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.

As Steady as a Rock! Gaining Insight in Recruitment and Retention Among Primary School Children With Behavioural Problems in Sport Mix Club

The number of children dealing with behavioural problems is increasing. A major challenge in many health-supportive programmes is the recruitment and retention of these children. In the current study, Sport Mix Club (SMC), an approach to enhance socioemotional disorders of 4- to 12-year-old children through sport classes in municipality Vaals, the Netherlands, is used as an illustration. Where many studies faced difficulties getting and keeping children in their interventions, SMC overcame this challenge. Therefore, we decided to explore “What factors contribute to enhanced recruitment and retention procedures among children with behavioural problems in Sport Mix Club?” A qualitative case study design using the analysis of the administrative logbook of the SMC coach and trainees, individual interviews with the SMC coach, trainees (n = 2), school teachers (n = 3) and parents of participating children (n = 9), and four focus group interviews with children (n = 13) were carried out. During the recruitment and retention of SMC, the human psychological need of relatedness seemed to be of crucial value. The fact that the SMC coach: (1) made efforts to become a familiar face for children, parents and community partners beforehand; (2) showed enthusiasm; and (3) placed her focus on having fun as opposed to the children's problems, seemed to be decisive in the process of getting children to participate in SMC and retaining their participation.

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.

Possible Interventions for Preventing the Development of Psychopathic Traits among Children and Adolescents?

Individuals with the combination of psychopathy and severe conduct disorder often get in a lot of trouble from their early childhood, and can cause great suffering and problems for other people and their immediate environment. Their antisocial behaviour has a tendency to develop into a chronic pattern early in life, and the treatment prognosis in adulthood is poor. A large proportion of serious violent crimes in society can be attributed to this group of perpetrators. Until recently, it has been unclear whether traits of this type can be prevented or changed, so that these individuals and their surroundings can benefit from targeted treatments at an early stage. To reduce serious crime in a society, it is very important to develop effective measures for this particular group. A lack of empathy, indifference to others, and a lack of concern about their own performance appear to be key early signs in children and adolescents with persistent behavioural problems and more serious norm violations who continue into a criminal career upon reaching adulthood. These characteristics have been termed callous−unemotional (CU) traits, and they are considered to be a precursor to psychopathic traits in adulthood. In recent years, several studies have evaluated the degree to which treatments that have been proved effective for children and adolescents with severe behavioural problems also show effectiveness for children and adolescents with CU traits. Interventions specifically tailored to children with CU traits have also been developed with the aim of directly changing the ongoing development of this precursor to psychopathy. In this paper, we will address the extent to which current evidence-based treatment methods developed for children and adolescents with behavioural difficulties are equally effective when a child has CU traits. We will also take a closer look at the effects of interventions designed to change this trait. There will be a discussion regarding what seems relevant for a change in the trait itself, as well as a change in their antisocial behaviour.

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.