Socio-economic inequalities in adolescent mental health in the UK: multiple socio-economic indicators and reporter effects

There are socio-economic inequalities in the experience of mental ill-health. However, less is known about the extent of inequalities by different indicators of socio-economic position (SEP). This is relevant for insights into the mechanisms by which these inequalities arise. For young people's mental health there is an additional layer of complexity provided by the widespread use of proxy reporters. Using data from the UK Millennium Cohort Study (N=10,969), we investigated the extent to which five objective SEP indicators (parent education, household income, household wealth, parent occupational status, and relative neighbourhood deprivation) predict adolescent internalising mental health and how this varies as a function of reporter. Both parent report and adolescent self-report were considered. Regression models demonstrated that whilst all five SEP indicators were associated with parent-reported adolescent mental health (regression coefficients for the most disadvantaged groups and adolescent mental health: parent education β=0.53 [0.44;0.62], household income β=0.56 [0.50;0.62], household wealth β=0.18 [0.10;0.27], parent occupational status β=0.40 [0.35;0.46], and relative neighbourhood deprivation β=0.41 [0.33;0.49]), only income (β=0.11 [0.04;0.17]), wealth (β=0.12 [0.02;0.21]), and occupational status (β=0.08 [0.03;0.13]) were associated with self-reported mental health. The magnitude of these effects was greater for parent-reported than self-reported adolescent internalising symptoms: SEP indicators jointly predicted 5.2% of the variance in parent-reported compared to 1.4% of the variance in self-reported internalising mental health. Income predicted the most variance in both parent (4.2% variance) and self-reported internalising symptoms (0.5% variance). Interestingly, the gradient of parent-reported adolescent mental health across SEP indicators mirrors that of parent's own mental health (for example, income predicted 7.3% variance). Our findings highlight that the relevance of different SEP indicators to adolescent internalising mental health differs between parent and adolescent reports. Therefore, it is important to consider the various perspectives of mental health inequalities gained from different types of reporters.

Write It Out: Examining Recreational Youth Sport Parent Emotions Through an Expressive Writing Exercise

Youth sport parents experience an array of emotions as part of their child’s youth sport experience. This may include emotions related to watching their child play, supporting their child’s emotions, or simply related to daily parenting responsibilities. This research examined youth sport parent emotions through an expressive writing exercise. Twelve parents completed a total of 32 expressive writing exercises. In each exercise, parents were asked to write about their emotions as a youth sport parent. Quantitative analysis with Linguistic Inquiry and Word Count (LIWC; Pennebaker et al., 2015) software and qualitative thematic analysis were employed to analyze writings. Results indicate that though parents experienced both positive and negative emotions, negative emotions were most common and salient. Thematic analysis resulted in six themes, including one theme related to positive emotions (happiness for child experience), and five themes related to negative emotions: 1) general stress and negativity, 2) responsibilities, 3) role as parent, 4) coach, and 5) performance. Results also lead to practical implications for park and recreation administrators. First, as substantial stress is related to the time and financial responsibilities associated with sport parenting, organizations may wish to seek ways to support parents including through scholarship funds, and facilitating communication and duty sharing among parents. Parent education programs may also be a way to help parents navigate their own emotions related to parenting roles. Coaches were also a source of negative emotions for parents, though not always for the same reasons. Youth sport organizations can facilitate coach-parent communication to ensure that parent-coach goals are aligned, and provide training for coaches in both sport-specific skills and positive youth development. In addition to facilitating coach-parent communication, organizations may also encourage child-parent communication related to goals. This could include email communications with exercises designed to encourage specific conversations about goals of youth sport participation. Each of these implications is tied directly to negative emotions expressed by parents as part of this research. Assisting parents with these emotions will improve the experience for both the parent and will likely enable the youth participant to have a more positive experience as well.

The Effects of Parent Education on Perceptions of Augmentative and Alternative Communication

Objectives: Parents’ incomplete knowledge of AAC is apt to make them believe in misconceptions about AAC, which hinders them from having the appropriate interventions for their children. Considering the fact that parents’ perception of AAC has a large impact on AAC intervention, this study aims to examine the effects of parent education on the perception of AAC.Methods: Twenty-five mothers of children with complex communication needs participated in the study. Parent Education is designed as a 40-minute program consisting of (1) introduction to AAC, (2) exploring AAC systems, (3) developing linguistic competence using AAC, (4) tips for using AAC at home, and (5) policies and financial support. Extra time for question-and-answers was provided to each participant. To measure the effect of parent education on parents’ AAC perception and the relationship of participants’ change in perception with their satisfaction with the education program, two types of survey questionnaires were developed.Results: The repeated measured ANCOVA showed that the difference between the total scores of pre-and post-surveys was significant. The Spearman’s rho was .443, indicating a moderate positive correlation between the degree of satisfaction and the change in AAC perception.Conclusion: This study showed that parent education had a positive effect on parents’ perceptions of AAC overall. In particular, there was a significant change of opinion in the misconception that children must have intact cognitive skills to use speech-generating devices, the idea which showed the lowest scores in the pre-survey. It seems that the education program which focused on correcting misconceptions about AAC and providing relevant information and opportunities to use AAC devices helped to lead to these positive effects.

Gestational Age, Parent Education, and Education in Adulthood

BACKGROUND: Adults born preterm (<37 weeks) have lower educational attainment than those born term. Whether this relationship is modified by family factors such as socioeconomic background is, however, less well known. We investigated whether the relationship between gestational age and educational attainment in adulthood differed according to parents’ educational level in 4 Nordic countries. METHODS: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents’ educational level (low, intermediate, high) on the association between gestational age at birth (25–44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions. RESULTS: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level. CONCLUSIONS: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.

Parent Coaching Behaviors Used Within an Adaptive Responsive Teaching Intervention

The coaching service delivery model is often implemented within parent-mediated interventions for infants at an elevated likelihood of autism spectrum disorder. However, less is known about the exact coaching behaviors used within intervention sessions. Therefore, we examined the coaching behaviors implemented within the adaptive responsive teaching intervention. We also investigated the associations between coaching behaviors and parent education levels and the associations between the coaching behaviors and a parent outcome, that is, parent responsiveness. Results indicated that the interventionists demonstrated joint interaction and child-focused behaviors the most frequently. The interventionists much less frequently demonstrated guided practice, caregiver practice, and problem-solving behaviors. The use of joint interaction behaviors was positively associated with parent education levels, whereas the use of child-focused behaviors was negatively associated with parent education level. More information sharing by the interventionists predicted a greater change in parent responsiveness, whereas more child-focused behaviors predicted less change in parent responsiveness.

Dependency, Mortality, Invisibility: Linking Childhood Disability with Life Course Health Outcomes

People who experienced disability in childhood are living longer. It is not clear if longer lives indicate better health and less dependency, or if longer life is accompanied by increased dependency. We addressed that question by studying the joint dynamics of mortality and dependency. This population is “invisible” in most national surveys, which do not ask about childhood disability. We evaluated special education history as an indicator of childhood disability, and used that indicator to estimate dependency and life expectancy throughout adult life. Data: Panel Study of Income Dynamics and the Health and Retirement Study (n=20,563). Activities of daily living (ADLs), instrumental ADLs, and cognition defined five functioning levels including dependency and death. Multinomial logistic Markov models estimated probabilities for transitioning among the levels, with or without a history of childhood disability, adjusted for demographics. We used the probabilities in microsimulations, creating large populations of completed lives, identifying dependency at each age for each individual. Analysis showed special education history was a valid indicator of childhood disability; 13% had such history. With parent education less than high school, remaining life at age 20 was 46.0 years for people with that history, 58.3 for others; corresponding results with parent’s bachelor’s degree: 48.3 and 60.7 (p<0.05). Corresponding population percentages dependent 5+ years were: 15.2% and 3.8%, 13.1% and 3.8% (all p<0.05). Special education history can indicate childhood disability. People with that history had significantly more dependency than others, and shorter lives. Accommodations and interventions can improve their health and functioning.

Examining the Use of a Brief Online Intervention in Primary Care for Changing Low-Income Caregivers’ Attitudes Toward Spanking

There is a robust and growing literature base indicating that spanking is a common, but potentially problematic, discipline strategy. Goals: Using a randomized controlled trial design, this study examined whether participation in a brief online program, Play Nicely, would result in favorable changes in caregivers’ attitudes toward spanking. The study also examined whether the intervention was equally effective for participants of color (POC) and White participants, and it assessed caregivers’ perceptions of the program’s cultural sensitivity. Methods: Participants were 52 caregivers from 1- to 5-year-old children who were visiting a pediatric clinic. Participants were enrolled and randomly assigned to either engage in the Play Nicely online program ( n = 21) or view a control condition website ( n = 31) in a clinic exam room. Results: There was not a statistically significant difference between the treatment and control groups’ scores on attitudes toward spanking (ATS) at post-test ( F (1, 49) = 1.515, p = 0.224), but a small between-group effect size was detected ( d = 0.20). Within the treatment condition, desired changes in ATS scores were significantly higher among White participants than POC ( t (17) = −2.125, p = 0.049), but there was not a significant difference in reported perceptions of Play Nicely’s cultural acceptability between White participants and POC ( t (19) = 0.469, p = 0.644). Conclusions: Findings suggest a need for further investigation of Play Nicely’s impact on caregivers’ ATS with a larger sample to clarify the program’s utility as a potential population-based tool for parent education and violence prevention. Additional research is needed to identify sociocultural factors that may moderate the effects of spanking interventions for families across diverse racial backgrounds.

A Scoping Review of Mental Health Programs for Parents of Children with Complex Medical Conditions

Background: Medical care advancements have increased the survival rates of children with complex medical conditions (CMC). Parents/caregivers of these children experience a range of positive and negative emotional experiences as a result. This population experiences an increased risk of mental health concerns, versus the public; however, there is a dearth of available mental health interventions. Objectives: To summarize extant research on interventions targeting the mental health of parents/caregivers of children with CMC. Eligibility Criteria: Peer-reviewed, assessed parent/caregiver, child was 0-12 years old with a persistent CMC, participants received an intervention for their mental health, written in English, and published January 1, 2000 to May 19, 2020. Sources of Evidence: The PsycINFO, Medline, CINAHL, Web of Science, PubMED, and Social Services Abstracts databases were searched. Charting Methods: Articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews and Arksey and O’Malley’s five-stage method of scoping reviews. Results and Conclusions: Nine studies were included, each assessing parent mental health and/or process and feasibility outcomes. Favorable reductions in depression, anxiety, stress, and an increase in quality of life, psychological flexibility, mindfulness, coping skills, and shared management were found; however, results were mixed. Parental support/education and parent education/child developmental supports appear important in the treatment of stress and quality of life, respectively. Parental stress interventions appear more effective when provided near the child’s CMC diagnosis. Findings highlight the need for further research to improve the mental health of parents of children with CMC.

The Early Humor Survey (EHS): A reliable parent-report measure of humor development for 1- to 47-month-olds

We created a 20-item parent-report measure of humor development from 1 to 47 months: the Early Humor Survey (EHS). We developed the EHS with Study 1 (N = 219) using exploratory factor analysis, demonstrating the EHS works with 1- to 47-month-olds with excellent reliability and a strong correlation with age, showing its developmental trajectory. We replicated the EHS with Study 2 (N = 587), revealing a one-factor structure, showing excellent reliability, and replicating a strong correlation with age. Study 3 (N = 84) found the EHS correlated with a humor experiment, however it no longer correlated once age was accounted for, suggesting low convergent validity. Subsamples of parents from Studies 2 and 3 showed excellent inter-observer reliability between both parents, and good longitudinal stability after 6 months. Combining participants from all studies, we found the EHS is reliable across countries (Australia, United Kingdom, United States), parent education levels, and children’s age groups. We charted expected humor development by age (in months), and the expected proportion of children who would appreciate each humor type by age (in months). Finally, we found no demographic differences (e.g., country: Australia, Canada, United Kingdom, United States; parents’ education) in humor when pooling all data. The EHS is a valuable tool that will allow researchers to understand how humor: (1) emerges; and (2) affects other aspects of life, e.g., making friends, coping with stress, and creativity. The EHS is helpful for parents, early years educators, and children’s media, as it systematically charts early humor development.

Imprisonment: Young Pacific womens' experiences of living with depression

<p>Research has shown that depression is prevalent in adolescence. This descriptive phenomenological study explored the lived experiences of young Pacific Island (PI) women (17-25 years of age) living in New Zealand. Phenomenological interviewing was used to capture the lived experiences of depression with the aim of developing a deeper understanding of what it is like to be a young depressed PI woman. The essence of being depressed was imprisonment. Young PI women described how family and cultural pressures, experiences of failure and abuse led to their depression. They experienced rejection, being labelled, misunderstood and silenced by others and their circumstances and depression trapped them. The women managed their depression by finding their voice in writing journals, listening to music, reading bible scriptures, prayer and connecting to others with similar lived experience. The implications of the study are discussed in relation to improving parent education and culturally relevant support for young PI women. Recommendations for future research include developing approaches to research that include a more specific cultural and gender focus.</p>