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 research studies on:

Using data from the Longitudinal Study of Australia Children, Christian and colleagues (2020) found that owning a pet was associated with reduced odds of abnormal levels of emotional symptoms, prosocial behaviours (i.e. acting in a kind and helpful way towards others), and problems with peers.  That is, pet ownership was “associated with fewer social-emotional problems in young children” (Christian et al., p. 4).

This Australian study by Piotrowska and colleagues (2020) has identified different profiles of social-emotional and cognitive vulnerability in children at early childhood and middle childhood.  Risk factors that had the strongest effects on children transitioning between different vulnerability profiles were contact with child protective services and parental mental illness. Other risk factors included parental criminal offending and being male.

This study explored the rates of children and adolescents re-presenting with self-harm at the Emergency Department (ED) of a tertiary paediatric hospital in Melbourne, Australia (Summers et al., 2020).  Key findings included that 44% of patients were considered to be presenting with self-harm for the first time and that almost one in four patients re-presented with self-harm within 1 year. Previous presentations for self-harm were a strong predictor of re-presenting with self-harm.

Researchers from Monash University, Melbourne have developed a new mental health literacy model for children (Bale, Grove, & Costello, 2020).  The model outlines valuable information about the mental health literacy needs of children.  The researchers also developed items that will inform the development of a world-first verbal scale for measuring mental health literacy in children.

This study by Boustani and colleagues synthesised existing knowledge about the content of evidence-based universal mental health programs for children to determine their common elements.  The most common elements represented in programs were psychoeducation, problem solving, insight building, social skills training, and communication skills.

Click the “Continue Reading” button below to view the key messages of each featured article.

Pet ownership and the social-emotional wellbeing of Australian children

Pets Are Associated with Fewer Peer Problems and Emotional Symptoms, and Better Prosocial Behavior: Findings from the Longitudinal Study of Australian Children (Australia)

Authors:  Christian, H., Mitrou, F., Cunneen, R., & Zubrick, S.R.

Journal:  The Journal of Paediatrics

Highlights:

  • This study investigated the association between pet ownership and children’s social-emotional development over time.
  • The study used data from the Longitudinal Study of Australia Children (LSAC). Data was analysed from two time-points:  when children were age 5 (sample of 4,242 children) and age 7 (sample of 4,431 children).
  • Children’s social-emotional development was measured using the Strengths and Difficulties Questionnaire (SDQ).
  • The study found that owning a pet was associated with reduced odds of abnormal SDQ levels in multiple areas compared to not owning a pet, including regarding:
    • emotional symptoms
    • problems with peers
    • prosocial behaviour (i.e. acting in a kind and helpful way towards others)
  • That is, “owning a household pet is associated with fewer social-emotional problems in young children” (p. 4).
  • Owning a dog was associated with reduced odds of having abnormal levels on all five SDQ scales (i.e. emotional symptoms, problems with peers, hyperactivity, conduct problems). These children were “20% less likely to have abnormal scores on any social-emotional development scale” compared to children with no pets (p. 4).
  • Pet ownership was associated with positive outcomes in social functioning (e.g., peer relationships, capacity to make friendships), especially in children without siblings.
  • Importantly, cause-effect relationships between pet ownership and children’s social-emotional development cannot be drawn from these findings (i.e. findings were associative). Further longitudinal research is needed to explore the possibility of casual relationships.
  • The researchers conclude that “pets may protect children in general from developing peer relationship problems, emotional symptoms, and deficits in prosocial behaviour” (p. 6).

Read the Abstract here

Profiles of social, emotional, and cognitive vulnerability in Australian children

Transitions between socio-emotional and cognitive vulnerability profiles from early to middle childhood: a population study using multi-agency administrative records (Australia)

Authors:  Piotrowska P.J., Whitten, T., Tzoumakis, S., Laurens, K.R., Katz, I.; Carr, V.J., Harris, F., & Green, M.J.

Journal:  European Child and Adolescent Psychiatry

Highlights:

  • This study aimed to identify profiles of social-emotional and cognitive vulnerability in children at early childhood (i.e. age 5-6) and middle childhood (i.e. age 10-11).
  • The study also investigated factors that influenced children’s transition between different profiles of vulnerability over time.
  • The study used linked data of 19,087 children and their parents from the New South Wales Child Development Study.
  • Three developmental profiles were found in early childhood:
  1. Typically developing (84% of children)
  2. Emotionally vulnerable (8.6%) – These children showed emotional difficulties.
  3. Cognitively vulnerable (7.4%) – These children showed cognitive difficulties.
  • Two developmental profiles were identified in middle childhood:
  1. Typically developing (74.4% of children)
  2. Vulnerable (25.6%) – These children demonstrated global vulnerabilities with difficulties in all social-emotional and cognitive areas.
  • “A substantial increase” was found in the proportion of children who were developmentally vulnerable from Time 1 to Time 2 (p. 8).
  • Generally speaking (and consistent with past research) children demonstrated “substantial stability in vulnerability profiles across time” (p. 9). Nevertheless, risk factors were identified that influenced the transition of children between different developmental profiles from early to middle childhood.  These risk factors were:
    • Being male
    • Having had contact with child protective services
    • Having a parent with a mental illness
    • Parental criminal offending
  • The factors that had the strongest effects on children transitioning between different vulnerability profiles were contact with child protection and parental mental illness.
  • The strongest risk factor was contact with child protective services, which the researchers considered unsurprising given the well-documented effects of child maltreatment on early development and vulnerability.
  • The researchers suggest the risk factors identified in this study may assist practitioners, service providers, and organisations in targeting early childhood interventions.
  • Professionals who work with children may wish to be mindful of these risk factors that may place particular clients at a higher risk of social-emotional and cognitive difficulties.

Read the Abstract here

Presentations for self-harm at an Australian Emergency Department

Repeated presentation of children and adolescents to the emergency department following self-harm: A retrospective audit of hospital data (Australia)

Authors:  Summers, P., O’Loughlin, R., O’Donnell, S., Borschmann, R., Carlin, J., & Hiscock, H.

Journal:  Emergency Medicine Australasia:  EMA

Highlights:

  • This study explored the rates of children and adolescents re-presenting with self-harm at an Emergency Department (ED) of a tertiary paediatric hospital in Melbourne, Australia.
  • The researchers analysed data from the medical records of 952 patients who presented to the ED for self-harm over a 2-year period (i.e. January 2017 to December 2018). Participants were aged 0 to 18 years.
  • Key findings included:
    • 44% of patients were considered to be presenting with self-harm for the first time.
    • 82% of all presentations for self-harm were
    • Almost one in four patients re-presented with self-harm within 1 year.
    • An estimated 15% of patients re-represented with self-harm within 3 months, 20% within 6 months, and 23% within 12 months.
  • There was no factor that strongly predicted re-presentation with self-harm with the exception of previous presentations for self-harm. But there were some factors that were weakly associated with an increased risk of re-presenting with self-harm, including:
    • Having been “flagged by a hospital clinician as vulnerable” (p. 1).
    • A history of depression or substance abuse
    • Being female
    • Having engaged in self-harm by self-cutting
    • Having required an “aggressive behaviour response team” when presenting (p. 1).
    • Living in an urban area.
  • Many of the above factors have previously been found to be associated with re-presentations of self-harm, including past self-harm, being female, engaging in self-cutting, having a mood disorder, and engaging in substance abuse.
  • This study is of interest to practitioners and researchers as it is the first to provide data within Australia about longer-term follow-up of presentations for self-harm in children and adolescents.
  • Further studies are needed across multiple Australian ED’s to increase understandings of children and adolescents who experience repeated self-harm presentations, particularly to clarify predictive factors and patterns in presentation. This research could help inform the delivery of supports to this sub-group of children.

Read the Abstract here

Mental health literacy of children

Building a mental health literacy model and verbal scale for children: Results of a Delphi study (Australia)

Authors:  Bale, J., Grové, C., & Costello, S.

Journal:  Children and Youth Services Review

Highlights:

  • Mental health literacy refers to “knowledge and attitudes about mental health and mental illness to help oneself and others” (p. 1).
  • This landmark study by researchers at Monash University, Melbourne has developed a new mental health literacy model for children (aged 8 to 12 years). The model outlines information about the mental health literacy content needs of children.
  • The model was developed to address the existing gap in mental health literacy frameworks for children. This is particularly important given that emerging evidence has suggested that “mental health literacy information needs to be developmentally appropriate” and carefully tailored to the particular point in the lifespan (p. 1).
  • Given a lack of scales that measure mental health literacy in children in an inclusive way (e.g., the majority are written measures), the study also created items to help develop a verbally-administered mental health literacy scale for children (aged 8 – 12 years).
  • The model and items were developed using the Delphi method. The method involved 35 experts responding to three rounds of surveys delivered online.
  • Experts consisted of teachers, researchers and psychologists with experience in working with children.
  • The researchers identified 6 themes “that encompass children’s MHL needs that…informed a new mental health literacy child focused model” (p. 1). The themes (see Figure 2) were:
    • Knowing what mental health is and recognising changes in mental health
    • Understanding how to get help and how to find mental health information
    • Knowing the supports that are available, including the roles of professionals (e.g. doctors, psychologists) and what they can offer.
    • Knowledge of positive and negative influences in daily life that can affect mental health
    • Understanding and using coping and resilience strategies to manage wellbeing
    • Promoting positive attitudes and decreasing negative attitudes regarding mental health
  • The model may help to inform the development of approaches that seek to prevent child mental health problems and promote social-emotional wellbeing through providing children with mental health literacy education.
  • The items developed in this study will help to inform the development of a world-first verbal scale to measure child mental health literacy in children.
  • Importantly, the researchers highlight the importance of additional research to gain children’s own perspectives regarding what they “might want and need to learn about mental health” (p. 9) as this current model is based solely on the views of professionals.

Read the Abstract here

Common elements of universal child mental health programs

Common Elements of Childhood Universal Mental Health Programming (USA)

Authors:  Boustani, M.M., Frazier, S.L., Chu, W., Lesperance, N., Becker, K.D., Helseth, S.A., Hedemann, E.R., Ogle, R.R., & Chorpita, B.F.

Journal:  Administration and Policy in Mental Health

Highlights:

  • This study synthesised existing knowledge on the content of evidence-based universal mental health programs for children to distil their common elements.
  • 78 programs for children aged 3 to 11 years were included in the synthesis.
  • The most common elements represented in universal mental health programs for children (p. 7) were:
    • Psychoeducation
    • Problem solving
    • Insight building
    • Social skills training
    • Communication skills
  • The above common elements were found to have a “strong presence” in universal mental health programs for children and “may reflect the relevance of these skills for successful interpersonal and mental health development” (p. 7). Elements of psychoeducation and problem solving were most common.
  • While the study explored the presence or absence of particular elements, it did not analyse the length of time given to each element, the potency of different elements, or the effectiveness of elements regarding specific outcomes.
  • These common elements will be of interest to stakeholders (e.g., education staff, community leaders, researchers, organisations, service providers) who wish to select, develop, or adapt universal mental health prevention programs for children to fit their specific population and context.

Read the Abstract here

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