Highlights in Child Mental Health Research: November 2018

Various, 2018

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.

 

Review article: Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence (Gronholm, P.C.; Nye, E.; Michelson, D.)

Background: School-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact.

Conclusions: This synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students’ engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students’ engagement in targeted mental health support, and serve to guide future research in this area.

Journal of Affective Disorders

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Research Review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis (Stuijfzand, S.; Creswell, C.; Field, A.P.; Pearcey, S.; Dodd, H.)

The tendency to interpret ambiguity as threat (negative interpretation) has been implicated in cognitive models of anxiety. A significant body of research has examined the association between anxiety and negative interpretation, and reviews suggest there is a robust positive association in adults. However, evidence with children and adolescents has been inconsistent. This study aimed to provide a systematic quantitative assessment of the association between anxiety and negative interpretation in children and adolescents.

Conclusions: Results extend findings from adult literature by demonstrating an association in children and adolescents with evidence for content specificity in the association. Age effects imply a role for development. Results raise considerations for when and for whom clinical treatments for anxiety focusing on interpretation bias are appropriate. The vast majority of studies included in the review have used correlational designs and there are a limited number of studies with young children. The results should be considered with these limitations in mind.

Journal of Child Psychology and Psychiatry

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Screening for childhood anxiety: A meta-analysis of the screen for child anxiety related emotional disorders. (Runyon, K.; Chesnut, S.R.; Burley, H.)

Background: The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a commonly used instrument that evaluates anxiety symptoms in children and adolescents.

Conclusions: Overall the child and parent versions of the SCARED have robust psychometric properties and perform consistently well in community and clinical settings across various countries. The SCARED is clinically relevant as mental health providers and researchers can use it during diagnostic procedures and to monitor intervention effectiveness.

Journal of Affective Disorders

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Research review: Internalising symptoms in developmental coordination disorder: A systematic review and metaanalysis. (Omer, S.; Jijon, A.M.; Leonard, H.C.)

Background: Developmental coordination disorder (DCD) affects 5%–6% of children. There is growing evidence that DCD is associated with greater levels of internalising symptoms (i.e. depression and anxiety). This is the first systematic review and meta‐analysis to explore the magnitude of this effect, the quality of the evidence and potential moderators.

Conclusions: The findings demonstrate that individuals with DCD experience greater levels of internalising symptoms than their peers. This highlights the importance of routine screening for emotional difficulties in DCD, raising awareness of the condition in mental health services and developing psychosocial interventions that extend beyond a focus on motor impairments. However, there is a need for higher quality, longitudinal studies to better understand the causal relationship between DCD and internalising symptoms.

Journal of Child Psychology and Psychiatry

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ADHD, CD, and ODD: Systematic review of genetic and environmental risk factors (Azeredo, A.; Moreira, D.; Barbosa, F.)

This review aims to analyse the relationships between Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD), particularly regarding the relative importance of genetic and environmental factors in the development of these disorders. Studies that examined at least two of these disorders were obtained from multiple databases, following the procedures of the Cochrane Collaboration initiative. Of the 279 documents obtained, nine were retained for in-depth analysis and were considered eligible for inclusion. In addition, eight studies from the manual search were included.

The objectives, methodological aspects (sample and instruments), and the main conclusions were extracted from each study. Overall, the results suggest that (a) the causes for the onset and maintenance of these disorders are more associated with genetic factors than environmental factors, although the importance of the latter is recognised, and (b) children with ADHD have a predisposition to manifest behaviours that are common to ODD and CD, including the antisocial behaviour that these children often display.

Research in Developmental Disabilities

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What is the level of evidence for the use of currently available technologies in facilitating the self-management of difficulties associated with ADHD in children and young people? A systematic review (Powell, L.; Parker, J.; Harpin, V.)

A number of technologies to help self-manage attention deficit hyperactivity disorder (ADHD) in children and young people (YP) have been developed. This review will assess the level of evidence for the use of such technologies. The review was undertaken in accordance with the general principles recommended in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. 7545 studies were screened. Fourteen studies of technology that aim to self-manage difficulties associated with ADHD in children and YP were included.

This review highlights the potential for the use of technology in paediatric ADHD management. However, it also demonstrates that current research lacks robustness using small sample sizes, non-validated outcome measures and little psychoeducation component. Future research is required to investigate the value of technology in supporting children and YP with ADHD and a focus on psychoeducation is needed.

European Child & Adolescent Psychiatry

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Paternal depression and child externalising behaviours: A meta-analysis.(Cheung, K.; Theule, J.)

Although there is a consensus that maternal depression is strongly related to child externalising behaviours, research on the association between paternal depression and child externalising behaviours is mixed. Some research shows that paternal depressive symptoms are positively associated with symptoms of externalising behaviours, including oppositional–defiant behaviour, conduct problems, and overall externalising behaviour, while other studies failed to find an association, or demonstrated a weak or negative association.

Child gender was the only statistically significant moderator, with studies with a larger proportion of boys showing a larger effect (Q = 4.30, p = .038, k = 40); however, one of the articles was identified as an outlier. This moderator was no longer significant after the outlier was removed. Overall, the results suggest that clinicians working with families of fathers with depression should be cognisant of possible co-occurring child externalising behaviours in the family. Directions for future research and other clinical implications are provided based on the findings of the current study.

Journal of Family Psychology

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A systematic review of wellbeing in children: a comparison of military and civilian families. (Williamson, V.; Stevelink, S.A.M.; Da Silva, E.; Fear, N.T.)

Background: Children in military families have uniquely different childhood experiences compared to their civilian peers, including a parent in employment and a stable familial income, frequent relocations, indirect exposure to and awareness of conflict, and extended separation from parents or siblings due to deployment. However, whether children from military families have poorer wellbeing than non-military connected children is not well understood.

Conclusions: This study is unique in its direct comparison of military and non-military connected youth. Our results highlight the need to examine the impact of military service in siblings and other close relatives on child wellbeing. Given the adverse impact of poor mental health on child functioning, additional research is needed ensure appropriate, evidence-based interventions are available for youth in military families.

Child & Adolescent Psychiatry & Mental Health

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A more extensive list of recently released research related to child mental health can be found here.