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Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds.

ABSTRACT: Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population. This study examined rates of reliable improvement/deterioration for children in a school sample over time. N = 9074 children (mean age 12; 52% female; 79% white) from 118 secondary schools across England provided self-report mental health (SDQ), quality of life and demographic data (age, ethnicity and free school meals (FSM) at baseline and 1 year and self-report data on access to mental health support at 1 year). Multinomial logistic regressions and classification trees were used to analyse the data. Of 2270 (25%) scoring above threshold for mental health problems at outset, 27% reliably improved and 9% reliably deteriorated at 1-year follow up. Of 6804 (75%) scoring below threshold, 4% reliably improved and 12% reliably deteriorated. Greater emotional difficulties at outset were associated with greater rates of reliable improvement for both groups (above threshold group: OR = 1.89, p < 0.001, 95% CI [1.64, 2.17], below threshold group: OR = 2.23, p < 0.001, 95% CI [1.93, 2.57]). For those above threshold, higher baseline quality of life was associated with greater likelihood of reliable improvement (OR = 1.28, p < 0.001, 95% CI [1.13, 1.46]), whilst being in receipt of FSM was associated with reduced likelihood of reliable improvement (OR = 0.68, p < 0.01, 95% CI [0.53, 0.88]). For the group below threshold, being female was associated with increased likelihood of reliable deterioration (OR = 1.20, p < 0.025, 95% CI [1.00, 1.42]), whereas being from a non-white ethnic background was associated with decreased likelihood of reliable deterioration (OR = 0.66, p < 0.001, 95% CI [0.54, 0.80]). For those above threshold, almost one in three children showed reliable improvement at 1 year. The extent of emotional difficulties at outset showed the highest associations with rates of reliable improvement.

SUBMITTER: Wolpert M

PROVIDER: S-EPMC7024693 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds.

Wolpert Miranda M Zamperoni Victoria V Napoleone Elisa E Patalay Praveetha P Jacob Jenna J Fokkema Marjolein M Promberger Marianne M Costa da Silva Luís L Patel Meera M Edbrooke-Childs Julian J

European child & adolescent psychiatry 20190503 2

Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population. This study examined rates of reliable improvement/deterioration for children in a school sample over time. N = 9074 children (mean age 12; 52% female; 79% white) from 118 secondary schools across England provided ...[more]

PMID: 31054126

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Project description:BackgroundIn many countries, including in the United Kingdom (UK), COVID-19 social distancing measures placed substantial restrictions on children's lives in 2020 and 2021, including closure of schools and limitations on play. Many children faced milestones such as transition to secondary school having missed several months of face-to-face schooling in the previous academic years.MethodsThis paper examines change in mental health difficulties, life satisfaction, school connectedness, and feelings about transition to secondary school among 10-11-year-olds in Wales, UK, using data from repeat cross-sectional surveys before and after the onset of the COVID-19 pandemic. Participants were 4032 10-11-year-old schoolchildren. The first cohort completed a school-based survey in 2019 (prior to introduction of social distancing measures), and the second in 2021 (following full return to school after two rounds of school closure).ResultsThe percentage of children reporting elevated emotional difficulties rose from 17% in 2019 to 27% in 2021 (Odds Ratio = 1.65; 95%CI = 1.23 to 2.20). There was no evidence of increased behavioural difficulties (OR = 1.04; 95%CI = 0.73 to 1.46). There was a tendency toward declines in life satisfaction in all analyses, but this intersected the null (OR = 0.86; 95%CI = 0.70 to 1.07). Children reported a high degree of school connectedness before and after the pandemic, with no evidence of change in ratings of teacher relationships, pupil relationships or pupil involvement in school life. There was no evidence of impacts of the pandemic on children's feelings about the transition to secondary school, with feelings becoming more positive as transition neared. Most findings were robust to a range of sensitivity analyses.ConclusionsSupporting children's emotional recovery from the COVID-19 pandemic is a public health priority requiring urgent and effective action at multiple levels of society. Maintaining connectedness to school through the pandemic may have played a role in preventing a steeper increase in child mental health difficulties.

Project description:BACKGROUND: Despite the large number of parenting questionnaires, considerable disagreement exists about how to best assess parenting. Most of the instruments only assess limited aspects of parenting. To overcome this shortcoming, the "Comprehensive General Parenting Questionnaire" (CGPQ) was systematically developed. Such a measure is frequently requested in the area of childhood overweight. METHODS: First, an item bank of existing parenting measures was created assessing five key parenting constructs that have been identified across multiple theoretical approaches to parenting (Nurturance, Overprotection, Coercive control, Behavioral control, and Structure). Caregivers of 5- to 13-year-olds were asked to complete the online survey in the Netherlands (N?=?821), Belgium (N?=?435) and the United States (N?=?241). In addition, a questionnaire regarding personality characteristics ("Big Five") of the caregiver was administered and parents were asked to report about their child's height and weight. Factor analyses and Item-Response Modeling (IRM) techniques were used to assess the underlying parenting constructs and for item reduction. Correlation analyses were performed to assess the relations between general parenting and personality of the caregivers, adjusting for socio-economic status (SES) indicators, to establish criterion validity. Multivariate linear regressions were performed to examine the associations of SES indicators and parenting with child BMI z-scores. Additionally, we assessed whether scores on the parenting constructs and child BMI z-scores differed depending on SES indicators. RESULTS: The reduced questionnaire (62 items) revealed acceptable fit of our parenting model and acceptable IRM item fit statistics. Caregiver personality was related as hypothesized with the GCPQ parenting constructs. While correcting for SES, overprotection was positively related to child BMI. The negative relationship between structure and BMI was borderline significant. Parents with a high level of education were less likely to use overly forms of controlling parenting (i.e., coercive control and overprotection) and more likely to have children with lower BMI. Based on several author review meetings and cognitive interviews the questionnaire was further modified to an 85-item questionnaire. CONCLUSIONS: The GCPQ may facilitate research exploring how parenting influences children's weight-related behaviors. The contextual influence of general parenting is likely to be more profound than its direct relationship with weight status.

Project description:It has been suggested that diverse interventions applied within children's everyday contexts have the potential to improve working memory (WM) and produce transfer to real-world skills but little is known about the effectiveness of these approaches. This review aims to examine systematically the effectiveness of non-computerised interventions with 4-11?year olds to identify: (i) their effects on WM; (ii) whether benefits extend to near- and far-transfer measures; (iii) if gains are sustained over time; (iv) the active ingredients; and (v) the optimum dosage. Searches were conducted across 12 electronic databases using consistent keywords. Papers were screened by title and abstract (n?=?6212) and judged against pre-defined eligibility criteria (n?=?63). Eighteen papers were included in the review. They used a range of non-computerised WM intervention approaches that included: (i) adapting the environment to reduce WM loads; (ii) direct WM training with and without strategy instruction; and (iii) training skills which may indirectly impact on WM (physical activity, phonological awareness, fantastical play and inhibition). Both direct training on WM tasks and practicing certain skills that may impact indirectly on WM (physical activity, fantastical play and inhibition) produced improvements on WM tasks, with some benefits for near-transfer activities. The common ingredient across effective interventions was the executive-loaded nature of the trained task i.e., training on a task that taps into attentional and processing resources under executive control and not just the storage of information. Few studies reported dosage effects, measured far-transfer effects (n?=?4), or tested the durability of gains over time (n?=?4). The lack of a clear theoretical framework in many of the included studies resulted in ambiguous predictions about training and transfer effects, and inadequate use of outcome measures. Methodological issues also constrain the strength of the evidence, including: small samples sizes; an absence of blinding of participant and outcome assessors; and lack of active control groups. Further well-designed and controlled studies with clear theoretical underpinnings are required to expand and enhance the evidence base. The heterogeneity of the interventions and of the study designs (randomised and non-randomised) in the included papers limited the synthesis of evidence across studies. However, this diversity enabled the identification of key ingredients, notably the training of executive-loaded WM tasks, which can help inform novel approaches to WM intervention in everyday contexts.

Dataset Information

Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds.

Publications

Predicting mental health improvement and deterioration in a large community sample of 11- to 13-year-olds.

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