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Marquez J, Humphrey N, Black L, Wozmirska S. This is the place: a multi-level analysis of neighbourhood correlates of adolescent wellbeing. Soc Psychiatry Psychiatr Epidemiol 2024; 59:929-946. [PMID: 37606648 PMCID: PMC11116214 DOI: 10.1007/s00127-023-02531-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE Adolescent wellbeing is a key research and policy priority, but little is known about neighbourhood-level influences. This study examined the extent to which adolescents' life satisfaction and internalising symptoms vary between neighbourhoods, and which neighbourhood characteristics are associated with individual outcomes. METHOD Baseline data from the #BeeWell cohort study in Greater Manchester (England) including 35,902 adolescents (aged 12-15) across 243 neighbourhoods were linked to neighbourhood characteristics (e.g. access to education and health services, leisure facilities) from the Co-op's Community Wellbeing Index and analysed using multi-level regression. RESULTS Neighbourhoods explained 0.61% and 1.17% of the variation in life satisfaction and internalising symptoms, respectively. Socio-demographic inequalities in these outcomes varied across neighbourhoods. Several neighbourhood characteristics were associated with wellbeing, but differences across model specifications were observed (e.g. adjusted vs unadjusted; unique associations vs grouped domains). However, higher levels of perceived wellbeing support from local people were associated with lower internalising symptoms in all models. Other characteristics associated with better wellbeing outcomes in various models included lower GP antidepressant prescription rates, and better access to health services, areas for leisure, and good places to spend free time. CONCLUSION Neighbourhoods account for a small but significant proportion of the variance in adolescent life satisfaction and internalising symptoms. Some neighbourhood characteristics (notably neighbourhood social capital) are associated with these outcomes at the individual level, and disparities in these outcomes for some groups vary across neighbourhoods. Our findings speak to the role of place as a determinant of adolescent wellbeing, with consequent implications for intervention.
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Zhang P, Huang N, Yang F, Yan W, Zhang B, Liu X, Peng K, Guo J. Determinants of depressive symptoms at individual, school and province levels: a national survey of 398,520 Chinese children and adolescents. Public Health 2024; 229:33-41. [PMID: 38394705 DOI: 10.1016/j.puhe.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/06/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES The aims of this study were to describe the national distribution of depressive symptoms in Chinese children and adolescents, to examine the determinants of depressive symptoms at individual, school and province levels and to assess the gender and age differences in the effect of school factors on depressive symptoms. STUDY DESIGN This was a national cross-sectional study. METHODS A school-based online survey was conducted in mainland China from between December 1, 2021, and January 1, 2022. A total of 398,520 eligible participants were included in the analysis. School-level data were drawn from students, headteachers and Baidu Maps, and province-level data were obtained from the national human development report. The Patient Health Questionnaire-2 was used to measure depressive symptoms. RESULTS Areas with the highest mean scores for depressive symptoms were in the northeastern, inner central and southwestern regions of China. At the individual level, younger age, male sex, being an only child, Han ethnicity, lower body mass index, more days of exercise, less drinking and smoking behaviours, higher subjective family socio-economic status (SES) and popularity in school were related to fewer depressive symptoms; however, objective family SES and maternal education were not related to fewer depressive symptoms. The school-level variables of public status, psychological activities and psychological courses and province-level variable of higher Human Development Index were associated with fewer depressive symptoms. The effect of psychological courses and activities on depressive symptoms was greater in females. CONCLUSIONS The results showed multilevel factors related to depressive symptoms and emphasised the importance of implementing school-based psychological activities to ameliorate depressive symptoms in Chinese children and adolescents across age and gender.
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Affiliation(s)
- P Zhang
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - N Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - F Yang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - W Yan
- Department of Psychology, Tsinghua University, Beijing 100084, China.
| | - B Zhang
- Department of Neurology, Boston Children's Hospital, Boston, MA 02215, United States
| | - X Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - K Peng
- Department of Psychology, Tsinghua University, Beijing 100084, China
| | - J Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China.
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Halladay J, MacKillop J, Acuff S, Amlung M, Munn C, Georgiades K. Early substance use and the school environment: A multilevel latent class analysis. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2024; 33:33-56. [PMID: 38449719 PMCID: PMC10914148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background Early substance use is associated with increased risks for mental health and substance use problems which are compounded when using several substances (i.e., polysubstance use). A notable increase in substance use occurs when adolescents transition from elementary to secondary schooling. Objective This study seeks to characterize student and school classes of substance use. Methods A cross-sectional multilevel latent class analysis and regression was conducted on a representative sample of 19,130 grade 6-8 students from 180 elementary schools in Ontario, Canada to: 1) identify distinct classes of student substance use; 2) identify classes of schools based on student classes; and 3) explore correlates of these classes, including mental health, school climate, belonging, safety, and extracurricular participation. Results Two student and two school classes were identified. 4.1% of students were assigned to the high probability of early polysubstance use class while the remaining 95.9% were in the low probability class. Students experiencing depressive and externalizing symptoms had higher odds of being in the early polysubstance use class (Odds Ratio [OR]s=1.1-1.25). At the school level, 19% of schools had higher proportions of students endorsing polysubstance use. Perceptions of positive school climate, belonging, and safety increased the odds of students being in the low probability of early polysubstance use student-level class (ORs=0.85-0.93) and lower probability of early polysubstance use school-level class. Associations related to extracurricular participation were largely not statistically significant. Conclusions Student and school substance use classes may serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown NSW, Australia
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Samuel Acuff
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, Lawrence, Kansas, United States
| | - Catharine Munn
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
- Offord Centre for Child Studies, McMaster University, Ron Joyce Children's Health Centre, Hamilton, Ontario
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Hinze V, Montero-Marin J, Blakemore SJ, Byford S, Dalgleish T, Degli Esposti M, Greenberg MT, Jones BG, Slaghekke Y, Ukoumunne OC, Viner RM, Williams JMG, Ford TJ, Kuyken W. Student- and School-Level Factors Associated With Mental Health and Well-Being in Early Adolescence. J Am Acad Child Adolesc Psychiatry 2024; 63:266-282. [PMID: 37866473 PMCID: PMC10935542 DOI: 10.1016/j.jaac.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/28/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Adolescence is a key developmental window that may determine long-term mental health. As schools may influence mental health of students, this study aimed to examine the association of school-level characteristics with students' mental health over time. METHOD Longitudinal data from a cluster randomized controlled trial comprising 8,376 students (55% female; aged 11-14 years at baseline) across 84 schools in the United Kingdom were analyzed. Data collection started in the academic years 2016/2017 (cohort 1) and 2017/2018 (cohort 2), with follow-up at 1, 1.5, and 2 years. Students' mental health (risk for depression [Center for Epidemiologic Studies Depression Scale], social-emotional-behavioral difficulties [Strength and Difficulties Questionnaire]) and well-being (Warwick-Edinburgh Mental Well-Being Scale) and relationships with student- and school-level characteristics were explored using multilevel regression models. RESULTS Mental health difficulties and poorer well-being increased over time, particularly in girls. Differences among schools represented a small but statistically significant proportion of variation (95% CI) in students' mental health at each time point: depression, 1.7% (0.9%-2.5%) to 2.5% (1.6%-3.4%); social-emotional-behavioral difficulties, 1.9% (1.1%-2.7%) to 2.8% (2.1%-3.5%); and well-being, 1.8% (0.9%-2.7%) to 2.2% (1.4%-3.0%). Better student-rated school climate analyzed as a time-varying factor at the student and school level was associated with lower risk of depression (regression coefficient [95%CI] student level: -4.25 [-4.48, -4.01]; school level: -4.28 [-5.81, -2.75]), fewer social-emotional-behavioral difficulties (student level: -2.46 [-2.57, -2.35]; school level: -2.36 [-3.08, -1.63]), and higher well-being (student level: 3.88 [3.70, 4.05]; school-level: 4.28 [3.17, 5.38]), which was a stable relationship. CONCLUSION Student-rated school climate predicted mental health in early adolescence. Policy and system interventions that focus on school climate may promote students' mental health.
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Affiliation(s)
| | - Jesus Montero-Marin
- University of Oxford, Oxford, United Kingdom; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain, and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Sarah-Jayne Blakemore
- University of Cambridge, Cambridge, United Kingdom; University College London, London, United Kingdom
| | | | - Tim Dalgleish
- University of Cambridge, Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Michelle Degli Esposti
- University of Oxford, Oxford, United Kingdom; Federal University of Pelotas, Pelotas, Brazil
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Lewer D, Gilbody S, Lewis G, Pryce J, Santorelli G, Wadman R, Watmuff A, Wright J. How do schools influence the emotional and behavioural health of their pupils? A multi-level analysis of 135 schools in the Born in Bradford inner city multi-ethnic birth cohort. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02608-8. [PMID: 38195962 DOI: 10.1007/s00127-023-02608-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE To estimate variation in emotional and behavioural problems between primary schools in Bradford, an ethnically diverse and relatively deprived city in the UK. METHODS We did a cross-sectional analysis of data collected from 2017 to 2021 as part of the 'Born In Bradford' birth cohort study. We used multilevel linear regression in which the dependent variable was the Strengths and Difficulties Questionnaire (SDQ) total score, with a random intercept for schools. We adjusted for pupil-level characteristics including age, ethnicity, socioeconomic status, and parental mental health. RESULTS The study included 5,036 participants from 135 schools. Participants were aged 7-11 years and 56% were of Pakistani heritage. The mean SDQ score was 8.84 out of a maximum 40. We estimated that the standard deviation in school-level scores was 1.41 (95% CI 1.11-1.74) and 5.49% (95% CI 3.19-9.37%) of variation was explained at school level. After adjusting for pupil characteristics, the standard deviation of school-level scores was 1.04 (95% CI 0.76-1.32) and 3.51% (95% CI 1.75-6.18%) of variation was explained at school level. Simulation suggested that a primary school with 396 pupils at the middle of the distribution has 63 pupils (95% CI 49-78) with a 'raised' SDQ score of 15 + /40; and shifting a school from the lower to the upper quartile would prevent 26 cases (95% CI 5-46). CONCLUSION The prevalence of emotional and behavioural problems varies between schools. This is partially explained by pupil characteristics; though residual variation in adjusted scores may suggest that schools have a differential impact on mental wellbeing.
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Affiliation(s)
- Dan Lewer
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department for Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Simon Gilbody
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Health Sciences, University of York, York, YO10 5DD, UK
- Hull York Medical School, University of York, York, YO10 5DD, UK
| | - Gemma Lewis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Joseph Pryce
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Ruth Wadman
- Department of Health Sciences, University of York, York, YO10 5DD, UK.
| | - Aidan Watmuff
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK
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Durbeej N, Ssegonja R, Salari R, Dahlberg A, Fabian H, Sarkadi A. Preschool-level socio-economic deprivation in relation to emotional and behavioural problems among preschool children in Sweden. Scand J Public Health 2024:14034948231218040. [PMID: 38166546 DOI: 10.1177/14034948231218040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
AIMS The aim of this study was to explore the association between preschool-level socio-economic deprivation and emotional and behavioural problems among preschool children in Sweden using a multilevel approach. METHODS In this cross-sectional study, we used data on 2267 children whose parents and preschool teachers had responded to items measuring individual-level socio-economic deprivation and the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioural problems. Further, the Socioeconomic Structure Compensation Index (SSCI), collected from Uppsala municipality, was used to assess preschool-level socio-economic deprivation. Unadjusted and adjusted multilevel logistic regression models were used to explore the relations between preschool-level socio-economic deprivation and emotional and behavioural problems. RESULTS In unadjusted models, children who attended preschools classified as highly deprived had elevated odds for emotional symptoms (odds ratio (OR) 1.71) as rated by parents. However, this association did not remain significant after adjusting for individual-level socio-economic deprivation factors. In both unadjusted and adjusted models, children who attended preschools classified as moderately deprived had elevated odds for peer-relationship problems as rated by parents (OR 1.63; adjusted OR 1.48). There were no significant associations between preschool deprivation and emotional and behavioural problems as rated by preschool teachers. CONCLUSIONS Swedish preschools may have a compensatory capacity in addressing children's emotional and behavioural problems, whereas preschool-level deprivation remained significantly associated with peer-relationship problems after controlling for individual-level socio-economic deprivation factors. This implies that peer-relationship problems in deprived preschools need to be addressed in a broader community context.
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Affiliation(s)
- Natalie Durbeej
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Richard Ssegonja
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
- Respiratory, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, Sweden
| | - Raziye Salari
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anton Dahlberg
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Helena Fabian
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Sweden
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Halladay J, Ogrodnik M, Farag Alla J, Sunderland M, Gardner LA, Georgiades K. Playing for more than winning: Exploring sports participation, physical activity, and belongingness and their relationship with patterns of adolescent substance use and mental health. Drug Alcohol Depend 2024; 254:111039. [PMID: 38043225 DOI: 10.1016/j.drugalcdep.2023.111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Promoting adolescent sports participation and physical activity may be effective low-barrier prevention strategies for co-occurring adolescent substance use (SU) and mental health symptoms (MH). The objectives of this study were to: 1) explore associations between profiles of SU/MH and sports participation; and 2) determine whether physical activity and belongingness account for these associations. METHODS Data came from a representative sample of 11,994 grade 9-12 Ontarian students (ages ~14-18) previously grouped into five SU/MH profiles based on patterns of use and symptoms. A series of multinomial logistic regressions, adjusted for socio-demographics and school clustering, were used to predict the risks of students belonging to SU/MH profiles based on: 1) school sports participation (>=weekly), 2) sports and physical activity (>=60minutes; 0-7 days), and 3) sports, physical activity, and school belongingness. RESULTS Greater school sports participation, physical activity, and belongingness were each associated with reduced risks of belonging to most profiles with elevations in SU and/or MH symptoms relative to the low SU/MH profile (Relative Risk Ratios: sports=0.62-0.87, physical activity=0.78-0.98, belonging=0.75-0.83). Frequency of physical activity accounted for ~32-60% of the associations between sports and SU/MH profiles, while school belongingness accounted for the remaining associations. Physical activity and belongingness remained independently associated with SU/MH profiles. CONCLUSIONS Findings suggest possible indirect associations between school sports participation and SU/MH profiles through physical activity and school belongingness, which may be promising prevention targets that have independent associations over and above sports. School sports participation may be one of a number of ways to achieve these goals.
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Affiliation(s)
- J Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia.
| | - M Ogrodnik
- Department of Kinesiology and Health Sciences, University of Waterloo, Canada
| | - J Farag Alla
- Offord Centre for Child Studies, McMaster University, Canada
| | - M Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - L A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - K Georgiades
- Offord Centre for Child Studies, McMaster University, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
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Montero-Marin J, Hinze V, Crane C, Dalrymple N, Kempnich MEJ, Lord L, Slaghekke Y, Tudor K, Byford S, Dalgleish T, Ford TJ, Greenberg MT, Ukoumunne OC, Williams JMG, Kuyken W. Do Adolescents Like School-Based Mindfulness Training? Predictors of Mindfulness Practice and Responsiveness in the MYRIAD Trial. J Am Acad Child Adolesc Psychiatry 2023; 62:1256-1269. [PMID: 37236303 PMCID: PMC10935541 DOI: 10.1016/j.jaac.2023.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/30/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE We explored what predicts secondary school students' mindfulness practice and responsiveness to universal school-based mindfulness training (SBMT), and how students experience SBMT. METHOD A mixed-methods design was used. Participants were 4,232 students (11-13 years of age), in 43 UK secondary schools, who received universal SBMT (ie, ".b" program), within the MYRIAD trial (ISRCTN86619085). Following previous research, student, teacher, school, and implementation factors were evaluated as potential predictors of students' out-of-school mindfulness practice and responsiveness (ie, interest in and attitudes toward SBMT), using mixed-effects linear regression. We explored pupils' SBMT experiences using thematic content analysis of their answers to 2 free-response questions, 1 question focused on positive experiences and 1 question on difficulties/challenges. RESULTS Students reported practicing out-of-school mindfulness exercises on average once during the intervention (mean [SD] = 1.16 [1.07]; range, 0-5). Students' average ratings of responsiveness were intermediate (mean [SD] = 4.72 [2.88]; range, 0-10). Girls reported more responsiveness. High risk of mental health problems was associated with lower responsiveness. Asian ethnicity and higher school-level economic deprivation were related to greater responsiveness. More SBMT sessions and better quality of delivery were associated with both greater mindfulness practice and responsiveness. In terms of students' experiences of SBMT, the most frequent themes (60% of the minimally elaborated responses) were an increased awareness of bodily feelings/sensations and increased ability to regulate emotions. CONCLUSION Most students did not engage with mindfulness practice. Although responsiveness to the SMBT was intermediate on average, there was substantial variation, with some youth rating it negatively and others rating it positively. Future SBMT developers should consider co-designing curricula with students, carefully assessing the student characteristics, aspects of the school environment, and implementation factors associated with mindfulness practice and responsiveness. SBMT teacher training is key, as more observed proficiency in SBMT teaching is associated with greater student mindfulness practice and responsiveness to SBMT.
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Affiliation(s)
- Jesus Montero-Marin
- University of Oxford, Oxford, United Kingdom; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), Spain
| | | | | | | | | | - Liz Lord
- University of Oxford, Oxford, United Kingdom
| | | | - Kate Tudor
- University of Oxford, Oxford, United Kingdom
| | - Sarah Byford
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), Spain
| | - Tim Dalgleish
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, United Kingdom
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Montero-Marin J, Hinze V, Mansfield K, Slaghekke Y, Blakemore SJ, Byford S, Dalgleish T, Greenberg MT, Viner RM, Ukoumunne OC, Ford T, Kuyken W. Young People's Mental Health Changes, Risk, and Resilience During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2335016. [PMID: 37733343 PMCID: PMC10514742 DOI: 10.1001/jamanetworkopen.2023.35016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
Importance As young people's mental health difficulties increase, understanding risk and resilience factors under challenging circumstances becomes critical. Objective To explore the outcomes of the COVID-19 pandemic on secondary school students' mental health difficulties, as well as the associations with individual, family, friendship, and school characteristics. Design, Setting, and Participants For this cohort study, follow-up data from the My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial were collected across 2 representative UK cohorts. Mainstream UK secondary schools with a strategy and structure to deliver social-emotional learning, with an appointed head teacher, and that were not rated "inadequate" in their latest official inspection were recruited. A total of 5663 schools were approached, 532 showed interest, and 84 consented. Cohort 1 included 12 schools and 864 students, and cohort 2 included 72 schools and 6386 students. COVID-19 was declared a pandemic after cohort 1 had completed all assessments (September 2018 to January 2020), but cohort 2 had not (September 2019 to June 2021). Exposures Cohort 2 was exposed to the COVID-19 pandemic, including 3 national lockdowns. Associations of individual, family, friendship, and school characteristics with students' mental health were explored. Main Outcomes and Measures Changes in students' risk for depression (Center for Epidemiological Studies-Depression scale); social, emotional, and behavioral difficulties (Strengths and Difficulties Questionnaire); and mental well-being (Warwick-Edinburgh Mental Well-Being Scale). Results Of the 7250 participants included, the mean (SD) age was 13.7 (0.6) years, 3947 (55.4%) identified as female, and 5378 (73.1%) self-reported their race as White. Twelve schools and 769 of the 864 students (89.0%) in cohort 1 and 54 schools and 2958 of the 6386 students (46.3%) in cohort 2 provided data and were analyzed. Mental health difficulties increased in both cohorts but to a greater extent among students exposed to the pandemic, including for risk of depression (adjusted mean difference [AMD], 1.91; 95% CI, 1.07-2.76); social, emotional, and behavioral difficulties (AMD, 0.76; 95% CI, 0.33-1.18); and mental well-being (AMD, -2.08; 95% CI, -2.80 to -1.36). Positive school climate, high home connectedness, and having a friend during lockdown were protective factors during the pandemic. Female gender and initial low risk for mental health difficulties were associated with greater mental health deteriorations. Partial school attendance during lockdown was associated with better adjustment than no attendance when returning to school. Conclusions and Relevance This cohort study of secondary school students demonstrated that to promote mental health and adjustment, policy interventions should foster home connectedness, peer friendship, and school climate; avoid full school closures; and consider individual differences.
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Affiliation(s)
- Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain
| | - Verena Hinze
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Karen Mansfield
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Yasmijn Slaghekke
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
| | - Sarah-Jayne Blakemore
- Department of Psychology, University of Cambridge, Cambridge, England, United Kingdom
| | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King’s Health Economics, King’s College London, London, England, United Kingdom
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, England, United Kingdom
| | - Mark T. Greenberg
- Edna Bennett Pierce Prevention Research Center, College of Health and Human Development, Pennsylvania State University, State College, Pennsylvania
| | - Russell M. Viner
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, England, United Kingdom
| | - Obioha C. Ukoumunne
- National Institute for Health and Care Research Applied Research Collaboration (PenARC) South West Peninsula, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, England, United Kingdom
| | - Tamsin Ford
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, England, United Kingdom
| | - Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, England, United Kingdom
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Panayiotou M, Finning K, Hennessey A, Ford T, Humphrey N. Longitudinal pathways between emotional difficulties and school absenteeism in middle childhood: Evidence from developmental cascades. Dev Psychopathol 2023; 35:1323-1334. [PMID: 34955109 DOI: 10.1017/s095457942100122x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emotional difficulties are associated with both authorized and unauthorized school absence, but there has been little longitudinal research and the temporal nature of these associations remains unclear. This study presents three-wave random-intercepts panel models of longitudinal reciprocal relationships between teacher-reported emotional difficulties and authorized and unauthorized school absence in 2,542 English children aged 6 to 9 years old at baseline, who were followed-up annually. Minor differences in the stability effects were observed between genders but only for the authorized absence model. Across all time points, children with greater emotional difficulties had more absences, and vice versa (authorized: ρ = .23-.29, p < .01; unauthorized: ρ = .28, p < .01). At the within-person level, concurrent associations showed that emotional difficulties were associated with greater authorized (β = .15-.17, p < .01) absence at Time 3 only, but with less unauthorized (β = -.08-.13, p < .05) absence at Times 1 and 2. In cross-lagged pathways, neither authorized nor unauthorized absence predicted later emotional difficulties, and emotional difficulties did not predict later authorized absence at any time point. However, greater emotional difficulties were associated with fewer unauthorized absences across time (β = -13-.22, p < .001). The implications of these findings are discussed.
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Affiliation(s)
| | | | | | | | - Neil Humphrey
- University of Manchester, Manchester Institute of Education, Manchester, UK
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11
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Granada-López JM, Ramón-Arbués E, Echániz-Serrano E, Juárez-Vela R, Cobos-Rincón A, Satústegui-Dordá PJ, Navas-Echazarreta N, Santolalla-Arnedo I, Nash M. Mental health knowledge and classroom experiences of school teachers in Aragon, Spain. Front Public Health 2023; 11:1171994. [PMID: 37441655 PMCID: PMC10335789 DOI: 10.3389/fpubh.2023.1171994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Background Research shows that many mental disorders begin in childhood but are sometimes not diagnosed until later years. School-age children spend much of their time in schools and have daily interactions with school teachers. Aim Examine school teachers' experiences of mental disorders in school going children and adolescents and their associated mental health training needs. Method and sample A descriptive cross-sectional study was carried out with teachers in Infant-Primary and Secondary Education-Baccalaureate schools. Results A convenience sample of 685 teachers responded to the online survey. Participants worked in both urban and rural areas and in Infant-Primary and Secondary Education-Baccalaureate schools. Over half of participants reported classroom experiences of learner mental disorders such as ADHD, anxiety, conduct disorders or autism. Most participants acknowledged a training need, both in recognition of symptoms of mental disorders and in care resources and processes. However, 80% of respondents reported having not received any training in this regard. Participant preferences for training included face-to-face or hybrid - combined online learning. Participants also considered the management of their own mental health to be deficient, therefore any training should incorporate personal mental health awareness and self-help strategies. Conclusion In Aragón (Spain), teachers of children and adolescents with mental disorders, recognize a need for training in the identification of symptoms and other aspects of mental healthcare, such as availability and access to services. Protocols for early identification and referral would promote mentally healthy school environments and reduce stigma which could be a barrier to timely intervention. In addition, any training should include mental health self-care for teachers.
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Affiliation(s)
- José Manuel Granada-López
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group GIISA021, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Enrique Ramón-Arbués
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
- Faculty of Health Sciences, University San Jorge, Zaragoza, Spain
| | - Emmanuel Echániz-Serrano
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Pedro José Satústegui-Dordá
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Research Group SAPIENF (B53_23R), University of Zaragoza, Zaragoza, Spain
| | - Noelia Navas-Echazarreta
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Iván Santolalla-Arnedo
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Michael Nash
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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12
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Okobi OE, Egbujo U, Darke J, Odega AS, Okereke OP, Adisa OT, Salawu MA, Kimble R. Association of Bullying Victimization With Suicide Ideation and Attempt Among School-Going Adolescents in Post-conflict Liberia: Findings From the Global School-Based Health Survey. Cureus 2023; 15:e40077. [PMID: 37425537 PMCID: PMC10326865 DOI: 10.7759/cureus.40077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background School-based bullying is a global problem that negatively impacts the victims' and perpetrators' health and well-being. There is a paucity of data regarding bullying in schools and its association with suicide behaviors among adolescents in Liberia. Objective The study investigated the impact of bullying victimization on suicidal thoughts and suicide attempts among adolescents in Liberia. It aimed to provide insights into the consequences of bullying victimization on adolescents' mental health regarding their thoughts of self-harm and suicide attempts. Methods The study utilized data from the 2017 Liberia Global School-based Health Survey (GSHS) to analyze information on 2744 students between the ages of 11 and 18 years, with 52.4% being males. Prevalence rates of bullying victimization and suicide behaviors were calculated using descriptive statistics. Multiple logistic regressions were used to model the relationship between being bullied and experiencing suicidal behaviors (ideation and attempts). Results Among the 2744 adolescents examined, 20% experienced suicidal thoughts, with about 30% of the adolescents reporting suicide attempts at some point in the year preceding the survey. Within 30 days prior to the survey, the prevalence of bullying victimization was 50%, with 44.9% experiencing frequent victimization (3 or more days). Bullying victimization was significantly linked to increased odds of suicidal ideation with planning (aOR: 1.86; P < 0.001), at least a suicide attempt (aOR: 2.16; P < 0.001), and multiple attempts at suicide (aOR: 2.67; P < 0.001). We also observed that a greater number of days bullied was dose-dependently associated with higher odds for suicide ideation and attempts. Conclusion These findings support and extend those from other developing countries, highlighting the association between school-based bullying and suicidal behaviors. The relatively high prevalence of bullying among adolescents in Liberia underscores the importance of implementing effective anti-bullying policies and suicide prevention strategies in schools.
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Affiliation(s)
- Okelue E Okobi
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Uzoamaka Egbujo
- Internal Medicine, Lagos University Teaching Hospital, Lagos, NGA
| | - Jennifer Darke
- Education, Institute for Teacher Education and Continuing Professional Development (ITECPD), Kumasi, GHA
- Education, University of Education, Winneba, Kumasi, GHA
| | - Amaka S Odega
- Community and Family Medicine, Windsor University School of Medicine, Basseterre, KNA
- Public Health, University of South Wales, Cardiff, GBR
- Family Medicine, Olabisi Onabanjo University, Sagamu, NGA
- Psychiatry, PsycIME, London, CAN
| | | | - Olufunmilola T Adisa
- Internal Medicine and Psychiatry, Lagos State University College of Medicine, Lagos, NGA
| | - Mujeeb A Salawu
- Medicine and Surgery, University of Ilorin College of Health Sciences, Ilorin, NGA
- Internal Medicine and Psychiatry, Houston Health department, Houston, USA
| | - Rita Kimble
- Research and Development, University of Maryland, Laurel, USA
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13
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Kuyken W, Blakemore SJ, Byford S, Dalgleish T, Ford T, Hinze V, Mansfield K, Montero-Marin J, Ukoumunne OC, Viner RM. Mental health in adolescence: the role of schools-based social emotional teaching. J Ment Health 2023; 32:537-540. [PMID: 37226816 DOI: 10.1080/09638237.2023.2210668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/23/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Sarah-Jayne Blakemore
- Department of Psychology, University of Cambridge, Cambridge, UK
- UCL Institute of Cognitive Neuroscience, London, UK
| | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, King's Health Economics, London, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Cambridge, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Verena Hinze
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Karen Mansfield
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain
| | - Obioha C Ukoumunne
- Department of Health and Community Sciences, Faculty of Health and Life Sciences, NIHR Applied Research Collaboration South-West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Russell M Viner
- Population, Policy & Practice Research Programme, UCL Great Ormond St. Institute of Child Health, London, UK
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14
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Goodfellow C, Willis M, Inchley J, Kharicha K, Leyland AH, Qualter P, Simpson S, Long E. Mental health and loneliness in Scottish schools: A multilevel analysis of data from the health behaviour in school-aged children study. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2023; 93:608-625. [PMID: 36683467 PMCID: PMC10952245 DOI: 10.1111/bjep.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 12/26/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood. AIMS Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health. SAMPLE Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286). METHODS Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation. RESULTS Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores. CONCLUSIONS The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.
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Affiliation(s)
- Claire Goodfellow
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Kalpa Kharicha
- Campaign to End Loneliness part of What Works Centre for WellbeingLondonUK
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Pamela Qualter
- Manchester Institute of EducationUniversity of ManchesterManchesterUK
| | - Sharon Simpson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Emily Long
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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15
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Rakesh D, Zalesky A, Whittle S. The Role of School Environment in Brain Structure, Connectivity, and Mental Health in Children: A Multimodal Investigation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:32-41. [PMID: 35123109 DOI: 10.1016/j.bpsc.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/05/2022] [Accepted: 01/20/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Much work has been dedicated to understanding the effects of adverse home environments on brain development. While the school social and learning environment plays a role in child development, little work has been done to investigate the impact of the school environment on the developing brain. The goal of the present study was to examine associations between the school environment, brain structure and connectivity, and mental health. METHODS In this preregistered study we investigated these questions in a large sample of adolescents (9-10 years of age) from the Adolescent Brain Cognitive Development (ABCD) Study. We examined the association between school environment and gray matter (n = 10,435) and white matter (n = 10,770) structure and functional connectivity (n = 9528). We then investigated multivariate relationships between school-associated brain measures and mental health. RESULTS School environment was associated with connectivity of the auditory and retrosplenial temporal network as well as of higher-order cognitive networks like the cingulo-opercular, default mode, ventral attention, and frontoparietal networks. Multivariate analyses revealed that connectivity of the cingulo-opercular and default mode networks was also associated with mental health. CONCLUSIONS Findings shed light on the neural mechanisms through which favorable school environments may contribute to positive mental health outcomes in children. Our findings have implications for interventions targeted at promoting positive youth functioning through improving school environments.
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Affiliation(s)
- Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia.
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia.
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16
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Copeland JN, Babyak M, Inscoe AB, Maslow GR. Seasonality of Pediatric Mental Health Emergency Department Visits, School, and COVID-19. Pediatr Emerg Care 2022; 38:e1673-e1677. [PMID: 35319855 PMCID: PMC9722329 DOI: 10.1097/pec.0000000000002671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to explore how the academic calendar, and by extension school-year stressors, contributes to the seasonality of pediatric mental health emergency department (ED) visits. METHODS The authors reviewed all pediatric mental health ED visits at a large urban medical center from 2014 to 2019. Patients who were younger than 18 years at time of presentation, were Durham residents, and had a primary payer of Medicaid were included in the sample population, and the dates of ED visits of the sample population were compared against dates of academic semesters and summer/winter breaks of a relevant school calendar. Of patients with multiple ED visits, only the first ED presentation was included, and descriptive statistics and a rate ratio were used to describe the study group and identify the rate of ED visits during semesters compared with breaks. RESULTS Among the sample population from 2014 to 2019, there were 1004 first pediatric mental health ED visits. Of these ED visits, the average number of visits per week during summer/winter breaks was 2.2, and the average number of visits per week during academic semester dates was 3.4. The rate of ED visits was significantly greater during academic semesters compared with breaks (Rate Ratio, 1.6; 95% confidence interval, 1.4-2.0; P < 0.001). CONCLUSIONS Children may be at greater risk of behavioral health crises or having increased mental needs when school is in session. As many children's mental health has worsened during the COVID-19 (coronavirus disease 2019) pandemic, these findings highlight the need for increased mental health services in the school setting as children return to in-person learning. In addition, it may benefit health systems to plan behavioral health staffing around academic calendars.
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17
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Halladay J, MacKillop J, Munn C, Amlung M, Georgiades K. Individual- and school-level patterns of substance use and mental health symptoms in a population-based sample of secondary students: A multilevel latent profile analysis. Drug Alcohol Depend 2022; 240:109647. [PMID: 36244138 DOI: 10.1016/j.drugalcdep.2022.109647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions. METHODS A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety. RESULTS Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types. CONCLUSIONS The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
| | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7.
| | - Michael Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, the United States of America.
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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18
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Sohn E. Tackling the mental-health crisis in young people. Nature 2022; 608:S39-S41. [DOI: 10.1038/d41586-022-02206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Lin Q, Abbey C, Zhang Y, Wang G, Lu J, Dill SE, Jiang Q, Singh MK, She X, Wang H, Rozelle S, Jiang F. Association between mental health and executive dysfunction and the moderating effect of urban-rural subpopulation in general adolescents from Shangrao, China: a population-based cross-sectional study. BMJ Open 2022; 12:e060270. [PMID: 35998954 PMCID: PMC9403159 DOI: 10.1136/bmjopen-2021-060270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To examine the association between mental health and executive dysfunction in general adolescents, and to identify whether home residence and school location would moderate that association. DESIGN A population-based cross-sectional study. SETTING A subsample of the Shanghai Children's Health, Education, and Lifestyle Evaluation-Adolescents project. 16 sampled schools in Shangrao city located in downstream Yangtze River in southeast China (December 2018). PARTICIPANTS 1895 adolescents (48.8% male) which were divided into three subpopulations: (A) adolescents who have urban hukou (ie, household registration in China) and attend urban schools (UU, n=292); (B) adolescents who have rural hukou and attend urban schools (RU, n=819) and (C) adolescents who have rural hukou and attend rural schools (RR, n=784). MEASURES The Depression Anxiety and Stress Scale-21 was used to assess adolescent mental health symptoms, and the Behaviour Rating Inventory of Executive Function (parent form) was applied to measure adolescent executive dysfunction in nature setting. RESULTS Mental health symptoms were common (depression: 25.2%, anxiety: 53.0%, stress: 19.7%) in our sample, and the prevalence rates were lower among UU adolescents than those among the RR and RU, with intersubgroup differences in screen exposure time explaining most of the variance. We found the three types of symptoms were strongly associated with executive dysfunction in general adolescents. We also observed a marginal moderating effect of urban-rural subgroup on the associations: UU adolescents with depression (OR 6.74, 95% CI 3.75 to 12.12) and anxiety (OR 5.56, 95% CI 1.86 to 16.66) had a higher executive dysfunction risk when compared with RR youths with depression (OR 1.93, 95% CI 0.91 to 4.12) and anxiety (OR 1.80, 95% CI 1.39 to 2.33), respectively. CONCLUSIONS Rural adolescents experienced more mental health symptoms, whereas urban individuals with mental health problems had a higher executive dysfunction risk.
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Affiliation(s)
- Qingmin Lin
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cody Abbey
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guanghai Wang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Jinkui Lu
- Department of Physical Education, Shangrao Normal University, Shangrao, China
| | - Sarah-Eve Dill
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Qi Jiang
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - M K Singh
- Stanford University School of Medicine, Stanford, California, USA
| | - Xinshu She
- Stanford University School of Medicine, Stanford, California, USA
| | - Huan Wang
- Stanford Center on China's Economy and Institutions, Stanford University, Stanford, California, USA
| | - Scott Rozelle
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, California, USA
| | - Fan Jiang
- Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
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20
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Tudor K, Maloney S, Raja A, Baer R, Blakemore SJ, Byford S, Crane C, Dalgleish T, De Wilde K, Ford T, Greenberg M, Hinze V, Lord L, Radley L, Opaleye ES, Taylor L, Ukoumunne OC, Viner R, Kuyken W, Montero-Marin J. Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators, Mediators, and Implementation Factors. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:934-953. [PMID: 35267177 PMCID: PMC9343282 DOI: 10.1007/s11121-022-01361-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 02/02/2023]
Abstract
There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such training, how training exerts effects, and how implementation impacts effects. This study aimed to provide an overview of the evidence on the mediators, moderators, and implementation factors of SBMT, and propose a conceptual model that can be used both to summarize the evidence and provide a framework for future research. A scoping review was performed, and six databases and grey literature were searched. Inclusion and exclusion criteria were applied to select relevant material. Quantitative and qualitative information was extracted from eligible articles and reported in accordance with PRISMA-ScR guidelines. The search produced 5479 articles, of which 31 were eligible and included in the review. Eleven studies assessed moderators of SBMT on pupil outcomes, with mixed findings for all variables tested. Five studies examined the mediating effect of specific variables on pupil outcomes, with evidence that increases in mindfulness skills and decreases in cognitive reactivity and self-criticism post-intervention are related to better pupil outcomes at follow-up. Twenty-five studies assessed implementation factors. We discuss key methodological shortcomings of included studies and integrate our findings with existing implementation frameworks to propose a conceptual model. Widespread interest in universal SBMT has led to increased research over recent years, exploring who SBMT works for and how it might work, but the current evidence is limited. We make recommendations for future research and provide a conceptual model to guide theory-led developments.
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Affiliation(s)
- Kate Tudor
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Anam Raja
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ruth Baer
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Sarah Byford
- Health Service and Population Research, King's College London, London, UK
| | | | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Mark Greenberg
- Human Development and Family Studies, Penn State University, State College, USA
| | - Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Liz Lord
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Lucy Radley
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Laura Taylor
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Russell Viner
- Institute of Child Health, University College London, London, UK
| | | | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Jesus Montero-Marin
- Department of Psychiatry, University of Oxford, Oxford, UK
- Teaching, Reseach & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
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21
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Walsh EH, McMahon J, Herring MP. Research Review: The effect of school-based suicide prevention on suicidal ideation and suicide attempts and the role of intervention and contextual factors among adolescents: a meta-analysis and meta-regression. J Child Psychol Psychiatry 2022; 63:836-845. [PMID: 35289410 PMCID: PMC9544521 DOI: 10.1111/jcpp.13598] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Globally, suicide is the fourth highest cause of adolescent mortality (Suicide: https://www.who.int/news-room/fact-sheets/detail/suicide). The effects of post-primary school-based suicide prevention (PSSP) on adolescent suicidal thoughts and behaviours (STBs) have not been comprehensively synthesised. We aim to estimate the population effect for PSSP interventions on adolescent STBs and explore how intervention effects vary based on intervention and contextual moderators. METHODS Searches of PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials identified cluster randomised trials examining the effectiveness of PSSP on adolescent STBs. The Cochrane Risk of Bias tool assessed bias. Crude and adjusted back-transformed odds ratios (ORs) were calculated. Multilevel random-effects models accounted for dependencies of effects. Univariate meta-regression explored variability of intervention and contextual moderators on pooled effects. RESULTS There were 19 and 12 effects for suicidal ideation (SI) and suicide attempts (SA). Compared with controls, interventions were associated with 13% (OR = 0.87, 95%CI [0.78, 0.96]) and 34% (OR = 0.66, 95%CI [0.47, 0.91]) lower crude odds reductions for SI and SA, respectively. Effects were similar for adjusted SI (OR = 0.85, 95%CI [0.75, 0.95]) and SA (OR = 0.72, 95%CI [0.59, 0.87]) models. Within-study (0.20-9.10%) and between-study (0-51.20%) heterogeneity ranged for crude and adjusted SA models and SI heterogeneity was 0%. Moderator analyses did not vary SA effects (ps > .05). CONCLUSIONS This meta-analysis contributes to the PSSP evidence-base by demonstrating that PSSP targeting STBs as both primary intervention outcomes and with other health and well-being outcomes reduced SI and SA among 33,155 adolescents attending 329 schools, compared to controls. The number needed to treat estimates suggests the potential of reducing the incidence of SA and SI in one adolescent by implementing PSSP in 1-2 classrooms, supporting PSSP as a clinically relevant suicide prevention strategy. Although moderator analyses were nonsignificant and contained a small number of trials, larger SA effect sizes support particular effectiveness for interventions of a duration of ≤1 week, involving multiple stakeholders and with a 12-month follow-up.
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Affiliation(s)
- Eibhlin H. Walsh
- School, Child & Youth (SCY) Mental Health and Wellbeing Research LabNational Institute of Studies in EducationHealth Research InstituteUniversity of LimerickLimerickIreland,Department of PsychologyUniversity of LimerickLimerickIreland
| | - Jennifer McMahon
- School, Child & Youth (SCY) Mental Health and Wellbeing Research LabNational Institute of Studies in EducationHealth Research InstituteUniversity of LimerickLimerickIreland,Department of PsychologyUniversity of LimerickLimerickIreland
| | - Matthew P. Herring
- Physical Activity for Health Cluster, Health Research InstituteUniversity of LimerickLimerickIreland,Department of Physical Education and Sports SciencesUniversity of LimerickLimerickIreland
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22
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Wilkinson E. Mindfulness training in schools does not improve children's mental health. BMJ 2022; 378:o1819. [PMID: 35878908 DOI: 10.1136/bmj.o1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Kuyken W, Ball S, Crane C, Ganguli P, Jones B, Montero-Marin J, Nuthall E, Raja A, Taylor L, Tudor K, Viner RM, Allwood M, Aukland L, Dunning D, Casey T, Dalrymple N, De Wilde K, Farley ER, Harper J, Hinze V, Kappelmann N, Kempnich M, Lord L, Medlicott E, Palmer L, Petit A, Philips A, Pryor-Nitsch I, Radley L, Sonley A, Shackleford J, Tickell A, Team M, Blakemore SJ, Ukoumunne OC, Greenberg MT, Ford T, Dalgleish T, Byford S, Williams JMG. Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial. EVIDENCE-BASED MENTAL HEALTH 2022; 25:ebmental-2022-300424. [PMID: 35820990 PMCID: PMC9340006 DOI: 10.1136/ebmental-2022-300424] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/30/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Education is broader than academic teaching. It includes teaching students social-emotional skills both directly and indirectly through a positive school climate. OBJECTIVE To evaluate if a universal school-based mindfulness training (SBMT) enhances teacher mental health and school climate. METHODS The My Resilience in Adolescence parallel group, cluster randomised controlled trial (registration: ISRCTN86619085; funding: Wellcome Trust (WT104908/Z/14/Z, WT107496/Z/15/Z)) recruited 85 schools (679 teachers) delivering social and emotional teaching across the UK. Schools (clusters) were randomised 1:1 to either continue this provision (teaching as usual (TAU)) or include universal SBMT. Data on teacher mental health and school climate were collected at prerandomisation, postpersonal mindfulness and SBMT teacher training, after delivering SBMT to students, and at 1-year follow-up. FINDING Schools were recruited in academic years 2016/2017 and 2017/2018. Primary analysis (SBMT: 43 schools/362 teachers; TAU: 41 schools/310 teachers) showed that after delivering SBMT to students, SBMT versus TAU enhanced teachers' mental health (burnout) and school climate. Adjusted standardised mean differences (SBMT minus TAU) were: exhaustion (-0.22; 95% CI -0.38 to -0.05); personal accomplishment (-0.21; -0.41, -0.02); school leadership (0.24; 0.04, 0.44); and respectful climate (0.26; 0.06, 0.47). Effects on burnout were not significant at 1-year follow-up. Effects on school climate were maintained only for respectful climate. No SBMT-related serious adverse events were reported. CONCLUSIONS SBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements. CLINICAL IMPLICATIONS SBMT has limited effects on teachers' mental and school climate. Innovative approaches to support and preserve teachers' mental health and school climate are needed.
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Affiliation(s)
- Willem Kuyken
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Susan Ball
- NIHR Applied Research Collaboration Southwest Peninsula (PenARC), University of Exeter, Exeter, Devon, UK
| | - Catherine Crane
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Poushali Ganguli
- King's College London, King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK
| | - Benjamin Jones
- NIHR Applied Research Collaboration Southwest Peninsula (PenARC), University of Exeter, Exeter, Devon, UK
| | - Jesus Montero-Marin
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
- Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Elizabeth Nuthall
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anam Raja
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Laura Taylor
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Kate Tudor
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Russell M Viner
- Population, Policy & Practice research programme, UCL Great Ormond St. Institute of Child Health, London, UK
| | - Matthew Allwood
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Louise Aukland
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Darren Dunning
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Tríona Casey
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Nicola Dalrymple
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Katherine De Wilde
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Eleanor-Rose Farley
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Jennifer Harper
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Verena Hinze
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Nils Kappelmann
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Maria Kempnich
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Liz Lord
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Emma Medlicott
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Lucy Palmer
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Ariane Petit
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Alice Philips
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Isobel Pryor-Nitsch
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Lucy Radley
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Anna Sonley
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Jem Shackleford
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Alice Tickell
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Myriad Team
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
| | - Sarah-Jayne Blakemore
- Department of Psychology, University of Cambridge, Cambridge, UK
- UCL Institute of Cognitive Neuroscience, London, UK
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration Southwest Peninsula (PenARC), University of Exeter, Exeter, Devon, UK
| | - Mark T Greenberg
- Department of Human Development and Family Studies, Pennsylvania State University, Pennsylvania, Pennsylvania, USA
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Sarah Byford
- King's College London, King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK
| | - J Mark G Williams
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
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24
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McKinlay J, Wilson C, Hendry G, Ballantyne C. "It feels like sending your children into the lions' den" - A qualitative investigation into parental attitudes towards ASD inclusion, and the impact of mainstream education on their child. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104128. [PMID: 34837755 DOI: 10.1016/j.ridd.2021.104128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Increasing numbers of autistic children are being educated in mainstream schools. The success of inclusive education is dependent upon multiple factors, including key stakeholders (i.e., teachers and parents). Research has tended to focus on teachers' experiences of inclusion with limited focus on parents. AIMS The study aimed to qualitatively investigate parental attitudes and experiences of inclusive education. As such, the research question was: What are attitudes towards, and experiences of, inclusive education for parents of autistic children? METHODS AND PROCEDURE Semi-structured interviews were conducted with 12 parents of autistic children. Data was analysed using Thematic Analysis (Braun & Clarke, 2006). OUTCOMES AND RESULTS four themes were identified; 1) Feeling Unheard; 2) Implementation of Inclusive Strategies; 3) Social Exclusion; 4) Mental Health and Wellbeing Impact. Findings suggested that parents felt their child struggled socially in mainstream school, with such experiences negatively impacting upon their child's wellbeing. The detrimental impacts were a result of parents believing school staff dismissed their concerns and thus appropriate strategies for their child were not always implemented. CONCLUSIONS AND IMPLICATIONS This highlights the need for school staff and parents to work together to enhance inclusivity both academically and socially for autistic children.
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Affiliation(s)
- Jack McKinlay
- The University of the West of Scotland, School of Education and Social Sciences, UWS Paisley Campus, High Street, Paisley, Scotland, PA1 2BE, UK
| | - Claire Wilson
- University of Strathclyde, School of Education, LordHope Building, 141 St James Road, Glasgow, Scotland, G4 0LT, UK.
| | - Gillian Hendry
- The University of the West of Scotland, School of Education and Social Sciences, UWS Paisley Campus, High Street, Paisley, Scotland, PA1 2BE, UK
| | - Carrie Ballantyne
- The University of the West of Scotland, School of Education and Social Sciences, UWS Paisley Campus, High Street, Paisley, Scotland, PA1 2BE, UK
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25
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Rayan A, Harb AM, Baqeas MH, Al.Khashashneh OZ, Harb E. The Relationship of Family and School Environments with Depression, Anxiety, and Stress Among Jordanian Students: A Cross-Sectional Study. SAGE Open Nurs 2022; 8:23779608221138432. [PMID: 36419775 PMCID: PMC9677291 DOI: 10.1177/23779608221138432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/13/2022] [Accepted: 10/23/2022] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Depression, anxiety, and stress are highly prevalent among adolescents. The role of impaired family and school environments in adolescents' depression, anxiety, and stress in Jordan has yet to be established. OBJECTIVE The purpose of this study was to explore the association of family and school environments with the depression, anxiety, and stress of adolescents in Jordan. METHODS A cross-sectional correlational survey was used. A sample of 220 adolescents aged 12-18 years completed the study. Data were collected about family and school environments and adolescents' depression, anxiety, and stress. RESULTS School climate had a strong significant relationship with both general family functioning (r = .53, p < 0.01) and family process (r = .58, p < 0.01). General family functioning and school climate were uniquely associated with stress, anxiety, and depression (Β = -.280 or higher), p < 0.05, controlling for demographics. CONCLUSION The general family functioning and overall school climate were shown to play important role in adolescents' depression, anxiety, and stress. School nurses and psychiatric nurses may want to respond to the needs of adolescents with depression, anxiety, and stress through campaigns, lectures, and conferences and encourage them to access professional psychological counseling.
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Affiliation(s)
- Ahmad Rayan
- Psychiatric and Mental Health Nursing, Faculty of Nursing, Zarqa
University Faculty of Nursing, Zarqa, Jordan
| | - Alaa Mohamad Harb
- Community Health Department, School of
Nursing, University of Jordan, Amman, Jordan
| | - Manal Hassan Baqeas
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | | | - Eman Harb
- Department of community and mental health, Princess Salma Faculty of
Nursing, Al Albayt University, Mafraq, Jordan
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26
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Pumariega AJ. Editorial: Mental Health and Schools: Has the Time Arrived? J Am Acad Child Adolesc Psychiatry 2021; 60:1454-1456. [PMID: 33984425 DOI: 10.1016/j.jaac.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
The focus of public discourse around schools over the past 2 decades in the United States has been around the response to or prevention of school shooting incidents. This often became a rallying cry to compensate for a recent history of tragic events (mass shootings and school shootings as a subset) that seem to have no end nor sufficient political will to pursue definitive deterrents.1 However, in recent months, we have faced a new experience around the role that schools have in promoting the mental health of our youths as a result of the COVID-19 pandemic. Schools all around the country were forced to shut down to prevent the spread of the virus, and students have had to rapidly shift to online learning from home, with at best parental assistance, isolated from their teachers, peers, and the familiar environment and structure of schools. Many have reported rising problems with myriad educational challenges, with students falling behind academically, struggling to learn through virtual environments or distance technologies, experiencing increasing frustration with learning, along with their parents, and increasing expressions of distress from social isolation and loneliness.2 These experiences have been associated with worsening and parallel mental health challenges, including worsening impact of attention-deficit/hyperactivity disorder (ADHD), worsening depressive and anxiety symptoms, children on the autism spectrum battling multiple changes, with rising youth psychiatric hospitalizations.3,4 The only children who have seemed to do better are those with social anxiety symptoms, who are temporarily protected from their daily stress triggers, but who will face them with a heightened vengeance once the pandemic is over.
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Affiliation(s)
- Andres J Pumariega
- Division of Child and Adolescent Psychiatry, University of Florida College of Medicine, Gainesville.
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27
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Blackburn R, Ajetunmobi O, Mc Grath-Lone L, Hardelid P, Shafran R, Gilbert R, Wijlaars L. Hospital admissions for stress-related presentations among school-aged adolescents during term time versus holidays in England: weekly time series and retrospective cross-sectional analysis. BJPsych Open 2021; 7:e215. [PMID: 34794519 PMCID: PMC8612011 DOI: 10.1192/bjo.2021.1058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Schools are a potential stressor for adolescents and may contribute to emergency hospital admissions. AIMS We describe rates of stress-related presentations (SRPs) among school-aged adolescents (11-17 years) during school terms and holidays, and explore differences by age and gender. METHOD Using national administrative hospital data, we defined an SRP as an emergency hospital admission with a primary diagnosis related to pain, psychosomatic symptoms (e.g. fatigue) or mental health problems, or with self-harm indicated in any diagnostic position. We estimated incidence rate ratios for weekly SRPs in term time versus holidays from 2014-2015 to 2017-2018, using negative binomial regression models, stratified by age and gender. We estimated the cumulative incidence of any SRP between 11 and 17 years by analysing prior hospital admission histories of adolescents with an SRP in 2017-2018. RESULTS Over the 4-year study period, 305 491 SRPs in 171 013 school-aged adolescents accounted for 31% of emergency admissions for this group. SRPs were predominantly for mental health problems or self-harm (38%), or pain (35%). Weekly admission rates for SRPs were higher in term time than holidays for all ages (age-specific incidence rate ratios were 1.15-1.49 for girls and 1.08-1.60 for boys). Rates were highest for girls aged 14 and 15 years. The estimated cumulative incidence of any SRP between 11 and 17 years was 7.9% for girls and 4.1% for boys. CONCLUSIONS Hospital admissions for SRPs are common among adolescents, affecting around two girls and one boy in every classroom. Higher rates in term time than holidays suggest that school factors may contribute.
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Affiliation(s)
- Ruth Blackburn
- UCL Institute of Health Informatics, University College London, UK
| | | | | | - Pia Hardelid
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK
| | - Roz Shafran
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK
| | - Ruth Gilbert
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK
| | - Linda Wijlaars
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, UK
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