Journal of Child and Adolescent Mental Health最新文献

Truancy among adolescents may negatively affect the achievement of academic goals. The aim of the study was to investigate the prevalence and correlates of school truancy in the Association of Southeast Asian Nations (ASEAN) member states. The analysis included 28 419 school children aged 13-15 years from seven ASEAN member states that participated in the Global School-based Student Health Survey (GSHS) between 2007 and 2013. The overall prevalence of past 30 day truancy across six ASEAN countries (excluding Brunei) was 24.8%; ranging from below 20% in Myanmar, Thailand, and Vietnam to more than 30% in Brunei Darussalam, Indonesia, and the Philippines. In multivariable logistic regression analysis, socio-demographic factors (older age, being male, the experience of hunger), externalising behaviour (tobacco use, alcohol use, having been in a physical fight, being bullied, having sustained an injury), and lack of protective social-familial factors (lack of peer support and lack of parental or guardian support) were found to be associated with truancy. High rates of truancy were found in ASEAN member states calling for interventions aimed to reduce truancy considering identified associated factors.

Objective: Chronic pain is common in paediatric populations and many patients do not respond to the currently available evidence-based treatments. Mindfulness-based interventions (MBIs) have a growing evidence-base in adults, but evidence is limited in youth with chronic pain.

Methods: We conducted an open-label pilot study to test the feasibility of an 8-week MBI for this population.

Results: Seven adolescents (age range 14-17; median age 15; six female) completed the intervention. There were no dropouts. Median class attendance was seven of eight total sessions (SD = 0.76). Only one (14.3%) participant reported not finding it useful; five (71.4%) reported that they would recommend it to a friend; and the remaining two (28.6%) reported "maybe". There was no worsening of internalizing symptoms. Secondary outcomes included significant reduction of pain intensity, which was maintained at three-month follow-up. Somatic symptoms and functional disability were both non-significantly lower immediately following the intervention; but were significantly improved at three-month follow-up.

Conclusion: An eight-week group MBI is a feasible intervention for adolescents with chronic pain, and warrants further investigation as a potential alternative to cognitive behavioural therapy in this population.

Objective: The phenomenon of street children in Egypt constitutes a public health concern. This study aimed to investigate the characteristics of institutionalised street children in Alexandria, to compare the prevalence of substance abuse and conduct disorder between street children and school children, and to identify predictors of these mental health outcomes among street children.

Methods: Institutionalised street children (n = 102) participated in a cross-sectional comparative study with a matched group of school children (n = 156). An interviewing questionnaire was used to assess demographic characteristics and substance use. Conduct disorder was measured using the Revised Ontario Child Health study scale.

Results: Poverty, family breakdown, and domestic violence were the main reasons for street children having left home. Street children recorded significantly higher rates of substance use (9.8%) and conduct disorder (35.3%) compared to school children. In street children, smoking was a significant predictor of substance use and conduct disorder. Other predictors of conduct disorder included physical illness and having 5 to 7 siblings.

Conclusion: Substance abuse and conduct disorder were present among institutionalised street children at higher rates than school children. Absence of basic life needs and disrupted families constituted the main reasons for leaving home. Interventions at the governmental and non-governmental levels are needed.

Objective: To determine levels and correlates of caregiver burden among caregivers of children and adolescents with psychiatric morbidity.

Method: Over a period of four months, a total of 252 caregivers of children and adolescents with psychiatric morbidity were recruited. Data on socio-demographic factors, psychiatric morbidity among caregivers, and level of caregiver burden was collected using a researcher-designed socio-demographic questionnaire, Mini International Neuropsychiatric Interview, and Zarit burden interview, respectively. Data was analysed using statistical package for social sciences (SPSS) version 21.

Results: Females (n = 211, 83.7%) and mothers (n = 182, 72.2%) accounted for the majority of the study participants. The majority of caregivers reported moderate to severe caregiver burden; (n = 100, 39.7%). Being single or separated (B = -6.91, p = 0.001, β = -0.18) and presence of psychiatric morbidity (B = 7.44, p = 0.009, β = 0.22) in the caregiver significantly contributed to the high levels of caregiver burden.

Conclusion: Caregivers of children and adolescents with psychiatric morbidity suffer high levels of caregiver burden. A multidisciplinary approach to management of children with psychiatric morbidity to address challenges faced by the caregivers may alleviate the burden; thereby improving clinical outcomes of children and adolescents with psychiatric morbidity.

Objective: Attention is a core process underlying competence in higher-order cognitive abilities. Previous research suggests that healthy children from low socioeconomic status (SES) backgrounds perform poorly, relative to those from higher SES backgrounds, on tasks assessing attentional abilities. In this pilot study, we investigated the effects of an attention-training intervention on task performance in low-SES children.

Method: We conducted a quasi-controlled trial with stratified randomisation, using a pre-test/ post-test design. Participants were low-SES children aged 7-13 years. Each was assigned to either an intervention group, a play control group, or a test-only control group (n = 5 per group). We implemented a ten-week manualised cognitive rehabilitation program, Pay Attention!, administering standardised tests of attention, working memory, and inhibition before and after the intervention. Between- and within-group analyses and Reliable Change Index statistics evaluated differences in scores from pre- to post-intervention.

Results: Analyses detected no notable between-group differences at either pre- or post-intervention testing. However, on tests of selective attention, attentional control, and inhibition, there were significant within-group and positive individual reliable changes exclusive to the intervention-group participants.

Conclusions: Given the variability in our findings, more research needs be conducted with a larger sample to determine, with greater rigour, the efficacy of the intervention within samples of healthy children from low-SES backgrounds.

Objective: The aim of this South African study was to explore parents' experiences of living with a child with attention deficit hyperactivity disorder (ADHD).

Methods: A qualitative research design was followed. Purposive sampling was used to select ten parents living with children diagnosed with ADHD receiving outpatient treatment at a psychiatric facility. Data, collected through unstructured individual interviews, were analysed using open coding. Measures to ensure trustworthiness and ethical research practices were applied.

Results: Five themes emerged: burden of care; emotional effects; social effects; impact of the educational challenges, and attempts to cope with the burden of care.

Conclusion: Parents living with a child with ADHD experience stress as they struggle to cope with the child's symptoms amidst the stigmatising attitudes from family and community members. Parents experience burdensome emotions and impaired social and occupational functioning. Health care practitioners need to take note of the challenges inherent to parenting a child with ADHD in order to provide multi-disciplinary interventions aimed at empowering and supporting parents.

Objective: Research on parental divorce suggests that the nature of the divorce process, as experienced by the child, is the most important factor in his or her post-divorce adjustment. Research regarding children's experiences of the divorce process has been limited and the adult perspective has dominated the discourse on divorce; only recently has research started to consider children's viewpoint. This article describes a narrative inquiry into the experiences and perceptions of parental divorce, of 9- to 10-year-old children. Its aim is to use children's stories of parental divorce to inform the practice of professionals working with such children.

Method: The research adopted a narrative paradigm. Unstructured interviews were conducted with five children whose parents were divorced. Data were analysed thematically.

Findings: Seven themes were identified. The first theme explored children's endeavours to describe and explain parental divorce. An additional six themes were developed around the types of stories children told of the divorce process. The seven themes were: (i) What is a divorcement; (ii) Stories of loss; (iii) Stories of gain; (iv) Stories of change; (v) Stories of stability; (vi) Healing stories; and (vii) Complicating stories.

Conclusion: On the basis of the narratives elicited from children on parental divorce, this article proposes several guidelines for professionals such as psychologists, registered counsellors, social workers, and teachers as well as parents in their possible interventions with children. Some guidelines may also be of use to family and maintenance courts, and the government departments of health and education.

The literature on suicide among the Chinese indicates that younger individuals from rural areas are at higher risk of suicide than their urban counterparts. While earlier studies have investigated the relationship between psychological health and major demographic variables, the relationship of psychological health as it relates to suicide by those from urban and rural areas have been rare. Studying the psychological health of college students from rural China in comparison with students who originate from urban areas may shed light on the mental health disparities of the two populations. This study examined the relationship of psychological health and rural/urban origins of college students in China. Data was obtained from 2 400 college students who completed a survey questionnaire while in attendance at a key university in Beijing China in 2013. Four standardised psychological health scales were administered to obtain measures of participants' self-esteem, depression, social support, and suicide ideation. Findings indicated that urban students had significantly higher scores than their rural counterparts on self-esteem and social support. However, there was no statistically significant difference between the groups on measures of depression and suicide ideation.

Background: Mental health problems of adolescents are underserved in low and middle-income countries where they account for a significant proportion of disease burden. Perinatally infected HIV-positive adolescents have a high prevalence of mental health disorders; however, little is known about those retained in care in South Africa.

Methods: HIV-positive adolescents aged 13-19 years (n = 343) accessing five paediatric antiretroviral clinics in Johannesburg were assessed using standardized measures for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidality. Descriptive and bivariate analyses were conducted on all variables using Statistica v13.

Results: Twenty-seven percent were symptomatic for depression, anxiety, or PTSD; 24% reported suicidality. Peer violence was significantly correlated to all mental health problems, as was hunger, being inappropriately touched, being hit, and being female. Those reporting sickness in the past year were more symptomatic. High exposure to violence was evident. Additionally, not feeling safe at home or in the community increased risk for all mental health disorders. Knowing one's HIV status was protective as was having dreams for the future.

Conclusion: HIV-positive adolescents accessing care demonstrated high levels of mental health problems that are largely unrecognized and could potentially be addressed within health systems. Mental health difficulties are driven by social challenges that require attention.

Objective: Young people who are victims of, or witnesses to, aggression are at increased risk of developing a psychological disorder and behaving aggressively themselves. The aim of this study was to report the prevalence of exposure to aggression in a sample of 1 770 students, aged 15-26 years recruited from technical colleges in Thailand.

Method: Self-report questionnaires were used to assess the prevalence rates for both experiencing aggression as a victim and for witnessing an aggressive incident. Logistic regression methods were then used to examine the possible association between acting aggressively and being a victim of, or a witness to, aggression.

Results: In the previous six months, over half of all students reported being yelled at and had witnessed friends being hit. Those students who reported 'being pushed' or 'being hit' themselves had higher levels of anger expression. Being an indirect victim and witnessing aggression were only weakly associated with anger expression.

Conclusions: Adolescents in Thailand experience high rates of victimisation and commonly witness aggression. Being personally victimised was shown to be significantly related to a subsequent expression of anger, suggesting that interventions to prevent direct confrontation may help to reduce the likelihood of victims becoming perpetrators.