Pub Date : 2024-07-22DOI: 10.2174/0122106766304121240718112939
Oluwadunni Adegbite, Andrew Enegela, Crystal Obiozor, Edore Onigu-Otite
Adolescence is a unique developmental period marked by biophysiological changes and psychosocial exploration. Risk-taking behaviors, including experimentation with psychoactive substances, are common during this period. Emergency room (ER) visits for adverse events related to adolescent substance use have increased over the last two decades. Without a continuum of care from the ER, significant opportunities to intervene are missed. The narrative review article aims to provide an overview of substance use during Adolescence in the United States, highlight related ER visits, and discuss extending care beyond the ER. A literature review was conducted to reveal historical and recent studies related to adolescent substance use trends, morbidity, and mortality patterns, as well as the much-needed continuum of care after the ER. Our approach prioritized capturing diverse perspectives and significant studies relevant to these themes, aiming for a thorough discussion without strict adherence to systematic review methodologies. The selection of studies involved a comprehensive search across multiple databases, including PubMed, Google Scholar, and relevant academic journals. Search terms were tailored to capture studies addressing adolescent substance abuse, ER visitation, and aftercare. Studies were screened based on title, abstract, and full-text review, with a focus on relevance and significance to the review's objectives. The strategy for this narrative review facilitated a detailed exploration of the selected themes while also allowing for flexibility in study selection and interpretation. National studies indicate an overall decline in the proportions of adolescents using substances compared to pre-COVID-19 levels. However, morbidity and mortality patterns have not mirrored this decline. Various factors, including gender, location, and specific mental health disorders, are associated with adolescent substance use presentations. Acute care providers in emergency settings, employing protocols like SBIRT, can significantly impact outcomes by facilitating appropriate screening and referral to aftercare treatment programs. Identification of barriers to care, such as stigma and social determinants of health, is important in formulating tailored interventions. While acute care provides an opportunity to intervene and initiate treatment, a continuum of care is essential to reduce morbidity and mortality patterns among adolescents with substance use.
{"title":"Adolescent Substance Use, and Related Emergency Room Visits, and Continuum of Care","authors":"Oluwadunni Adegbite, Andrew Enegela, Crystal Obiozor, Edore Onigu-Otite","doi":"10.2174/0122106766304121240718112939","DOIUrl":"https://doi.org/10.2174/0122106766304121240718112939","url":null,"abstract":"\u0000\u0000Adolescence is a unique developmental period marked by\u0000biophysiological changes and psychosocial exploration. Risk-taking behaviors,\u0000including experimentation with psychoactive substances, are common during this\u0000period. Emergency room (ER) visits for adverse events related to adolescent\u0000substance use have increased over the last two decades. Without a continuum of care\u0000from the ER, significant opportunities to intervene are missed. The narrative review\u0000article aims to provide an overview of substance use during Adolescence in the\u0000United States, highlight related ER visits, and discuss extending care beyond the ER.\u0000A literature review was conducted to reveal historical and recent studies related to\u0000adolescent substance use trends, morbidity, and mortality patterns, as well as the\u0000much-needed continuum of care after the ER. Our approach prioritized capturing\u0000diverse perspectives and significant studies relevant to these themes, aiming for a\u0000thorough discussion without strict adherence to systematic review methodologies.\u0000The selection of studies involved a comprehensive search across multiple databases,\u0000including PubMed, Google Scholar, and relevant academic journals. Search terms\u0000were tailored to capture studies addressing adolescent substance abuse, ER visitation,\u0000and aftercare. Studies were screened based on title, abstract, and full-text review,\u0000with a focus on relevance and significance to the review's objectives. The strategy for\u0000this narrative review facilitated a detailed exploration of the selected themes while\u0000also allowing for flexibility in study selection and interpretation. National studies\u0000indicate an overall decline in the proportions of adolescents using substances\u0000compared to pre-COVID-19 levels. However, morbidity and mortality patterns have\u0000not mirrored this decline. Various factors, including gender, location, and specific\u0000mental health disorders, are associated with adolescent substance use presentations.\u0000Acute care providers in emergency settings, employing protocols like SBIRT, can\u0000significantly impact outcomes by facilitating appropriate screening and referral to\u0000aftercare treatment programs. Identification of barriers to care, such as stigma and\u0000social determinants of health, is important in formulating tailored interventions.\u0000While acute care provides an opportunity to intervene and initiate treatment, a\u0000continuum of care is essential to reduce morbidity and mortality patterns among\u0000adolescents with substance use.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-03DOI: 10.2174/0122106766307916240626104350
M. Shukla, Niti Upadhyay
This systematic review aimed at exploring the impact of the coronavirus pandemic on adolescents’ psychosomatic problems and whether the pandemic differentially impacted different genders. It also explored whether particular clusters of psychosomatic problems, viz., psychological, somatic, and musculoskeletal, manifested more post-pandemic than before. An extensive search of eight electronic databases for studies published/conducted between 2014-2018 for pre-pandemic prevalence of psychosomatic problems among adolescents (11-17 years) and for studies published and conducted between 2019-2023 during/post-pandemic prevalence resulted in the final selection of 38 studies. This included 25 pre-pandemic studies, six studies published and conducted during/after the pandemic, and seven studies that reported pre-post-pandemic comparison. The review was reported following PRISMA guidelines. ROBINS-E tool was used for assessing the risk of bias while the JBI Critical Appraisal Tools were used to assess study quality. Findings showed that sleep problems and headaches dominated adolescent psychosomatic problems pre-pandemic. Sleep problems continued to be the most common problem post-pandemic, followed by stomach ache and feeling low, dizziness, irritability, appetite loss, tension, and difficulty concentrating. In general, females reported more psychosomatic symptoms, though limited research explored gender differences. Only one study found improved psychosomatic health postpandemic, more so for boys than girls. Psychological complaints increased postpandemic; however, results were mixed about somatic and musculoskeletal complaints after the pandemic. Some studies found no change in post-pandemic psychosomatic symptoms. Gender-specific, tailored training programs are crucial for enhancing resilience and coping to mitigate the impact of the pandemic on adolescents’ psychosomatic health.
{"title":"Psychosomatic Problems Among Adolescents During/Post the\u0000COVID-19 Pandemic: A Systematic Review","authors":"M. Shukla, Niti Upadhyay","doi":"10.2174/0122106766307916240626104350","DOIUrl":"https://doi.org/10.2174/0122106766307916240626104350","url":null,"abstract":"\u0000\u0000This systematic review aimed at exploring the impact of the\u0000coronavirus pandemic on adolescents’ psychosomatic problems and whether the\u0000pandemic differentially impacted different genders.\u0000\u0000\u0000\u0000It also explored whether particular clusters of psychosomatic problems, viz.,\u0000psychological, somatic, and musculoskeletal, manifested more post-pandemic than\u0000before. An extensive search of eight electronic databases for studies\u0000published/conducted between 2014-2018 for pre-pandemic prevalence of\u0000psychosomatic problems among adolescents (11-17 years) and for studies published\u0000and conducted between 2019-2023 during/post-pandemic prevalence resulted in the\u0000final selection of 38 studies. This included 25 pre-pandemic studies, six studies\u0000published and conducted during/after the pandemic, and seven studies that reported\u0000pre-post-pandemic comparison. The review was reported following PRISMA\u0000guidelines. ROBINS-E tool was used for assessing the risk of bias while the JBI\u0000Critical Appraisal Tools were used to assess study quality.\u0000\u0000\u0000\u0000Findings showed that sleep problems and headaches dominated adolescent\u0000psychosomatic problems pre-pandemic. Sleep problems continued to be the most\u0000common problem post-pandemic, followed by stomach ache and feeling low,\u0000dizziness, irritability, appetite loss, tension, and difficulty concentrating. In general,\u0000females reported more psychosomatic symptoms, though limited research explored\u0000gender differences. Only one study found improved psychosomatic health postpandemic, more so for boys than girls. Psychological complaints increased postpandemic; however, results were mixed about somatic and musculoskeletal\u0000complaints after the pandemic. Some studies found no change in post-pandemic\u0000psychosomatic symptoms.\u0000\u0000\u0000\u0000Gender-specific, tailored training programs are crucial for enhancing\u0000resilience and coping to mitigate the impact of the pandemic on adolescents’\u0000psychosomatic health.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141682750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.2174/0122106766308034240605043308
Fatma Özgün Öztürk
Posttraumatic Stress Disorder (PTSD) is a prevalent psychological response among those who survive earthquakes. This study investigates the relationships between sociodemographic and clinical differences and symptoms of avoidance, re-experiencing, and hyperarousal, which are key indicators of PTSD in adolescents. Research data were collected through online surveys using a simple random sampling method. The sample group consisted of 178 adolescents who met the inclusion criteria. Data were collected using the Personal Information Form (PIF) and the Posttraumatic Stress Disorder Symptoms Scale-Self-Report Scale (PSS-SR) for Children. Of the participants, 77% were female, with a mean age of 16.99. A total of 84.3% lived with their families. The rate of those trapped under debris during the earthquake was 97.2%. During the earthquake, 84.8% of adolescents were injured, and 25.8% lost a family member due to the earthquake. Female participants showed significantly higher total trauma, re-experiencing, and hyperarousal scores than males (p<0.05). Those physically injured during the earthquake had significantly lower total trauma and avoidance scores compared to those not injured (p<0.05). Participants who lost a family member during the earthquake had significantly lower total trauma, re-experiencing, and hyperarousal scores compared to those who did not lose a family member (p<0.05). Females exhibited more PTSD symptoms compared to males. Those not injured or who did not lose a family member during the earthquake showed more PTSD symptoms than those who experienced injury or loss.
{"title":"Factors Associated with Posttraumatic Stress Disorder in\u0000Adolescents Experiencing Earthquake Trauma","authors":"Fatma Özgün Öztürk","doi":"10.2174/0122106766308034240605043308","DOIUrl":"https://doi.org/10.2174/0122106766308034240605043308","url":null,"abstract":"\u0000\u0000Posttraumatic Stress Disorder (PTSD) is a prevalent\u0000psychological response among those who survive earthquakes.\u0000\u0000\u0000\u0000This study investigates the relationships between sociodemographic\u0000and clinical differences and symptoms of avoidance, re-experiencing, and\u0000hyperarousal, which are key indicators of PTSD in adolescents.\u0000\u0000\u0000\u0000Research data were collected through online surveys using a simple\u0000random sampling method. The sample group consisted of 178 adolescents who\u0000met the inclusion criteria. Data were collected using the Personal Information\u0000Form (PIF) and the Posttraumatic Stress Disorder Symptoms Scale-Self-Report\u0000Scale (PSS-SR) for Children.\u0000\u0000\u0000\u0000Of the participants, 77% were female, with a mean age of 16.99. A total\u0000of 84.3% lived with their families. The rate of those trapped under debris during\u0000the earthquake was 97.2%. During the earthquake, 84.8% of adolescents were\u0000injured, and 25.8% lost a family member due to the earthquake. Female\u0000participants showed significantly higher total trauma, re-experiencing, and\u0000hyperarousal scores than males (p<0.05). Those physically injured during the\u0000earthquake had significantly lower total trauma and avoidance scores compared\u0000to those not injured (p<0.05). Participants who lost a family member during the\u0000earthquake had significantly lower total trauma, re-experiencing, and\u0000hyperarousal scores compared to those who did not lose a family member\u0000(p<0.05).\u0000\u0000\u0000\u0000Females exhibited more PTSD symptoms compared to males. Those\u0000not injured or who did not lose a family member during the earthquake showed\u0000more PTSD symptoms than those who experienced injury or loss.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141359421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-04DOI: 10.2174/0122106766279589240529123124
Stephanie Washburn, Reilly Branch, Ishara Jean-Francois, Steven L. Berman
The developmental period of late adolescence is when significant identity formation takes place, especially for college students (Erikson, 1968). However, traumatic experiences can affect identity development and lead to extreme identity distress. With exposure to trauma, executive functioning can also diminish, leading to a decrease in self-control and greater sensitivity. Although trauma affects both executive functioning and identity, the possible direct link between identity and executive function has not been adequately explored. Among a college sample (N = 507), those who experienced trauma reported higher levels of identity distress, ruminative identity exploration, and lower levels of executive functioning. It was hypothesized that identity variables plus PTSD would better predict executive functioning than PTSD alone. The hypothesis was supported, suggesting the incremental validity of using identity in addition to PTSD to predict executive functioning scores. Implications of this study include the need to consider identity development in the treatment and prevention of PTSD, as well as trauma history, in interventions aimed at promoting positive identity development in youth
{"title":"The Role of Identity in the Relationship between PTSD and\u0000Executive Functioning","authors":"Stephanie Washburn, Reilly Branch, Ishara Jean-Francois, Steven L. Berman","doi":"10.2174/0122106766279589240529123124","DOIUrl":"https://doi.org/10.2174/0122106766279589240529123124","url":null,"abstract":"\u0000\u0000The developmental period of late adolescence is when\u0000significant identity formation takes place, especially for college students\u0000(Erikson, 1968). However, traumatic experiences can affect identity development\u0000and lead to extreme identity distress. With exposure to trauma, executive\u0000functioning can also diminish, leading to a decrease in self-control and greater\u0000sensitivity.\u0000\u0000\u0000\u0000Although trauma affects both executive functioning and identity, the\u0000possible direct link between identity and executive function has not been\u0000adequately explored. Among a college sample (N = 507), those who experienced\u0000trauma reported higher levels of identity distress, ruminative identity exploration,\u0000and lower levels of executive functioning.\u0000\u0000\u0000\u0000It was hypothesized that identity variables plus PTSD would better\u0000predict executive functioning than PTSD alone. The hypothesis was supported,\u0000suggesting the incremental validity of using identity in addition to PTSD to\u0000predict executive functioning scores.\u0000\u0000\u0000\u0000Implications of this study include the need to consider identity\u0000development in the treatment and prevention of PTSD, as well as trauma history,\u0000in interventions aimed at promoting positive identity development in youth\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.2174/0122106766298494240510052101
Faraz Khan, Sarah Mohiuddin
Fasting in Ramadan, a holy month in Islam, is considered a religious obligation to Muslims after puberty. Fasting during Ramadan entails abstinence from consuming food and liquids, as well as abstaining from other activities, including smoking and sexual activity, from dawn until sunset. Literature exists regarding the management of multiple medical conditions impacted by the month of fasting; however, limited literature exists to guide the management of Attention-Deficit/Hyperactivity Disorder (ADHD) during Ramadan. This systematic review employed a PUBMED search which was conducted using keywords ((ADHD) AND (Muslims)) OR ((ADHD) AND (FASTING)) OR ((ADHD) AND (RAMADAN)) OR ((RAMADAN) AND (MANAGEMENT)) and search strategies to find existing literature on ADHD management during Ramadan or while fasting. Eight hundred and sixty-one results were obtained. Of these, full texts of clinical trials, systematic reviews, reviews, randomized control trials, and metaanalyses resulted in 303 results that were screened by title or abstract for relevance to the topic. The duplicate articles were removed. Eighty-nine results were incorporated into this paper, including full articles, book excerpts, and online articles. Muslim adolescents may face challenges with academic and social functioning as they navigate psychosocial changes in the context of Ramadan. ADHD management options should be discussed with individuals who are planning to fast. Pharmacologic management options include continuing on the current regimen, dose adjustment to mitigate side effect exacerbation, a change in medication class, or a change in medication formulation. For severe cases or cases with comorbid conditions, continued fasting may not be recommended. In these cases, the patient should attempt to seek counsel with their community’s religious scholar in collaboration with their medication provider. Ultimately, there are limitations in the available data, and there is a need for further investigation into the impacts of fasting during Ramadan on individuals with ADHD and the effectiveness of interventions to promote treatment adherence.
{"title":"Review of Clinical Considerations in the Management of Adolescents with ADHD During Ramadan","authors":"Faraz Khan, Sarah Mohiuddin","doi":"10.2174/0122106766298494240510052101","DOIUrl":"https://doi.org/10.2174/0122106766298494240510052101","url":null,"abstract":"\u0000\u0000Fasting in Ramadan, a holy month in Islam, is considered a\u0000religious obligation to Muslims after puberty. Fasting during Ramadan entails\u0000abstinence from consuming food and liquids, as well as abstaining from other\u0000activities, including smoking and sexual activity, from dawn until sunset. Literature\u0000exists regarding the management of multiple medical conditions impacted by the\u0000month of fasting; however, limited literature exists to guide the management of\u0000Attention-Deficit/Hyperactivity Disorder (ADHD) during Ramadan.\u0000\u0000\u0000\u0000This systematic review employed a PUBMED search which was\u0000conducted using keywords ((ADHD) AND (Muslims)) OR ((ADHD) AND\u0000(FASTING)) OR ((ADHD) AND (RAMADAN)) OR ((RAMADAN) AND\u0000(MANAGEMENT)) and search strategies to find existing literature on ADHD\u0000management during Ramadan or while fasting.\u0000\u0000\u0000\u0000Eight hundred and sixty-one results were obtained. Of these, full texts of\u0000clinical trials, systematic reviews, reviews, randomized control trials, and metaanalyses\u0000resulted in 303 results that were screened by title or abstract for relevance to\u0000the topic. The duplicate articles were removed. Eighty-nine results were incorporated\u0000into this paper, including full articles, book excerpts, and online articles.\u0000\u0000\u0000\u0000Muslim adolescents may face challenges with academic and social\u0000functioning as they navigate psychosocial changes in the context of Ramadan.\u0000ADHD management options should be discussed with individuals who are planning\u0000to fast. Pharmacologic management options include continuing on the current\u0000regimen, dose adjustment to mitigate side effect exacerbation, a change in medication\u0000class, or a change in medication formulation. For severe cases or cases with comorbid\u0000conditions, continued fasting may not be recommended. In these cases, the patient\u0000should attempt to seek counsel with their community’s religious scholar in\u0000collaboration with their medication provider. Ultimately, there are limitations in the\u0000available data, and there is a need for further investigation into the impacts of fasting\u0000during Ramadan on individuals with ADHD and the effectiveness of interventions to\u0000promote treatment adherence.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-14DOI: 10.2174/0122106766286711240509061416
Kammarauche Aneni, Soyon Kim, Jenny Meyer, Isabella Gomati de la Vega, Uzochukwu Imo, H. Onyeaka, Philip Baiden, Joseph Woolston
Unmet mental health needs can lead to worsening outcomes in youth. Given that youth depend on family for access to mental health services, and positive family functioning is associated with improved health outcomes, understanding the association between family-level factors and youth’s unmet mental health needs is essential to inform inclusive solutions. This study aimed to examine the association between family functioning (parental aggravation, parent-child communication, family resilience) and unmet mental health needs among school-aged youth. A cross-sectional analysis of the combined 2019-2020 National Survey on Children’s Health (NSDH) dataset was performed (n=9,204). Bivariate and multivariate logistic regression models were used to examine the association between unmet mental health needs (primary outcome) and family functioning using three explanatory variables, parental aggravation, parent-child communication, and family resilience. We also examined age-related differences in these associations between children aged 6-11 and adolescents aged 12-17. The weighted proportion of youth with reported unmet mental health needs was 18%. Weighted unadjusted analyses showed that low family resilience was associated with 60% higher odds of unmet mental health needs, while parental aggravation and poor parentchild communication were not associated with unmet mental health needs. After adjusting for potential confounders, low family resilience was associated with 50% higher odds of unmet mental health needs among school-aged youth (AOR=1.54, 95% CI: 1.15-2.07). Being Black (AOR=2.28, 95% CI: 1.41-3.69), younger (AOR=0.95, 95% CI: 0.91-0.99), lacking consistent health insurance (AOR=2.64, 95% CI: 1.59-4.38), and having a mother with poor maternal health (AOR=1.82, 95% CI: 1.36-2.46), were also associated with unmet mental health needs. Among children aged 6-11 years, low family resilience, being Black, lacking consistent insurance, and having a mother with poor maternal health were associated with unmet mental health needs (all p’s < 0.05). Similarly, among adolescents aged 12-17 years, low family resilience, being Black, lacking consistent insurance, and having a mother with poor maternal health were associated with unmet mental health needs (all p < 0.05). Having a parent with a college education was associated with lower odds of unmet mental health needs among children (6-11 years), but not adolescents (12-17 years). Our findings have suggested an association between low family resilience and unmet mental health needs among school-aged youth. Since families are an integral part of meeting youth’s needs, applying approaches to addressing unmet mental health needs that consider family resilience and parental well-being is imperative. Identifying and addressing factors contributing to unmet health needs barriers may help address existing racial disparities.
{"title":"Family Functioning and Unmet Mental Health Needs among School-Aged Youth","authors":"Kammarauche Aneni, Soyon Kim, Jenny Meyer, Isabella Gomati de la Vega, Uzochukwu Imo, H. Onyeaka, Philip Baiden, Joseph Woolston","doi":"10.2174/0122106766286711240509061416","DOIUrl":"https://doi.org/10.2174/0122106766286711240509061416","url":null,"abstract":"\u0000\u0000Unmet mental health needs can lead to worsening outcomes in\u0000youth. Given that youth depend on family for access to mental health services, and positive\u0000family functioning is associated with improved health outcomes, understanding the\u0000association between family-level factors and youth’s unmet mental health needs is essential\u0000to inform inclusive solutions.\u0000\u0000\u0000\u0000This study aimed to examine the association between family functioning\u0000(parental aggravation, parent-child communication, family resilience) and unmet mental\u0000health needs among school-aged youth.\u0000\u0000\u0000\u0000A cross-sectional analysis of the combined 2019-2020 National Survey on\u0000Children’s Health (NSDH) dataset was performed (n=9,204). Bivariate and multivariate\u0000logistic regression models were used to examine the association between unmet mental\u0000health needs (primary outcome) and family functioning using three explanatory variables,\u0000parental aggravation, parent-child communication, and family resilience. We also examined\u0000age-related differences in these associations between children aged 6-11 and adolescents\u0000aged 12-17.\u0000\u0000\u0000\u0000The weighted proportion of youth with reported unmet mental health needs was\u000018%. Weighted unadjusted analyses showed that low family resilience was associated with\u000060% higher odds of unmet mental health needs, while parental aggravation and poor parentchild\u0000communication were not associated with unmet mental health needs. After adjusting\u0000for potential confounders, low family resilience was associated with 50% higher odds of\u0000unmet mental health needs among school-aged youth (AOR=1.54, 95% CI: 1.15-2.07).\u0000Being Black (AOR=2.28, 95% CI: 1.41-3.69), younger (AOR=0.95, 95% CI: 0.91-0.99),\u0000lacking consistent health insurance (AOR=2.64, 95% CI: 1.59-4.38), and having a mother\u0000with poor maternal health (AOR=1.82, 95% CI: 1.36-2.46), were also associated with\u0000unmet mental health needs. Among children aged 6-11 years, low family resilience, being\u0000Black, lacking consistent insurance, and having a mother with poor maternal health were\u0000associated with unmet mental health needs (all p’s < 0.05). Similarly, among adolescents\u0000aged 12-17 years, low family resilience, being Black, lacking consistent insurance, and\u0000having a mother with poor maternal health were associated with unmet mental health needs\u0000(all p < 0.05). Having a parent with a college education was associated with lower odds of\u0000unmet mental health needs among children (6-11 years), but not adolescents (12-17 years).\u0000\u0000\u0000\u0000Our findings have suggested an association between low family resilience and\u0000unmet mental health needs among school-aged youth. Since families are an integral part of\u0000meeting youth’s needs, applying approaches to addressing unmet mental health needs that\u0000consider family resilience and parental well-being is imperative. Identifying and addressing\u0000factors contributing to unmet health needs barriers may help address existing racial\u0000disparities.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Impulsivity, characterized by the tendency to act on impulse without consideration for consequences, has been implicated in health disorders such as problematic substance use among adolescents. Understanding impulsivity's nature, clinical manifestations, quantification, and management in a clinical context could help address underlying disorders. We reviewed previous studies where different impulsivity dimensions were identified and explored the manifestations of impulsivity across conditions characterized by high impulsivity. Similarly, we pursued a literature search on various factors influencing impulsivity, methods employed to quantify them, and commonly used treatments for impulsivity control. The multidimensional and transdiagnostic nature of impulsivity was acknowledged across several studies. Various health disorders such as substance use disorders, borderline personality disorder, and attention-deficit/hyperactivity disorder implicated impulsivity, even among the adolescent groups. We identified biological, psychological, and environmental factors influencing impulsivity. We also present the commonly employed approaches to quantifying impulsivity and new measurement approaches under active investigation that are relevant in characterizing impulsivity in adolescents. Treatment options to manage impulsivity were also reviewed and are presented in this work. This work offers a comprehensive understanding of impulsivity as one of the underlying factors in adolescent substance use and related health disorders, emphasizing factors affecting impulsivity, approaches for measurement, and implications of high impulsivity on mental health and behaviors.
{"title":"Impulsivity: A Transdiagnostic Approach to Understanding Adolescent Substance Use","authors":"Bishal Lamichhane, Zishen Li, Ashutosh Sabharwal, Nidal Moukaddam","doi":"10.2174/0122106766297440240430133940","DOIUrl":"https://doi.org/10.2174/0122106766297440240430133940","url":null,"abstract":"\u0000\u0000Impulsivity, characterized by the tendency to act on\u0000impulse without consideration for consequences, has been implicated in health\u0000disorders such as problematic substance use among adolescents. Understanding\u0000impulsivity's nature, clinical manifestations, quantification, and management in a\u0000clinical context could help address underlying disorders.\u0000\u0000\u0000\u0000We reviewed previous studies where different impulsivity dimensions\u0000were identified and explored the manifestations of impulsivity across conditions\u0000characterized by high impulsivity. Similarly, we pursued a literature search on\u0000various factors influencing impulsivity, methods employed to quantify them, and\u0000commonly used treatments for impulsivity control.\u0000\u0000\u0000\u0000The multidimensional and transdiagnostic nature of impulsivity was\u0000acknowledged across several studies. Various health disorders such as substance\u0000use disorders, borderline personality disorder, and attention-deficit/hyperactivity\u0000disorder implicated impulsivity, even among the adolescent groups. We identified\u0000biological, psychological, and environmental factors influencing impulsivity. We\u0000also present the commonly employed approaches to quantifying impulsivity and\u0000new measurement approaches under active investigation that are relevant in\u0000characterizing impulsivity in adolescents. Treatment options to manage\u0000impulsivity were also reviewed and are presented in this work.\u0000\u0000\u0000\u0000This work offers a comprehensive understanding of impulsivity as\u0000one of the underlying factors in adolescent substance use and related health\u0000disorders, emphasizing factors affecting impulsivity, approaches for\u0000measurement, and implications of high impulsivity on mental health and\u0000behaviors.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140977849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.2174/0122106766288982240509041026
Zoe Sirotiak, Jenna L. Adamowicz, E. B. Thomas
Associations between mindfulness and improved physical and psychological health have been established, but COVID-19 presents a novel context. This study examined the relationship between individual mindfulness facets and general stress among college students experiencing at least one symptom of acute COVID-19 infection in the context of the pandemic. Five hundred sixteen university students experiencing at least one CDC-identified COVID-19 symptom completed measures of general stress, mindfulness, and somatic symptoms in 2020-2021 during the COVID-19 pandemic following IRB approval and informed consent. Associations between mindfulness and improved physical and psychological health have been established, but COVID-19 presents a novel context. This study examined the relation between individual mindfulness facets and general stress among college students experiencing at least one symptom of acute COVID-19 infection in the context of the pandemic. The act with awareness, nonjudgment, and nonreactivity facets of mindfulness were associated with general stress. In total, the model accounted for over half of the variance in general stress (R2 = 0.51, p < 0.001). Mindfulness may be particularly important in explaining general stress among college students reporting a symptom of COVID-19. Mindfulness may benefit college students as the pandemic continues to unfold, and monitoring one’s physical health remains a primary mitigation strategy. These results may also inform understanding and responses to future public health emergencies in which monitoring somatic symptoms is encouraged by public health officials to contain the spread.
{"title":"Reduced Stress among COVID-Symptomatic Undergraduates: Act With Awareness, Nonjudgment, and Nonreactivity as Key Facets of Mindfulness","authors":"Zoe Sirotiak, Jenna L. Adamowicz, E. B. Thomas","doi":"10.2174/0122106766288982240509041026","DOIUrl":"https://doi.org/10.2174/0122106766288982240509041026","url":null,"abstract":"\u0000\u0000Associations between mindfulness and improved physical\u0000and psychological health have been established, but COVID-19 presents a novel\u0000context. This study examined the relationship between individual mindfulness\u0000facets and general stress among college students experiencing at least one\u0000symptom of acute COVID-19 infection in the context of the pandemic.\u0000\u0000\u0000\u0000Five hundred sixteen university students experiencing at least one\u0000CDC-identified COVID-19 symptom completed measures of general stress,\u0000mindfulness, and somatic symptoms in 2020-2021 during the COVID-19\u0000pandemic following IRB approval and informed consent.\u0000\u0000\u0000\u0000Associations between mindfulness and improved physical and psychological health have been established, but COVID-19 presents a novel context. This study examined the relation between individual mindfulness facets and general stress among college students experiencing at least one symptom of acute COVID-19 infection in the context of the pandemic.\u0000\u0000\u0000\u0000The act with awareness, nonjudgment, and nonreactivity facets of\u0000mindfulness were associated with general stress. In total, the model accounted for\u0000over half of the variance in general stress (R2 = 0.51, p < 0.001).\u0000\u0000\u0000\u0000Mindfulness may be particularly important in explaining general\u0000stress among college students reporting a symptom of COVID-19. Mindfulness\u0000may benefit college students as the pandemic continues to unfold, and monitoring\u0000one’s physical health remains a primary mitigation strategy. These results may\u0000also inform understanding and responses to future public health emergencies in\u0000which monitoring somatic symptoms is encouraged by public health officials to\u0000contain the spread.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.2174/0122106766298492240320044542
Federico Cardelle-Pérez, María Ángeles Díaz-Caneja Greciano
It has been 25 years since the definition of the concept of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The abrupt onset of neuropsychiatric symptoms requires a comprehensive differential diagnosis involving complementary tests and optimal treatment selection. This paper describes aspects related to the diagnosis and clinical management of PANDAS. A clinical perspective is developed starting from an example that meets the Swedo's criteria. A comprehensive approach, including interdisciplinary management and urgent evaluation of potential organic causes, is crucial for effective treatment. Treatment decisions should consider severity, symptoms, and available evidence. Collaboration with neuropediatric or neurological services is needed. ASLO/anti-DNase B and 25-OH-Vitamin D tests are valuable for atypical OCD/Tic presentations, always maintaining a broader organic screening.
{"title":"PANDAS: Twenty-Five Years Later","authors":"Federico Cardelle-Pérez, María Ángeles Díaz-Caneja Greciano","doi":"10.2174/0122106766298492240320044542","DOIUrl":"https://doi.org/10.2174/0122106766298492240320044542","url":null,"abstract":"\u0000\u0000It has been 25 years since the definition of the concept\u0000of Pediatric Autoimmune Neuropsychiatric Disorders Associated with\u0000Streptococcal Infections (PANDAS). The abrupt onset of neuropsychiatric\u0000symptoms requires a comprehensive differential diagnosis involving\u0000complementary tests and optimal treatment selection.\u0000\u0000\u0000\u0000This paper describes aspects related to the diagnosis and clinical\u0000management of PANDAS. A clinical perspective is developed starting from an\u0000example that meets the Swedo's criteria.\u0000\u0000\u0000\u0000A comprehensive approach, including interdisciplinary management\u0000and urgent evaluation of potential organic causes, is crucial for effective\u0000treatment. Treatment decisions should consider severity, symptoms, and available\u0000evidence. Collaboration with neuropediatric or neurological services is needed.\u0000ASLO/anti-DNase B and 25-OH-Vitamin D tests are valuable for atypical\u0000OCD/Tic presentations, always maintaining a broader organic screening.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-05DOI: 10.2174/0122106766257259240229070230
Ali Unlu, Parna Prajapati, Mariam Rahmani, Andres Pumariega
To explore the associations between the type and the amount of substances used with depression and anxiety symptoms by high school students. The study data was collected by the Istanbul Department of Education on 31,604 high school students which was a survey of 66 questions administered in the school setting. The primary questions and sub-questions on anxiety and depression scores were added to generate a scaled score. Specific substances used by the participants were used to explore the relationship between substance use and depression and anxiety scores by using multinomial logistic regression models. Two regression models were analyzed, one for each dependent variable, keeping the significance level at 0.05. Odds ratios were calculated to explore the association between depression and anxiety scores and specific substance use among the youth. The participants with low levels of anxiety were at an increased odds of using heavy amounts of sleep pills (OR=1.6) and alcohol (OR=1.3) as compared to those without anxiety. In addition to sleep pills and alcohol, illicit substances such as LSD and inhalant use were also seen in the participants with higher levels of anxiety. The participants with low levels of depression were found to be at an increased odds of using sleep pills (OR=1.8) and alcohol (OR=1.3). In addition to this pattern of substance use, participants with higher levels of depression were also found to be heavy cocaine users, low inhalant users, heavy steroid users, and low alcohol users. A decrease in the use of homemade brews was seen in the participants with low and high levels of depression as compared to those who didn’t have any depressive symptoms. A unique pattern of drug and alcohol use was found in the participants experiencing varying levels of anxiety and depression.
{"title":"Comparative Associations between Substances Used with Depression and Anxiety in a Sample of High School Students in Turkey","authors":"Ali Unlu, Parna Prajapati, Mariam Rahmani, Andres Pumariega","doi":"10.2174/0122106766257259240229070230","DOIUrl":"https://doi.org/10.2174/0122106766257259240229070230","url":null,"abstract":"\u0000\u0000To explore the associations between the type and the\u0000amount of substances used with depression and anxiety symptoms by high school\u0000students.\u0000\u0000\u0000\u0000The study data was collected by the Istanbul Department of Education\u0000on 31,604 high school students which was a survey of 66 questions administered\u0000in the school setting. The primary questions and sub-questions on anxiety and\u0000depression scores were added to generate a scaled score. Specific substances used\u0000by the participants were used to explore the relationship between substance use\u0000and depression and anxiety scores by using multinomial logistic regression\u0000models. Two regression models were analyzed, one for each dependent variable,\u0000keeping the significance level at 0.05. Odds ratios were calculated to explore the\u0000association between depression and anxiety scores and specific substance use\u0000among the youth.\u0000\u0000\u0000\u0000The participants with low levels of anxiety were at an increased odds of\u0000using heavy amounts of sleep pills (OR=1.6) and alcohol (OR=1.3) as compared\u0000to those without anxiety. In addition to sleep pills and alcohol, illicit substances\u0000such as LSD and inhalant use were also seen in the participants with higher levels\u0000of anxiety. The participants with low levels of depression were found to be at an\u0000increased odds of using sleep pills (OR=1.8) and alcohol (OR=1.3). In addition to\u0000this pattern of substance use, participants with higher levels of depression were\u0000also found to be heavy cocaine users, low inhalant users, heavy steroid users, and\u0000low alcohol users. A decrease in the use of homemade brews was seen in the\u0000participants with low and high levels of depression as compared to those who\u0000didn’t have any depressive symptoms.\u0000\u0000\u0000\u0000A unique pattern of drug and alcohol use was found in the\u0000participants experiencing varying levels of anxiety and depression.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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