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?

The October 2021 evidence snapshot also contains summaries on:

This scoping review identifies and describes evidence on psychosocial support programs for children and adolescents affected by natural disasters. The interventions identified in this review showed positive impacts across a range of programs, delivery modes, and settings. Cognitive behavioural therapy was identified as the most beneficial treatment-focused intervention for children. Involving young people in the development of disaster recovery planning can be beneficial and have a positive influence on their self-efficacy. The review highlights that whilst standardised programs are more easily replicated, they may not be able to adapt to local contexts and needs.

This study examined the reflections of child and adolescent psychiatry trainees and their supervisors on e-mental health during COVID-19. The study found that e-mental health can be particularly useful for families that find travel difficult, but it can also be inaccessible to those without the right equipment (such as a stable internet connection and digital literacy). Some clinicians, children, and families find e-mental health does not work well for them even if access is not a problem. These findings suggest that a model that allows for face-to-face and virtual psychiatry services may better address the needs of families.

This systematic review synthesised the evidence for video-modelling interventions for individuals with attention-deficit hyperactivity disorder (ADHD). A total of 11 studies were included, nine reported positive outcomes immediately after the video-modelling intervention, and two studies reported mixed findings. The findings suggest that video-modelling may be a promising intervention approach for targeting the social skills and behaviours of individuals with ADHD when used in conjunction with other intervention components.

This study evaluated the long-term efficacy of two programs aimed to build resilience to prevent worry, a transdiagnostic feature across anxiety and depression: an emotion regulation-based program and a behavioural activation-based program. Both programs showed promising results for certain anxiety disorders, in particular generalised anxiety disorder and major depressive disorder decreased significantly in the behavioural activation-based program. The results suggest that preventive strategies for children with symptoms of generalised anxiety disorder and depressive disorder may require a behavioural component to target their symptoms and produce clinical benefits.

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

Recently released report on COVID-19:

This Australian report presents an overview of the mental health impacts of COVID-19 and resultant policy measures. Findings suggest that Australians are experiencing deteriorating mental health as a result of the COVID-19 Pandemic and the impact of the pandemic on mental health appears to have disproportionately burdened some members of Australian society. The impact of social connection and disconnection on Australians’ mental health is becoming increasingly clear.

Recently released research on COVID-19:

This study presents findings from a review of electronic medical records at a large children’s hospital in Australia during the stay-at-home restrictions from 1st April to 30th September 2020 compared with the same dates in 2019. Findings show that whilst there was an overall decrease in ED presentations, the absolute increase in mental health presentations for children and adolescents during the stay-at-home restriction period was pronounced. Diagnoses with greatest percentage increases were eating disorders, social issues, and suicidality.

Psycho-social support programs for children affected by natural disasters

Child and adolescent psychosocial support programs following natural disasters: A scoping review of emerging evidence

Authors: Gibbs L., Marinkovic K., Nursey J., Tong L. A., Tekin E., Ulubasoglu M., Callard N., Cowlishaw S., Cobham V. E.

Journal: Current Psychiatry Reports.

Highlights

  • There is an increased risk of mental health problems for both adults and children in the aftermath of a mass trauma event such as a natural disaster.
  • This scoping review found promising indications of program benefits for groups with repeated exposure to natural disasters.

Key findings

  • The interventions included in this review showed positive impacts across a range of programs, delivery modes and settings, including a reduction in PTSD symptoms, depression, anxiety, sleep problems and the promotion of resilience, perceived social support and self-efficacy.
  • Of the treatment-focused interventions, cognitive behavioural therapy (CBT) was the most beneficial intervention for children, followed by eye movement desensitisation therapy (EMDR).
  • The most common focus across all interventions was promotion of a sense of calm and safety.
  • The strength of evidence is limited due to heterogeneity in interventions and evaluations. Findings were often mixed in terms of which aspects of the interventions were most effective and which sub-groups benefitted the most.
  • Gaps identified in the evidence included groups likely to be at most risk: preschool children, people with ethnically diverse, people with disability, and people experiencing social disadvantage.

Implications

  • The review highlights that standardised programs may be more easily replicated across large geographic areas with multiple locations, but they can have the disadvantage of not adapting to local and individual resources and needs.
  • Involvement in disaster recovery planning and activities can be beneficial for young people and this could have a positive influence on self-efficacy.
  • It is important to include at risk groups in the development and evaluation of psychosocial support programs following natural disasters.

Read the free full text

E-mental health in child psychiatry during COVID-19

E-mental health in child psychiatry during COVID-19: An initial attitudinal study

Authors: Eapen, V., Dadich, A., Balachandran, S., Dani, A., Howari, R., Sequeria, A. Z., Singer, J. D,

Journal: Australasian Psychiatry

Highlights

  • COVID-19 led many mental health services across Australia to rapidly adapt to accommodate social restrictions, including using e-mental health services to support individuals aged 0–18 years and families.
  • The authors conducted a lexical analysis of clinician reflections on how rapid responses to COVID-19 impacted psychiatry, patients and families, and the lessons learnt.

Key findings

  • The reflections of child and adolescent psychiatry trainees and their supervisor on e-mental health during COVID-19 indicate there are advantages and disadvantages.
  • E-mental health can help to extend the reach of, and access to psychiatry services, particularly for individuals who find travel difficult.
  • However, some clinicians, children and families do not prefer e-mental health. This finding aligns with the results of a national survey of parents of children with neurodevelopmental disabilities that found just 30% reported telehealth worked well for their child.
  • E-mental health services can also be inaccessible as they require equipment; (stable) internet access; space; (some degree of) digital literacy; skills and self-efficacy to conduct physical examinations, monitor child development and assess safety; risk management protocols; and privacy assurances.

Implications

  • The findings suggests that e-mental health, in isolation, might not always meet the needs or preferences of clinicians, patients and families during pandemics. A model that allows for face-to-face and virtual psychiatry services might address this.
  • This model would require practical, yet flexible policies and protocols that protect the privacy of children and families, safeguard them from harm, and respect the needs and preferences of children, families and clinicians.

Read the free full text

Video-modelling interventions for children with attention-deficit hyperactivity disorder

A systematic review of video-modelling interventions for children and adolescents with attention-deficit hyperactivity disorder

Authors: Wilkes-Gillan, S., Cordier, R., Chen, Y.-W., Swanton, R., Mahoney, N., Trimboli, C., Yule, E., & Tam, E.

Journal: Australian Occupational Therapy Journal

Highlights

  • This systematic review synthesises the evidence for video-modelling interventions for individuals with attention-deficit hyperactivity disorder (ADHD).
  • Video-modelling is where individuals watch footage of themselves (video self-modelling) or others (pre-taped video-modelling) demonstrating desired target behaviours successfully and discuss the behaviours.
  • There is preliminary evidence to suggest video-modelling may be a promising intervention approach for targeting the social skills and behaviours of individuals with ADHD when used in conjunction with other intervention components.

Key findings

  • Eleven original studies met the inclusion criteria. Studies included a total of 106 participants aged 5–16 years with ADHD. This contrasts with the large number of studies investigating the benefits of video-modelling for children with other diagnoses, including autism spectrum disorder (ASD).
  • Nine studies reported positive outcomes immediately after intervention, including one RCT study with a control group which reported a significant improvement and large effect size in children’s social play skills following a play-based intervention.
  • Two studies reported mixed findings including increased appropriate behaviours but no decrease in inappropriate behaviours, and an increased willingness to seek help with friendships but no effect was found on friendship quality.
  • Video-feedback may be most effective for children with ADHD when an opportunity to practice skills follows immediately, or alongside spontaneous peer interaction and adult assistance.

Implications  

  • Video-modelling studies for children with ADHD contain preliminary evidence for effectiveness with small samples. Emerging evidence suggests this approach has the potential to be an effective technique to capture the attention of children with ADHD.
  • Video-modelling used in conjunction with other intervention components (i.e., parent training and involvement), and using video-modelling in multiple settings, may increase children’s ability to generalise the skills and behaviours and maintain treatment effects.

Read the abstract

Building resilience to manage worry using universal prevention programs

A randomised controlled trial evaluating two universal prevention programs for children: Building resilience to manage worry

Authors: Chen, J., Johnstone, K., and Kemps, E.

Journal: Journal of Affective Disorders

Highlights

  • Childhood anxiety and depression lead to great distress and impairment. Preventing them simultaneously in early life is critically important.
  • This study evaluated the long-term efficacy of two programs aimed to build resilience to prevent worry, a transdiagnostic feature across anxiety and depression: an emotion regulation-based program and a behavioural activation-based program.

Key findings

  • Participants in the emotion regulation-based and behavioural activation-based programs reported similar levels of worry, anxiety, or depression at post-program and at 6- and 12-month follow-ups compared to controls.
  • The percentage of children who met the clinical cut-offs for generalised anxiety disorder and major depressive disorder decreased significantly in the behavioural activation-based program at 12-month follow-up, with no change in the control group.
  • The percentage of children who met the clinical cut-off for obsessive compulsive disorder decreased in the emotion regulation-based program immediately after the program, but this was not maintained over time at 6- or 12-month follow ups.

Implications

  • The emotional-regulation and behavioural activation-based prevention programs for childhood anxiety and depression showed promising results for certain anxiety disorders not otherwise observed in universal school-based studies.
  • The results suggest that preventive strategies for children with symptoms of generalised anxiety disorder and depressive disorder may require a behavioural component to adequately target their symptoms and produce clinical benefits.
  • Universal prevention programs often show null findings as participants are not required to experience symptoms to participate, which reduces their capacity for improvement over time. Observing effect sizes may be more appropriate to assess clinical and practical significance.

Read the abstract

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

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