The December 2018 research highlights provide a selection of recently released systematic reviews and meta-analyses related to infant and child mental health and relevant to the work of the National Workforce Centre for Child Mental Health. Abstracts and links to full-text articles, where available, are provided.

Barriers and facilitators to understanding of ADHD in primary care: a mixed-method systematic review (French B; Sayal K; Daley D)

This systematic review aims to establish the barriers and facilitators with regard to attitudes, beliefs and experiences of ADHD within primary care. Electronic searches of multiple databases identified 3898 articles of which 48 met our inclusion criteria-primary care professionals from any country, understanding, knowledge, awareness, attitude and recognition of ADHD. Four main themes were identified: (1) need for education, (2) misconceptions and stigma, (3) constraints with recognition, management and treatment, and (4) multidisciplinary approach.

The findings suggest many interacting factors are at play in the recognition of ADHD by primary care practitioners with a strong recurring theme of a significant need for better education on ADHD. Implications for research and practice are discussed, suggesting that educational interventions for primary care practitioners could improve the recognition of ADHD in this setting.

European Child & Adolescent Psychiatry

Read the full text here.

Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes (Kreuze, L.J.; Pijnenborg, G.H.M.; de Jonge, Y.B.; Nauta, M.H.)


  • Anxiety-focused CBT led to large improvement in general functioning.
  • Anxiety-focused CBT reduced depressive symptoms and externalizing behaviors.
  • Positive results remained or even further improved at follow-up.
  • Social competence improved at follow-up.
  • Higher parental involvement seems to be beneficial at follow-up.

Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains. Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety.

A meta-analysis (nstudies = 42, nparticipants = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence.

Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms.

Journal of Anxiety Disorders

Read the abstract hereA Science Direct account is required to access the full text.

A meta-synthesis of how parents of children with autism describe their experience of advocating for their children during the process of diagnosis  (Boshoff K; Gibbs D; Phillips RL; Wiles L; Porter L)

The diagnostic process for children with autism can be complex for parents to navigate as they advocate for their child in order to obtain answers to their concerns, and receive the subsequent support they need. Gaining an understanding of parents’ experiences during this process will assist service providers in supporting families adequately.

This systematic review was undertaken to consolidate in-depth qualitative data from parents of their experience of advocating for their child with autism, during the process of diagnosis. A qualitative meta-synthesis was conducted, whereby fifteen databases were systematically searched. Twenty-two studies were identified and appraised using an adapted version of the Critical Appraisal Skills Programme tool.

Our findings highlight the intense emotional journey for parents during identification of their initial concerns and the formal process of diagnosis, and their perceptions of not being supported by others on this journey. This review illustrates the significant impact that positive experiences with first-line professionals have during the process of diagnosis, and how these experiences lay the foundation for all future relationships with other service providers. As a result, awareness of parents’ experiences will assist service providers to reconsider their communication style, information sharing, provision of support and to incorporate parents’ contributions in facilitating a more streamlined and more supportive process of diagnosis.

Health & Social Care In The Community

Read the full text here.

Physical activity and depression, anxiety, and self-esteem in children and youth: An umbrella systematic review (Dale, Leila Pfaeffli; Vanderloo, Leigh; Moore, Sarah; Faulkner, Guy)

Problem: A 2011 review of reviews reported small to moderate associations between physical activity (PA) and depression, anxiety and self-esteem among children and youth (aged 5–17 years). Due to the increase in reviews examining PA and mental health outcomes in children and youth over the past decade, we conducted an umbrella review to determine the current state of the literature, including whether effects were moderated by dose and type of PA, age, sex, or severity of mental illness.

Conclusions: PA appears to be an effective intervention for reducing depression/depressive symptoms and improving physical self-perceptions, although additional high-quality research and moderator analyses are needed to determine what type of PA interventions may result in better mental health outcomes for children and youth.

Mental Health and Physical Activity

Read the abstract hereA Science Direct account is required to access the full text.

Quasi-Experimental Evidence on Short- and Long-Term Consequences of Bullying Victimization: A Meta-Analysis. (Schoeler, Tabea; Duncan, Lauren; Ploubidis, George B.; Cecil, Charlotte M.; Pingault, Jean-Baptiste)

Exposure to bullying victimization is associated with a wide-range of short and long-term adverse outcomes. However, the extent to which these associations reflect a causal influence of bullying victimization remains disputed.

Based on the most stringent evidence available to date, findings indicate that bullying victimization may causally impact children’s wellbeing in the short-term, especially anxiety and depression levels. The reduction of adverse effects over time highlights the potential for resilience in individuals who have experienced bullying. Secondary preventive interventions in bullied children should therefore focus on resilience and address children’s pre-existing vulnerabilities.

Psychological Bulletin

Read the full text here.

Half‐Sibling and Stepsibling Relationships: A Systematic Integrative Review (Sanner, Caroline; Russell, Luke T.; Coleman, Marilyn; Ganong, Lawrence)

Increases in divorce, remarriage, and stepfamily formation have added complexity to sibling composition. Biological siblings have been found to be key players in children’s lives, and relationships with half and stepsiblings also likely influence individual development and adjustment.

In this systematic integrative review, we synthesize and critique 46 studies on half and stepsibling relationships, a literature that has seen marked growth in recent years. Researchers have focused predominately on two areas: individual outcomes associated with having half or stepsiblings and predictors of half and stepsibling relationship quality.

Although research designs have become more methodologically sophisticated, deficit‐comparison studies in which half and stepsiblings are compared to siblings in nuclear families remain common. We discuss challenges in studying sibling complexity and propose opportunities for examining how half and stepsibling relationships may contribute to individual and family resilience.

Journal of Family Theory & Review

Read the abstract here.  A Wiley Online account is required to access the full text.

A more extensive list of recently released research related to child mental health can be found here.

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