Growth in Self-Regulation Over the Course of Adolescence Mediates the Effects of Foster Care on Psychopathology in Previously Institutionalized Children: A Randomized Clinical Trial

Children reared in institutions experience severe psychosocial deprivation, resulting in lasting consequences for social and emotional development. This study evaluated growth trajectories of self-regulation from ages 8 to 16 among previously institutionalized children randomized to foster care (foster-care group; FCG) or to remain in institutional care (care-as-usual group; CAUG) compared with a never-institutionalized group (NIG). We then tested a developmental pathway by which growth in self-regulation reduces general psychopathology at age 16 for the FCG relative to the CAUG. The FCG experienced modest growth in self-regulation over adolescence and “caught up” to the NIG by age 16. The beneficial effect of foster care on psychopathology operated through growth in self-regulation; part of this effect was further mediated by reduced peer difficulties for the FCG. Findings reveal that the effects of foster care on self-regulation emerge over adolescence and that growth in self-regulation is a mechanism by which foster care mitigates the impact of institutionalization on psychopathology.

Paranoia in patients attending child and adolescent mental health services

Objective: Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services. Method: A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later. Results: Most of the adolescents had affective disorders ( n = 195), self-harm/suicidality ( n = 82), or neurodevelopmental conditions ( n = 125). Few had suspected psychosis ( n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time. Conclusion: Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.

Children With Persistent Versus Transient Early Language Delay: Language, Academic, and Psychosocial Outcomes in Elementary School

Purpose The objective of this study was to compare children with persistent versus transient preschool language delay on language, academic, and psychosocial outcomes in elementary school. Method Children with persistent language delay ( n = 30), transient language delay ( n = 29), and no language delay (controls; n = 163) were identified from a population-based sample of twins. They were compared on language skills, academic achievement, and psychosocial adjustment in kindergarten and Grades 1, 3, 4, and 6. Results Children with persistent language delay continued to show language difficulties throughout elementary school. Furthermore, they had academic difficulties, in numeracy, and psychosocial difficulties (attention-deficit/hyperactivity disorder behaviors, externalizing behaviors, peer difficulties) from Grade 1 to Grade 6. Children with transient language delay did not differ from controls on language and academic performance. However, they showed more externalizing behaviors in kindergarten and peer difficulties in Grade 1 than controls. Conclusion Difficulties at school age are widespread and enduring in those with persistent early language delay but appear specific to psychosocial adjustment in those with transient language delay.

Is Vegetation Cover in Key Behaviour Settings Important for Early Childhood Socioemotional Function? A Preregistered, Cross-sectional Study

The association between vegetation cover (comprising trees, shrubs, and grassed areas) in four key behaviour settings for children aged 2-5 and socioemotional functioning was investigated (n = 1196). The results showed that emotional difficulties were inversely associated with vegetation cover in the home yard (OR: 0.81 [0.69-0.96]) and neighbourhood (OR: 0.79 [0.67-0.94]), but not in the early childhood education and care outdoor areas or neighbourhood. Enhanced risk of emotional difficulties associated with lower levels of maternal education was reduced with higher percentages of home yard vegetation cover. We found no evidence of associations with conduct, hyperactivity and inattention, or peer difficulties. However, time spent playing outside was associated with reduced risk of peer difficulties and enhanced prosocial behaviours.