Association of Existence of Third Places and Role Model on Suicide Risk Among Adolescent in Japan: Results From A-CHILD Study

Resilience in development: Neighborhood context, experiences of discrimination, and children's mental health

An understanding of child psychopathology and resilience requires attention to the nested and interconnected systems and contexts that shape children's experiences and health outcomes. In this study, we draw on data from the National Survey of Children's Health, 2016 to 2021 (n = 182,375 children, ages 3- to 17 years) to examine associations between community social capital and neighborhood resources and children's internalizing and externalizing problems, and whether these associations were moderated by experiences of racial discrimination. Study outcomes were caregiver-report of current internalizing and externalizing problems. Using logistic regression models adjusted for sociodemographic characteristics of the child and household, higher levels of community social capital were associated with a lower risk of children's depression, anxiety, and behaviors. Notably, we observed similar associations between neighborhood resources and child mental health for depression only. In models stratified by the child's experience of racial/ethnic discrimination, the protective benefits of community social capital were specific to those children who did not experience racial discrimination. Our results illustrate heterogeneous associations between community social capital and children's mental health that differ based on interpersonal experiences of racial/ethnic discrimination, illustrating the importance of a multilevel framework to promote child wellbeing.

School- and community-level protective factors for resilience among chronically maltreated children in Japan

PURPOSE

Few studies have investigated how school- and community-level modifiable factors might enhance resilience, defined as an ability to recover from and cope with adversity, among chronically maltreated pre-adolescent children. This study aims to investigate school and community factors that can increase children's resilience following maltreatment.

METHODS

We used data from the Adachi child health impact of living difficulty (A-CHILD) Study, a population-based prospective longitudinal study starting with first-grade children in all public elementary schools in Adachi City, Tokyo, Japan in 2015. Children who experienced chronic maltreatment while in 1st and 4th grades and whose resilience scores were available at those grades were included in the analysis (N = 789). Crude and multiple regressions were used to examine associations of child-reported school factors (i.e., school social capital, number of friends to consult with) and community factors (i.e., having a non-parental role model and supportive adult, having a third place, which is defined as a place other than home to spend time after school) with parent-reported resilience at 4th grade. These regressions were also performed stratified by sex.

RESULTS

School social capital and having a non-parental role model at 4th grade were positively associated with resilience after adjusting covariates, including resilience at 1st grade [coefficient = 3.63, 95% confidence intervals (CI) 2.26-4.99; coefficient = 2.52, 95% CI 0.57-4.38, respectively]. Analysis by sex revealed that having a supportive adult, but not a role model, was associated with resilience among girls (coefficient = 5.50, 95% CI 0.20-10.8).

CONCLUSIONS

The findings suggest that school and community factors can promote resilience following child maltreatment, and these factors are different between boys and girls.

Food Categories for Breakfast and Mental Health among Children in Japan: Results from the A-CHILD Study

There is limited evidence that what children eat for breakfast contributes to their mental health. This study aimed to examine the associations between food categories for breakfast and mental health among children in Japan. A proportion of participants aged 9-10 years in the Adachi Child Health Impact of Living Difficulty (A-CHILD) study in Japan who consumed breakfast daily were included (n = 281). Foods eaten for breakfast were reported by the children each morning for 7 consecutive days, and defined according to the food categories in the Japanese Food Guide Spinning Top. Child mental health was assessed by caregivers using the Strength and Difficulties Questionnaire. The mean intake frequencies per week were six times for grain dishes, two times for milk products, and one time for fruits. Linear regression analysis revealed an inverse association between the frequent intake of grain dishes, whether rice or bread, and problem behaviors after adjustment for potential confounders. However, confectionaries, which mainly consisted of sweet breads or pastries, were not associated with problem behaviors. The intake of non-sweet grain dishes at breakfast may be effective for preventing behavioral problems in children.

No moderating effect of coping skills on the association between bullying experience and self-esteem: Results from K-CHILD study

Introduction

Few studies have investigated the moderating effect of coping skills on the association between bullying experience and low self-esteem. The aim of this study was to examine whether coping skills have a moderating effect on the association between bullying experience and self-esteem among Japanese students.

Methods

Data from the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study conducted in 2016 were analyzed. Participants included fifth-and eighth-grade students living in Kochi Prefecture, Japan. A questionnaire for the students (n = 5,991) assessed the bullying experience, self-esteem (the Japanese Edition of the Harter's Perceived Competence Scale for Children), and coping skills that comprised six types (The shortened version of coping skills for elementary school children). Multivariate linear regression analyses were conducted to examine the association between bullying experience and self-esteem and then the moderating effects of six types of coping as interaction terms on the association were considered.

Results

Bullying experience was inversely associated with self-esteem. All six types of coping did not moderate the relationship between bullying experience and low self-esteem even after adjusting for cofounders (all P for interaction > 0.15).

Conclusion

Coping skills did not moderate the association between bullying experience and self-esteem, suggesting that intervention to boost coping skills to mitigate the adverse effect of bullying experience may not be promising.

Impact of adverse childhood experience on physical and mental health: A life-course epidemiology perspective

Adverse childhood experiences (ACEs) have been shown to have long-term effects on physical and mental health, not only in the US, but also other countries, including Japan. In this paper, measurement of assessment of ACEs has been discussed, that is, concept (what is ACEs), inquiry (how to ask about ACEs), scoring (how to count the number of ACEs), and prevalence (how many ACEs do we have). In addition, a possible mechanism on how ACEs affect health was summarized from a life-course perspective, using the critical/sensitive period model, pathway model, and cumulative model with recent evidence on neurological findings. Intergenerational transmission, that is, maternal ACEs affecting the health of the offspring was also reviewed. Finally, future directions on how to prevent and remedy the impact of ACEs on health was discussed.

Association between maternal adverse childhood experiences and child resilience and self-esteem: Results from the K-CHILD study

BACKGROUND

Previous studies have found that children of mothers with adverse childhood experiences (ACEs) are more likely to have adverse mental health outcomes. However, little is known about the role of other cognitive abilities, such as resilience and self-esteem, in how children deal with stressful situations.

OBJECTIVE

To examine the association between maternal ACEs and resilience and self-esteem in children.

PARTICIPANTS AND SETTING

The data was collected as part of the population-based Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016. Participants included 2759 in first grade, 2878 in fifth grade, 3143 in eighth grade, and 3611 children in 11th grade living in Kochi Prefecture, Japan (N = 12,391).

METHODS

Maternal ACEs and covariates were reported by mothers. Mothers provided information regarding their children's resilience for children in the first, fifth, and eighth grades. Children in the fifth, eighth, and 11th grades reported their own self-esteem.

RESULTS

Children of mothers with a larger number of ACEs had lower levels of resilience (p for trend (i.e., linear associations) < 0.001) as well as lower levels of self-esteem (p for trend <0.001), adjusting for potential confounding variables. These associations became non-significant after adjusting for potential mediators, and the relationship was mediated by variables such as maternal psychological distress, current socioeconomic status, and parenting behaviors.

CONCLUSIONS

There was a significant dose-response relationship between the number of maternal ACEs and children's resilience and self-esteem, and this relationship may be mediated by maternal psychological distress, current socioeconomic status, and positive parenting behaviors. Further interventional studies that break the link between maternal ACEs and resilience and self-esteem should be conducted.

Association between subjective degree of influence in class and thinness among adolescents in Japan

Social status in school, measured by subjective degree of influence in class (DOI), may influence thinness among adolescents. This study examined the association between subjective degree of influence in class and thinness among Japanese adolescents. Data were obtained from the Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, which Was a population-based study targeting 5th, 8th and 11th grade adolescents living in Kochi Prefecture, Japan (N = 9,998). DOI was assessed by adolescents via questionnaire. Weight and height were given by caregivers for 5th grade adolescents, whilst they were self-reported for 8th and 11th grade adolescents. Collected data on weight and height were used to calculate body mass index z-scores of WHO standards. Models included grade, gender, number of friends, household income, location of school and depressive symptoms as covariates. The results showed that both high and low DOI were positively associated with thinness after adjustment for other individual covariates (high DOI, OR = 1.59, 95% CI 1.05-2.43; low DOI, OR = 2.04, 95% CI 1.36-3.06). Further stratification by gender revealed that low DOI was positively associated with thinness (OR = 2.14, 95% CI 1.34-3.44) among boys, but there was no association among girls. Both high and low DOI were associated with the risk of being thin in adolescents. Focusing on DOI for adolescents may be important to address thinness among adolescents. Further studies are needed to examine the causality between DOI and thinness in adolescents.

Association Between Parenting and School Refusal Among Elementary School Children in Japan: Results From A-CHILD Longitudinal Study

Objective: The aim of this study was to examine the association between parenting, including the parent-child interaction and child maltreatment in the first grade (6-7 years old), and school refusal in the second (7-8 years old) and fourth (9-10 years old) grades among elementary school children in Japan. Methods: Data were from the Adachi Child Health Impact of Living Difficulty (A-CHILD) longitudinal study conducted in 2015, 2016, and 2018 in Adachi City, Tokyo, Japan. A questionnaire was distributed to all the first-grade school children (N = 5,355) in 2015. Of the total 4,291 valid children (response rate: 80.1%), 3,590 and 3,070 children were followed up to the second and fourth grades, respectively. Caregivers responded to the questionnaire on the parent-child interaction and child maltreatment, including neglect, physical abuse, and psychological abuse in the first grade and school refusal in the second and fourth grades. We conducted multiple imputation for missing data. Multivariate logistic regression model was used for this analysis adjusting for child mental health in the first grade and sociodemographic characteristics. Results: Prevalence of school refusal was 1.8% (n = 64) in the second grade and 2% (n = 60) in the fourth grade. We found no association of the parent-child interaction and child maltreatment in the first grade and with school refusal in the second and fourth grades, respectively, after adjusting for covariates. Conclusions: Parenting, such as the parent-child interaction and child maltreatment, may not be associated with school refusal among elementary school children. Further longitudinal research is needed to elucidate other factors, such as peer relationships and school environment, which can affect school refusal.