Highlights in Child Mental Health Research: July 2019
Various, Australia, 2019
This 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 that 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?
An Australian study by Perales and Campbell (2019) is the first to explore the association between sexual orientation and health/well-being in Australian adolescents.
Screen-time and physical activity
A study by researchers at Australian Catholic University investigated trajectories in children’s screen-time and physical activity during early childhood (del Pozo Cruz et al., 2019). The researchers also explored the consequences of particular trajectories for children’s socio-emotional outcomes and health-related quality of life.
Indigenous mental health
A new systematic review by Lopez-Carmen and colleagues analysed the research literature measuring or evaluating primary health care interventions that focused on improving the mental health of Indigenous children using intersectoral service integration strategies.
Social media and “sharenting”
Researchers from Belgium have published two research studies exploring the experiences, thoughts, and feelings of adolescents regarding their parents’ “sharenting” (i.e., sharing posts and photos about their children on social networking sites) behaviour (Verswijvel et al., 2019; Ouvrein & Verswijvel, 2019).
Children and adolescents who are refugees
A practitioner paper by Hodes and Vostanis (2019) offers a review of recent research regarding the mental health problems of refugee children/adolescents, including information related to risk and protective factors for mental health problems, service issues, and management/treatment issues.
You can also read about family factors found to predict the development of anxiety and internalising problems in temperamentally inhibited young children (Bayer et al., 2019).
Predicting Temperamentally Inhibited Young Children’s Clinical-Level Anxiety and Internalizing Problems from Parenting and Parent Wellbeing: a Population Study (Australia)
Authors: Bayer, J.K.; Morgan, A.; Prendergast, L.A.; Beatson, R.; Gilbertson, T.; Bretherton, L.; Hiscock, H.
Journal: Journal of Abnormal Child Psychology
Why do some temperamentally inhibited young children go on to develop anxiety disorders (and wider anxious/depressive problems), while others do not?
This was the question that the researchers aimed to answer in this Australian longitudinal prevention study. Temperamentally inhibited refers to a temperament whereby there is a tendency to withdraw and respond fearfully when facing people, objects or situations that are unfamiliar.
The study sample initially consisted of 545 parents of temperamentally inhibited preschool children. This sample reduced to 498 after 1 year and 469 after 2 years.
Parents participated in interviews designed to diagnose child anxiety disorders. They also completed questionnaires about child internalising problems (i.e. anxious/depressive problems), parenting practices and parent well-being.
Key findings included:
- “During the follow up period close to half of the inhibited young children had anxiety disorders.”
- Family factors that predicted child anxiety disorders were over-involved/protective parenting and worse parent well-being.
- During the follow up period one in seven inhibited young children had broader clinical-level internalising problems (i.e. anxious/depressive problems).
- Family factors that predicted these internalising problems were harsh discipline and worse parent well-being.
- The mental health problems of inhibited preschool children tended to persist over time. More than two-thirds showed ongoing problems over 12 months.
As the researchers highlight, these findings provide support for interventions that are family-focused and that support positive parenting strategies in promoting children’s mental health, particularly amongst parents of children with vulnerable temperaments.
Early roots of sexual-orientation health disparities: associations between sexual attraction, health and well-being in a national sample of Australian adolescents (Australia)
Authors: Perales, F; Campbell, A
Journal: Journal Of Epidemiology And Community Health
This landmark study is the first of its kind to explore the association between sexual orientation and health/well-being in Australian adolescents.
Using a sample of 3,318 adolescents (aged 14 to 15 years) from The Longitudinal Study of Australian Children, the researchers explored the association between sexual orientation and 30 outcomes related to health and well-being (including socio-emotional functioning, depressive symptoms, victimisation, peer problems, self-harm and suicidality).
Key findings included:
- “Lesbian, gay, bisexual and questioning adolescents displayed significantly worse health/well-being than their heterosexual peers in all outcomes” (p. 1).
- The disparity was greatest in the outcomes of emotional problems, peer problems, self-harm and suicidality.
- Female sexual-minority adolescents demonstrated worse outcomes relative to male sexual-minority adolescents.
- Adolescents that were attracted to both sexes demonstrated worse outcomes relative to adolescents that were attracted to the same sex.
The authors report that their findings are consistent with the wider academic literature, which has suggested that being of a sexual-minority is a risk factor for sub-optimal adolescent health and well-being.
The authors highlight that their findings lend additional support to the critical need for services and interventions that aim to target these inequalities for adolescents that are of a sexual-minority.
Joint physical-activity/screen-time trajectories during early childhood: socio-demographic predictors and consequences on health-related quality-of-life and socio-emotional outcomes (Australia)
Authors: del Pozo-Cruz, B; Perales, F; Parker, P; Lonsdale, C; Noetel, M; Hesketh, K.D; Taren, S
Journal: International Journal of Behavioral Nutrition and Physical Activity
This study by Australian researchers investigated trajectories (i.e. pathways) in children’s screen-time and physical activity during early childhood.
The study used data from two large cohorts (i.e. groups) from The Longitudinal Study of Australian Children (children aged 0 to 5 years; children aged 4 to 9 years). Screen-time and physical activity were measured using time-use diaries completed by children’s guardians.
Key findings included:
- Three trajectories (i.e. pathways) in children’s screen-time and physical activity were identified:
- Children who sustained low levels of physical activity and screen-time (around 50% of the sample)
- Children who gradually increased their physical activity and maintained low screen-time levels (around 25% of the sample)
- Children who maintained low levels of physical activity and increased screen-time (around 25% of the sample)
- Children who demonstrated a gradual increase in physical activity and sustained low screen-time levels demonstrated the best socio-emotional outcomes and health-related quality of life.
- Children who sustained low levels of physical activity and increased screen-time demonstrated the worst socio-emotional outcomes and health-related quality of life.
- Children with the following characteristics demonstrated an increased risk of falling into the first and third trajectories:
- Non-English-speaking background
- Living in a more-affluent household
- Parents with poor mental health
- Not living with two biological parents
- Not having any siblings
As the researchers highlight, these findings provide support for initiatives that that promote “healthy lifestyle habits” during early childhood, including increasing physical activity and reducing screen-time (p. 11).
Read the Full Text here
Sharenting: Parental adoration or public humiliation? A focus group study on adolescents’ experiences with sharenting against the background of their own impression management (Belgium)
Authors: Ouvrein, G; Verswijvel, K
Journal: Child and Youth Services Review
Sharenting, is it a good or a bad thing? Understanding how adolescents think and feel about sharenting on social network sites (Belgium)
Authors: Karen Verswijvel, Michel Walrave, Kris Hardies, Wannes Heirman
Journal: Child and Youth Services Review
Researchers from Belgium have published two articles reporting the results of studies exploring the experiences, thoughts, and feelings of adolescents regarding their parents’ “sharenting” behaviour.
The researchers defined “sharenting” as the practice by which “parents share posts and pictures about their children on social network sites (SNSs)” (Ouvrein and Verswijvel, 2019, p. 319).
Study 1 – Focus Group Study
In their focus group study with 46 adolescents (aged 12 to 14 years), Ouvrein and Versqijvel (2019) investigated adolescents’ experiences and views in relation to “sharenting.” These experiences and views were explored against a background of adolescents’ trying to manage their own online impression.
Key findings from adolescents sampled were:
- Parents shaped the “online identity of their children by sharing posts about them” (p. 319).
- “Sharenting” sometimes led to feelings of frustration in adolescents.
- Parents could sometimes post content that was contrary to the online impression that adolescents were trying to create (e.g. content that might result in embarrassment).
- “Parents should ask permission before posting” content about their adolescent children (p. 319). They should also respect their adolescent’s boundaries around sharing posts, including how frequently they post and with which individuals they share information.
Study 2 – Survey Study
Through conducting surveys with 814 adolescents, Verswijvel and colleagues (2019) investigated adolescents’ thoughts and feelings towards “sharenting”. They also explored the views of adolescents on the reasons why their parents engage in “sharenting”.
Key findings included:
- Adolescents perceived that there were four main reasons for why their parents engage in “sharenting” (p. 319):
- Parental advice motives
- Social motives
- Impression management motives
- Information-archiving motives
- “Preliminary analyses pointed out that adolescents largely disapproved of sharenting…[and] mainly considered it as embarrassing and useless” (p.319)
- Adolescents were of the belief the main reason for “sharenting” was the “information-archiving motives.” The more adolescents believed that “sharenting” was occurring due to this motive, the less they disapproved of the behaviour.
- The more that adolescents believed that “sharenting” was occurring due to impression management motives, the more negative they were toward the behaviour.
- Adolescent disapproval of sharenting was more likely in adolescents that were more concerned about their online privacy.
Working together to improve the mental health of indigenous children: A systematic review (Australia)
Authors: Lopez-Carmen, V; Janya McCalman, Tessa Benveniste, Deborah Askew, Geoff Spurling.
Journal: Children and Youth Services Review
- This systematic review aimed to analyse research measuring or evaluating primary health care interventions that focused on improving the mental health of Indigenous children via intersectoral service integration processes and tools.
- The 11 studies included were conducted with Indigenous children (aged 4 to 17 years) in one of five countries (Australia, New Zealand, Canada, Norway and/or the United States). Five studies were conducted in Australia.
- Nine key strategies adopted by service integration interventions were identified (see p. 3-6) including:
- Engaging the members of the Indigenous community
- Empowerment of families
- Adapting interventions and care to the specific socio-cultural circumstances
- Cultural strengthening and empowerment of Indigenous children’s identity.
- Six factors that enabled the implementation of service integration were identified (see p. 7 – 8) including:
- Including and involving the community and stakeholders
- Sensitivity to culture, including to historical background and inter-generational trauma
- Multi-disciplinary and collaborative health services
- Resourcing factors (e.g. funding, costs, time availability, staff/organisation capacity).
- Six outcomes of interventions focussed on intersectoral integration were identified (see p. 8-9) including:
- “Improvements in children’s psychosocial functioning, stress management, and individual empowerment” (p. 8).
- Improvements in health service access and use
- Empowerment of both families and communities.
- Increased links and collaboration between the community and health services.
- The authors conclude that while the research evidence for interventions focused on improving the mental health of Indigenous children via intersectoral service integration is preliminary, the emerging evidence base suggests these interventions hold potential.
- The authors identify the need for further research, particularly to incorporate Indigenous voices in evaluation, help clarify impact, and to evaluate costs.
Practitioner Review: Mental health problems of refugee children and adolescents and their management
Authors: Hodes, M; Vostanis, P
Journal: Journal of Child Psychology and Psychiatry
This practitioner paper offers a valuable review of recent research regarding the mental health problems of refugee children/adolescents. It considers information related to risk and protective factors, service issues, and management/treatment issues with regards to mental health.
Key messages include:
- It is essential that practitioners, organisations and policy-makers are aware that refugee children and adolescents may have been subject to “disrupted early lives, high violence and further adverse experiences in re-settlement countries” (p. 725).
- These aforementioned experiences place children who are refugees at an increased risk of mental health problems. PTSD, depression and anxiety are the most prevalent mental health problems, but developmental disorders may also occur (e.g. Autism Spectrum Disorder).
- It is critical that refugee children and adolescents, as well as their families, are provided with support to address these high mental health needs.
- It is also important to recognise that “many refugee children show resilience and function well, even in the face of substantial adversities” (p. 716).
- Due to a combination of the high, complex mental health needs and cultural issues, the authors propose that adapted stepped care approaches within existing healthcare care systems are needed.
Hodes and Vostanis (2019) emphasise the need for further research to investigate key gaps in the evidence base on this topic. They offer multiple possible areas for future research, including investigating service delivery systems and evaluating interventions.