Child and Adolescent Mental Health最新文献

Background: A growing body of evidence demonstrates that school-based mental health interventions may be potentially harmful. We define potential harm as any negative outcome or adverse event that could plausibly be linked to an intervention. In this scoping review, we examine three areas: the types of potential harms and adverse events reported in school-based mental health interventions; the subgroups of children and adolescents at heightened risk; and the proposed explanations for these potential harms.

Methods: We searched eight databases (1960-2023), performed an author search and hand-searched for published and unpublished studies that evaluated controlled trials of school-based group mental health interventions based on cognitive-behavioural therapy and/or mindfulness techniques, with the aim of reducing or preventing internalising symptoms or increasing wellbeing. Two independent raters screened studies for eligibility and assessed study quality using Cochrane tools. From eligible studies, we reviewed those that reported at least one negative outcome.

Results: Ten out of 112 (8.93%) interventions (described in 120 studies) reported at least one negative outcome such as a decrease in wellbeing or an increase in depression or anxiety. Three out of 112 interventions (2.68%) reported the occurrence of specific adverse events, none of which were linked to the intervention. Of the 15/120 studies rated as high quality (i.e. those with low risk of bias), 5/15 (33.33%) reported at least one negative outcome. Negative outcomes were found for a number of subgroups including individuals deemed at high risk of mental health problems, male participants, younger children and children eligible for free school meals. About half (54.5%) of the studies acknowledged that the content of the intervention itself might have led to the negative outcome.

Conclusion: To design and implement effective school-based mental health interventions, the issues of potential harm and their related measurement and reporting challenges must be addressed.

Background: War profoundly impacts adolescent development and may increase the likelihood of aggressive responses when such behavior is perceived as acceptable and accessible. War may, hence, exacerbate a form of interpersonal violence already prevalent among children and adolescents.

Methods: We conducted a comparative cross-sectional study 2 years after the Russian invasion of Eastern Ukraine in 2014 by comparing the prevalence of bullying victimization among adolescents aged 11-17 years (N = 2766) in two administrative regions with different levels of wartime traumatic stressor exposure.

Results: Female adolescents in the war-affected region were bullied more often compared to those in the non-affected region [65.3% vs. 56.3%, adjusted Odds Ratio (aOR) = 1.5, 95% CI 1.2-1.9]. For both boys and girls, symptoms of psychopathology were associated with bullying victimization often [girls: depression (aOR = 2.9, 95% CI 2.4-3.4); boys: depression (aOR = 3.3, 95% CI 2.6-4.1) and PTSD (aOR = 1.7, 95% CI 1.4-2.02)]. In the war-affected region, a dose-response relationship between bullying victimization often and war-event exposure was observed in both sexes [girls: 1-3 war-events (aOR = 1.4, 95% CI 0.7-2.6), 4-6 (aOR = 2.4, 95% CI 1.3-4.5) and ≥7 (aOR = 5.5, 95% CI 2.7-11.1); boys: 1-3 (aOR = 1.4, 95% CI 0.7-2.8), 4-6 (aOR = 3.2, 95% CI 1.7-6.3), and ≥7 (aOR = 6.8, 95% CI 3.1-14.8)].

Conclusions: War exposure was associated with bullying victimization, with girls being bullied more often than boys. Bullying victimization was linked to cumulative traumatic stressor exposure in the war-affected region for both sexes.

There is growing evidence about the positive impact of greenspaces on mental health and wellbeing. In their various forms, greenspaces such as parks, gardens, sports fields, and open spaces serve as crucial public amenities. This paper contributes to current debates on the mental health benefits of rural and urban environments by arguing for a nuanced and contextual understanding that goes beyond the urban-rural dichotomy, as access to these spaces has been shown to reduce stress and significantly improve mental wellbeing in both urban and rural settings. Through a critical examination of the literature, we focus on specific characteristics of greenspaces connected to mental health benefits. We then explore the ways in which specific urban environments and their qualities play crucial roles in mental health outcomes. The paper discusses the unique challenges and benefits of urban and rural greenspaces, emphasising the need for context-specific strategies. We argue that urban planning and policy must prioritise the quality of greenspaces, particularly in urban environments, to recognise them as fundamental public health infrastructure and maximise their mental health benefits.

Researchers and education leaders have suggested that universal school-based prevention programs could improve youth mental health at a population level, yet recent trials of universal school-based prevention programs (e.g., MYRIAD, CSC) found null or iatrogenic results. In this debate piece, we argue that these results must be contextualized alongside existing knowledge that universal programs are ideally implemented within multitiered systems, promoting student autonomy tends to promote uptake and adherence, and individual trials do not outweigh decades of academic and community expertise. We offer suggestions for moving forward in research on and implementation of universal school-based prevention programs.

Despite widespread research and academic pressures, mindfulness researchers have an ethical responsibility to take a careful and considered approach to their work, particularly when investigating the mental health of children. This Letter to the Editor addresses an earlier debate article published in the journal by further elaborating on the issues raised by a recent large trial of a mindfulness-informed school-based intervention, and the ethical implications for mindfulness research.

We have engaged in work that aligns with the call from Birrell et al. (Child and Adolescent Mental Health, 2024), particularly in terms of thinking about co-design with young people to develop new outcomes and targets of universal school-based interventions. We engaged young people in a Cochrane systematic review and co-designed the outcomes for this review. What emerged was the need for research led by young people to develop and evaluate innovative universal school-based interventions that focus on creating environments that build and support young people's ability to cope by expressing and managing emotions. Whole-of-school approaches that ensure compassionate and caring responses can support the development of coping skills to manage distress, mental illness, self-harm and suicidal ideation.

The manosphere is an international network of social media influencers and communities promoting male supremacy and antifeminist ideologies. Young men are engaging with this extremist content at high rates. Despite growing concerns among educators, policymakers and researchers, systematic data on the long-term impact of the manosphere on young people's mental health and behaviour remains limited. However, preliminary data suggest that the manosphere is encouraging sexist attitudes, exacerbating existing inequalities in schools, and spreading dangerous messages about mental health. We discuss the current state of research, highlight the challenges of measuring engagement with online misogyny, and propose priorities for future work. Our commentary underscores the urgent need for multilevel interventions to counteract the negative effects of the manosphere on the attitudes of young men, and their downstream consequences for the mental health and well-being of women and girls.

Universal school-based mental health interventions present a promising approach to addressing youth mental health challenges; however, evidence suggests their effectiveness is often limited and unsustained. One contributing factor to this issue is the frequent superficial involvement of students in the design, implementation and evaluation of initiatives. In response, this paper advocates for the urgent prioritisation of student voice within these programmes, using in-depth and purposive qualitative approaches that empower youth to actively co-create and shape interventions. Research highlights that incorporating student voice can yield vital insights into what is effective and ineffective in programmes, particularly for marginalised groups. Moreover, engaging students in co-designing methodologies that help amplify their voices ensures research processes are better aligned with their needs and preferences, fostering greater ownership and improved outcomes. This shift, which repositions students as active collaborators rather than passive recipients, has the potential to enhance both the effectiveness and equity of initiatives.