Foster Care, Mental Health, & Primary Care Visits

Research Paper Title

A Comparison Study of Primary Care Utilization and Mental Health Disorder Diagnoses Among Children In and Out of Foster Care on Medicaid.

Background

The purpose of this study was to compare the utilisation of primary care services and presence of mental health disorder diagnoses among children in foster care to children on Medicaid not in foster care in a large health system.

Methods

The data for this study were analysed from a clinical database of a multi-practice paediatric health system in Houston, Texas.

The sample included more than 95 000 children covered by Medicaid who had at least one primary care visit during the 2-year study period.

Results and Conclusions

The results of the study demonstrated that children not in foster care had a greater number of primary care visits and the odds of having >3 visits were significantly lower for children in foster care with a mental health disorder diagnosis.

Additionally, more than a quarter of children in foster care had a diagnosis of a mental health disorder, compared with 15% of children not in foster care.

Reference

Keefe, R.J., Van Horne, B.S., Cain, C.M., Budolfson, K., Thompson, R. & Greeley, C.S. (2020) A Comparison Study of Primary Care Utilization and Mental Health Disorder Diagnoses Among Children In and Out of Foster Care on Medicaid. Clinical Pediatrics. 59(3), pp.252-258. doi: 10.1177/0009922819898182. Epub 2020 Jan 3.

Is There a link between Separation Anxiety Trajectory in Early Childhood & Risk for Sleep Bruxism?

Research Paper Title

High separation anxiety trajectory in early childhood is a risk factor for sleep bruxism at age 7.

Background

The evolution of sleep bruxism manifestations and their co-occurrence with separation anxiety in early childhood remain unclear.

The researchers threefold aim was to:

  1. Describe developmental sleep bruxism trajectories in early childhood;
  2. Investigate co-occurrences between trajectories of sleep bruxism and separation anxiety; and
  3. Determine whether distinct trajectories of separation anxiety increase the risk of presenting sleep bruxism during the first year of elementary school.

Methods

This study is part of the Québec Longitudinal Study of Child Development.

Sleep bruxism scores were assessed from age 1.5 to 7 years with the Self-Administered Questionnaire for Mother (n=1,946).

Separation anxiety scores were measured from age 1.5 to 6 years with the Interviewer-Completed Computerised Questionnaire (n=2,045).

Results

The researchers identified:

  • Four sleep bruxism trajectories from age 1.5 to 6 years:
    • High-Increasing sleep bruxism at age 1.5 (14.1%);
    • High-Increasing sleep bruxism at age 4 (18.3%);
    • Low-Persistent sleep bruxism (12.1%); and
    • Never-Persistent sleep bruxism (55.5%).
  • Four separation anxiety trajectories from age 1.5 to 6 years:
    • Low-Persistent separation anxiety (60.2%);
    • High-Increasing separation anxiety (6.9%);
    • High-Decreasing separation anxiety (10.8%); and
    • Low-Increasing separation anxiety (22.1%).

Sleep bruxism and separation anxiety trajectories were weakly associated (X2=37.84, P<0.001).

Compared with preschoolers belonging to the Low-Persistent separation anxiety trajectory, preschoolers in the High-Increasing separation anxiety trajectory had almost double the risk of presenting sleep bruxism at age 7 (95% CI=1.25-3.22, P=.04).

Conclusions

When separation anxiety issues are detected in early childhood, it would be useful to target sleep bruxism during the first year of elementary school.

Reference

Rostami, E.G., Touchette, É., Huynh, N., Montplaisir, J., Tremblay, R.E., Battaglia, M. & Boivin, M. (2020) High separation anxiety trajectory in early childhood is a risk factor for sleep bruxism at age 7.

What is the Intergenerational Transmission of Risk for PTSD Symptoms & the Roles of Maternal and Child Emotion Dysregulation?

Research Paper Title

Intergenerational transmission of risk for PTSD symptoms in African American children: The roles of maternal and child emotion dysregulation.

Background

Emotion dysregulation is a transdiagnostic risk factor for many mental health disorders and develops in the context of early trauma exposure.

Research suggests inter-generational risk associated with trauma exposure and post-traumatic stress disorder (PTSD), such that maternal trauma experiences and related symptoms can negatively impact child outcomes across development.

The goals of the present study were to examine child and mother correlates of child PTSD symptoms and the unique roles of child and maternal emotion dysregulation in understanding child PTSD symptoms.

Methods

Subjects included 105 African American mother-child dyads from an urban hospital serving primarily low-income minority individuals.

Results

Correlational results showed that child trauma exposure, child emotion dysregulation, maternal depressive symptoms, maternal emotion dysregulation, and potential for maternal child abuse all were significantly associated with child PTSD symptoms (ps < 0.05).

Hierarchical linear regression models revealed that child trauma exposure, maternal depression, and maternal abuse potential accounted for 29% of the variance in child PTSD symptoms (p < 0.001).

Both child emotion dysregulation (Rchange² = 0.14, p < .001) and maternal emotion dysregulation (Rchange² = 0.04, p < .05) were significantly associated with child PTSD symptoms independent of other risk factors and potential for maternal abuse was no longer a significant predictor.

Conclusions

These results suggest that maternal emotion dysregulation may be an important factor in influencing their child’s PTSD symptoms above and beyond child-specific variables.

Both maternal and child emotion dysregulation could be valuable treatment targets for improving maternal mental health and parenting behaviours and bolstering child health outcomes, thus reducing inter-generational transmission of risk associated with trauma.

Reference

Powers, A., Stevens, J.S., O’Banion, D., Stenson, A.F., Kaslow, N., Jovanovic, T. & Bradley, B. (2020) Intergenerational transmission of risk for PTSD symptoms in African American children: The roles of maternal and child emotion dysregulation. Psychological Trauma: Theory, Research, Practice and Policy. doi: 10.1037/tra0000543. [Epub ahead of print].

What Haunts Us (2018)

Introduction

The 1979 class of Porter Gaud School in Charleston, South Carolina graduated 49 boys. Within the last 35 years, six of them have died by suicide.

Outline

When Paige Goldberg Tolmach gets word that another former student from her beloved high school has killed himself, she decides to take a deep dive into her past in order to uncover the surprising truth and finally release the ghosts that haunt her hometown to this day.

Production & Filming Details

  • Director(s): Paige Tolmach.
  • Producer(s): Sarah Gibson, James Huntsman, Andreas Olavarria, and Told Slater.
  • Music: Nathan Halpern.
  • Cinematography: Adam Dubrowa.
  • Editor(s): Derek Doneen and Allan Duso.
  • Production: Diamond Docs, Matt Tolmach Productions, and The Kennedy/Marshall Company.
  • Distributor(s): Blue Fox Entertainment.
  • Release Date: 24 February 2018 (Boulder International Film Festival) and 11 May 2018 (US, general release).
  • Running Time: 72 minutes.

Book: Parenting the New Teen in the Age of Anxiety

Book Title:

Parenting the New Teen in the Age of Anxiety: A Complete Guide to Your Child’s Stressed, Depressed, Expanded, Amazing Adolescence.

Author(s): Dr. John Duffy.

Year: 2019.

Edition: First.

Publisher: Mango.

Type(s): Paperback, Kindle, and Audiobook.

Synopsis:

Learn about the “New Teen” and how to adjust your parenting approach. Kids are growing up with nearly unlimited access to social media and the internet, and unprecedented academic, social, and familial stressors. Starting as early as eight years old, children are exposed to information, thought, and emotion that they are developmentally unprepared to process. As a result, saving the typical “teen parenting” strategies for thirteen-year-olds is now years too late.

Urgent advice for parents of teens. Dr. John Duffy’s parenting book is a new and necessary guide that addresses this hidden phenomenon of the changing teenage brain. Dr. Duffy, a nationally recognised expert in parenting for nearly twenty-five years, offers this book as a guide for parents raising children who are growing up quickly and dealing with unresolved adolescent issues that can lead to anxiety and depression.

Unprecedented psychological suffering among our young and why it is occurring. A shift has taken place in how and when children develop. Because of the exposure they face, kids are emotionally overwhelmed at a young age, often continuing to search for a sense of self well into their twenties. Paradoxically, Dr. Duffy recognises the good that comes with these challenges, such as the sense of justice instilled in teenagers starting at a young age.

Readers of this book will:

  • Sort through the overwhelming circumstances of today’s teens and better understand the changing landscape of adolescence.
  • Come away with a revised, conscious parenting plan more suited to addressing the current needs of the New Teen.
  • Discover the joy in parenting again by reclaiming the role of your teen’s ally, guide, and consultant.

Book: Child Psychology & Development for Dummies

Book Title: Child Psychology & Development for Dummies

Author(s): Laura L. Smith, PhD and Charles H. Elliott, PhD.

Year: 2011.

Edition: First.

Publisher: Wiley Publishing, Inc.

Synopsis:

Grasp a child’s cognitive development, detect abnormalities, and learn what to do next.

An essential guide for parents, teachers, and caregivers, Child Psychology & Development For Dummies provides an informational guide to cognitive development at every stage of a child’s life, as well as expert tips and guidance on how to diagnose, treat, and overcome the cognitive barriers that impede learning and development.

  • The nuts and bolts – delve into the soup of kids’ development, including biology, psychology, learning, environment, and culture.
  • What makes kids tick? – discover how heredity, environment, experience, and culture interact to determine a child’s physical and emotional development.
  • Watch them grow – get an understanding of what a “normal” childhood should look like from conception through adolescence, and the types of behaviours to anticipate throughout.
  • Learn to spot trouble – find out what can go wrong during a child’s development, from physical problems like chronic illness to psychological problems like autism.
  • Ask for help – get expert guidance on the therapies and interventions that work, and how you can collaborate with professionals for an even better outcome.

Is there Evidence of Cognitive Impairment in Psychosis Risk Syndrome Children & Adolescents?

Research Paper Title

Neuropsychological profile of children and adolescents with psychosis risk syndrome: the CAPRIS study.

Background

Neuropsychological underperformance is well described in young adults at clinical high risk for psychosis, but the literature is scarce on the cognitive profile of at-risk children and adolescents.

The aim of this study is to describe the neuropsychological profile of a child and adolescent sample of patients with psychosis risk syndrome (PRS; also known as Attenuated Psychosis Syndrome) compared to healthy controls and to analyse associations between attenuated psychotic symptoms and cognitive impairment.

Methods

Cross-sectional baseline data analysis from a longitudinal, naturalistic, case-control, two-site study is presented.

Eighty-one help-seeking subjects with PRS and 39 healthy controls (HC) aged between 10 and 17 years of age were recruited.

PRS was defined by:

  • Positive or negative attenuated symptoms;
  • Brief Limited Intermittent Psychotic Symptoms (BLIPS);
  • Genetic risk (first- or second-degree relative); or
  • Schizotypal personality disorder plus impairment in functioning.

A neuropsychological battery was administered to assess:

  • General intelligence;
  • Verbal and visual memory;
  • Visuospatial abilities;
  • Speed processing;
  • Attention; and
  • Executive functions.

Results

The PRS group showed lower general neuropsychological performance scores at a multivariate level and lower scores than controls in general intelligence and executive functions.

Lower scores on executive function and poorer attention were associated with high scores of positive attenuated psychotic symptoms.

No association with attenuated negative symptoms was found.

Conclusions

This study provides evidence of cognitive impairment in PRS children and adolescents and shows a relationship between greater cognitive impairment in executive functions and attention tasks and severe attenuated positive symptoms.

However, longitudinal studies are needed to clarify the nature of cognitive impairment as a possible vulnerability marker.

Reference

Tor, J., Dolz, M., Sintes-Estevez, A., de la Serna, E., Puig, O., Muñoz-Samons, D., Pardo, M., Rodríguez-Pascual, M., Sugranyes, G., Sánchez-Gistau, V. & Baeza, I. (2020) Neuropsychological profile of children and adolescents with psychosis risk syndrome: the CAPRIS study. European Child & Adolescent Psychiatry. doi: 10.1007/s00787-019-01459-6. [Epub ahead of print].

Children: Foster Care & Mental Health

Research Paper Title

A Comparison Study of Primary Care Utilisation and Mental Health Disorder Diagnoses Among Children In and Out of Foster Care on Medicaid.

Background

The purpose of this study was to compare the utilisation of primary care services and presence of mental health disorder diagnoses among children in foster care to children on Medicaid not in foster care in a large health system.

Methods

The data for this study were analysed from a clinical database of a multi-practice paediatric health system in Houston, Texas.

The sample included more than 95 000 children covered by Medicaid who had at least one primary care visit during the 2-year study period.

Results & Conclusions

The results of the study demonstrated that children not in foster care had a greater number of primary care visits and the odds of having >3 visits were significantly lower for children in foster care with a mental health disorder diagnosis.

Additionally, more than a quarter of children in foster care had a diagnosis of a mental health disorder, compared with 15% of children not in foster care.

Reference

Keefe, R.J., Van Horne, B.S., Cain, C.M., Budolfson, K., Thompson, R. & Greeley, C.S. (2020) A Comparison Study of Primary Care Utilization and Mental Health Disorder Diagnoses Among Children In and Out of Foster Care on Medicaid. Clinical Pediatrics. doi: 10.1177/0009922819898182. [Epub ahead of print].

A Review of Effective/Cost Effective Interventions of Child Mental Health Problems in Low- and Middle-Income Countries (LAMIC)

Research Paper Title

Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review.

Background

This systematic review protocol aims to examine the evidence of effectiveness and cost-effectiveness of interventions for children and adolescents with, or at risk of developing mental disorders in low- and middle-income countries (LAMICs).

Methods

The researchers will search Medline Ovid, EMBASE Ovid, PsycINFO Ovid, CINAHL, LILACS, BDENF and IBECS. We will include randomised and non-randomised controlled trials, economic modelling studies and economic evaluations.

Participants are 6 to 18 year-old children and adolescents who live in a LAMIC and who present with, or are at high risk of developing, one or more of the conditions: depression, anxiety, behavioural disorders, eating disorders, psychosis, substance abuse, autism and intellectual disabilities as defined by the DSM-V.

Interventions which address suicide, self-harm will also be included, if identified during the extraction process.

The researchers will include in person or e-health interventions which have some evidence of effectiveness (in relation to clinical and/or functional outcomes) and which have been delivered to young people in LAMICs.

They will consider a wide range of delivery channels (e.g., in person, web-based or virtual, phone), different practitioners (healthcare practitioners, teachers, lay health care providers) and sectors (i.e., primary, secondary and tertiary health care, education, guardianship councils).

In the pilot of screening procedures, 5% of all references will be screened by two reviewers.

Divergences will be resolved by one expert in mental health research.

Reviewers will be retrained afterwards to ensure reliability. The remaining 95% will be screened by one reviewer.

Covidence web-based tool will be used to perform screening of references and full text paper, and data extraction.

Results

The protocol of this systematic review will be disseminated in a peer-reviewed journal and presented at relevant conferences.

The results will be presented descriptively and, if possible, meta-analysis will be conducted. Ethical approval is not needed for anonymised secondary data.

Conclusions

The systematic review could help health specialists and other professionals to identify evidence-based strategies to deal with child and adolescents with mental health conditions.

Reference

Grande, A.J., Ribeiro, W.S., Faustino, C., de Miranda, C.T., Mcdaid, D., Fry, A., de Moraes, S.H.M., de Oliveira, S.M.D.V.L., de Farias, J.M., de Tarso Coelho Jardim, P., King, D., Silva, V., Ziebold, C. & Evans-Lacko, S. (2020) Effective/cost effective interventions of child mental health problems in low- and middle-income countries (LAMIC): Systematic review. Medicine (Baltimore). 99(1):e18611. doi: 10.1097/MD.0000000000018611.