Socioeconomic and sex inequalities in parent-reported adolescent mental ill-health: Time trends in four British birth cohorts

BackgroundStudies using symptom-based screeners have suggested that mental health problems have increased in adolescents in recent decades, however, few studies have explicitly tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, few studies have explored whether changes in socioeconomic position (SEP) and sex inequalities across generations have impacted trends in adolescent mental health. MethodsUsing structural equation modelling, we explore sex differences in harmonised parent-reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS’58; N= 11,398), the 1970 British Cohort Study (BCS’70; N= 8,161), the 1991-92 Avon Longitudinal Study of Parents and Children (ALSPAC’91; N= 5,304), and the 2001 Millennium Cohort Study (MCS’01; N= 10,384). We also delineate associations between four harmonised indicators of childhood SEP and adolescent mental health, and test whether changes in SEP account for increases in mental ill-health over time. Results We found an increase in the latent means of parent-reported emotional and behavioural problems across time in both males and females in more recent cohorts, with the exception of ALSPAC’91. Sex-inequalities did not change over time, with females having consistently higher emotional problems. The associations between the four indicators of SEP and emotional problems were strongest in the MCS’01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in all of the cohorts, with housing tenure again more strongly associated with problems in the MCS’01. Inconsistent mediation (i.e. regression suppression) suggested that the increases in mental health problems occurred despite broadly improving average socio-economic conditions. ConclusionsOur findings suggest that parent-reported adolescent mental health problems have risen in recent generations and that this trend is not due solely to reporting styles. A failure to address widening inequalities may result in further increases in mental ill-health amongst disadvantaged young people.

Teacher-reported emotional and behavioural problems and ethnic background associated with children’s psychosocial care use: a longitudinal population-based study

Approximately, 15% of children in Western countries suffer from emotional and behavioural problems. However, not all children receive the psychosocial care they need, especially children with a non-Western background experience an unmet need for care. This might be because parents of non-Western children report a lower need for care than parents of Western children, unrelated to the actual need. This study examined the association between teacher-reported problems and psychosocial care use, independent of mother-reported problems. Further, the role of ethnic background in this association was investigated. The study sample of 9-year-old children was retrieved from the Generation R Study (N = 3084), a prospective, population-based cohort of children born in Rotterdam, the Netherlands. Teacher- and mother-reported problems were measured via questionnaire when the children were 6/7 years old. Psychosocial care use was mother-reported at the research centre when children were 9 years old (8.1%). Hierarchical logistic regressions showed significant positive associations between teacher-reported total, externalising and internalising problems and later psychosocial care use. These associations were independent of mother-reported problems. Children with a non-Western background used less care, but ethnic background did not moderate the association between teacher-reported problems and care use. Our findings suggest that teachers might have an important role, next to parents, in the identification of problems and children’s access to care. This may be particularly important for non-Western children, as they use less psychosocial care than Western children, despite other research showing that they generally display higher levels of problems. Directions for future research and implications are discussed.

Harsh parental discipline and offspring emotional and behavioural problems: Comparing findings from the random-intercept cross-lagged panel model and the monozygotic twin difference design

Objective. To elucidate associations between parental harsh discipline and child emotional and behavioural problems in monozygotic twins aged 9, 12 and 16 and to compare distinct approaches to causal inference.Method. Child reports of 5,698 identical twins from the Twins Early Development Study (TEDS) were analysed. We tested three types of longitudinal structural equation models: a cross-lagged panel model (CLPM), a random intercept CLPM (RI-CLPM) and a monozygotic twin difference version of the CLPM (MZD-CLPM). Results. Given the study aim to infer causation, interpretation of models focussed primarily on the magnitude and significance of cross-lagged associations. Behavioural problems resulted in harsher parental discipline across all models. In the CLPM, we found bidirectional effects between parental discipline behavioural problems at age 9 and 12. Point estimates of all other associations between parental harsh discipline and child emotional and behavioural problems were in the same direction but magnitude varied across models. In the MZD-CLPM, twin differences in harsh parental discipline at 9 predicted twin differences in emotional problems at 12. In the RI-CLPM, emotional problems at 12 predicted a reduction in harsh parental discipline at 16 within person. Conclusions. Findings can be interpreted as corroborating (but not definite) evidence in favour of a causal effect of child behavioural problems on later experienced harsh parental discipline. Yet, in light of the triangulated methods, results also illustrate divergence in the MZD-CLPM and RI-CLPM outcomes, and underline the importance of a well-defined research question, careful model selection and refining causal conclusions on within-person processes.

Parents’ and teachers’ perceptions of emotional and behavioural problems of school-going adolescents

Self-reported studies alone cannot be used to deduce the significance of adolescent problems. Therefore, the current study focuses on parents’ and class teachers’ perspectives of school-going adolescents’ emotional and behavioural problems. The objectives are to apprehend the prevalence of adolescent problems, comparisons on gender, school-area; and its association with socio-demographic details. A cross-sectional questionnaire-based study was conducted among 19 schools from government-private and rural-urban schools across Kollam District, Kerala. Malayalam/English version of the Strength and Difficulties Questionnaire (SDQ) was administered among a sample of 600 parents and 60 class teachers of school-going adolescents. Gender correlation with parents’ report found emotional problems (P<0.01), conduct problems (P<0.01), hyperactivity (P<0.001), peer problems (P<0.001) whereas in teachers’ report found relationship with emotional problems (P<0.05) and hyperactivity (P<0.001). Multivariate test results reveal that there is a statistically significant difference in emotional and behavioural problems of school-going adolescents based on school area (government-urban, government-rural, private-urban and private-rural). Multiple linear regression analysis on parents reports is significantly predicted with gender (P<0.01), urban-rural settings (P<0.001) and socioeconomic status (P<0.01). Teachers’ report has significantly been predicted with urban-rural settings (P<0.01) and socioeconomic status (P<0.001). Parents’ reports revealed a less overall prevalence of emotional and behavioural problems than teachers’ reports. Female adolescents tend to have more emotional problems and males were found to be more hyperactive. A significant difference was found with the school-area settings and significant association with socio-demographic details of adolescents. More attention is needed for the protection of adolescents’ mental health and fills mental health gaps in services.

Does Schoolmate and Teacher Support Buffer against the Effect of Adverse Childhood Experiences on Emotional and Behavioural Problems?

This study aims to explore the associations of schoolmate and teacher support with emotional and behavioural problems (EBP) and whether schoolmate and teacher support affects the associations of adverse childhood experiences (ACE) and of EBP in adolescence. We obtained data from 5220 students aged from 11 to 15 (48.7% boys), who participated in the Health Behaviour in a School-aged Children study (2018, Slovakia). Using logistic regression adjusted for gender, age and family affluence we assessed the modification of the relations of ACE and EBP by schoolmate and teacher support. Schoolmate and teacher support decreased the probability of EBP (Odds Ratios, 95% confidence intervals: 0.76, 0.74|0.79; and 0.86, 0.83|0.89, respectively). However, we found no statistically significant interactions of schoolmate and teacher support regarding the association of ACE with EBP. Schoolmate and teacher support decreased the likelihood of EBP among adolescents but do not buffer the relation of any previous ACE with EBP.

Does Resilience Mediate the Association of Adverse Early Childhood Experiences With Emotional and Behavioural Problems?

Objectives: To explore the role of resilience as a mediator in the association between adverse childhood experiences (ACE) and emotional and behavioural problems (EBP) among adolescents.Methods: We used data from the Slovak 2018 Health Behaviour in School-aged Children study, comprising 2,839 adolescents aged 13–15 (mean age 13.93; 49.6% boys). We used multivariate linear regression performed on 5000 bootstrap samples adjusted for age, gender, family affluence to explore mediation of the associations between ACE (measured using the adapted Adverse Childhood Experience Questionnaire) and EBP (measured using the Strengths and Difficulties Questionnaire) by resilience (measured with the Child and Youth Resilience Measure).Results: We found ACE [B = 0.78; 95% confidence interval (CI): 0.67|0.90] and resilience (B = −0.73; 95% CI: −0.79|−0.67) to be significantly associated with EBP. The association of ACE and EBP was mediated by resilience. The mediated indirect effect of resilience was ab = 0.25; 95% CI: 0.18|0.32.Conclusion: Resilience seems to play a mediator role in the relationship between ACE and EBP. Helping adolescents with ACE to build and use internal and external sources of resilience can decrease the negative impact of ACE on EBP.

Risk of Behavioural and Emotional Disorders in Lithuanian School Aged Children as Assessed with SDQ During the Second Lockdown due to COVID-19

As a result of the outbreak of COVID-19 and consequent restrictions, the distance education was introduced in Lithuania in 2020 spring (the first lockdown, lasted for around 3 months) and 2020 autumn (the second lockdown, still lasting, June 2021). The prevalence of children’s mental health problems during the first lockdown was similar to pre-epidemic rates in Lithuania, but the prolonged lockdown (and therefore school closure) might have more negative consequences on children’s mental health. This study aimed to reveal the incidence of mental health problems as rated by parents with a Strengths and Difficulties Questionnaire during the second lockdown in school aged children. This research sample included data of 514 children (46% girls), aged 7 to 14 years old (mean age 10.15 years, SD = 3.47). The children’s mental health problems were assessed using a Lithuanian version of the Strengths and Difficulties Questionnaire, parental form, in April–May 2021. Results revealed that 29.6% of Lithuanian children had scores in the clinical (abnormal) range of emotional problems and 21.6% – of conduct problems. Based on total difficulties score, 31.6% of children get in clinical range of emotional and behavioural problems, as rated by parents by the end of the second lockdown. The results are compared to pre-pandemic epidemiological rates of emotional and behavioural problems reported and those documented after the first quarantine in Lithuania and highlight important findings for professionals and policy makers about the detrimental effects of prolonged lockdown and school closure on children’s mental health.