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Highlights in child mental health research: August 2020

Prepared by AIFS, Australia, August 2020

Related to Child mental health, Children of parents with a mental illness, Depression, Family and domestic violence, Family and social relationships, Family conflict, separation and divorce, Mental health care, Pandemic, Parental mental illness, Parenting, Perinatal infant mental health, Prevention and early intervention, Stress

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.

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 COVID-19 pandemic and how it might affect children and families. While research is only starting to emerge on children’s views about the COVID-19 pandemic, a new study performed in Spain offers new insights into children’s perceptions and coping.

Using data from over 3,400 Australian children and their parents, this study found a significant association between children’s mental health and parents’ ongoing difficulties with work-family conflict (Leach et al., 2020).

This study of over 1,900 parents and their children found that specific parenting factors were associated with child flourishment and family resilience in children with mental, emotional, and behavioural disorders (Herbell et al., 2020).

This review of 233 studies investigated the associations between children’s friendship experiences and their emotional wellbeing (specifically loneliness and depressive symptoms). Participants ranged from kindergarten to Grade 12.  Small, but significant, associations were found (Schwartz-Mette et al., 2020).

This review found support for an association between a range of prenatal factors and an increased risk of problems in emotional and behavioural development in childhood (Tien, Lewis, & Liu, 2020). These findings highlight the importance of various prenatal supports for parents, which can lead to positive flow-on effects for child wellbeing.

Coronavirus (COVID-19) and children: Resources, research, and reports

Recently released reports and journal articles on COVID-19 include:

This Commentary discusses the psychological impacts of the pandemic on infants and their mothers. Recommendations for supporting infant and maternal mental health during COVID-19 are provided, including in clinical practice and policy.

This study investigated the effects of the COVID-19 pandemic on Australian women from pre-birth to post-birth, including the emotional impact. This was done through analysing the themes that arose in an online support forum for these women.

This practitioner review provides an overview of the assessment and intervention of health-related anxiety and worries in children that are related to the pandemic.

The Life during COVID-19 survey, which had over 7,000 participants, explored how families adjusted to the pandemic. The fourth report in the series discusses how fathers spent more quality time with their children during the COVID-19 pandemic.

While research articles are only just emerging into the effects of the pandemic on children’s wellbeing, a new research study that explores children’s voices is summarised below:

Exploring Children’s Social and Emotional Representations of the COVID-19 Pandemic

Authors: Idoiaga, N., Berastegi, N., Eiguren, A., & Picaza, M.

Journal: Frontiers in Psychology

Highlights

  • Research is only beginning to emerge about children’s views and perceptions on the COVID-19 pandemic, including their emotional responses.
  • This qualitative study conducted in Spain offers new insights into how children are representing and coping with the COVID-19 pandemic.
  • 228 children (aged 3 to 12 years) completed a “free association exercise” where they were asked to respond to two questions (p. 1):
    • “When you hear the word coronavirus, what comes to mind, or what do you think?”
    • “How are you feeling these days because of the coronavirus?”
  • Children’s responses were analysed to identify their main ideas in relation to COVID-19. The ideas that emerged from this specific sample of children included:
    • Children viewed COVID-19 as an “enemy that is being fought by the doctors” (p. 1)
    • Children felt worried and afraid about getting COVID-19, but this was predominantly because they thought they could pass it on to their grandparents leading to guilt
    • Lockdowns fostered conflicting feelings in children. While negative emotions were present (e.g. scared, lonely, bored, sad, angry), positive emotions were also experienced by children when at home with their families (e.g. happy, calm, safe)
    • The question of when the situation will end is something that arises for children.
  • Given that the study was performed in Spain and was qualitative in nature, the generalisability of the findings to the Australian context is likely limited. Nevertheless, it provides a valuable example of how research can increase understandings of children’s views and needs with regards to the COVID-19 pandemic, as well as the effect the situation is having on their emotional well-being.
  • It will be important that researchers and policy makers seek and consider children’s voices when responding to the pandemic, as well as uphold children’s rights to meaningfully participate in discussions and decisions about their lives and well-being.

Click to read the free full-text

Parental work-family conflict and the mental health of Australian children

Australian parents’ work–family conflict: accumulated effects on children’s family environment and mental health (Australia)

Authors: Leach, L.S., Dinh, H., Cooklin, A., Nicholson, J.M., & Strazdins, L.

Journal: Social Psychiatry and Psychiatric Epidemiology

Highlights

  • This study investigated the relationship between parents’ work-family conflict (WFC) and their children’s mental health. It also explored potential factors in the family environment that might influence this relationship.
  • Children’s ages ranged from 4 – 5 years (time point 1) to 12 – 13 years (time point 5). The study was limited to coupled parents who were employed.
  • Key findings included:
    • ­There was a significant association between children’s mental health (at age 12 – 13 years) and parents’ accumulated difficulties in managing work-family conflict. No difference was observed in this association between mothers and fathers.
    • Parents’ WFC also influenced factors in the family environment, which had flow-on effects for child mental health. These family factors were irritability in parenting, parents’ marriage satisfaction, and parents’ psychological distress.
  • Given that children whose parents experienced ongoing or accumulating WFC were more likely to experience worse mental health outcomes, the researchers propose that change is needed in workplaces, public health promotion, and policy to:
    • Promote family-friendly and flexible work arrangements across industries.
    • Create workplaces that value and promote positive mental health.
  • The researchers suggest that these strategies will be particularly important given that WFC is common and is experienced by around one in three Australian parents.
  • Some families were under-represented in this study (e.g. families experiencing disadvantage; single-parent families). Hence further research is needed to explore the relationship between WFC and child mental health in other types of families.

Read the Abstract here

Parenting factors that promote family resilience and child flourishment

Family resilience and flourishment: Well-being among children with mental, emotional, and behavioral disorders (USA)

Authors: Herbell, K., Breitenstein, S.M., Melnyk, B.M., & Guo, J.

Journal: Research in Nursing and Health

Highlights

  • Using data from 1,900 parents and their children, this study identified parenting factors associated with child flourishment and family resilience in children (aged 6 to 17 years) with mental, emotional, and behavioural (MEB) disorders.
  • Child flourishment can be viewed a marker of resilience, well-being, and positive mental health. In this study, it was defined as a child’s skills in self-regulation, resilience, and curiosity.
  • Family resilience refers to “a family’s ability to cope effectively, adapt, and grow when encountering stressors” (p. 2).
  • Key findings included:
    • Family resilience was positively associated with parents perceiving that they had emotional support available with regards to parenting, as well as with parents’ perceptions of coping in relation to raising their children.
    • Parental perceptions of coping were also positively associated with child flourishment.
    • Aggravation of parents in relation to their child was negatively associated with child flourishment.
    • Parental mental health might underpin family resilience given that the findings highlight the importance of parental coping and emotional support.
  • These findings provide support for interventions that incorporate parent training to promote emotional regulation of parents (e.g., increasing skills in coping and tolerating frustration). These interventions may also have positive flow-on effects for the development and well-being of children and families.
  • The researchers highlight the importance of parental supports and services in promoting family resilience and child well-being. Examples include help with navigating the mental health system, access to social supports (e.g. peer supports/mentors), and provision of parental emotional and mental health support.

Read the Abstract here

Children’s friendships and their mental health

Relations of friendship experiences with depressive symptoms and loneliness in childhood and adolescence: A meta-analytic review

Authors: Schwartz-Mette, R.A., Shankman, J., Dueweke, A.R., Borowski, S., & Rose A.J.

Journal: Psychological Bulletin

Highlights

  • This meta-analytic review investigated the associations between children’s friendship experiences and their emotional well-being (i.e. loneliness and depressive symptoms).
  • The associated was explored with regards to 3 indicators (indices) of friendship experiences:
    • Number of friendships
    • Positive friendship qualities (e.g., companionship; emotional support; practical help)
    • Negative friendship qualities (e.g. conflict; critical interactions; dominance)
  • The review included 233 studies. Participants ranged from kindergarten to Grade 12.
  • Key findings included:
    • “Relatively small but significant…associations…between the 3 indices of friendship with depressive symptoms and loneliness” (Schwartz-Mette et al., 2020, p. 662).
    • Children’s overall friendship experiences might be more strongly linked with feelings of loneliness than with depressive symptoms.
    • Negative friendship quality was more strongly linked to later depressive symptoms (compared to positive friendship quality), suggesting that negative experiences may have a more salient effect.
    • The relationship between children’s friendship experiences and loneliness/depressive features was stronger in younger participants than those who were older.
  • Due to the small sizes of the effects found (as well as friendship experiences being only one of many potential contributors to emotional well-being), the researchers suggest that prevention and early intervention strategies that are limited to improving friendship experiences would probably not be most effective. Instead, they suggest that components that target friendship experiences could be incorporated into broader programs that also focus on other risk factors for emotional difficulties.

Read the Abstract here

Importance of prenatal factors in children’s wellbeing

Prenatal risk factors for internalizing and externalizing problems in childhood

Authors: Tien, J., Lewis, G.D., & Liu, J.

Journal: World Journal of Pediatrics

Highlights

  • This review summarises research that has investigated the association between pre-natal risk factors (i.e. risk factors during pregnancy) and later problems in children’s emotional and behavioral development.
  • It specifically focuses on the link to internalizing problems (i.e. inward-focused negative emotions) and externalising problems (i.e. outward-focused negative behaviours) in childhood and beyond.
  • The review found support for a negative association between the following prenatal factors and an “increased risk of emotional/behavioural problem development during childhood and beyond” (Tien, Lewis, & Liu, 2020, p. 341):
    • Maternal exposure to intimate partner violence
    • Maternal anxiety and depression
    • Maternal health-related factors, such as substance use or abuse (e.g., smoking, secondhand smoke, alcohol consumption), inflammation/infection, and being overweight or obese.
  • The implications of these findings are discussed, including that these potentially modifiable risk factors may offer valuable opportunities for prevention and early intervention (both health-related and psychosocial-related) to promote parental and child well-being. Possible examples include incorporating screening, support, and referral for parental mental health or intimate partner violence into prenatal care.
  • These findings provide further evidence for the importance of pre-natal supports for parents. They also lend additional support to the idea that the promotion of children’s development and well-being should begin even before they are born.

Read the Abstract here

Up Next: Coronavirus (COVID-19) and children: Resources, research, and reports
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