Breastfeeding and cortisol in hair in children

Background One of the most important protective health factors for children is breast-feeding, but the mechanisms for this effect are not fully elucidated. Our objective was to assess if the duration of breastfeeding influences cortisol in hair, used as a biomarker for stress in children still at school-age. Methods ABIS (All Babies in Southeast Sweden) is a prospective population-based child cohort study of 17,055 children born Oct 1st1997- Oct 1st 1999, with the aim to study development of immune-mediated diseases. Questionnaires were answered at birth and then at regular follow-ups, and biological samples were collected. As a biomarker of stress, we measured the child’s cortisol in hair collected at 8 years of age, those randomly selected N = 126 children among those with enough hair samples for analyses of hair at 8 years of age. Duration of breastfeeding had been registered as well as psycho-social factors related to breastfeeding and/or stress. Results There was a negative correlation (r = − 0.23, p = 0.01) between total duration of breastfeeding and hair cortisol levels at 8 years of age. In a multivariate analysis this association persisted (p = 0.01) even when adjusted for other potential intervening factors like age of mother at delivery and early psychosocial vulnerability in the family, an index based on 11 factors (Multivariate model: df = 5, adj R2 = 0.15, F = 5.38, p < 0.01). Conclusion Our results show that longer breastfeeding is associated with lower cortisol levels in the child many years later. These associations should be more elaborated in further studies, and these findings also give some implications for public health. Mothers should be encouraged to breastfeed their children also in the modern society, since breastfeeding promotes health in the child. This information could be given via the obstetric departments and later at the well-baby clinics.

Born in Brussels screening tool: the development of a screening tool measuring antenatal psychosocial vulnerability

Background Antenatal psychosocial vulnerability is a main concern in today’s perinatal health care setting. Undetected psychosocially vulnerable pregnant women and their unborn child are at risk for unfavourable health outcomes such as poor birth outcomes or mental state. In order to detect potential risks and prevent worse outcomes, timely and accurate detection of antenatal psychosocial vulnerability is necessary. Therefore, this paper aims to develop a screening tool ‘the Born in Brussels Screening Tool (ST)’ aimed at detecting antenatal psychosocial vulnerability. Methods The Born in Brussels ST was developed based on a literature search of existing screening tools measuring antenatal psychosocial vulnerability. Indicators and items (i.e. questions) were evaluated and selected. The assigned points for the answer options were determined based on a survey sent out to caregivers experienced in antenatal (psychosocial) vulnerability. Further refinement of the tool’s content and the assigned points was based on expert panels’ advice. Results The Born in Brussels ST consists of 22 items that focus on 13 indicators: communication, place of birth, residence status, education, occupational status, partner’s occupation, financial situation, housing situation, social support, depression, anxiety, substance use and domestic violence. Based on the 168 caregivers who participated in the survey, assigned points account between 0,5 and 4. Threshold scores of each indicator were associated with adapted care paths. Conclusion Generalied and accurate detection of antenatal psychosocial vulnerability is needed. The brief and practical oriented Born in Brussels ST is a first step that can lead to an adequate and adapted care pathway for vulnerable pregnant women.

College from home during COVID-19: A mixed-methods study of heterogeneous experiences

This mixed-method study examined the experiences of college students during the COVID-19 pandemic through surveys, experience sampling data collected over two academic quarters (Spring 2019 n1 = 253; Spring 2020 n2 = 147), and semi-structured interviews with 27 undergraduate students. There were no marked changes in mean levels of depressive symptoms, anxiety, stress, or loneliness between 2019 and 2020, or over the course of the Spring 2020 term. Students in both the 2019 and 2020 cohort who indicated psychosocial vulnerability at the initial assessment showed worse psychosocial functioning throughout the entire Spring term relative to other students. However, rates of distress increased faster in 2020 than in 2019 for these individuals. Across individuals, homogeneity of variance tests and multi-level models revealed significant heterogeneity, suggesting the need to examine not just means but the variations in individuals’ experiences. Thematic analysis of interviews characterizes these varied experiences, describing the contexts for students’ challenges and strategies. This analysis highlights the interweaving of psychosocial and academic distress: Challenges such as isolation from peers, lack of interactivity with instructors, and difficulty adjusting to family needs had both an emotional and academic toll. Strategies for adjusting to this new context included initiating remote study and hangout sessions with peers, as well as self-learning. In these and other strategies, students used technologies in different ways and for different purposes than they had previously. Supporting qualitative insight about adaptive responses were quantitative findings that students who used more problem-focused forms of coping reported fewer mental health symptoms over the course of the pandemic, even though they perceived their stress as more severe. These findings underline the need for interventions oriented towards problem-focused coping and suggest opportunities for peer role modeling.

Quality of attachment, trauma, psychopathology, and frequency of non-suicidal self-injury in Mexican adolescents suffering from psychosocial vulnerability: Description of a risk profile

Introduction. Suffering from psychosocial vulnerability, particularly during adolescence, increases the likelihood of experiencing adverse life circumstances, psychiatric conditions, and non-suicidal self-injury (NSSI). Objective. We studied: 1. record-based demographic and clinical characteristics, as well as the frequency of NSSI in adolescents, beneficiaries of services for vulnerable population of one of six Non-Governmental Organizations (NGO’s), we compared by beneficiary type: internal (IB) versus external (EB); 2. predictive relationship of NSSI with depression, difficulties in emotion regulation (DER) and suicidal ideation (administered measures); 3. Comparison of average scores on measures by: quality of attachment (QOA) and presence/absence of NSSI. Method. A convenience sample of 255 adolescents (45.5% women, ages 11-15) answered instruments in institutional facilities (Mexico City and Puebla), where 181 (71%) resided as IB and 74 (29%) resided in family home (EB). The mental health staff of each NGO specified according to the record: demographics, psychiatric diagnoses, history of trauma, and QOA between the minor and his attachment figure. Results. 42% denied NSSI episodes, 16.9% indicated a non-significant pattern, and 35.6% reported a significant and recent pattern. IB presented higher scores in all measurements, higher report of interpersonal trauma, depressive, anxiety, and behavior disorders. Minors with positive QOA obtained significantly lower scores. Discussion and conclusion. Compared to EB’s, adolescents residing in NGOs have a higher risk profile, particularly those without a positive QOA, a fact that is associated with a greater presence of psychopathology and significant and recent NSSI.

Establishing and Evaluating a Multidisciplinary Community-Based Sleep Clinic for Children with Neurodevelopmental Difficulties in Inner London

We describe our experience of setting up and evaluating a community-based multi-disciplinary sleep service for children with neurodevelopmental disorders and psychosocial vulnerabilities.Referrals are accepted for children (1-18 years of age) with persistent sleep problems, and neurodevelopmental difficulties or significant psychosocial adversity, living in two inner-city boroughs.Holistic sleep assessment involves 1-hour Paediatrician-led consultation, often followed by Psychologist-led parent workshop, with follow-up telephone/face-to-face contacts to support implementation of behavioural interventions.Acceptability is measured through parent feedback; efficacy measured through Composite Sleep Disturbance Index, Sleep Problem rating, and locally developed Burden Score.Referrals for 354 children were received in the first two years.99% of families report the service met their child’s needs well/very well.Sleep studies were accessed for around a quarter of children.Medical and social complexity was common, and more prevalent in families who were less able to engage to completion of intervention (significant psychosocial vulnerability in 43.4% of suboptimally engaged, versus 22.7% of engaged group).Clinical outcome measure scores improved for a subset of families in whom data was available, who had been able to engage in the intervention.There has been a high demand for our community-based multi-disciplinary sleep service, with positive feedback from families.Intervention has resulted in positive impacts on sleep outcome measures for those engaged.There continue to be barriers to accessing intervention, and putting in place recommendations, for some families which requires further evaluation and potential service development. We believe the community-based multi-disciplinary model of this service could be readily replicated in other localities to benefit sleep health on a wider scale.