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Highlights in child mental health research: February 2022

Prepared by AIFS, Australia, February 2022

Related to Anxiety, Autism, Child and family, Child development, Child mental health, Cultural identity, migration and refugees, Depression, Family and social relationships, Family conflict, separation and divorce, Pandemic, Parenting, Resilience, Responding to traumatic events, Stress, Trauma

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:

Parents of Australian children with ADHD completed a survey when COVID-19 restrictions were in place. Parents reported that the COVID-19 pandemic had contributed to worse functioning for their children across some aspects of physical health, media use, and mental health (less exercise; increased TV and gaming; increased sad/depressed/unhappy mood), however some areas (sleep; feeling anxious) were unchanged. Parents also reported some positive impacts such as increased family time. This cohort of children will be followed longitudinally to understand the longer-term impacts. 

This systematic review found that screening for Adverse Childhood Experience (ACEs) increases identification of adversity and may increase referrals to services. However, there are limited data about whether this leads to an increase in referral uptake by families, and there are no reported data addressing mental health outcomes. Authors present a narrative description of outcomes as meta-analysis was not possible because of the small number of studies and significant heterogeneity.

This scoping review found that children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change. Anxiety and worry related to climate change awareness were prevalent in many child populations, although there was heterogeneity in how anxiety and worry were measured. However, research in this area is in its early stages and there is a need for more conceptual clarity and agreement on terminology.

This study uses an explanatory sequential mixed-method design to examine the risk factors associated with perinatal depression and anxiety in Australian fathers. Maternal depression, marital distress, masculine gender role stress, and work–family conflict were identified as risk factors. This study suggests that fathers may not necessarily share the same risk factors for perinatal depression and anxiety as mothers. Men with dominant masculine norms may express depressive symptoms differently and are less likely to seek medical treatment and counselling.

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

Additional research on COVID-19:

The COVID-19 pandemic is linked to particularly potent psychological effects for children and their caregivers while families adjust to new daily routines for work, education, and self-care. This study found different patterns of resilience, stress, and parenting outcomes by parent gender, including connections between resilience and parent stress or parent perceived child stress, and linkages to parent depression, caregiver burden and parent–child relationship quality.

This international cross-sectional study aims to describe the mental health outcomes of children with and without special healthcare needs and of their caregivers following the first national lockdown in Germany and to investigate the impact of socioeconomic status, disease complexity and psychosocial burden on parent-reported child mental health problems. We found a high prevalence of parent-reported mental health problems in children. Parent-reported mental health problems were more likely to affect children from low SES, with complex chronic disease and those whose parents screened positive for depression.

Physical health, media use, and mental health in children with ADHD during COVID-19

Physical health, media use, and mental health in children and adolescents with ADHD during the COVID-19 pandemic in Australia

Authors: Sciberras, E., Patel, P., Stokes, M. A., Coghill, D., Middeldorp, C. M., Bellgrove, M. A. et al.

Journal: Journal of Attention Disorders

Highlights

  • Parents of Australian children with ADHD completed a survey when COVID-19 restrictions were in place. This cohort of children will be followed longitudinally to understand the longer-term impacts.
  • Parents reported that the COVID-19 pandemic had contributed to worse functioning for their children across some aspects of physical health, media use, and mental health, however, some areas were unchanged.

Key findings

  • Two hundred and twenty-one parents of children aged between 5 and 17 (mean age 11 years) with ADHD consented to participate in the survey.
  • Parents reported several areas of child functioning that had declined during the pandemic, including less regular exercise, less outdoor time, increased TV time, increased social media use, increased gaming, increased sad/depressed/unhappy mood, reduced enjoyment in usual activities, and increased loneliness.
  • No overall differences were found in the proportion of children experiencing sleep problems or feeling anxious or worried. This is consistent with the growing body of research reporting a high prevalence of sleep problems and anxiety in children with ADHD.
  • Child COVID-19 stress was related to negative changes across most areas of functioning, particularly mental health functioning, even when accounting for pre-existing diagnoses and ADHD medication use.
  • Two-thirds of parents of children with ADHD reported some positive impacts, including more family time.

Implications

  • It is anticipated that with the lifting of restrictions some of these changes may improve, however, strategies may be needed to support families to reduce screen time and sedentary behaviour to pre-pandemic levels.
  • Resources specifically for children with neurodevelopmental disorders, including ADHD, to help cope with COVID-19 and associated restrictions will likely be helpful.

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Screening for adverse childhood experiences in children

Screening for adverse childhood experiences in children: A systematic review

Authors: Loveday, S., Hall, T., Constable, L., Paton, K., Sanci, L., Goldfeld, S., & Hiscock, H.

Journal: Pediatrics

Highlights

  • This systematic review found that screening for Adverse Childhood Experience (ACEs) increases identification of adversity and may increase referrals to services.
  • There are limited data about whether this leads to an increase in referral uptake by families, and there are no reported data addressing mental health outcomes.

Key findings

  • A total of 5816 articles were screened, with 4 articles meeting inclusion criteria, all of which were conducted in the United States and were of moderate quality.
  • Authors present a narrative description of outcomes as meta-analysis was not possible because of the small number of studies and significant heterogeneity.
  • The evidence that screening for ACEs improves identification of adversity is limited. However, it is difficult to compare screening studies because all the studies screened for different ACEs using different tools. This is in part due to the lack of a universal definition of ACEs.
  • Screening for ACEs can lead to increased referral rates to community-based services referral, but uptake of community services after a positive screen is dependent on health professional, parent, and systems factors.
  • None of the studies identified in this systematic review reported on child or parent mental health outcomes.
  • None of the included studies reported any assessment of harm associated with the screening test.

Implications

  • There is evidence that screening can improve detection of adversity and may improve referrals to community services, but there are no data on whether ACE screening improves child or parent mental health outcomes.
  • Further robust research is needed to determine if screening for ACEs can lead to improved outcomes, or unintentional harms, before widespread screening is advisable.
  • To realise the hypothesized benefits of ACEs screening on child and parent mental health, it is important to fully understand the barriers for families taking up referrals.

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The impact of climate change awareness on children’s mental wellbeing

The impact of climate change awareness on children’s mental wellbeing and negative emotions: A scoping review

Authors: Martin, G., Reilly, K., Everitt, H. and Gilliland, J.A.

Journal: Child and Adolescent Mental Health

Highlights

  • Children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change.
  • However, research in this area is in its early stages and there is a need for more conceptual clarity and agreement on terminology.

Key findings

  • Thirty-three articles were included in a narrative synthesis. Many articles were reviews or editorials/commentaries. Of the empirical research, most were from Europe, North America, and Australia.
  • The reviews included in this scoping review suggest that the mental wellbeing impacts and negative emotions that stem from climate change awareness may be common among child populations.
  • Anxiety and worry related to climate change awareness were prevalent in many child populations, although there was heterogeneity in how anxiety and worry were measured.
  • Some studies suggest how children cope with climate change, as well as their sense of hope and optimism, may play a role in both their mental well-being and engagement in pro-environmental behaviours.

Implications

  • Future research should examine how to support children experiencing impacts on their mental well-being and negative emotions from climate change awareness, and explore the role of practitioners, schools, parents and guardians, and communities in this. Measures should be developed and examined for reliability and validity across and within populations of children.
  • It is important to clearly define concepts and terminology regarding mental well-being and emotional responses that are attributed to an awareness of climate change (e.g., eco anxiety, climate anxiety, worry about climate change, and climate despair).
  • Studies from a broader range of countries and communities are needed, as there may be differential impacts of climate change on different groups, such as people who may rely on the land and land-based activities for their culture and livelihood (e.g., Indigenous peoples and farmers).

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Predictive factors for depression and anxiety in fathers during the perinatal period

Predictive factors for depression and anxiety in men during the perinatal period: A mixed methods study

Authors: Chhabra, J., Li, W., and McDermott, B.

Journal: American Journal of Men’s Health

Highlights

  • Paternal perinatal anxiety and depression have substantial impact on the father’s health and the mental health of his partner and newborn. Identifying risk factors can provide empirical evidence for the prediction and prevention of paternal perinatal anxiety and depression
  • This explanatory study aims to identify the risk factors associated with paternal perinatal depression and anxiety in a sample of Australian fathers and to examine the associations between depressive and anxiety symptoms and the identified risk factors.

Key findings

  • This study uses an explanatory sequential mixed-method design to examine the risk factors associated with perinatal depression and anxiety in Australian fathers. The authors used semi-structured interviews and an online cross-sectional survey to collect data.
  • Maternal depression, marital distress, masculine gender role stress (MGRS), and work–family conflict were identified as risk factors by both qualitative and quantitative studies. MGRS was identified as the greatest predictor for paternal perinatal depression and anxiety.
  • Both qualitative and quantitative data found that sleep disturbance was a risk factor for paternal perinatal depression and anxiety, which has been rarely discussed previously.
  • Unplanned pregnancy was found as a risk factor only in the qualitative component of this study.

Implications

  • The authors suggest that fathers during the perinatal period should be screened for anxiety and depression within a clinical setting.
  • This study suggests that fathers may not necessarily share the same risk factors for perinatal depression and anxiety as mothers. Men with dominant masculine norms may express depressive symptoms differently and are less likely to seek medical treatment and counselling.
  • Father-specific diagnostic and intervention tools could be developed to support early detection and treatment of paternal perinatal depression and anxiety.

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