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Purpose: An internal model deficit is considered to underlie developmental coordination disorder (DCD); thus, children with DCD have an altered sense of agency (SoA), which is associated with depressive symptoms. Furthermore, the perception of action-outcome regularity is present in early development, is involved in the generation of SoA, and has roles in adaptive motor learning and coordinated motor skills. However, perceptual sensitivity to action-outcome regularity has not been examined in children with DCD. Methods: We investigated perceptual sensitivity to action-outcome regularity in 6–15-year-old children with DCD and age- and sex-matched typically developing (TD) children. Both groups were assessed for coordinated motor skills with the Movement Assessment Battery for Children-2nd Edition, while the DCD group was assessed with the DCD Questionnaire, Social Communication Questionnaire, Attention-Deficit/Hyperactivity Disorder-Rating Scale, and Depression Self- Rating Scale for Children. Results: Perceptual sensitivity to action-outcome regularity was significantly reduced in children with DCD. However, there was a significant correlation between perceptual sensitivity to action-outcome regularity and age in DCD and TD children. Perceptual sensitivity to action-outcome regularity was significantly lower in younger children with DCD than in younger and older TD children, but there were no significant differences between older children with DCD and younger and older TD children. Conclusion: The current results suggest that children with DCD have significantly reduced perceptual sensitivity to action-outcome regularity at younger ages, which may alter SoA and inhibit internal model development, thereby reducing motor skill coordination. [ABSTRACT FROM AUTHOR]

Background: Depression is a common mental disorder in children and adolescents, with a global prevalence of approximately 33%, severely affecting their physical, mental health, and academic performance. This study aims to identify and assess the 100 most-cited articles (T100 articles) on depression in children and adolescents. Methods: The T100 articles in the field of depression were retrieved from the SCI-E and SSCI databases. A comprehensive analysis of the T100 articles was conducted, including the number of citations, countries, journals, keywords, authors, and topics. Results: Between 1981 and 2021, T100 articles in child and adolescent depression received 423 to 3949 citations. Most articles originated from the USA, with Kovacs M as the top-ranked author. The University of Pittsburgh and Columbia University published the top two T100 articles. The T100 articles were published in 36 journals, led by AMA Psychiatry. Co-occurrence keywords analyses reveal six key foci: Pathogenesis of Depression, Treatment of MDD in Children, Early Childhood Treatment, Adolescent Depression Manifestations, Gender and Depression, and Primary Care Considerations, with pathogenesis as a future trend. Conclusions: Our research presents an exhaustive list of the most highly cited articles on depression in children and adolescents. Our findings not only underscore the significance of international cooperation but also reveal a pressing need to prioritize and bolster preventive research, particularly the development and refinement of early screening and intervention programs. [ABSTRACT FROM AUTHOR]

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management. [ABSTRACT FROM AUTHOR]

Background: Despite a world-leading educational system, an achievement gap in educational outcomes exists between children of refugee background and native-born peers in Finland. To offer targeted support for children at schools, we need to be able to reliably assess and understand the interplay of the aspects of children's cognitive, social, and mental health functions that may explain the underachievement of refugee children. This study tests a novel research-based, universally applicable screening battery for evaluating cognitive, social, and mental health functioning of children at schools and planning supportive actions. It aims to answer research questions about a) the cognitive, social, and mental health functioning of refugee children compared with non-refugee immigrant and native-born children, b) the interplay of these different functions among refugee and other children, c) whether implementing a screening battery can inform schools in planning supportive actions for (refugee) children, and d) whether such supportive actions result in improvements in cognitive, social, and mental health functioning. Methods: Four hundred fifty children aged 10–12 will be recruited from primary schools, including 150 children of refugee background, 150 of non-refugee immigrant background, and 150 native-born Finnish children. A screening battery including tasks and questionnaires on different aspects of cognitive, social, and mental health functioning will be used to assess the children in their classrooms at the start and end of a school year. Supporting information will also be collected from parents and teachers. The information gathered will be collated into class-level feedback reports for teachers and, with parental permission, individualized reports for multiprofessional student welfare bodies, for informing supportive actions. Correlational and latent profile analyses, ANOVAs, and linear regression will be used to answer the research questions. Discussion: This study will help clarify how the interplay of cognitive, social, and mental health factors may explain underachievement at school among refugee children. It will provide evidence about the extent to which a standardized screening battery could be helpful in informing and planning supportive actions for children at schools, and whether such supportive actions can lead to positive cognitive, social, or mental health outcomes. Trial registration: The study will be preregistered on the Open Science Framework. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the association between child-specific and household material deprivation with depression among elementary and middle school students in Japan. Methods: We used cross-sectional data from 10,505 and 10,008 students for fifth-grade elementary school students (G5) and second-grade middle school students (G8), respectively, and their caregivers. The data were collected from August to September 2016 in 4 municipalities of Tokyo and from July to November 2017 in 23 municipalities of Hiroshima prefecture. Caregivers completed questionnaires including household income and material deprivation, and children completed child-specific material deprivation and depression status using the Japanese version of the Birleson depression self-rating scale for children (DSRS-C). To explore the associations, logistic regression was used after conducting multiple imputation for the missing data. Results: 14.2% of G5 students and 23.6% of G8 students had DSRS-C scores of more than or equal to 16, denoting the risk of depression. We found that household equivalent income was not associated with childhood depression in both G5 and G8 students when adjusted for material deprivations. While at least one item of household material deprivation was significantly associated with depression in G8 students (OR = 1.19, CI = 1.00, 1.41), but not in G5 children. Child-specific material deprivation of more than 5 items was significantly associated with depression in both age groups (G5: OR = 1.53, CI = 1.25, 1.88; G8: OR = 1.45, CI = 1.22, 1.73). Conclusion: Future research on child mental health needs to consider children's perspectives, especially material deprivation in young children. [ABSTRACT FROM AUTHOR]

Earliest memories have been the topic of scientific research for over a century and seen use as tools of clinical assessment. Still, it remains unclear whether they are in some way distinct or revealing about the person reporting them. This preregistered study examined whether children's self-reported earliest memories differ from other memories, and how their features link with mood and gender. Urban 9–13-year-old children in Finland (N = 166) reported on their earliest memory and another old autobiographical memory, and mood. Memories were coded for specificity, thematic content, social orientation, and emotional content. No differences between earliest and other memories were noted in specificity, trauma- and accident-related content, or emotional content. However, earliest memories had more play- and less visit-related content and were less likely to be social. Negative mood did not generally correlate with features of memories. Girls reported more social earliest and other memories, and more positive earliest memories. The findings are compared to research in other cultural environments. Overall, they do not support a privileged position for the earliest memory as an object of scientific research or clinical assessment. [ABSTRACT FROM AUTHOR]

The dual pathway hypothesis of risk for substance use was tested by examining risk from symptoms of conduct problems and depressive symptoms in adolescence (from ages 10-11 to 17-18 years) to substance use—including tobacco, alcohol, cannabis, and other illicit drugs—in both early adulthood (approximately from ages 20 to 29 years) and middle adulthood (approximately from ages 29 to 38 years). Hypotheses were tested on a sample of boys who were at risk for conduct problems by virtue of the neighborhoods where they lived in childhood (the Oregon Youth Study; N = 206 at Wave 1). Dual-trajectory modeling (Latent Class Analysis) resulted in a 3-group solution of high, moderate, and low co-occurring symptoms. The latent class of boys with co-occurring symptoms in adolescence showed higher levels of substance use in adulthood; namely, higher levels of cannabis and illicit substance use during early adulthood compared to either of the moderate or low symptom classes, and higher use of cannabis in midadulthood than the low symptom class. Those with co-occurring symptoms also showed, overall, higher vulnerability to use of tobacco in these 2 periods, but not to higher use of alcohol. Regression analyses indicated that the higher substance use of the co-occur group of men was related to their adolescent conduct problems, but was not related to their adolescent depressive symptoms; however, these associations were nonsignificant when adolescent use of the respective substances were included in the models. Thus, the dual-trajectory hypothesis was not supported. However, the findings indicated that, as assessed in the present study, the psychopathology symptoms of boys with conduct problems in adolescence who show risk for later substance use may be complex, involving depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Interpersonal violence against children and adolescents can affect their mental health and functioning in the long term. To reduce mental health problems in children and adolescents, school-based mental health interventions have been shown to be beneficial. A review of school-based interventions designed to mitigate posttraumatic symptoms after interpersonal violence is lacking to date. Methods: We searched for original studies published in English or German until November 2019 in 6 electronic databases. Supplementary search strategies to reduce publication bias were implemented. Peer-reviewed original studies assessing school-based interventions for children and adolescents under the age of 21 after interpersonal violence were included. Relevant data was extracted, synthesised and assessed qualitatively. The methodological quality of included studies was assessed. Results: Of 5,021 unduplicated publications, 15 studies met eligibility criteria. The included studies were almost exclusively conducted in the USA; over half utilised a randomised-controlled design. Studies mainly focussed on Posttraumatic Stress Disorder (PTSD) or depression. In all studies, implemented interventions partially or fully mitigated posttraumatic symptoms. Nine school-based interventions, five of which were based on cognitive behavioural therapy (CBT), were identified. School staff were often involved in intervention implementation besides mental health professionals. Conclusions: School-based interventions can be beneficial to reduce mental health problems in children and adolescents after interpersonal violence. Trained school staff aided by mental health professionals can implement trauma-informed practices at school. While school-based interventions may be a feasible way to provide children and adolescents with accessible mental health care, further research on school-based trauma interventions outside the USA is necessary. [ABSTRACT FROM AUTHOR]

A multivariate model was used to study outcomes of childhood bereavement. The model included exogenous factors such as engagement and within-person resilience factors. Sixty-two parent-child dyads were recruited from a local children's grief center and completed measures of engagement in the programming, resilience and grief. A complex model was revealed in which parental engagement in the grief program was related to child engagement and the child's control beliefs which in turn were significantly related to the child's grief symptoms. These variables existed within a system, rather than within an individual. [ABSTRACT FROM AUTHOR]

Objective: This systematic review explored the effectiveness of using physical activity (PA) interventions to enhance psychological well‐being and reduce psychological ill‐being (e.g., anxiety and depression) in children aged six to 11 years old from the general population. Methods: Electronic databases were searched for studies published between January 2005 and June 2020: Web of Science, ProQuest Psychology Journals, PsycINFO, Pub Med, ASSIA, CINHAL PLUS, SPORTDiscus, EMBASE and Wiley Online Library. Search terms included 'physical activity intervention', 'psychological well‐being' and 'child*'. After removing duplicates, 11 390 studies were independently screened by two authors based on inclusion/exclusion criteria and assessed for risk of bias. Results: A total of 23 studies were narratively synthesized and categorized into four domains: Quality of Life (QOL), body image, self‐esteem and psychological ill‐being. Evidence was provided for the impact of PA interventions in improving QOL, body image and self‐esteem. Despite the positive effect on psychological well‐being, evidence for a reduction in the frequency and severity of symptoms associated with psychological ill‐being in children is less clear. Conclusions: Reviewed studies support the use of PA interventions in enhancing the psychological well‐being of children in school and community settings. More research is warranted to understand the impact of PA interventions on reducing psychological ill‐being in children from the general population. [ABSTRACT FROM AUTHOR]

Background: Following disasters, children and adolescents can use coping strategies to feel better. A growing body of studies investigated the relation between them and maladjustment/adjustment, i.e., negative symptomatology/positive indicators of development. Yet, these constructs are studied separately. Objective: We conducted two meta-analyses to examine the mean correlation between disaster-related coping strategies and indicators of maladjustment/adjustment following natural disasters in children and adolescents, considering the role of some moderators. Methods: We used PsycINFO, PubMed, Eric, and Scopus databases to identify articles on natural disasters (filters: participants ≤ 18 years at the disaster, peer-review, English language). Inclusion required investigating the relation between at least one coping strategy and at least one indicator of maladjustment (e.g., post-traumatic stress disorder, depression) and/or adjustment (e.g., self-efficacy, emotion understanding), for a total of 26 studies (k = 64, n = 9692, for maladjustment; k = 37, n = 3504, for adjustment). Results: There were global positive significant correlations between coping strategies and negative symptomatology (rpooled =.23) for maladjustment, and positive indicators (rpooled =.17) for adjustment. Negative symptomatology positively correlated with escape (r =.19), social isolation (r =.15), submission (r =.64), and opposition (r =.16); positive indicators positively correlated with problem solving (r =.31), social support (r =.22), and submission (r =.30). We found a moderating role of age, disaster type, and continent for maladjustment. Conclusions: The study presented an analysis of the coping strategies that can be effective for children and adolescents dealing with natural disasters. [ABSTRACT FROM AUTHOR]

There is limited evidence on the cultural appropriateness of first-stage psychosocial interventions for youth with mental health problems who experience conflict and disadvantage in low- and middle-income countries (LMIC). To evaluate the feasibility of such an intervention (Writing for Recovery – WfR) among youth with emerging emotional problems following internal displacement in Kenya. Fifty-four youth aged 14–17 years were randomly allocated to a six-session intervention or a waiting list control group. They completed measures of stressful life events; post-traumatic stress, depressive and anxiety symptoms; quality of life; and free text on their experience of the intervention. Young participants reported high levels of trauma exposure and emotional problems. The intervention was perceived as flexible and culturally acceptable, with reported short-term impact. This was found to have promising post-intervention effect in reducing post-traumatic stress, but not depressive or anxiety symptoms; and in enhancing quality of life scores. Similar psychosocial interventions that can be delivered by paraprofessionals are important for resource-constrained LMIC settings, but need to be integrated within a comprehensive scaled service model. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety symptoms in early childhood have a major effect on children's mental health growth and cognitive development. The effect of mental health problems on cognitive development has been studied by researchers for the last 2 decades. Objective: In this paper, we sought to use machine learning techniques to predict the risk factors associated with schoolchildren's depression and anxiety. Methods: The study sample consisted of 3984 students in fifth to ninth grades, aged 10-15 years, studying at public and refugee schools in the West Bank. The data were collected using the health behaviors schoolchildren questionnaire in the 2013-2014 academic year and analyzed using machine learning to predict the risk factors associated with student mental health symptoms. We used 5 machine learning techniques (random forest [RF], neural network, decision tree, support vector machine [SVM], and naive Bayes) for prediction. Results: The results indicated that the SVM and RF models had the highest accuracy levels for depression (SVM: 92.5%; RF: 76.4%) and anxiety (SVM: 92.4%; RF: 78.6%). Thus, the SVM and RF models had the best performance in classifying and predicting the students' depression and anxiety. The results showed that school violence and bullying, home violence, academic performance, and family income were the most important factors affecting the depression and anxiety scales. Conclusions: Overall, machine learning proved to be an efficient tool for identifying and predicting the associated factors that influence student depression and anxiety. The machine learning techniques seem to be a good model for predicting abnormal depression and anxiety symptoms among schoolchildren, so the deployment of machine learning within the school information systems might facilitate the development of health prevention and intervention programs that will enhance students'mental health and cognitive development. [ABSTRACT FROM AUTHOR]

Understanding early childhood mental health service utilization in community-based clinical settings is important. Project Linking Actions for Unmet Needs in Children's Health (Project LAUNCH) provided mental health-related services for young children and families within pediatric medical homes. Using data from the Project LAUNCH evaluation (n = 106), we implemented negative binomial regression models to determine if baseline variables were associated with service utilization, defined as the number of encounters between the family and the team. Past-year homelessness emerged as a significant predictor of service utilization. Encounters for families with children who experienced homelessness within the last 12 months occurred at a rate 34.5% lower than those who had not experienced homelessness. Results highlight the importance of addressing homelessness as a barrier to mental health service utilization for families. Screening for recent housing insecurity and developing interventions that integrate housing support services into mental health programs may inform strategies to increase attendance for families with young children. [ABSTRACT FROM AUTHOR]

An underlying concern about the COVID-19 pandemic is the decline of children's mental health. The present study is aimed to investigate whether a single school-based intervention, including self-monitoring and psychoeducation for COVID-19, effectively achieved its aim to promote children's mental health. The study was conducted in a junior high school. We assigned the third grade as the intervention group, the second grade as the announcement group, and the first grade as the control group. We hypothesized that the intervention group would experience improved mental health and reduced fear of COVID-19 compared to the announcement and control groups. Interaction effects were observed only for depression, indicating a significant effect in the intervention group. These findings suggest that a single school-based intervention that includes self-monitoring and psychoeducation for COVID-19 can help improve children's mental health. It is suggested that school-based interventions that intend to raise children's awareness of COVID-19 promote their healthy development and adaptation to crises within the school. [ABSTRACT FROM AUTHOR]

Background: Children of parents with a mental illness are at higher risk for various psychiatric problems and adaptive difficulties compared to those of parents without mental health problems. Certain preventive psychoeducational interventions target these children to promote their well-being and resilience and prevent the emergence of adaptive difficulties. However, few such interventions have been developed and evaluated specifically for elementary school-aged children of parents with a mental illness. Objectives: This study aims to evaluate an interpersonal psychotherapy-based book targeting children living with a parent with a mental illness. Methods: The study examines children, parents and psychosocial workers' perception of the acceptability, appropriateness and utility of the book. In total, 22 participants answered online open-ended questions after reading the book. Results: The book was highly appreciated and positively perceived by the families and psychosocial workers. Results suggest that children, parents and psychosocial workers viewed it as an appropriate and useful tool for supporting children with a parent with a mental illness. The present study reveals that the bibliotherapy appears well adapted to the developmental level of school-age children. Discussion: This study presents a book that shows promise for supporting the resilience of elementary school-aged children having a parent with a mental illness. Results highlight the importance of tailoring the content and modalities of interventions to the developmental level, needs and preferences of elementary school-aged children. The relevance of a collaborative method is also discussed, thus providing knowledge regarding this type of approach for the development of interventions targeting children. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Revised Child Anxiety and Depression Scale (RCADS-47) are established cross-culturally but lacking for the Greek population. The present study examined RCADS internal consistency and validity (structural and concurrent) in Greek adolescents, and tested measurement invariance across sex and age groups. We recruited 619 secondary school students (n = 321 females), aged 12–18 years (n = 318, 12–14-year-olds). Besides RCADS, all students completed Strengths and Difficulties Questionnaire (SDQ), a subsample (n = 300) completed Screen for Child Anxiety-Related Emotional Disorders (SCARED), whereas a non-overlapping subsample (n = 219) completed Depression Self-Rating Scale (DSRS). Structural validity was examined with Confirmatory Factor Analysis and measurement invariance was assessed with Multiple Indicators Multiple Causes (MIMIC) modeling. Convergent and divergent validity were examined using Spearman correlations between RCADS subscales and DSRS, SCARED, and SDQ validators. The six-factor model fitted the data best, validating the originally proposed RCADS structure. Three items displayed differential item functioning for sex, another three for age group, and one item for both, albeit with trivial effect sizes (d < 0.2). Cronbach's alpha was.94. Convergent and divergent validity were also established. In conclusion, the RCADS is a valid and reliable instrument for assessing anxiety and depression symptoms in Greek adolescents. [ABSTRACT FROM AUTHOR]

Background: The present study examined the effectiveness of the Universal Unified Prevention Program for Diverse Disorders (Up2-D2) for internalizing and externalizing problems for children aged 9–11 years. Methods: We used two feasibility studies. The Up2-D2 entailed 12 sessions delivered by teachers; each session was developed based on cognitive-behavioral and positive psychological interventions. In Studies 1 and 2, 58 elementary school children aged 9–11 and 73 elementary school children aged 10–11 attended the Up2-D2. The teachers in Study 1 received 1.5 h of on-site teacher training for learning rationales for interventions, how to run the program, and received ongoing supervision by professionals with mental health expertise. In contrast, the teachers in Study 2 were given self-learning DVD materials in place of on-site training and ongoing supervision. Results: Mixed models revealed that general difficulties, which is total score of both internalizing and externalizing problems, decreased in Study 1 but not in Study 2. Additional analyses for children with subclinical general difficulties revealed that general difficulties, internalizing problems, and externalizing problems decreased in Study 1, whereas in Study 2, general difficulties and internalizing problems decreased, except for externalizing problems. Conclusions: These results suggest that on-site teacher training and ongoing supervision are imperative for improving general difficulties in children at a universal level. In addition, universal preventive interventions by classroom teachers without on-site training and continuous supervision might be efficacious for reducing general difficulties and internalizing problems for children with subclinical difficulties. [ABSTRACT FROM AUTHOR]

Purpose: A meta-analysis of group interventions to reduce post-traumatic stress symptoms (PTSS) and/or depression among refugee and immigrant children and adolescents. Methods: A systematic search was followed by independent reviews of each study for risk of bias. The meta-analysis pooled between- and within-condition effect sizes on PTSS and depression across studies using a random effects model. Results: The search yielded 16 studies utilizing eight interventions involving 976 participants. For all studies, within conditions, there were good effects on PTSS (d = −0.66, 95% CI [−0.86, −0.46]) and depression (d = −0.51, 95% CI [−0.79, −0.23]) with substantial heterogeneity. For studies with control groups, the between-group effect sizes yielded a small effect on PTSS (d = −0.31, 95% CI [−0.65, 0.03]) with no significant effect on depression. Conclusions: The interventions helped to reduce PTSS and depression. Most studies lacked rigorous designs and provided little information on group variables needed for replication. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to provide a summary of the measures to assess narcoleptic symptoms or complications in pediatric narcolepsy patients. Methods: We searched in the National Center for Biotechnology Information (NCBI) for measures of narcoleptic symptoms for pediatric patients. Further review was conducted if relevant questionnaires or information were mentioned. Results: There were only two narcolepsy-specific questionnaires, the narcolepsy severity scale and Ullanlinna Narcolepsy Scale, neither of them was developed or validated in the pediatric population. For cataplexy, all the measures were study-specific diaries and were not validated questionnaires. For excessive daytime sleepiness, the Epworth Sleepiness Scale was most frequently used to measure excessive daytime sleepiness in children. For nighttime sleep, the Children's Sleep Habits Questionnaire was most frequently used. For depression, the Children Depression Inventory was the most frequently used. For attention-deficit/hyperactivity disorder, the Child Behavior Checklist was the most frequently used. For quality of life, KIDSCREEN was most frequently used. Conclusions: At present, there is a lack of disease-specific and validated questionnaires for pediatric narcoleptic patients. This need can be met by modifying and adjusting the existing adult questionnaires and developing new questionnaires for pediatric narcoleptic patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: The long-term separation of parents and children as well as the incomplete family structure affect the mental health development of left-behind children and the formation of healthy personality, good interpersonal relationships and positive coping styles in adulthood. At present, there is insufficient empirical investigations on the mental resilience of left-behind children. OBJECTIVE: It is aimed to understand the mental health of left-behind children and explore the characteristics of mental resilience, self-esteem and emotional processing bias, as well as social coping styles. METHODS: The random sampling method is used to select the left-behind children as the research subject. The general demographic information questionnaire, RSCA (Resilience Scale for Chinese Adolescent), emotional self-rating scale, SES (Self-Esteem Scale), and coping style questionnaire are used for the survey. Also, the experiments on cognitive processing bias effects of self-esteem and emotion are further carried out. RESULTS: There are differences in demographic variables in mental resilience, self-esteem level, emotional level, and social coping styles. The low mental resilience group shows a processing bias towards low praise words, while the high mental resilience group shows a processing bias towards high praise words. At a low level of self-esteem, there is an interaction between mental resilience and self-esteem on low praise words. Mental resilience has a significant effect on the cognitive processing bias of emotion. Under the induction of positive emotions, the high mental resilience group responds significantly more slowly to the negative words than the low mental resilience group. Under the induction of negative emotions, the high mental resilience group responds significantly faster to the negative words than the low mental resilience group. CONCLUSIONS: Promoting the mental health education of left-behind children can start from enhancing positive emotions, reducing negative emotions, developing high self-esteem, and improving mature coping styles. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traumatic exposure combined with significant stressors in resettlement place Bhutanese refugees at risk for mental health problems. Despite this, refugee youth often are reluctant to seek mental health services. Psychosocial support services, such as school‐based groups, offer one solution to this barrier to care. We had 2 aims in this study: (1) to describe the psychosocial needs of resettled Bhutanese refugee students; and (2) to evaluate the impact of skills‐based groups on these students' sense of school belonging and mental health. METHODS: Bhutanese refugee students in middle school (N = 34) participated in the 12‐week group curriculum (a component of Trauma Systems Therapy for Refugees) and the associated preevaluation/postevaluation. RESULTS: Baseline descriptive analyses indicated high levels of mental health symptoms; approximately, 49% of students met partial or full criteria for posttraumatic stress disorder. In addition, sense of school belonging was significantly inversely associated with depressive and posttraumatic stress symptoms at baseline. Paired sample t tests indicate that students' avoidance symptoms significantly decreased postintervention. CONCLUSIONS: Findings suggest that skills‐based groups may be an effective way to engage students in supportive services and address psychosocial needs. Results further highlight the potential protective role of school belonging in reducing refugee students' vulnerability to psychological distress. [ABSTRACT FROM AUTHOR]

Refinement, targeting, and better dissemination of trauma-focused therapies requires understanding their underlying mechanisms of change. Research on such mechanisms among multiply traumatized children and adolescents is scarce. We examined the role of improvements in problematic qualities of traumatic memories and maladaptive posttraumatic cognitions in PTSD symptom reduction, in a randomized, pragmatic trial of narrative exposure therapy vs. treatment as usual with 40 participants 9–17 years old (48% female, 75% refugee background) repeatedly exposed to war or family violence related trauma. Posttraumatic cognitions, quality of traumatic memories and PTSD symptoms were assessed by self-report before and after treatment. Improvements in both quality of traumatic memories (rMI =.36) and posttraumatic cognitions (rMI =.46) correlated with symptom reduction. However, improvement during treatment was only significant for quality of traumatic memories (FMI(11,333.56) = 4.77), not for posttraumatic cognitions. We detected no difference in effects of narrative exposure therapy and treatment as usual on cognitions or memories. We tentatively suggest problematic, overly sensory and incoherent quality of traumatic memories may be a useful target in the treatment of PTSD symptoms among multiply traumatized children and adolescents. Changing maladaptive posttraumatic cognitions, though important, may be challenging among those with severe, repeated trauma. [ABSTRACT FROM AUTHOR]

Purpose: We developed a Japanese version of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) and examined its reliability and validity across three studies. Patients and Methods: In Study 1, the Japanese version of ERQ-CA was developed and administered to 389 children aged 8– 12 years. In Study 2, the questionnaire was administered to 1738 adolescents aged 12– 18 years. In Study 3, utilizing a sample of 1300 children and adolescents, the test was administered twice over a period of four weeks in order to assess test–retest reliability. Results: In Study 1, the Japanese version of ERQ-CA showed the same factor structure as the original version, along with good internal consistency reliability and acceptable construct validity. In Study 2, the questionnaire's factor structure, internal consistency reliability, and construct validity were again confirmed. Finally, in Study 3, measurement invariance was tested across distinct age groups (8– 11, 12– 15, and 16– 18 years), and the questionnaire had good test–retest reliability over a period of four weeks. Conclusion: The Japanese version of the ERQ-CA had good reliability and validity. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents can be prone to mental health problems such as post-traumatic stress disorder (PTSD) and depression following disasters. School teachers can provide timely psycho-social support that could instill hope and improve mental health among adolescents in a post-earthquake situation in a low-resource setting. This study examined the effect of training for school teachers on psycho-social support on adolescents’ mental health and hope in an earthquake affected district in Nepal. Methods: This cluster randomized controlled trial was conducted in 15 schools in Dhading, a severely affected district by the 2015 earthquake in Nepal. The schools were randomized, as a result, 8 were in the intervention group and 7 in the control group. A total of 1,220 adolescents were recruited at baseline of which 605 adolescents belonged to intervention group and 615 to control group. The follow-up rate at 6 months was 83%. This trial was registered with Clinicaltrials.gov with registration number NCT03387007. Results: The intervention did not show significant effects for PTSD symptoms (Intervention*time, β = 0.33, p = 0.536), depression symptoms (Intervention*time, β = 0.30, p = 0.249), and hope (Intervention*time, β = -0.23, p = 0.588), among the adolescents at 6 months follow-up. Conclusion: The intervention did not improve mental health symptoms and hope among adolescents at 6 months follow-up. More focused and longer training could be necessary to address mental health among adolescents affected by earthquake. Additionally, longer follow-up could be necessary to assess the changes taking place over time. Trial registration: ClinicalTrials.gov . [ABSTRACT FROM AUTHOR]

Problem: Worldwide, the psychopathological effects of catastrophes such as earthquake, hurricane and war are causing traumas in an enormous number of children. Identification and assessment of the impact on children of catastrophic events is essential to their healing and continued well‐being. Methods: To identify the relevant tools Google Scholar, SID, PsycInfo, Medlib, MedLine, and PubMed databases were searched using the relevant Mesh terms and their equivalents including ("anxiety" or "fear" or "depression" or "psychosocial distress" or "prolonged grief" or "trauma general effect") AND ("tool and measures") OR ("cognition" and "parents") AND "scale and measures") from inception to March 2019. Findings: Sixty‐four measures were identified to be applied for measuring traumas' psychosocial effects on children. Anxiety and depression, posttraumatic stress disorder (PTSD), sexual abuse, trauma general effect and stress were among the important emanated tools to the assessment of posttrauma psychosocial predicaments in children. Conclusion: Few measures are identified to measure post trauma fear, prolonged grief and psychosocial distress in young children. However; a suitable scale for assessment of parents' cognition about general effects of traumas and parents' cognition about effects of trauma on children is less emphasized in current literature. [ABSTRACT FROM AUTHOR]

This study aimed to assess the prevalence of depression and anxiety among (12) Iraqi refugee children, 6 males and 6 females (aged 7–14) who had fled ISIS and are residing in Jordan awaiting resettlement. The authors used four scales to measure depression, field observation, and structured interviews with the mothers to examine exile-related variables and their association with depression: social isolation, lack of meaningful daily activities, lack of pleasurable activities, and emotional and behavioural problems. The results varied among the four scales as follows: Beck's Scale (50%) the highest, were found to be moderately depressed; Burn's (42%) the highest were found to be mildly depressed; DSRS (83.3%) the highest had major depression but not considered severe requiring hospitalization, and PTCI (75%) the highest were found to be mildly depressed. There was strong association between exile-related variables and depression: social isolation (92%), daily activities (100%), meaning to their daily lives (100%), and emotional and behavioural problems (59%). [ABSTRACT FROM AUTHOR]

Europe is in the midst of a large-scale migration crisis, which has implications for healthcare provision for asylum-seeking children and families. The authors set out to identify the psychological status of asylum-seeking children and highlight their needs. A search of three electronic databases was carried out, resulting in 15 studies. Data show that asylum-seeking children appear to experience many mental health difficulties, including post-traumatic stress disorder, depression, self-harm, sleep disturbance and behavioural difficulties. The daily living situation includes a range of psychological stressors, such as lack of space and control; fear of deportation; feelings of inadequacy and hopelessness; poor parental mental health; lack of recreational facilities; communication issues; and financial worries. Since many asylum-seeking children have experienced past trauma, hospitalisation and healthcare encounters may trigger traumatic memories and cause further distress. Awareness of the psychological impact of the situation on children and families may help nurses to provide empathetic, sensitive and culturally competent care. [ABSTRACT FROM AUTHOR]

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Concerns over anxiety and depressive symptoms in children with premature adrenarche (PA) have been recently raised. However, to date, most relevant studies are on a small number of girls. In this cross-sectional study, 82 pre-pubertal children (66 girls and 16 boys) diagnosed with PA, were compared to 63 control children regarding their psychological characteristics and hypothalamic-pituitary-adrenal (HPA) axis function, as assessed by salivary cortisol measurement. Symptoms of anxiety and depression were assessed by child self-report (Spence Children's Anxiety Scale (SCAS) and Depression self-rating scale for Children (DSRS)) and parent-report (Child Behaviour Checklist (CBCL)) tests validated for the Greek population. Salivary cortisol levels were determined directly after awakening (approximately 7am) and evening (8pm) of the same day. Morning serum DHEAS levels were assessed in PA children. Girls with PA scored significantly higher on anxiety (p = .016) and depression (p =.039) scales than controls. No group differences were noted for parent reports and children's salivary cortisol concentrations. Boys with PA did not demonstrate significant differences in any of the aforementioned parameters. Our findings suggest that girls with PA may be at higher risk for reporting symptoms of anxiety and depression than their non-PA peers. HPA axis dysregulation in this population was not documented. [ABSTRACT FROM AUTHOR]

Children of parents who experience mental health difficulties (COPE-MHD) consistently demonstrate numerous negative outcomes, including risks of intergenerational continuity of mental health difficulties (MHD). Numerous studies have analysed the experiences and understanding of parents’ MHD from the perspective of COPE-MHD. This metasynthesis aims to capture, across available literature, the way in which COPE-MHD make sense of their parent’s MHD and how this perception impacts their life. For inclusion in the review, research articles were required to be published in peer-reviewed journals, apply qualitative methods of data collection and analysis and report on the direct accounts of COPE-MHD regarding their understanding or experience of their parents’ MHD. Five electronic databases were used; Academic Search Complete, CINAHL, MEDLINE, PsycINFO and Child Development and Adolescent Studies. Fourteen studies were included. Analysis produced three overarching themes. The findings illustrate children’s sophisticated biopsychosocial conceptualisation of the cause and process of their parent’s MHD. It also highlights how they utilise this understanding to manage the day-to-day concerns associated with their parent’s experience of MHD. Clinical implications highlight a need for services working with children, parents and families to more frequently enquire about parents’ MHD and to consider the outcomes of such enquiry in the psychological formulation of children and young peoples’ mental health and development. Limitations and recommendations for future research are presented. [ABSTRACT FROM AUTHOR]

Post-traumatic Stress Disorder (PTSD) is a mental illness that causes significant distress and impairment. Studies generally indicate lower rates of PTSD post-disaster in Chinese child populations. Irrespective of population examined, findings suggest that trauma alone cannot account for the development of PTSD (Ma et al. 2011). It is important to understand what other variables may contribute to the onset of PTSD. This was the first meta-analysis conducted to investigate risk and protective factors for PTSD (as well as mediating/moderating variables) in children directly impacted by natural disasters in China. Understanding these factors can help guide disaster readiness efforts, as well as post-disaster interventions (Yule et al. 2000). Also, this study is extremely relevant given recent earthquakes in China that have devastated many. [ABSTRACT FROM AUTHOR]

Accumulating literature demonstrates that immigration detention is harmful to children. However, there is a scarcity of scientifically rigorous and reliable data about the health of children held in detention facilities. The aim of the study was to compare a community-based population of recently arrived refugee children flown into Australia, not detained, resettled in a non-urban area, with a population of children who arrived by boat seeking asylum, detained since arrival. The parent-version of the strength and difficulties questionnaire (SDQ) of children aged 4-15 years was compared in children living in the community with those held in detention. We compared 86 children who had a parent-completed SDQ performed, 38 (44%) in the community group and 48 (56%) in the detention group. The community sample had been living in Australia for 325 days, with no time in detention. The detention sample had been living in detention for a mean of 221 days. The mean age was similar for the community and detention sample at 8.4 years (P = 0.18). In the total sample, children in the detention group had significantly higher SDQ total difficulties scores than children in the community group (P < 0.0001). There was no difference between age groups (P = 0.82). The children in the detention group had, on average, an SDQ total difficulties score that was 12 points higher than children in the community group. Four of the five SDQ subscale scores indicated greater disturbance amongst children in detention (< 0.0001) compared to children living in the community. The detention group had significantly higher scores (P < 0.001) for all except Pro-social scores as compared to Australian norms for the 4-6 and 7-15 years age group. This study presents a rare opportunity to compare the wellbeing of displaced children who were detained following arrival in Australia with those settled in the Australian community since arrival. The community children’s scores approximated data from the general Australian childhood population. Children held in detention had significantly more social, emotional and behavioural difficulties than children living in the community, and at levels resembling a clinical cohort. Despite the small sample size, data restrictions and other limitations of the data, statistical significance in differences between the community and detention children is marked and arguably demonstrates the negative impact of post-arrival detention in children who are presumed to have similar levels of pre-arrival adversity. If the objective is to optimise the health and wellbeing of children seeking asylum, removal of post-arrival detention is one of the most powerful interventions available to host countries. [ABSTRACT FROM AUTHOR]

Background: The INTER-NDA is a novel assessment of early child development measuring cognition, language, motor skills, behaviour, attention, and socio-emotional reactivity in 2 year olds in 15 minutes. Here, we present the results of an evaluation of the INTER-NDA against the Bayley Scales of Infant Development III edition (BSID-III), its sensitivity and specificity and its psychometric properties. Methods: Eighty-one infants from Oxford, UK, aged 23.1–28.3 months, were evaluated using the INTER-NDA and the BSID-III. The agreement between the INTER-NDA and the BSID-III was assessed using interclass correlations (for absolute agreement), Bland-Altman analyses (for bias and limits of agreement), and sensitivity and specificity analyses (for accuracy). The internal consistency of the INTER-NDA and uni-dimensionality of its subscales were also determined. Results: The interclass correlation coefficients between the BSID-III and the INTER-NDA cognitive, motor and behaviour scores ranged between 0.745 and 0.883 (p<0.001). The Bland-Altman analysis showed little to no bias in the aforementioned subscales. The sensitivity and specificity of INTER-NDA cognitive scores ≤1 SD below the mean are 66.7% and 98.6% respectively, with moderate agreement between INTER-NDA and BSID-III classifications (κ = 0.72, p<0.001). The sensitivity and specificity of INTER-NDA scores <2 SD below the mean, in predicting low BSID-III scores (<70), are 100% each for cognition, and 25% and 100% respectively for language. More than 97% of children who scored in the normal range of the INTER-NDA (<1SD below mean) also scored in the normal range in the BSID-III (≥85). The INTER-NDA demonstrates satisfactory internal consistency and its subscales demonstrate good unidimensionality. Conclusion: The INTER-NDA shows good agreement with the BSID-III, and demonstrates satisfactory psychometric properties, for the assessment of ECD at 22–28 months. [ABSTRACT FROM AUTHOR]

This study examined (1) how attachment style predicts changes in mental health, and (2) whether change in emotion regulation (ER) intensity mediates that association in the context of psychosocial intervention among war-affected children. Participants were 482 Palestinian children whose school classes were randomized to either intervention (Teaching Recovery Techniques, TRT) or waiting-list groups. Attachment style, emotion regulation, and mental health were measured. The children with secure attachment were more likely to gain improved mental health in both conditions, but also preoccupied-insecure children showed improved mental health in the TRT. In the control group, instead, children with more attachment avoidance reported deteriorated mental health, and no changes in mental health was found among preoccupied children. Changes in the ER intensity did not mediate the association between attachment style and mental health in either groups. Discussion focuses on attachment-specific mechanisms underlying recovery from war trauma. [ABSTRACT FROM AUTHOR]

The contents of earliest memories (EM), as part of autobiographical memory, continue to fascinate scientists and therapists. However, research is scarce on the determinants of EM, especially among children. This study aims, first, to identify contents of EM of children living in war conditions, and, second, to analyse child gender, traumatic events and mental health as determinants of the contents of EM. The participants were 240 Palestinian schoolchildren from the Gaza Strip (10–12 years,M = 11.35,SD = 0.57; 49.4% girls). They responded to an open-ended EM question, and reported their trauma exposures (war trauma, losses and current traumatic events), posttraumatic stress, depressive symptoms and psychosocial well-being, indicating mental health. The EM coding involved nature, social orientation, emotional tone and specificity. Results showed, first, that 43% reported playing or visiting a nice place as EM, and about a third (30%) traumatic events or accidents (30%) or miscellaneous events (27%). The individual and social orientation were almost equally common, the emotional tone mainly neutral (45.5%), and 60% remembered a specific event. Second, boys remembered more EM involving traumatic events or accidents, and girls more social events. Third, war trauma was associated with less positive emotional tone and with more specific memories. [ABSTRACT FROM AUTHOR]

Problem Little evidence exists showing how a given high-risk group of children born to parents with poor mental health seek help and how care may be improved in order to better reach and support their families. Methods A systematic literature review was undertaken to identify the needs and help-seeking behaviors of children and their parents. Through an analysis of both quantitative and qualitative studies, published in German- and English-speaking research literature, the needs of children and parents were identified and categorized. Findings concerning their help-seeking behavior and the influence of demographic variables on needs and help-seeking behaviors were also described. Findings In the primary studies, the most identified parental needs were 'the need for being a good parent'; 'worries about the child's well-being'; and 'the need for practical help.' For children, the categories identified included 'the need for knowledge'; 'worries about parent's well-being'; and 'the need for normality.' However, information about help-seeking behaviors and influences of demographic factors was fairly limited in the literature. Conclusions In families with parental mental health problems, it seems especially important to take a family-focused approach. The individual needs of children (and their families) should shape the planning of treatment and nursing care. [ABSTRACT FROM AUTHOR]

Millions of children have been maimed, displaced, orphaned and killed in modern warfare that targets civilian populations. Several reviews have documented the impact of political trauma on children's mental health but none has focused specifically on young children (ages 0-6). Since developmental factors influence the young child's perception and experience of traumatic events, this developmental period is characterized by a unique spectrum of responses to political trauma. This systematic review, comprising 35 studies that included a total of 4365 young children, examined the effects of exposure to war, conflict and terrorism on young children and the influence of parental factors on these effects. Results showed that effects include PTSD and post-traumatic stress symptoms, behavioral and emotional symptoms, sleep problems, disturbed play, and psychosomatic symptoms. Correlations emerged between parental and children's psychopathology and, additionally, family environment and parental functioning emerged as moderators of the exposure-outcome association for children. [ABSTRACT FROM AUTHOR]

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The article presents a study conducted by Vanessa Greco, Heather C. Lambert, and Melissa Park which examines the prevalence of mental health disorders of children in North America. Topics discussed include encouragement of clinicians to participate in adult occupational therapy (OT), the use of screening process for self-report measure, and identification of child's perspective.

Background Sleep disorders are frequently associated with childhood behavioral problems and mental illnesses such as anxiety disorder. To identify promising behavioral targets for pediatric anxiety disorder therapy, we investigated the associations between specific sleep and behavioral problems. Methods We conducted retrospective reviews of 105 patients aged 4-12 years who met the DSM-IV criteria for primary diagnosis of generalized anxiety disorder (n = 33), separation anxiety disorder (n = 23), social phobia (n = 21), or obsessive compulsive disorder (n = 28). Sleep problems were evaluated using the Children's Sleep Habits Questionnaire ( CSHQ) and behavioral problems by the Spence Children's Anxiety Scale, Oppositional Defiant Behavior Inventory ( ODBI), and Depression Self- Rating Scale for Children. Results Depressive behavior was weakly correlated with CSHQ subscores for sleep onset delay and night waking but not with total sleep disturbance. Anxiety was correlated with bedtime resistance, night waking, and total sleep disturbance score. Oppositional defiance was correlated with bedtime resistance, daytime sleepiness, sleep onset delay, and most strongly with total sleep disturbance. On multiple regression analysis ODBI score had the strongest positive association with total sleep disturbance and the strongest negative association with total sleep duration. Conclusions Sleep problems in children with anxiety disorders are closely related to anxiety and oppositional defiant symptoms. [ABSTRACT FROM AUTHOR]

Background: Millions of children worldwide suffer from posttraumatic stress disorder (PTSD) symptoms and other mental health problems due to repeated exposure to war or organized violence. Forms of cognitive-behavioral therapy (CBT) are the most commonly used treatment for PTSD and appear to be effective for children as well, but little is known about the mechanisms of change through which they achieve their effectiveness. Here we present the study protocol of a randomized controlled trial (RCT) studying the effectiveness and mechanisms of change of Narrative Exposure Therapy (NET), a CBT-based, manualized, short-term intervention for PTSD symptoms resulting from repeated traumatization, in immigrant children traumatized by war. Methods/Design: We are conducting a multicentre, pragmatic RCT in a usual care setting. Up to 80 9-17-year-old immigrant children who have experienced war and suffer from PTSD symptoms will be randomized into intervention (NET) and control (treatment as usual, TAU) groups of equal sizes. The effectiveness of NET treatment will be compared to both a waiting list and the parallel TAU positive control group, on the primary outcomes of PTSD and depressive symptoms, psychological distress, resilience, and level of cognitive performance. The effects of the intervention on traumatic memories and posttraumatic cognitions will be studied as potential mechanisms of change mediating overall treatment effectiveness. The possible moderating effects of peritraumatic dissociation, level of cognitive performance, and gender on treatment effectiveness will also be considered. We hypothesize that NET will be more effective than a waitlist condition or TAU in reducing PTSD and other symptoms and improving resilience, and that these effects will be mediated by changes in traumatic memories and posttraumatic cognitions. Discussion: The results of this trial will provide evidence for the effectiveness of NET in treating trauma-related symptoms in immigrant children affected by war. The trial will also generate insights into the complex relationships between PTSD, memory functions, posttraumatic cognitions and cognitive performance in children, and help guide the future development and implementation of therapeutic interventions for PTSD in children. [ABSTRACT FROM AUTHOR]

Numerous studies have shown that Major Depressive Disorder (MDD) in adults is associated with deficits in cognitive control. Particularly, impairment on executive function (EF) tasks has been observed. Research into EF deficits in children and adolescents with MDD has reported mixed results and it is currently unclear whether paediatric MDD is characterised by impairments in EF and attention. PsycInfo, Scopus and Medline were systematically searched to identify all studies that have investigated EF and attention in paediatric depressive disorders between 1994 and 2014. 33 studies meeting inclusion/exclusion criteria were identified. While across different domains of EF some studies identified a deficit in the clinical group, the majority of studies failed to find deficits in response inhibition, attentional set shifting, selective attention, verbal working memory, and verbal fluency. More research is needed to clarify the relationship between depressive disorders in children and adolescents and spatial working memory processing, sustaining attention, planning, negative attentional bias and measures of 'hot' EF. There is little support for EF deficits in paediatric depression. However, there are numerous methodological problems that may account for null findings. Alternatively, chronicity and/or severity of symptoms may explain discrepancies between cognitive deficits in adult and paediatric MDD. Recommendations for future studies are discussed. [ABSTRACT FROM AUTHOR]

Background: With the inclusion of trauma-related cognitions in the DSM-5 criteria for posttraumatic stress disorder (PTSD), the assessment of these cognitions has become essential. Therefore, valid tools for the assessment of these cognitions are warranted. Objective: The current study aimed at validating the Dutch version of the Child Posttraumatic Cognitions Inventory (CPTCI). Method: We included children aged 8-19 years in our study and assessed the factor structure, reliability and validity of the CPTCI in a clinical sample (n=184) and a school sample (n=318). Results: Our results supported the two-factor structure of the CPTCI and showed good internal consistency for the total scale and the two subscales. We found significant positive correlations between the CPTCI and measures of PTSD, depression, and anxiety disorder. The CPTCI correlated negatively with a measure of quality of life. Furthermore, we found significantly higher scores in the clinical sample than in the school sample. For children who received treatment, we found that a decrease in CPTCI scores was accompanied by a decrease in posttraumatic stress symptoms and comorbid problems indicating that the CPTCI is able to detect treatment effects. Conclusion: Overall, our results suggest that the Dutch CPTCI is a reliable and valid instrument. [ABSTRACT FROM AUTHOR]

Background: Mental health problems are an important issue among institutionalized children. Although positive communication with parents is essential for children's well-being, it has not been sufficiently verified how interactions with parents affect mental health among institutionalized children, who have experienced childhood adversity and likely lack secure attachment formation with their parents. The objectives of this study were to investigate the association between parental visitation and depressive symptoms among institutionalized children in Japan, and to explore whether the established security of attachment interacts with that association. Methods: A cross-sectional data from 399 institutionalized children aged 9 to 18 in Japan was used for the analysis. A mixed effects regression analysis was conducted to investigate the associations. Results: Institutionalized children who had parental visitation showed higher depressive symptoms than those who did not. In particular, father's visitations were significantly associated with higher depressive symptoms. There was a significant interaction with score of secure attachment; children with low scores on secure attachment showed higher levels of depression with their father's visitation, whereas children with high scores on secure attachment did not. Conclusions: Findings suggested that parental visitation and the frequency of visitation were not actually associated with better psychological status, but that instead, father's visitations were associated with higher depressive symptoms among institutionalized children. It should be noted that our cross-sectional results cannot infer any causal relationship and do not emphasize that parental visitation should be avoided. However, it may be important to conduct careful assessment before starting parental visitation, especially when children seem to have problems with attachment formation. [ABSTRACT FROM AUTHOR]

Background: Mental health issues can reach epidemic proportions in developed countries after natural disasters, but research is needed to better understand the impact on children and adolescents in developing nations. Methods: A cross-sectional study was performed to examine the relationship between earthquake exposures and depression, PTSD, and resilience among children and adolescents in Phulpingdanda village in Nepal, 1 year after the 2015 earthquakes, using the Depression Self-Rating Scale for Children, Child PTSD Symptom Scale, and the Child and Youth Resilience Measure, respectively. To quantify exposure, a basic demographic and household questionnaire, including an earthquake exposure assessment tool for children and adolescents, was created. Results: Of the 62 respondents interviewed, 3.23% and 4.84% displayed symptomatology of depression and PTSD. A large number of respondents interviewed scored high for resiliency (80.65%). All 62 respondents were displaced from their household and witnessed severe damage of both their homes and village. The number of earthquake exposures had a strong, positive correlation with PTSD symptomatology. Conclusions: Although the number of respondents who showed signs of depression and PTSD symptomatology was lower than anticipated, resilience scores were considerably higher. Future research should explore which protective factors may contribute to high resiliency in Nepali children and adolescents. [ABSTRACT FROM AUTHOR]