1
|
Nabunya P, Byansi W, Bahar OS, Namuwonge F, Atwebembere R. Emotional and Behavior Difficulties and the Mental Health of Caregivers of Adolescents Living with HIV. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:3766-3774. [PMID: 37362624 PMCID: PMC10256973 DOI: 10.1007/s10826-023-02609-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
This study examined the relationship between child emotional and behavioral difficulties, parenting stress and the mental health of caregivers of adolescents living with HIV. Caregiver data from a two-year pilot study for adolescents and their caregivers (N = 89 dyads) in Uganda, were analyzed. Ordinary Least Square regression models were conducted to examine the association between child difficulties reported by caregivers using the Strengths and Difficulties Questionnaire on parenting stress (measured by Parenting Stress Index) and caregiver mental health (measured by the Brief Symptoms Inventory). Results indicate that 12.36% of caregivers reported child difficulty scores within the borderline range and 8.99% reported scores within the abnormal range. Child difficulties (b = 0.52, 95% CI: 0.18, 0.85) were associated with parenting stress. Similarly, the perceived impact of child difficulties was associated with both parenting stress (b = 0.89, 95% CI: 0.24, 1.54) and caregiver mental health (b = 1.73, 95% CI: 1.09, 2.37). Study findings have important implications for developing effective psychosocial interventions targeting children and adolescents living with HIV and their caregivers.
Collapse
Affiliation(s)
- Proscovia Nabunya
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - William Byansi
- Boston College, School of Social Work, Chestnut Hill, MA USA
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | - Flavia Namuwonge
- International Center for Child Health and Development, Brown School, Washington University in St. Louis, St. Louis, MO USA
| | | |
Collapse
|
2
|
Tutlam NT, Filiatreau LM, Byansi W, Brathwaite R, Nabunya P, Sensoy Bahar O, Namuwonge F, Ssewamala FM. The Impact of Family Economic Empowerment Intervention on Psychological Difficulties and Prosocial Behavior Among AIDS-Orphaned Children in Southern Uganda. J Adolesc Health 2023; 72:S51-S58. [PMID: 37062584 PMCID: PMC10159782 DOI: 10.1016/j.jadohealth.2023.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/22/2022] [Accepted: 01/03/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Children orphaned by AIDS are more likely to have psychological and emotional problems compared to their counterparts. Poverty resulting from orphanhood is linked to the negative psychological outcomes experienced by AIDS-orphaned adolescents. No studies have investigated the impact of an economic empowerment intervention on child psychological and emotional problems and prosocial behavior. Therefore, we aimed to examine the impact of a family economic empowerment intervention on psychological difficulties and prosocial behavior among AIDS-orphaned adolescents. METHODS We analyzed data from a two-arm cluster randomized controlled trial conducted in 10 primary schools in southern Uganda. Schools were randomized to either bolstered usual care (n = 5 schools; 167 participants) or a family-economic empowerment intervention (Suubi-Maka; n = 5 schools; 179 individuals). We used t-test and multi-level mixed effects models to examine the impact of Suubi-Maka on psychological and behavioral outcomes. RESULTS No differences were observed between intervention and control groups in almost all the outcomes at baseline, 12 months, and 24 months. Simple main effects comparisons of 12 months versus baseline within each condition indicate modest to significant declines in emotional symptoms, hyperactivity, peer relationships (Δs = -1.00 to -2.11, all p < .001), and total difficulties (Δs = -4.85 to -4.89, both p < .001) across both groups. DISCUSSION Our analysis found no meaningful difference between intervention and control groups in child psychological difficulties and prosocial behavior postintervention. However, improvements were observed across both control and treatment groups following the intervention. Future studies should investigate the impact of different components of the intervention.
Collapse
Affiliation(s)
- Nhial T Tutlam
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Lindsey M Filiatreau
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - William Byansi
- Boston College, School of Social Work, Chestnut Hill, Massachusetts
| | - Rachel Brathwaite
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Proscovia Nabunya
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Flavia Namuwonge
- International Center for Child Health and Development Field Office, Masaka, Uganda
| | - Fred M Ssewamala
- International Center for Child Health and Development, Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri.
| |
Collapse
|
3
|
Garcia-Cerde R, Lopes de Oliveira CW, Ferreira-Junior V, Caetano SC, Sanchez ZM. Psychiatric Symptomatology is Associated with Polydrug Use and School Violence in Early Adolescence. Child Psychiatry Hum Dev 2023; 54:109-122. [PMID: 34398344 DOI: 10.1007/s10578-021-01228-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/02/2021] [Indexed: 01/25/2023]
Abstract
This study investigated the association between psychiatric symptoms and polydrug use, school violence, and sociodemographic factors among Brazilian early adolescents. Using the baseline data collection from the effectiveness evaluation of PROERD, a school-based drug use prevention program, implemented in 30 public schools in São Paulo (n = 2316, M age = 12.3 years, 48.5% girls), multinomial logistic regressions were performed using Strengths and Difficulties Questionnaire (SDQ) subscales as response variables, and polydrug use, school violence, and sociodemographic characteristics as explanatory variables. In most SDQ subscales, girls and older students were more likely to have psychiatric symptoms. A positive association was identified between polydrug use and psychiatric symptoms. It was found that those who suffered and perpetrated physical violence had a greater likelihood of presenting psychiatric symptoms. Preventive interventions should consider the greater vulnerability related to the mental health of girls, older students, and those who suffer and perpetrate physical violence at school.
Collapse
Affiliation(s)
- Rodrigo Garcia-Cerde
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil
| | - Camila W Lopes de Oliveira
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Valdemir Ferreira-Junior
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Sheila Cavalcante Caetano
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil.
| |
Collapse
|
4
|
Too EK, Chongwo E, Mabrouk A, Abubakar A. Adolescent Connectedness: A Scoping Review of Available Measures and Their Psychometric Properties. Front Psychol 2022; 13:856621. [PMID: 35664205 PMCID: PMC9159472 DOI: 10.3389/fpsyg.2022.856621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/25/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity. Methods We searched CINAHL, Embase, PsycInfo, PubMed, and Web of Science databases for relevant articles published since database inception to 7th February 2021. Our search structure contained the key words "Adolescents", "Connectedness", and "Measures". We also searched Open Gray for potentially relevant gray literature. Results We identified 335 measures from 960 eligible studies assessing various domains of adolescent connectedness, including school, family, community, peer, ethnic, racial, cultural, religious/spiritual, and self-connectedness. Most of the included studies (72.1%) were from North America and Europe. Most of the measures (n = 132, 39.4%) were measures of school connectedness among adolescents. Of the identified measures, 60 of them met our criteria of frequently used measures (i.e., the top five most used measures per domain of connectedness). These frequently used measures were used across 481 of the included studies with 400 of them reporting their psychometric properties. The reported reliability of these measures was adequate (Cronbach's alpha ≥ 0.70) in 89.8% of these studies. These measures also appeared to be valid in terms of their face, content, construct, criterion, convergent, discriminant, concurrent, predictive, measurement invariance, and cross-cultural validity. Conclusions There exists a wide array of measures of adolescent connectedness. Sixty of these measures have been frequently used across studies and appear to be reliable and/or valid. However, this evidence is mostly from North America and Europe. This is a reflection of the limitation of this review where only studies published in English were considered. It might also reflect the paucity of research in other regions of the world. More research is needed for clearer insights.
Collapse
Affiliation(s)
- Ezra K. Too
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | | | | |
Collapse
|
5
|
Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Common mental health problems among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. J Child Adolesc Ment Health 2021; 33:90-110. [PMID: 38041439 DOI: 10.2989/17280583.2023.2266451] [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: 12/03/2023]
Abstract
Background and aim: This review examined the prevalence of mental health problems among adolescents in sub-Saharan Africa.Methods: The review included studies indexed in the MEDLINE, EMBASE, and PsycINFO databases, supplemented by a search on Google Scholar and tracking of references from articles identified. A total of 725 articles were found, of which 28 met the inclusion criteria. Finally, 22 eligible studies were reviewed.Findings: The pooled current prevalence of mental health problems was 23% (95% CI: 18; 28, I2 = 99.41%). Any depression, 19% (95% CI: 9; 30, I2 = 99.64%), and anxiety, 20% (95% CI: 01; 31, I2 = 99.64%), were the most common mental health problems reported. Attention deficit hyperactivity disorder, 5% (95% CI: 3; 7, I2 = 97.60%), and conduct disorders, 15% (95% CI: 8; 22, I2 = 99.58%), were also significant mental health problems among adolescents in the region.Conclusion: About one in five adolescents in sub-Saharan Africa suffer from one or more mental health problems. The findings have important implications for policy and practice as they indicate that mental health problems are a major public health issue among adolescents in sub-Saharan Africa and that there is a need for effective and context-specific interventions that address mental health.
Collapse
Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Yadeta Dessie
- School of Public Health College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Biftu Geda
- Department of Preventive Medicine, School of Public Health College of Health Sciences, Addis Ababa University, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Negussie Deyessa
- Department of Nursing, College of Health Sciences, Shashamene Compass, Madda Walabu University, Ethiopia
| |
Collapse
|
6
|
Frías Armenta M, Corral-Frías NS. Positive University Environment and Agreeableness as Protective Factors Against Antisocial Behavior in Mexican University Students. Front Psychol 2021; 12:662146. [PMID: 34366980 PMCID: PMC8339411 DOI: 10.3389/fpsyg.2021.662146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
Violence in schools is a global issue. Approximately 32% of Mexican students have experienced some form of violence in the school setting in their lives. Previous research has tended to focus on the causes of violence and antisocial behaviors in offenders or adolescent samples and has found evidence to suggest the underlying role of environmental and personal factors. The present study investigates the effect of positive school environment and agreeableness as protective factors against antisocial behaviors in a sample of undergraduate and graduate students (n = 304) from northwestern Mexico. Our results demonstrate that a positive school environment has a negative effect on antisocial behaviors via mood and anxiety disorders as well as in interaction with agreeableness, suggesting an interplay between personality and environment. These findings can provide some basis for the development of university programs aimed at fostering positive environments that promote student mental health and protect against antisocial behaviors.
Collapse
|
7
|
Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2021; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.3] [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: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
Collapse
Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
| |
Collapse
|
8
|
Jiang S, Liang Z. Mediator of school belongingness and moderator of migration status in the relationship between peer victimization and depression among Chinese children: A multi-group structural equation modeling approach. J Affect Disord 2021; 278:382-389. [PMID: 33007628 DOI: 10.1016/j.jad.2020.09.075] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/03/2020] [Accepted: 09/21/2020] [Indexed: 11/30/2022]
Abstract
Peer victimization is a widespread threat to children's mental health. However, existing literature has yet to thoroughly investigate the mediators and moderators underlying the link between peer victimization and depression of Chinese children. Using a sample of school-aged children recruited through a multi-stage cluster random sampling in Southwest China (N = 1322), this study examined the mediating role of school belongingness between overt/relational victimization and children's depressive symptoms. In order to test the moderator of migration status, multi-group structural equation modeling (SEM) was adopted to investigate whether the paths in the mediation model were significantly different across migrant and non-migrant groups. Results indicated that overt and relational victimization had a direct impact on depression. School belongingness mediated the link between overt victimization and depression, but not the link between relational victimization and depression. Furthermore, migration status moderated the direct associations between peer victimization and depression. Specifically, the effect of overt victimization on depression was significant for migrant children but not for local children. By contrast, the effect of relational victimization on depression was significant for local children but not for migrant children. The contributions and implications of this study were discussed.
Collapse
Affiliation(s)
- Shan Jiang
- Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong, China.
| | - Zurong Liang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| |
Collapse
|
9
|
Jiang S, Liang Z. Mediator of school belongingness and moderator of migration status in the relationship between peer victimization and depression among Chinese children: A multi-group structural equation modeling approach. J Affect Disord 2021; 278:382-389. [DOI: https:/doi.org/10.1016/j.jad.2020.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
10
|
Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2021; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.2] [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: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among children in the general population in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using respectively descriptive statistics, and univariable and multivariable logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. Among the exposure variables examined in this study, including asthma, age, sex, grade of schooling, type of school and maternal and father's education and family socio-economic status, only asthma was associated with the disorders (MDD). Conclusions: The relatively high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
Collapse
Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
| |
Collapse
|
11
|
Nampijja M, Sembajjwe W, Mpairwe H, Mpango R, Kinyanda E. Prevalence and correlates of neurocognitive impairment and psychiatric disorders among schoolchildren in Wakiso District, Uganda: a cross-sectional study. Wellcome Open Res 2021; 6:217. [PMID: 36873715 PMCID: PMC9975401 DOI: 10.12688/wellcomeopenres.17005.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is limited data on the burden of mental disorders among 'healthy' children in Africa. We examined the prevalence and correlates of neurocognitive and psychiatric disorders among schoolchildren in Uganda. Methods: This cross-sectional study enrolled 322 schoolchildren aged 5-17years in Wakiso, Uganda. We assessed for neurocognitive impairment using the Kaufmann-Assessment-Battery, and psychiatric disorders (major-depressive-disorder (MDD), attention-deficit-hyperactivity-disorder (ADHD), generalised-anxiety-disorder (GAD), and substance-use-disorder (SUD)) using the parent version of the Child and Adolescent Symptom Inventory-5, and Youth Inventory-4R Self Report. Prevalence and risk factors were determined using percentages and logistic regression. Results: Twenty-five participants (8%) had neurocognitive impairment. Nineteen (5.9%) participants had MDD, nine (2.8%) had ADHD, seven (2.2%) had GAD, 14 (8.6%) had SUD; and 30 (9.3%) had any psychiatric disorder. None of the factors examined were associated with the disorders. Conclusions: The unexpectedly high burden of mental disorders in this general population of children warrants targeted screening of those at risk, and treatment of those affected. Further, future studies should extensively investigate the factors that underlie the identified psychiatric disorders in this and similar general populations.
Collapse
Affiliation(s)
- Margaret Nampijja
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Harriet Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, London, WC1E 7HT, UK., UK
| | - Richard Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.,Department of Psychiatry, College of Health Sciences, Makerere University, Kampala,, Kampala, P.O. Box 7072, Kampala, Uganda
| |
Collapse
|
12
|
Patalay P, O'Neill E, Deighton J, Fink E. School characteristics and children's mental health: A linked survey-administrative data study. Prev Med 2020; 141:106292. [PMID: 33075351 DOI: 10.1016/j.ypmed.2020.106292] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022]
Abstract
Mental health difficulties are childhood-onset with lifelong health, social and economic consequences. Children spend a large amount of time in schools, making schools an important context for mental health prevention and support. We examine how school composition and school climate, controlling for individual child-level characteristics, are associated with children's mental health difficulties (emotional and behavioural difficulties). Data from 23,215 children from 648 primary schools in England were analysed to examine the associations of school composition (size, gender, socioeconomic and ethnicity) and school climate with mental health (emotional symptoms, behavioural symptoms and above clinical cut-off scores) adjusting for individual child socio-demographic characteristics. We find that between 3% and 4.5% of the variation in children's mental health outcomes could be attributed to schools. Of this, small proportions were explained by school composition (1.4 to 3.8%) and larger proportions were explained by school climate (29.5 to 48.8%). Lower school socio-economic status was associated with higher behavioural symptoms (coef = 0.02 [95%CI: 0.01-0.04]) and slightly raised odds of high mental health difficulties (OR = 1.05, 95% CI: 1.01,1.09). More positive school climate was associated with lower emotional (coef = -0.09 [95%CI:-0.11,-0.08]) and behavioural (coef = -0.13 [95% CI,-0.15:-0.11]) symptoms and lower odds of mental health difficulties (OR = 0.78, 95%CI:0.74,0.81). Some associations between school factors and mental health were moderated by child sex and SES. School composition factors were weakly associated with children's mental health, whereas school climate explained a larger amount of between-school variation and appears a good target for universal prevention of mental health difficulties in children.
Collapse
Affiliation(s)
- Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, UCL, Gower Street, London, UK; Department of Psychological Sciences, University of Liverpool, Bedford Street South, Liverpool, UK.
| | - Erin O'Neill
- Department of Psychological Sciences, University of Liverpool, Bedford Street South, Liverpool, UK
| | - Jessica Deighton
- Evidence Based Practice Unit, UCL and The Anna Freud National Centre for Children and Families, UK
| | - Elian Fink
- Faculty of Education and the Centre for Family Research, University of Cambridge, UK
| |
Collapse
|
13
|
Pauli LA, Correa MB, Demarco FF, Goettems ML. The school social environment and oral health-related quality of life in children: a multilevel analysis. Eur J Oral Sci 2020; 128:153-159. [PMID: 31999873 DOI: 10.1111/eos.12679] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 11/27/2022]
Abstract
This study aimed to explore the association between schoolchildren's oral health-related quality of life (OHRQoL) and the school-related social environment (contextual factors). A cross-sectional study was performed with 1,211 children, aged 8-12 yr, from 20 private and public schools. Sociodemographic information was collected from a questionnaire given to parents, and children were interviewed using the Child Perceptions Questionnaire (CPQ) and examined for oral health conditions. Contextual variables were obtained from school coordinators regarding the social environment. Data analysis was performed through multilevel Poisson regression. A high negative impact on OHRQoL was found for participants who were girls, older, had very severe malocclusion, had dental trauma and caries, and had mothers with less schooling. A negative impact on OHRQoL was also found for children who attended schools in which police security was required (rate ratios [RR] = 1.11; 95% CI: 1.01-1.22) and in which violence among students occurred in the last year (RR = 1.17; 95% CI: 1.02-1.35). The need for police security was associated with a negative impact on the emotional well-being domain, and violence among students was associated with negative impact on the oral symptoms, functional limitations, and social well-being domains. Children in healthier environments have better OHRQoL.
Collapse
Affiliation(s)
- Laís A Pauli
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marcos B Correa
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marília L Goettems
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
14
|
Ssenyonga J, Magoba Muwonge C, Hecker T. Prevalence of family violence and mental health and their relation to peer victimization: A representative study of adolescent students in Southwestern Uganda. CHILD ABUSE & NEGLECT 2019; 98:104194. [PMID: 31629222 DOI: 10.1016/j.chiabu.2019.104194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite global efforts to end violence against children in all settings, reports reveal that violence against children is still highly prevalent, especially in low-and middle- income countries. Violence in childhood is associated with a host of negative outcomes, and exposure in one setting can easily spill over to other contexts. For instance, exposure to family violence was not only related to mental health problems but also seems to be a risk factor for peer victimization. OBJECTIVES The present study aimed to examine the prevalence of maltreatment within the family and adolescents' mental health problems and their relation to peer victimization. We also aimed to gain new insights into the perceptions of adolescents concerning maltreatment within their families. METHODS Data were collected from April to November 2017 in a representative sample of 702 students from 12 public secondary schools in Southwestern Uganda who responded to self-administered questionnaires. RESULTS Overall, 95% of the students experienced at least one type of family violence in the past month. Students (81.3%) had endorsed some level of acceptance of violent discipline as a valid strategy in response to any misbehavior. Maltreatment within the family was related to peer victimization (β = .47) and this relation was mediated by mental health problems (0.002, 95%-CI: 0.001-0.004). CONCLUSIONS The results indicated a high prevalence of maltreatment within Ugandan families that was associated with peer victimization. This underscores the need to implement interventions aiming to reduce maltreatment and violence in order to protect children from potentially negative consequences.
Collapse
Affiliation(s)
- Joseph Ssenyonga
- Department of Psychology, University of Konstanz, 78567 Konstanz, Germany.
| | - Charles Magoba Muwonge
- Department of Educational Foundations and Psychology, Mbarara University of Science and Technology, P.O. Box 1410, Uganda.
| | - Tobias Hecker
- vivo International, 78340 Konstanz, Germany; Department of Psychology, University of Bielefeld, 33501 Bielefeld, Germany.
| |
Collapse
|
15
|
Starkey L, Aber JL, Crossman A. Risk or resource: Does school climate moderate the influence of community violence on children's social-emotional development in the Democratic Republic of Congo? Dev Sci 2019; 22:e12845. [PMID: 31056828 DOI: 10.1111/desc.12845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 04/11/2019] [Accepted: 04/25/2019] [Indexed: 11/30/2022]
Abstract
Exposure to community violence is thought to create risk for the social and emotional development of children, including those children living in low-income, conflict-affected countries. In the absence of other types of community resources, schools may be one of the few community resources that can help buffer children from the negative effects of community violence exposure. We sampled 8,300 students ranging in age from 6-18 years in 123 schools from the eastern Democratic Republic of Congo to examine whether and how two distinct dimensions of positive school climate can protect two key features of children's social-emotional development in the presence of community violence. Multi-level models tested the hypothesis that students' perceptions of a positive school climate moderated the relation between community violence and self-reported mental health problems and peer victimization. Findings support the hypothesis. Specifically, a positive school climate protected against mental health problems and peer victimization in the presence of high community violence. Students who experienced high community violence and a negative school climate generally demonstrated the worst development. We find complex interactions between the dimensions of school climate and exposure to violence on student social-emotional development that highlight the salience of children's contexts for developmental studies in low-income countries. We use dynamic developmental systems theory and differential impact to discuss the dual potential of schools as a buffer against the effects of violence or as a source of compounded risk.
Collapse
Affiliation(s)
- Leighann Starkey
- The Graduate Center, City University of New York, New York, New York.,New York University, New York, New York
| | | | - Angela Crossman
- John Jay College, City University of New York, New York, New York
| |
Collapse
|
16
|
Hoosen N, Davids EL, de Vries PJ, Shung-King M. The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation. Child Adolesc Psychiatry Ment Health 2018; 12:6. [PMID: 29344084 PMCID: PMC5765647 DOI: 10.1186/s13034-017-0212-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/23/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Child and adolescent mental health in Africa remains largely neglected. Quick and cost-effective ways for early detection may aid early intervention. The Strengths and Difficulties Questionnaire (SDQ) is globally used to screen for mental health problems, but little is known about its use in Africa. We set out to perform a scoping review to examine existing studies that have used the SDQ in Africa. METHODS A comprehensive scoping review methodology was used to identify all peer-reviewed studies ever published that have used the SDQ in Africa. Data were extracted and analysed to assess the countries, languages and SDQ versions used, the purpose of the SDQ studies, psychometric properties of the SDQ, and to consider knowledge gaps for future in-country and cross-country studies. RESULTS Fifty-four studies from 12 African countries were identified, most from South Africa. Many different languages were used, but authorized SDQs in those languages were not always available on the SDQinfo website. Authors frequently commented on challenges in the translation and backtranslation of mental health terminology in African languages. The SDQ was typically used to investigate internalisation/externalization disorders in different clinical populations, and was most frequently used in the evaluation of children and adolescents affected by HIV/AIDS. Sixteen studies (29.6%) administered the SDQ to participants outside the intended age range, only 4 (7.4%) used triangulation of all versions to generate assessments, and eight studies (14.8%) used only subscales of the SDQ. Only one study conducted thorough psychometric validation of the SDQ, including examination of internal consistency and factor analysis. Where 'caseness' was defined in studies, UK cut-off scores were used in all but one of the studies. CONCLUSIONS The SDQ may be a very useful tool in an African setting, but the scoping review suggested that, where it was used in Africa researchers did not always follow instrument guidelines, and highlighted that very little is known about the psychometric properties of the SDQ in Africa. We recommend comprehensive evaluation of the psychometric properties of the SDQ in various African languages, including internal consistency, factor structure, need for local cut-off values and ensuring cultural equivalence of the instrument.
Collapse
Affiliation(s)
- Nikhat Hoosen
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
- Health Policy and Systems Division, University of Cape Town, Cape Town, South Africa
| | - Eugene Lee Davids
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Petrus J. de Vries
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
| | - Maylene Shung-King
- Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700 South Africa
- Health Policy and Systems Division, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
17
|
Namy S, Carlson C, Norcini Pala A, Faris D, Knight L, Allen E, Devries K, Naker D. Gender, violence and resilience among Ugandan adolescents. CHILD ABUSE & NEGLECT 2017; 70:303-314. [PMID: 28675814 PMCID: PMC5745577 DOI: 10.1016/j.chiabu.2017.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/16/2017] [Accepted: 06/07/2017] [Indexed: 05/06/2023]
Abstract
Resilience, commonly understood as the ability to maintain adaptive functioning in the face of adversity, has emerged as a salient entry point in the field of positive youth development. This study makes a unique contribution by exploring dimensions of resilience among adolescents in Uganda, examining associations between violence from different perpetrators and resilience, and testing whether sex moderates these relationships. Analyses are based on data from 3706 primary school students. Exploratory factor analysis (EFA) identified five factors underlying the construct of resilience: Emotional Support; Family Connectedness; School Connectedness; Social Assets; and Psychological Assets. We used regression analysis to investigate associations between these dependent variables, background characteristics, and experiences of violence (including exposure to intimate partner violence against female caregivers). Results reflect a complex relationship between violence and resilience, with patterns varying by perpetrator (e.g., teacher, peers, caregivers) and some evidence that the sex of the student moderates these dynamics. Overall, there is a consistently negative relationship between all violence measures and Psychological Assets. In addition, teacher violence is associated with lower resilience across factors and both caregiver violence and exposure to IPV are consistently associated with decreased Family Connectedness. These findings suggest that adolescents experiencing (and exposed to) violence from adults may be particularly vulnerable to internalizing and/or externalizing behaviors and withdrawal from the family. Findings point to preventing violence from teachers complemented with enhancing family relationships as promising avenues for resilience-strengthening interventions, and also emphasize the need to consider gendered strategies to ensure girls and boys benefit equally.
Collapse
Affiliation(s)
| | | | | | | | - Louise Knight
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Elizabeth Allen
- London School of Hygiene and Tropical Medicine, United Kingdom
| | - Karen Devries
- London School of Hygiene and Tropical Medicine, United Kingdom
| | | |
Collapse
|