were conducted. Findings indicate that students who presented higher levels of oppositional behavior showed lower behavioral engagement than their peers. Moreover, students who had close relationships with their teachers reported higher behavioral engagement. Although closeness in student-teacher relationships protected students from behavioral disengagement, students with higher oppositional behaviors were less protected than students who presented lower levels of oppositional difficulty. Having a warm relationship with a teacher was also more beneficial for the behavioral engagement of girls, whereas a high level of conflict between student and teacher was more harmful for the emotional engagement of boys. This was deemed to be true whether the boys or girls presented high levels of oppositional behavior or not. Overall, our findings highlight the importance of the student-teacher relationship in fostering all students’ engagement in school.

Keywords: Classroom engagement; Oppositional behaviors; Student-teacher relationship; Closeness; Conflict

Spouse and family functioning before and after a Marine’s suicide: Comparisons to deaths by accident and in combat.

The impact of service member suicides on families is not well understood. Civilian studies have demonstrated that family survivors of suicide deaths experience complicated grief, feel guilt and shame, and often do not receive sufficient social support. In this exploratory study, spouse survivors of Marines who died by suicide (N = 17), accident (N = 19), and in combat (N = 34) retrospectively reported on their immediate pre- and postmortem and current personal and family functioning. Nonparametric analyses revealed that several between-group differences existed. Observation of the means suggested that the spouses and families of Marines who died by suicide exhibited significantly poorer pre- and postmortem functioning compared with those whose spouses died in combat. Specific challenges included low family cohesion, high family conflict, perceived stigma, and shame. There were no differences in current spouse or family functioning, and there was weak evidence for posttraumatic growth among surviving spouses of those dying by suicide. These results should be considered preliminary and interpreted with caution given several methodological challenges. Impact Statement What is the public significance of this article?-This study found that there was less closeness and more conflict among families whose Marine fathers died by suicide compared to families whose fathers died by other means. Spouses of those who died by suicide experience more difficult feelings emotions than those who die by other means. Prevention efforts may be enhanced by working with the families of those who are at risk for suicide. Suicide survivors would benefit from services/supports targeted to their unique needs.

Keywords: suicide; bereavement; family; stigma; military

Gender specificity of children’s narrative representations in predicting depressive symptoms at early school age.

Our longitudinal study contributes to the body of literature on depression in childhood by examining potential protective factors. We investigated the influence of maternal depressive symptoms on child depressive symptoms at early school age and its gender-specific moderation by children’s narrative representations of the maternal figure, over and above children’s own depressive symptoms at preschool age. Children’s narrative representations were assessed using the MacArthur Story Stem Battery in 170 preschool children (92 girls; 54.1 %) oversampled for internalizing symptoms. Children’s depressive symptoms were assessed at preschool age (Time 1; 4-6 years) and at early school age (Time 2; 6-8 years) by maternal report; mothers’ depressive symptoms were assessed at Time 1. The results showed that for boys, only their own depressive symptoms at Time 1 predicted their depressive symptoms at Time 2. For girls, maternal depressive symptoms were a significant risk factor for their own depressive symptoms at Time 2. Regarding this association, we also found a moderation effect: girls with more positive narrative representations of the maternal figure showed a reduced negative impact of maternal depressive symptoms on their own depressive symptoms at Time 2. This implies that clinical practice should screen a child for early depressive symptoms, especially if the mother displays depressive symptoms. Clinicians might also assess children’s inner working models, which can serve as a protective factor.

Keywords: Childhood depression; Maternal depression; Narrative representations; Preschool/school age; Gender differences

Joint trajectories of behavioral, affective, and cognitive engagement in elementary school.

The aim of the present study was to model student trajectories of behavioral, affective, and cognitive engagement from Grade 3 to Grade 6. The authors also examined whether teachers perceptions could predict student trajectory membership. The authors collected data from a sample of 831 students and 152 teachers. Using multiple-process growth mixture modeling, they identified 5 distinct trajectories of student engagement. Although a large majority of children presented a stable and high level of engagement on the three dimensions over time, more than one third of them showed a lower or changing level of engagement as the years progressed. These students were more likely to be boys and to be perceived by teachers as being less engaged. They also present more learning or behavioral problems and share less positive relationships with teachers. The results support the need to consider group-based differences when designing and adapting prevention and intervention strategies to favor student engagement.

Keywords: Academic achievement; disruptive behaviors; elementary school; sex; student engagement