Highlights in Child Mental Health Research: April 2020
Various, Australia, April 2020
Resource Summary
The monthly research summary provides a selection of recently released papers, systematic reviews, and meta-analyses related to infant and child mental health.
Each summary includes an introductory overview of the content for the month, followed by a list of selected articles. Each article is accompanied by a brief synopsis which presents the key messages and highlights. Links to abstracts, full-text articles and related resources, where available, are provided.
Contents:
- What's new this month in child mental health research?
- Coronavirus (COVID-19) and children: Resources, research, and reports
- The link between childhood trauma and mental health: A transdiagnostic model
- Infant temperament and later vulnerability to mental health difficulties
- Socioeconomic disadvantage: Resilience and child mental health
- Shared decision-making with parents in child and adolescent mental health
What's new this month in child mental health research?
This month’s highlights include:
Check out recently released reports and journal articles on the coronavirus pandemic and how it might affect children and families. While research studies are only just emerging into the potential effects of the pandemic on children’s mental health, a new study from China has been included and summarised (i.e. Xie et al., 2020).
Transdiagnostic approaches aim to identify the “core mechanisms” that underlie multiple kinds of psychopathology (i.e. mental health problems) (McLaughlin et al., 2020, p.2). This article proposes a model of transdiagnostic mechanisms to help “explain the strong links between childhood trauma and psychopathology” (p. 1). The linking mechanisms proposed by the model are: 1) changes in how social information is processed, 2) changes in the way that emotions are processed, and 3) accelerations in biological ageing.
This systematic review by Kostyrka-Allchorne and colleagues (2020, p. 412) found a “small but significant association between infant temperament and later psychopathology suggesting that such measures can play a limited role in infant risk indices to help target children at risk”. In particular, “high negative emotionality and [low] self-regulation in infancy may be transdiagnostic” markers of early risk for psychopathology generally (p. 412).
Using the data of 636 children from the larger Born in Bradford study in the UK, this study found that family financial difficulty was associated with poorer child mental health outcomes (Kirby, Wright, & Allgar; 2020). Maternal warmth was a protective factor that affected this association, suggesting that interventions and supports that target parental warmth may help promote young children’s emotional well-being.
“Shared decision-making (SDM) is the communication process that allows service users and service providers to collaborate when making care and treatment decisions” (Liverpool et al., 2020, p. 2). This scoping review by Liverpool and colleagues (2020) explored interventions that aim to support shared decision-making with parents in child and adolescent mental health. The review identified key factors that impacted the use and implementation of these interventions. When grouped into over-arching themes, these key factors were related to time, accessibility, and appropriateness.
The link between childhood trauma and mental health: A transdiagnostic model
Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience (USA)
Authors: McLaughlin, K.A., Colich, N.L., Rodman, A.M., & Weissman, D.G.
Journal: BMC Medicine
Highlights:
- Transdiagnostic approaches aim to identify the “core mechanisms” that underlie multiple kinds of psychopathology (i.e. mental health problems) (p.2).
- Transdiagnostic approaches can offer advantages compared to approaches that are disorder-specific, such as helping to identify key mechanisms that could be targeted by interventions to treat or prevent multiple kinds of mental health problems (p. 2).
- “Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology” (p. 1).
- This opinion piece published by researchers in BMC Medicine proposes a model of transdiagnostic mechanisms to “explain the strong links between childhood trauma and psychopathology” (p. 1). The mechanisms proposed to link childhood trauma to psychopathology (p. 2) are:
- Biases and changes in how social information is processed (i.e., “social information processing”) – Examples include incorrectly classifying neutral and negative emotions as anger and being biased to attend to cues that are threat-related.
- Changes in the way that emotions are processed (i.e. “emotional processing”) – Examples include reduced awareness, learning, and regulation of emotions.
- Accelerations in biological ageing – Examples include accelerations in the ageing of cells (i.e. “cellular ageing”) and the timing of puberty.
- Social support, especially from caregivers, is a protective factor for multiple kinds of trauma-related mental health problems and encourages
- This article contributes to the identification and understanding of transdiagnostic mechanisms that have a role in multiple kinds of psychopathology. Knowledge about these mechanisms can contribute to developing early interventions and treatments through identifying key targets.
- “In contrast to disorder-specific approaches that have historically been common, altering these transdiagnostic mechanisms through intervention provides the opportunity to more broadly reduce…[the] risk” of child mental health problems (p. 6).
Infant temperament and later vulnerability to mental health difficulties
Research Review: Do parent ratings of infant negative emotionality and self-regulation predict psychopathology in childhood and adolescence? A systematic review and meta-analysis of prospective longitudinal studies
Authors: Kostyrka-Allchorne, K., Wass, S.V., & Sonuga-Barke, E.J.S.
Journal: Journal of Child Psychology and Psychiatry
Highlights
- This study investigated the association between infant temperament and subsequent psychopathology in childhood and adolescence. This was done via a systematic review and meta-analysis of prospective longitudinal research studies.
- 25 research studies met inclusion criteria for the review.
- The measures of infant temperament explored (grouped into five constructs) were (p. 402):
- negative emotionality (i.e. the intensity and frequency that negative emotions are experienced. Examples of such emotions include fear, sadness, and discomfort).
- self-regulation (i.e. regulating oneself and one’s emotions, such as by orienting to “sources of comfort” like touch or sound)
- behavioural inhibition (e.g., being shy; being fearful; withdrawing from social or new situations).
- surgency/extraversion (e.g., sociability; seeking pleasure; positive affect/emotions).
- activity level (i.e. the amount that a child physically moves)
- Examples of subsequent psychopathology explored included internalising problems, externalising problems, and neurodevelopmental problems (e.g. Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder).
- The review found a “small but significant association between infant temperament and later psychopathology suggesting that such measures can play a limited role in infant risk indices to help target children at risk” (p. 412).
- In particular, “high negative emotionality and [low] self-regulation in infancy may be transdiagnostic” markers of early risk for “psychopathology in general” (p. 412).
- Given that the association found was small (albeit significant) and the “predictive power of questionnaire-measured infant temperament” was found to be weak, the researchers conclude these questionnaires “can play only a limited role as indices of early risk for later psychopathology” (p. 411).
- While the researchers acknowledge that the above finding is disappointing, they highlight that this is not inconsistent with other more-general attempts that have been limited in this quest to identify markers of early risk for subsequent psychopathology.
Socioeconomic disadvantage: Resilience and child mental health
Child mental health and resilience in the context of socioeconomic disadvantage: results from the Born in Bradford cohort study (United Kingdom)
Authors: Kirby, N., Wright, B., & Allgar, V.
Journal: European Child & Adolescent Psychiatry
Highlights:
- This study explored the associations between family financial difficulty (i.e. socioeconomic disadvantage) and child mental health outcomes at age 4 to 5 years. Importantly, the researchers also investigated potential factors that might help promote resilience in children exposed to family financial difficulty.
- The study used data of 636 children from the larger Born in Bradford study, which is an ongoing multi-ethnic prospective cohort study in the United Kingdom.
- Key findings included:
- Family financial difficulty was associated with poorer child mental health outcomes. This finding is consistent with past research.
- Factors that were associated with positive mental health outcomes in children included high levels of parental warmth, high scores in child literacy, and stronger child physical development scores.
- Maternal warmth was a protective factor that affected the association between family financial difficulty and later child mental health problems.
- This study supports “warm parenting, child literacy and child physical development” as protective factors for children’s mental health. Warm and nurturing parenting may be especially important for children exposed to socioeconomic disadvantage given that maternal warmth appeared to buffer the effects of family financial difficulty on children’s mental health.
- “The importance of warm and supportive parenting has been established as being crucial in enabling children to develop intrinsic skills and resources important in coping with adversity, including: emotional security; self-belief; self-efficacy; capacity for problem solving; social competence, and a sense of purpose.” (p. 474).
- These findings are relevant to practitioners and service providers who work to optimise children’s well-being. It highlights the importance of parental warmth and suggests that interventions and supports that target this facet of parenting may help promote the emotional well-being of young children. Such interventions may be of “particular benefit to children growing up” with socioeconomic disadvantage (p. 475).
- The researchers recommend that future research should further explore the potential of parental warmth as a protective factor, including supportive interventions, especially in sub-groups with socioeconomic disadvantage.