What is the Impact of COVID-19 & Lockdown on the Mental Health of Children & Adolescents?

Research Paper Title

Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations.

Background

COVID-19 pandemic and lockdown has brought about a sense of fear and anxiety around the globe. This phenomenon has led to short term as well as long term psychosocial and mental health implications for children and adolescents. The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection.

This paper is aimed at narratively reviewing various articles related to mental-health aspects of children and adolescents impacted by COVID-19 pandemic and enforcement of nationwide or regional lockdowns to prevent further spread of infection.

Methods

The researchers conducted a review and collected articles and advisories on mental health aspects of children and adolescents during the COVID-19 pandemic. They selected articles and thematically organized them.

Results

The researchers put up their major findings under the thematic areas of impact on young children, school and college going students, children and adolescents with mental health challenges, economically underprivileged children, impact due to quarantine and separation from parents and the advisories of international organisations. They have also provided recommendations to the above.

Conclusions

There is a pressing need for planning longitudinal and developmental studies, and implementing evidence based elaborative plan of action to cater to the psycho social and mental health needs of the vulnerable children and adolescents during pandemic as well as post pandemic. There is a need to ameliorate children and adolescents’ access to mental health support services geared towards providing measures for developing healthy coping mechanisms during the current crisis.

For this innovative child and adolescent mental health policies with direct and digital collaborative networks of psychiatrists, psychologists, paediatricians, and community volunteers are deemed necessary.

Reference

Singh, S., Roy, D. Sinha, K., Parveen, S., Sharma, G. & Joshi, G. (2020) Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Research. 293, pp.113429. doi: 10.1016/j.psychres.2020.113429. Online ahead of print.

What is the Impact of COVID-19 & Lockdown on the Mental Health of Children & Adolescents?

Research Paper Title

Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations.

Background

COVID-19 pandemic and lockdown has brought about a sense of fear and anxiety around the globe. This phenomenon has led to short term as well as long term psychosocial and mental health implications for children and adolescents.

The quality and magnitude of impact on minors is determined by many vulnerability factors like developmental age, educational status, pre-existing mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection.

This paper is aimed at narratively reviewing various articles related to mental-health aspects of children and adolescents impacted by COVID-19 pandemic and enforcement of nationwide or regional lockdowns to prevent further spread of infection.

Methods

The researchers conducted a review and collected articles and advisories on mental health aspects of children and adolescents during the COVID-19 pandemic. They selected articles and thematically organised them. The researchers put up their major findings under the thematic areas of impact on young children, school and college going students, children and adolescents with mental health challenges, economically underprivileged children, impact due to quarantine and separation from parents and the advisories of international organisations. They have also provided recommendations to the above.

Conclusions

There is a pressing need for planning longitudinal and developmental studies, and implementing evidence based elaborative plan of action to cater to the psycho social and mental health needs of the vulnerable children and adolescents during pandemic as well as post pandemic.

There is a need to ameliorate children and adolescents’ access to mental health support services geared towards providing measures for developing healthy coping mechanisms during the current crisis.

For this innovative, child and adolescent mental health policies with direct and digital collaborative networks of psychiatrists, psychologists, paediatricians, and community volunteers are deemed necessary.

Reference

Singh, S., Roy, D., Sinha, K., Parveen, S. Sharma, G. & Joshi, G. (2020) Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Research. doi: 10.1016/j.psychres.2020.113429. Online ahead of print.

What is the Intergenerational Impact of War on Mental Health & Psychosocial Wellbeing?

Research Paper Title

The intergenerational impact of war on mental health and psychosocial wellbeing: lessons from the longitudinal study of war-affected youth in Sierra Leone.

Background

Globally, one in four children lives in a country affected by armed conflict or disaster often accompanied by exposure to a range of adversities including violent trauma and loss. Children involved with armed groups (often referred to as “child soldiers”) typically exhibit high levels of mental health needs linked to their experiences.

The Longitudinal Study of War-Affected Youth (LSWAY) in Sierra Leone is a seventeen-year prospective longitudinal study of the long-term effects of children’s experiences in the country’s eleven-year (1991-2002) civil war on their adult mental health and functioning in addition to exploring the potential mechanisms by which intergenerational transmission of emotional and behavioral disruptions due to war trauma may operate.

LSWAY illuminates how war-related and post-conflict experiences shape long-term adult functioning, family dynamics, and developmental outcomes in offspring

Discussion

The LSWAY study utilises mixed methodologies that incorporate qualitative and quantitative data to unpack risk and protective factors involved in social reintegration, psychosocial adjustment, parenting, and interpersonal relationships.

To date, study findings demonstrate striking levels of persistent mental health problems among former child soldiers as adults with consequences for their families, but also risk and protective patterns that involve family- and community-level factors.

This case study examines the course of LSWAY from inception through implementation and dissemination, including building on the study results to design and evaluate several intervention models.

Conclusions

The case study offers a unique perspective on challenges and field realities of health research in a fragile, post-conflict setting common in the context of humanitarian emergencies.

LSWAY findings along with lessons learned from the field can inform future research as well as intervention research and implementation science to address the mental health and development of war-affected young people.

With four waves of data collection and a planned fifth wave, LSWAY also provides rare insights into the intergenerational effects of humanitarian crises on children, youth, and families across generations.

Reference

Betancourt, T.S., Keegan, K., Farrar, J. & Brennan, R.T. (2020) The intergenerational impact of war on mental health and psychosocial wellbeing: lessons from the longitudinal study of war-affected youth in Sierra Leone. Conflict and Health. 14:62. doi: 10.1186/s13031-020-00308-7. eCollection 2020.

Linking Job Skills Training & Substance Misuse

Research Paper Title

Spillover Effects of Job Skills Training on Substance Misuse Among Low-Income Youths With Employment Barriers: A Longitudinal Cohort Study.

Background

To examine spillover effects of job skills training (vs basic services only [e.g. adult basic education, job readiness training]) on substance misuse among low-income youths with employment barriers.

Methods

Data came from the National Longitudinal Survey of Youth 1997, a longitudinal cohort study of youths born between 1980 and 1984 in the United States.

Based on respondents’ reports of substance misuse (past-month binge drinking and past-year marijuana and other illicit drug use) from 2000 to 2016, the researchers estimated substance misuse trajectories of job skills training (n = 317) and basic services (n = 264) groups.

They accounted for potential selection bias by using inverse probability of treatment weighting.

Results

Compared with the basic services group, the job skills training group showed notable long-term reductions in its illicit drug misuse trajectory, translating to a 56.9% decrease in prevalence rates from 6.5% in year 0 to 2.8% in year 16.

Conclusions

Job skills training can be an important service component for reducing substance misuse and improving employment outcomes among youths with economic disadvantages and employment barriers.

Reference

Oh, S., DiNitto, D.M. & Powers, D.A. (2020) Spillover Effects of Job Skills Training on Substance Misuse Among Low-Income Youths With Employment Barriers: A Longitudinal Cohort Study. American Journal of Public Health. 110(6), pp.900-906. doi: 10.2105/AJPH.2020.305631. Epub 2020 Apr 16.

Potential Web- & Mobile-based Interventions for Promoting Mental Health & Preventing Mental Illness at University

Research Paper Title

Mental Health-Related Digital Use by University Students: A Systematic Review.

Background

Mental health problems are common among students at university, representing a major public health concern.

The internet and new technologies are widely used by students and represent a significant resource to them for mental health information and support.

The aim of this systematic review is to summarise and critique studies of mental health-related digital use (including purposes, advantages, and barriers) by students worldwide, to support the implementation of future digital mental health interventions targeting university students.

Methods

The researches searched for peer-reviewed articles published between January 2008 and May 2018 by using Pubmed, Google Scholar, PsycINFO, PsycARTICLES, Psychology and Behavioural Sciences Collection, and SocINDEX. Studies were coded by author, year of publication, country, research design, recruitment and sampling, data collection, analysis method, key findings, and mean quality score.

Outcomes were synthetised through the textual narrative synthesis method.

Results

Of the 1,487 titles and abstracts screened, 24 articles were critically reviewed. Sample sizes ranged from 19 to 6,034 participants.

The two key findings were that students worldwide have a high need for mental health information and are prepared to use digital tools for their mental health and well-being.

However, they are currently struggling to discern trustworthy information online and are expressing a desire for reliable devices handling their sensitive data.

Conclusions

Through the description of patterns in university students’ mental health-related digital use, this review outlines important features for potential web- and mobile-based interventions for promoting mental health and preventing mental illness at the university.

Reference

Montagni, I., Tzourio, C., Cousin, T., Sagara, J.A., Bada-Alonzi, J. & Hogan, A. (2020) Mental Health-Related Digital Use by University Students: A Systematic Review. Telemedicine Journal and e-Health. 26(2), pp.131-146. doi: 10.1089/tmj.2018.0316. Epub 2019 Mar 19.

What is the Role of Informant Discrepancies in Mental Health in Relation to Sexuality?

Research Paper Title

Mental-health disparities between heterosexual and sexual-minority adolescents: Examining the role of informant discrepancies.

Background

An emerging literature documents substantial mental-health disparities by sexual orientation amongst adolescents, with sexual-minority youth exhibiting poorer mental health than heterosexual youth.

This brief report provides the first empirical account of how the association between sexual-minority status and adolescent mental health differs depending on who assesses adolescents’ mental health (child/mother/father/teacher), and how informant discrepancies in assessments of adolescent mental health differ by adolescents’ sexual orientation.

Methods

Data come from an Australian national sample of 14-/15-year-old adolescents (Longitudinal Study of Australian Children; n = 3,000).

Adolescent mental health is measured using multiple measures from the Strengths and Difficulties Questionnaire, and modelled using multivariable linear regression models.

Results

Mental-health disparities between sexual-minority and heterosexual adolescents emerged irrespective of who assessed the child’s mental health.

However, their magnitude varied substantially by informant, being largest when mental-health was reported by adolescents (~0.7 standard deviations) and smallest when reported by teachers (~0.2 standard deviations).

Discrepancies between mental-health scores collected from the child and other informants were largest for internalising than externalising behaviours, and in child-father than child-mother comparisons.

Conclusions

Understanding informant discrepancies and their meaning is pivotal to designing surveys that generate robust insights into the health of sexual-minority adolescents, as well as appropriate policy interventions.

Reference

Perales, F., Campbell, A. & Johnson, S. (2020) Mental-health disparities between heterosexual and sexual-minority adolescents: Examining the role of informant discrepancies. Journal of Adolescence. 79, pp.122-127. doi: 10.1016/j.adolescence.2020.01.006. Epub 2020 Jan 15.

Examining National Trends in the Care of Different Mental Health Problems & in Different Treatment Settings among Adolescents

National Trends in Mental Health Care for US Adolescents.

Background

The prevalence of adolescent depression and other internalising mental health problems has increased in recent years, whereas the prevalence of externalising behaviours has decreased. The association of these changes with the use of mental health services has not been previously examined.

Therefore, the purpose of this study was to examine national trends in the care of different mental health problems and in different treatment settings among adolescents.

Methods

Data for this survey study were drawn from the National Survey on Drug Use and Health, an annual cross-sectional survey of the US general population. This study focused on adolescent participants aged 12 to 17 years interviewed from January 1, 2005, to December 31, 2018. Data were reported as weighted percentages and adjusted odds ratios (aORs) and analysed from July 20 to December 1, 2019.

Time trends in 12-month prevalence of any mental health treatment or counselling in a wide range of settings were examined overall and for different:

  • Sociodemographic groups;
  • Types of mental health problems (internalising, externalising, relationship, and school related); and
  • Treatment settings (inpatient mental health, outpatient mental health, general medical, and school counselling).

Trends in the number of visits and nights in inpatient settings were also examined.

Results

A total of 47,090 of the 230,070 adolescents across survey years (19.7%) received mental health care. Of these, 57.5% were female; 31.3%, aged 12 to 13 years; 35.8%, aged 14 to 15 years; and 32.9%, aged 16 to 17 years.

The overall prevalence of mental health care did not change appreciably over time. However, mental health care increased among girls (from 22.8% in 2005-2006 to 25.4% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.19; P = .001), non-Hispanic white adolescents (from 20.4% in 2005-2006 to 22.7% in 2017-2018; aOR, 1.08; 95% CI, 1.03-1.14; P = .004), and those with private insurance (from 19.4% in 2005-2006 to 21.2% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.18; P = .002).

Internalising problems, including suicidal ideation and depressive symptoms, accounted for an increasing proportion of care (from 48.3% in 2005-2006 to 57.8% in 2017-2018; aOR, 1.52; 95% CI, 1.39-1.66; P < .001), whereas externalising problems (from 31.9% in 2005-2006 to 23.7% in 2017-2018; aOR, 0.67; 95% CI, 0.62-0.73; P < .001) and relationship problems (from 30.4% in 2005-2006 to 26.9% in 2017-2018; aOR, 0.75; 95% CI, 0.69-0.82; P < .001) accounted for decreasing proportions.

During this period, use of outpatient mental health services increased from 58.1% in 2005-2006 to 67.3% in 2017-2018 (aOR, 1.47; 95% CI, 1.35-1.59; P < .001), although use of school counselling decreased from 49.1% in 2005-2006 to 45.4% in 2017-2018 (aOR, 0.86; 95% CI, 0.79-0.93; P < .001).

Outpatient mental health visits (eg, private mental health clinicians, from 7.2 in 2005-2006 to 9.0 in 2017-2018; incidence rate ratio, 1.30; 95% CI, 1.23-1.37; P < .001) and overnight stays in inpatient mental health settings (from 4.0 nights in 2005-2006 to 5.4 nights in 2017-2018; incidence rate ratio, 1.18; 95% CI, 1.02-1.37; P = .03) increased.

Conclusions

This study’s findings suggest that the growing number of adolescents who receive care for internalising mental health problems and the increasing share who receive care in specialty outpatient settings are placing new demands on specialty adolescent mental health treatment resources.

Reference

Mojtabai, R. & Olfson, M. (2020) National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry. 77(7), pp.1-12. doi: 10.1001/jamapsychiatry.2020.0279. Online ahead of print.

Research Paper Title

National Trends in Mental Health Care for US Adolescents.

Background

The prevalence of adolescent depression and other internalising mental health problems has increased in recent years, whereas the prevalence of externalising behaviours has decreased. The association of these changes with the use of mental health services has not been previously examined.

Therefore, the purpose of this study was to examine national trends in the care of different mental health problems and in different treatment settings among adolescents.

Methods

Data for this survey study were drawn from the National Survey on Drug Use and Health, an annual cross-sectional survey of the US general population. This study focused on adolescent participants aged 12 to 17 years interviewed from January 1, 2005, to December 31, 2018. Data were reported as weighted percentages and adjusted odds ratios (aORs) and analysed from July 20 to December 1, 2019.

Time trends in 12-month prevalence of any mental health treatment or counselling in a wide range of settings were examined overall and for different:

  • Sociodemographic groups;
  • Types of mental health problems (internalising, externalising, relationship, and school related); and
  • Treatment settings (inpatient mental health, outpatient mental health, general medical, and school counselling).

Trends in the number of visits and nights in inpatient settings were also examined.

Results

A total of 47,090 of the 230,070 adolescents across survey years (19.7%) received mental health care. Of these, 57.5% were female; 31.3%, aged 12 to 13 years; 35.8%, aged 14 to 15 years; and 32.9%, aged 16 to 17 years.

The overall prevalence of mental health care did not change appreciably over time. However, mental health care increased among girls (from 22.8% in 2005-2006 to 25.4% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.19; P = .001), non-Hispanic white adolescents (from 20.4% in 2005-2006 to 22.7% in 2017-2018; aOR, 1.08; 95% CI, 1.03-1.14; P = .004), and those with private insurance (from 19.4% in 2005-2006 to 21.2% in 2017-2018; aOR, 1.11; 95% CI, 1.04-1.18; P = .002).

Internalising problems, including suicidal ideation and depressive symptoms, accounted for an increasing proportion of care (from 48.3% in 2005-2006 to 57.8% in 2017-2018; aOR, 1.52; 95% CI, 1.39-1.66; P < .001), whereas externalising problems (from 31.9% in 2005-2006 to 23.7% in 2017-2018; aOR, 0.67; 95% CI, 0.62-0.73; P < .001) and relationship problems (from 30.4% in 2005-2006 to 26.9% in 2017-2018; aOR, 0.75; 95% CI, 0.69-0.82; P < .001) accounted for decreasing proportions.

During this period, use of outpatient mental health services increased from 58.1% in 2005-2006 to 67.3% in 2017-2018 (aOR, 1.47; 95% CI, 1.35-1.59; P < .001), although use of school counselling decreased from 49.1% in 2005-2006 to 45.4% in 2017-2018 (aOR, 0.86; 95% CI, 0.79-0.93; P < .001).

Outpatient mental health visits (eg, private mental health clinicians, from 7.2 in 2005-2006 to 9.0 in 2017-2018; incidence rate ratio, 1.30; 95% CI, 1.23-1.37; P < .001) and overnight stays in inpatient mental health settings (from 4.0 nights in 2005-2006 to 5.4 nights in 2017-2018; incidence rate ratio, 1.18; 95% CI, 1.02-1.37; P = .03) increased.

Conclusions

This study’s findings suggest that the growing number of adolescents who receive care for internalising mental health problems and the increasing share who receive care in specialty outpatient settings are placing new demands on specialty adolescent mental health treatment resources.

Reference

Mojtabai, R. & Olfson, M. (2020) National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry. 77(7), pp.1-12. doi: 10.1001/jamapsychiatry.2020.0279. Online ahead of print.

Does Early Maternal Separation Exert a Negative Influence on Student’s Depression & Dysfunctional Attitude?

Research Paper Title

The impacts of maternal separation experience and its pattern on depression and dysfunctional attitude in middle school students in rural China.

Background

In China, because of the growth of economically driven rural-to-urban migration, there are lots of children in rural area who are separating or have separation experience with their parents.

Until now, few studies focused on solely maternal separation and no research studied whether its pattern will affect children’s later psychological status.

The aim of this study was to determine whether early or late maternal separation affects depression and dysfunctional attitude in middle school students and what is the role of cumulative duration and meeting frequency.

Methods

Maternal separation experience was obtained by using questionnaires. The researchers got early maternal separation group first. Then, late maternal separation and control group were obtained with the same number by matching grade, sex and family socioeconomic status.

All the students in the three groups completed the scales of Children’s Depression Inventory (CDI) and Dysfunctional Attitude Scale (DAS).

Results

Both CDI and DAS scores of early separation group are higher than the other two groups.

  • When the researches split the data by sex, only females presented the same results.
  • When cumulative duration is short, there is significant difference in both scores of CDI and DAS among the three groups, which showed the scores of early separation group are higher than the other two groups.
  • When the cumulative duration is long, there is no significant difference among the three groups.
  • When meeting frequency is high, there is no significant difference among the three groups.
  • When it is low, there is significant difference among the three groups, which showed the CDI and DAS scores of early separation group are higher than the other two groups.

Furthermore, the same results are also found in females.

Conclusions

Early maternal separation may exert negative influence on student’s depression and dysfunctional attitude.

The sex, cumulative duration and meeting frequency may also play important roles in the effect.

Reference

Cao, X.J., Huang, Y.X., Zhu, P. & Zhang, Z.G. (2020) The impacts of maternal separation experience and its pattern on depression and dysfunctional attitude in middle school students in rural China. The International Journal of Social Psychiatry. 66(2), pp.188-197. doi: 10.1177/0020764019895795. Epub 2020 Jan 2.

College Students & Substance Use: Do They Require different Strategies for Prevention & Intervention?

Research Paper Title

Cumulative Risk of Substance Use in Community College Students.

Background

Substance use in community college students has been explored in only a handful of studies.

Differences in population characteristics and substance use between 2- and 4-year students suggest that different factors may promote and thwart this behaviour.

Cumulative risk is a parsimonious methodology that provides better model stability and more statistical power, yet it has only been recently used in substance use research.

The aim of this study is to investigate multiple aspects of substance use risk in a population in need of substance use prevention and intervention services.

Methods

The researchers conducted a cross-sectional study of community college students (N = 288; 75% female) examining the relative contributions of different domains of cumulative risk (eg, life stressors, academic stressors, and mental health diagnoses) to develop different profiles of risk across substance use classes (ie, alcohol, cigarette, marijuana, and hard drug use).

Results

Cumulative risk analyses indicated that alcohol and tobacco use were associated with the domains of life stressors and peer/family substance use, marijuana use with peer/family substance use and stressful childhood experiences, and hard drug use with peer/family substance use, lack of social support, low access to care, and stressful childhood experiences.

Conclusions

Different strategies for prevention and intervention may be necessary to effectively address different forms of substance use in this population.

Scientific Significance

The risk domain profiles related to specific drugs may lead to targeted interventions to reduce substance use in community college students.

Reference

Salgado García, F., Bursac, Z. & Derefinko, K.J. (2020) Cumulative Risk of Substance Use in Community College Students. The American Journal on Addictions. 29(2), pp.97-104. doi: 10.1111/ajad.12983. Epub 2020 Jan 3.

Measuring Functional Independence using the interRAI Child and Youth Mental Health Assessment System.

Research Paper Title

Examining the Structure of a New Pediatric Measure of Functional Independence Using the interRAI Child and Youth Mental Health Assessment System.

Background

Activities of daily living (ADL) are key to daily living and adjustment. A number of ADL scales have been developed and validated to examine functional performance in the paediatric population; however, most of these scales are limited to specific groups.

The purpose of this research was to test the plausibility of developing and validating a hierarchical versus additive ADL summary scale for children and youth using the interRAI Child Youth Mental Health (ChYMH) assessment system.

Methods

Data from 8980 typically developing children (mean age 12.02 years) and 655 children with developmental disabilities (mean age 11.9 years) was used to develop ADL summary scales. Patterns among the data were analysed and, unlike with adult populations, a hierarchical scale did not capture ADL performance and mastery.

Results

Two new ADL additive summary scales for children and youth were developed to measure ADL skills within this group.

Reference

Stewart, S.L., Morris, J.N., Asare-Bediako, Y.A. & Toohey, A. (2019) Examining the Structure of a New Pediatric Measure of Functional Independence Using the interRAI Child and Youth Mental Health Assessment System. Developmental Neurorehabilitation. 1-8. doi: 10.1080/17518423.2019.1698070. [Epub ahead of print].