Highlights in Child Mental Health Research: January 2019
This research summary provides a selection of recently released systematic reviews and meta-analyses related to infant and child mental health and relevant to the work of the National Workforce Centre for Child Mental Health. Abstracts and links to full-text articles, where available, are provided.
Prevalence of Depressive Disorders in Individuals with Autism Spectrum Disorder: a Meta-Analysis (Hudson, Chloe C.; Hall, Layla; Harkness, Kate L.)
Substantial uncertainty exists about the prevalence of depressive disorders in individuals with autism spectrum disorder (ASD). This meta-analysis quantitatively summarized studies that assessed the lifetime and current prevalence of unipolar depressive disorders in children, adolescents, and adults with ASD. We also examined demographic, methodological, and study moderators. This meta-analysis adhered to PRISMA guidelines. A total of 7857 articles were identified through 5 databases (PubMed, Web of Science, PYSCInfo, CINAHL, ProQuest Dissertations and Theses), forward searches, and backward searches. Two reviewers independently screened articles and extracted data. Sixty-six articles met inclusion criteria.
In conclusion, we found that the rates of depressive disorders are high among individuals with ASD. Compared to typically developing individuals, individuals with ASD are 4-times more likely to experience depression in their lifetime. These results suggest that individuals with ASD should be regularly screened and offered treatment for depression.
Journal of Abnormal Child Psychology
Read the abstract here. A Springer subscription is required for full access.
Is obesity associated with depression in children? Systematic review and meta-analysis. (Sutaria, Shailen; Devakumar, Delan; Yasuda, Sílvia Shikanai; Das, Shikta; Saxena, Sonia)
Objectives: To compare the odds of depression in obese and overweight children with that in normal-weight children in the community.
Results: Twenty-two studies representing 143 603 children were included in the meta-analysis. Prevalence of depression among obese children was 10.4%. Compared with normal-weight children, odds of depression were 1.32 higher (95% CI 1.17 to 1.50) in obese children. Among obese female children, odds of depression were 1.44 (95% CI 1.20 to 1.72) higher compared with that of normal-weight female children. No association was found between overweight children and depression (OR 1.04, 95% CI 0.95 to 1.14) or among obese or overweight male subgroups and depression (OR 1.14, 95% CI 0.93 to 1.41% and 1.08, 95% CI 0.85 to 1.37, respectively). Subgroup analysis of cross-sectional and longitudinal studies separately revealed childhood obesity was associated with both concurrent (OR 1.26, 95% CI 1.09 to 1.45) and prospective odds (OR 1.51, 95% CI 1.21 to 1.88) of depression.
Conclusion: We found strong evidence that obese female children have a significantly higher odds of depression compared with normal-weight female children, and this risk persists into adulthood. Clinicians should consider screening obese female children for symptoms of depression.
Archives of Disease in Childhood
Read the abstract here. A BMJ Journal subscription is required for full access.
Foster care placement instability: A meta-analytic review (Konijn, Carolien; Admiraal, Sabine; Baart, Josefiene; van Rooij, Floor; Stams, Geert-Jan; Colonnesi, Cristina; Lindauer, Ramón; Assink, Mark)
Foster care is the preferred type of out-of-home placement for children and youth when they are not able to live with their own parents. However, placement instability, and its effect on children’s behavioral well-being, remains a major issue in foster care. Ten multilevel meta-analyses were performed to examine factors that can affect instability of foster care placement. We included 42 studies (published between 1990 and 2017) examining putative factors associated with placement instability, which yielded 293 effect sizes. Indications of publication bias were found, but the trim and fill procedure confirmed the main findings. Medium significant effects were found for child behavioral problems (r = 0.35), (non-)kinship care (r = 0.31), and quality parenting (r = 0.29). Smaller effects were found for age of the child (r = 0.25), placement with(out) siblings (r = 0.16), and history of maltreatment of the child before placement (r = 0.14). The effects were generally modest, but showed generalizability across continents and time. The findings can be used to improve interventions for the prevention of placement instability in foster care, and further investigations.
Children and Youth Services
Factors promoting emotional‐behavioural resilience and adjustment in children exposed to intimate partner violence: A systematic review (Fogarty, Alison; Wood, Catherine E.; Giallo, Rebecca; Kaufman, Jordy; Hansen, Michelle)
Objective: This is the first known article to systematically review the existing literature on the factors associated with emotional and behavioural resilience and positive functioning in children exposed to IPV.
Results: Of the 1,365 retrieved articles, 15 were eligible for inclusion. Results showed that maternal mental health was a significant predictor of resilience in children exposed to IPV. Preliminary evidence was found for emotion coaching, parenting, and child temperament. Broader socio‐contextual factors were largely neglected across the articles reviewed.
Conclusion: The findings from this review highlighted that there is still much to be learned about what helps children display resilience when exposed to IPV and what can be done to foster this resilience.
Australian Journal of Psychology
Read the abstract here. A Wiley Online Library subscription is required for full access.
Preventing intergenerational trauma transmission: A critical interpretive synthesis (Isobel, Sophie; Goodyear, Melinda; Furness, Trentham; Foster, Kim.)
Aim and objective: To synthesise and critically interpret literature of relevance to intervening in intergenerational transmission of relational trauma within parent–infant relationships.
Conclusions: Prevention is the most effective intervention approach for intergenerational transmission of trauma. Prevention requires trauma‐specific interventions with adults and attachment‐focused interventions within families. Preventative strategies need to target individual, relationship, familial, community and societal levels, as addressing and preventing trauma requires a multipronged, multisystemic approach.
Relevance to clinical practice: Systematic trauma‐informed attachment‐focused interventions in health and social service settings are recommended. There are opportunities to provide multifocal individual and relational interventions within existing services that work with parents to help prevent the likelihood and impact of transmission of intergenerational relational trauma within families. Nurses are well placed to provide preventative interventions in mental health, early childhood and primary health settings.
Journal of Clinical Nursing
Read the abstract here. A Wiley Online Library subscription is required for full access.
Strategies not accompanied by a mental health professional to address anxiety and depression in children and young people: a scoping review of range and a systematic review of effectiveness (Wolpert, Miranda; Dalzell, Kate; Ullman, Roz; Garland, Lauren; Cortina, Melissa; Hayes, Daniel; Patalay, Praveetha; Law, Duncan)
This Review reports on a scoping review followed by a systematic review to consider interventions designed to address or manage depression or anxiety in children and young people up to the age of 25 years without the need to involve mental health professionals.
These results highlight the disparity between the extensive range of approaches identified in the scoping review and the restricted number and focus found in the systematic review of effectiveness of these approaches. We call for an expanded research agenda that brings evaluation rigour to a wide range of self or community approaches.
The Lancet Psychiatry
Read the abstract here. A Lancet subscription is required for full access.
The Earlier the Better? Individual Participant Data and Traditional Meta-analysis of Age Effects of Parenting Interventions (Gardner, Frances; Leijten, Patty; Melendez‐Torres, G.J.; Landau, Sabine; Harris, Victoria; Mann, Joanna; Beecham, Jennifer; Hutchings, Judy; Scott, Stephen; Melendez-Torres, G J)
Strong arguments have been made for early intervention for child problems, stating that early is more effective than later, as the brain is more malleable, and costs are lower. However, there is scant evidence from trials to support this hypothesis, which we therefore tested in two well-powered, state-of-the-art meta-analyses with complementary strengths: (a) Individual participant data (IPD) meta-analysis of European trials of Incredible Years parenting intervention (k = 13, n = 1696; age = 2-11); (b) Larger, trial-level robust variance estimation meta-analysis of a wider range of parenting programs (k = 156, n = 13,378, Mage = 2-10) for reducing disruptive behavior. Both analyses found no evidence that intervention earlier in childhood was more effective; programs targeted at a narrower age range were no more effective than general ones.
Systematic Review and Meta-Analysis: Anxiety and Depressive Disorders in Offspring of Parents with Anxiety Disorders (Lawrence, Peter J.; Murayama, Kou; Creswell, Cathy)
Objective: We conducted meta-analyses to assess risk for anxiety disorders among offspring of parents with anxiety disorders, and to establish whether there is evidence of specificity of risk for anxiety disorders as opposed to depression in offspring, and whether particular parent anxiety disorders confer risks for particular child anxiety disorders. We also examined whether risk was moderated by offspring age, gender, temperament, and the presence of depressive disorders in parents.
Conclusion: Parent anxiety disorders pose specific risks of anxiety disorders to offspring. However, there is limited support for transmission of the same particular anxiety disorder. These results support the potential for targeted prevention of anxiety disorders.
Journal of the American Academy of Child & Adolescent Psychiatry
A more extensive list of recently released research related to child mental health can be found here.