Search

Background: Armed conflicts are associated with a wide range of impacts on the mental health of children and adolescents. We evaluated the effectiveness of a school-based intervention aimed at reducing symptoms of posttraumatic stress disorder, depression, and anxiety (treatment aim); and improving a sense of hope and functioning (preventive aim). Methods: We conducted a cluster randomized trial with 329 children in war-affected Burundi (aged 8 to 17 (mean 12.29 years, standard deviation 1.61); 48% girls). One group of children (n = 153) participated in a 15-session school-based intervention implemented by para-professionals, and the remaining 176 children formed a waitlist control condition. Outcomes were measured before, one week after, and three months after the intervention. Results: No main effects of the intervention were identified. However, longitudinal growth curve analyses showed six favorable and two unfavorable differences in trajectories between study conditions in interaction with several moderators. Children in the intervention condition living in larger households showed decreases on depressive symptoms and function impairment, and those living with both parents showed decreases on posttraumatic stress disorder and depressive symptoms. The groups of children in the waitlist condition showed increases in depressive symptoms. In addition, younger children and those with low levels of exposure to traumatic events in the intervention condition showed improvements on hope. Children in the waitlist condition who lived on their original or newly bought land showed improvements in hope and function impairment, whereas children in the intervention condition showed deterioration on these outcomes. Conclusions: Given inconsistent effects across studies, findings do not support this school-based intervention as a treatment for posttraumatic stress disorder and depressive symptoms in conflict-affected children. The intervention appears to have more consistent preventive benefits, but these effects are contingent upon individual (for example, age, gender) and contextual (for example, family functioning, state of conflict, displacement) variables. Results suggest the potential benefit of school-based preventive interventions particularly in post-conflict settings. Trial registration: The study was registered as ISRCTN42284825 [ABSTRACT FROM AUTHOR]

There is limited information on the perceived needs and living circumstances of people with mental illness (PMI) who are caring for young children in Singapore. An exploratory survey was conducted to identify the profile and perceived needs of PMI living in the community who have young children to improve clinical services. Screening in three outpatient clinics was conducted to identify PMI with young children. PMI with young children completed questionnaires regarding their bio-data, living circumstances, and perceived needs. The results show the need to develop integrative and innovative programs for PMI with young children and customized services for female parents. [ABSTRACT FROM AUTHOR]

Background In Sub Saharan Africa, there has been limited research on instruments to identify specific mental disorders in children in conflict-affected settings. This study evaluates the psychometric properties of three self-report scales for child mental disorder in order to inform an emerging child mental health programme in post-conflict Burundi. Methods Trained lay interviewers administered local language versions of three self-report scales, the Depression Self-Rating Scale (DSRS), the Child PSTD Symptom Scale (CPSS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED-41), to a sample of 65 primary school children in Burundi. The test scores were compared with an external 'gold standard' criterion: the outcomes of a comprehensive semistructured clinical psychiatric interview for children according the DSM-IV criteria (the Schedule for Affective Disorders and Schizophrenia for School-Age Children - K-SADS-PL). Results The DSRS has an area under the curve (AUC) of 0.85 with a confidence interval (c.i.) of 0.73-0.97. With a cut-off point of 19, the sensitivity was 0.64, and the specificity was 0.88. For the CPSS, with a cut-off point of 26, the AUC was 0.78 (c.i.: 0.62-0.95) with a sensitivity of 0.71 and a specificity of 0.83. The AUC for the SCARED-41, with a cut-off point of 44, was 0.69 (c.i.: 0.54-0.84) with a sensitivity of 0.55 and a specificity of 0.90. Conclusions The DSRS and CPSS showed good utility in detecting depressive disorder and posttraumatic stress disorder in Burundian children, but cut-off points had to be put considerably higher than in western norm populations. The psychometric properties of the SCARED-41 to identify anxiety disorders were less strong. The DSRS and CPSS have acceptable properties, and they could be used in clinical practice as part of a two-stage screening procedure in public mental health programmes in Burundi and in similar cultural and linguistic settings in the African Great Lakes region. [ABSTRACT FROM AUTHOR]

There are many children who are without parental care in India. Studies estimate that there are about 44 million destitute children and over 12 million orphan and abandoned children in India. Some of the children who do not receive parental care adequately owing to several factors are placed under institutional care. The health needs of the children in institutions need to be addressed as they constitute vulnerable groups and are at high risk for childhood health problems as well as health problems in adulthood. The objectives of the study were to determine the level of internalizing problems viz., emotional symptoms, hyperactivity and externalizing problems viz. conduct and peer problems; and to explore the level of depression among institutionalised children. The study was an exploratory study, in which 40 children - 22 boys and 18 girls, who are institutionalised and are between the ages of 12 to 15 years, were included through purposive sampling. Strengths and Difficulties Questionnaire and Adolescent Well being scale were administered. Results show that among internalizing problems, level of emotional symptoms and level of hyperactivity were in the normal range. Among externalizing problems, conduct problems were above the normal range and peer problems were in the normal range. The level of well being was also below the normal score indicating low well being as well as probable depression among institutionalised children. Children under institutional care face many psychosocial problems and are at risk for poor health. Intervention at an earlier stage has greater impact on current and future good health and well being. Specifically, interventions that are aimed towards developing better coping strategies thereby reducing depression and conduct problems would help the children in better handling of the psychosocial problems they encounter. [ABSTRACT FROM AUTHOR]

Purpose: Conduct problems and emotional distress have been identified as key problems among children and adolescents in post-war Burundi. This pilot study aims to evaluate the impact of a brief parenting psychoeducation intervention on children's mental health. Methods: This study employs a controlled pre and post evaluation design. The two-session psychoeducation intervention was offered to groups of parents of children (mean age 12.3 years, 60.8 % female) who had been screened for elevated psychosocial distress. Children in the intervention group ( n = 58) were compared to a waitlist control group ( n = 62). Outcome indicators included child-reported levels of aggression (using the Aggression Questionnaire), depression symptoms (using the Depression Self Rating Scale) and perceived family social support. Results: The intervention had a beneficial effect on reducing conduct problems compared to the control condition (Cohen d = 0.60), especially among boys, while not showing impact on depression symptoms or family social support. Parents evaluated the intervention positively, with increased awareness of positive parenting strategies and appropriate disciplinary techniques reported as the most common learning points. Conclusion: A brief parenting psychoeducation intervention conducted by lay community counselors is a promising public health strategy in dealing with widespread conduct problems in boys living in violence-affected settings and not so for social and emotional indicators and for girls. An efficacy study is warranted to confirm these preliminary findings. [ABSTRACT FROM AUTHOR]

Objective To assess the extent and nature of psychiatric morbidity among children (aged 8 to 13 years) 15 months after a car bomb explosion in the town of Omagh, Northern Ireland. Method A survey was conducted of 1945 school children attending 13 schools in the Omagh district. Questionnaires included demographic details, measures of exposure, the Horowitz Impact of Events Scale, the Birleson Self-Rating Depression Scale, and the Spence Children's Anxiety Scale. Results Children directly exposed to the bomb reported higher levels of probable PTSD (70%), and psychological distress than those not exposed. Direct exposure was more closely associated with an increase in PTSD symptoms than in general psychiatric distress. Significant predictors of increased IES scores included being male, witnessing people injured and reporting a perceived life threat but when co-morbid anxiety and depression are included as potential predictors anxiety remains the only significant predictor of PTSD scores. Conclusions School-based studies are a potentially valuable means of screening and assessing for PTSD in children after large-scale tragedies. Assessment should consider type of exposure, perceived life threat and other co-morbid anxiety as risk factors for PTSD. [ABSTRACT FROM AUTHOR]

Multiple types of victimization or poly-victimization ( PV) can occur simultaneously during childhood, resulting in outcomes that are detrimental and difficult to reverse. Very few studies have focused on PV in Chinese adolescents. The present study is based on information collected from a stratified cluster sample of 1,561 females and 1,594 males aged 12-18 years living in Shandong Province, China. A self-administered questionnaire was used to assess background information, the Juvenile Victimization Questionnaire was used to measure the extent of victimization and PV, the Screen for Child Anxiety Related Emotional Disorders was used to measure anxiety levels, and a Depression Self-rating Scale for Children was used to ascertain depression. A majority of the study sample (66.2%) had experienced at least one form of victimization over the past year. Prevalence of PV was 16.9%, and was significantly higher among males (21.1%) than females (12.5%). Younger ages, one-child families, and lower socioeconomic status were positively associated with PV. Logistic regression analysis indicated that smoking, alcohol consumption, exposure to pornography, and anxiety- and depression-like symptoms were risk factors of PV. Results of this study highlight the need for further exploration of factors related to the PV of Chinese adolescents. [ABSTRACT FROM AUTHOR]

Background Evidence is emerging that psychological problems, particularly symptoms of depression and post-traumatic stress disorder, are more prevalent in unaccompanied asylum-seeking children ( UASC) than their accompanied peers. However, little is known about help seeking and mental health service ( MHS) utilization in this group, and how this relates to their psychological needs. This study aims to describe the level of psychological distress among a group of UASC and the pattern of MHS contact. Method Socio-demographic data on 71 UASC residing in London was obtained and self-report questionnaires were completed regarding trauma events ( Harvard Trauma Questionnaire), general psychological distress [ Strengths and Difficulties Questionnaire (SDQ)], post-traumatic stress symptoms ( Impact of Event Scale), depressive symptoms ( Birleson Depression Self- Rating Scale for Children) and contact with MHS ( Attitudes to Health and Services Questionnaire). Results UASC were mainly male ( n = 48, 67.6%), Black African ( n = 39, 54.9%) and their median age was 17 years (interquartile range = 15; 17). They had been living in the UK for a median of 18 months. Eight (11.3%) scored on the SDQ borderline/abnormal range for total symptoms, but this was 21 (29.6%) using the SDQ emotional subscale. Forty-seven (66.2%) were at high risk for post-traumatic stress disorder and nine (12.7%) at high risk for depressive disorder. Only 12 (17%) had MHS contact. Predictors of MHS contact were depressive symptoms and duration of time in the UK. Conclusions UASC had a high level of emotional symptoms, especially post-traumatic stress symptoms. However, only a small proportion of UASC were in contact with MHS. This suggests a high level of MHS under-utilization, and reasons for this are discussed. [ABSTRACT FROM AUTHOR]

The current study aimed to assess the Teaching Recovery Techniques (TRT) trauma recovery program within the context of ongoing violence. Utilizing a randomized controlled trial, 11–14-year-old students in Nablus, Palestine, were allocated by class to intervention or wait-list control conditions. Standardized measures assessed trauma exposure, posttraumatic stress disorder (PTSD), grief, and depression. Program fidelity and participant experiences were measured by adherence questionnaires and focus groups. Analyses involved paired t-tests, ANCOVAs, and thematic analysis. Intervention students reported significant decreases in PTSD, grief, and depression. Findings indicate that the TRT program has the potential to ameliorate children's trauma symptoms during situations of ongoing violence. [ABSTRACT FROM PUBLISHER]

Studies into treatment processes in low-income settings are grossly lacking, which contributes to the scarcity of evidence-based psychosocial treatment. We conducted multiple n = 1 studies, with quantitative outcome indicators (depression-, PTSD- and anxiety- symptoms, hope) and qualitative process indicators (treatment- perceptions, content and progress) measured before, during and after counseling. We aimed to explore commonalities in treatment processes associated with change profiles within and between cases. The study was conducted in South Sudan with children aged between 10 and 15 years. Change profiles were associated with the quality of the counselor-client relationship (instilling trust and hope through self-disclosure, supportive listening and advice giving), level of client activation, and the ability of the counselor to match treatment strategies to the client's problem presentation (trauma- and emotional processing, problem solving, cognitive strategies). With limited time, due to restricted resources in low-income settings, training courses can now be better focused on key treatment processes. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to conduct an in-depth quantitative and qualitative evaluation of a family-based weight loss and healthy life style programme for clinically obese children in England. Design/methodology/approach – The mixed method case study evaluation used included obtaining pre and post measurements of anthropometry and a range of attitude and behavioural attributes. The qualitative phase of the study involved in-depth interviews and focus groups. Findings – The programme is demanding and resource intensive and designed as an intervention for children needing most help with their weight. Participants included the families of five referred children (n=18 individuals) and the intervention team (n=7). All but one child had reduced BMI centiles at the end of the programme. There were also improvements to a number of self-report aspects of healthy eating and levels of activity and quality of life, self-esteem and levels of depression indicators. The qualitative evaluation generated a number of insightful data themes. Research limitations/implications – Limitations include the case study design and small sample numbers. Also weight loss is an important indicator of any weight management programme's success however the short length of time programme was run is a barrier to seeing any substantive changes in any of the participating children's weights. Practical implications – The evaluation conducted gives insights into the positive aspects of the programme and can inform development of similar programmes. Originality/value – There are few examples of in-depth and comprehensive quantitative and qualitative approaches used to evaluate this type of intervention. [ABSTRACT FROM AUTHOR]

This study was conducted to examine the capacity of attachment insecurity and its dimensions to predict the development of obsessive–compulsive (OC) symptoms in children. A total of 221 female children, aged 10–12, were administered the Children's Yale-Brown Obsessive–Compulsive Scale, Birleson Depression Self-rating Scale, and the inventory of parent and peer attachment – revised version for children. Hierarchical regressions revealed that the level of attachment insecurity was strongly associated with the symptoms of obsessive–compulsive disorder (OCD) in children. Moreover, attachment insecurity subscale scores (trust, communication, and alienation) predicted a large percentage of variance in children's OC symptoms. Although all the attachment subscale scores were significantly associated with OC symptoms in children, parent–child communication was found to be the most powerful predictor, followed by emotional alienation and trust. Implications of these findings for theory and treatment of pediatric OCD are discussed. [ABSTRACT FROM PUBLISHER]

Background: Thirty-three Japanese children and adolescents diagnosed with an anxiety disorder participated in individual or group Cognitive Behaviour Therapy (CBT) that was modelled after evidence-based intervention programs developed in Western countries. Method: The treatment consisted of: (a) building rapport and education; (b) identifying emotions and recognizing cognitive self-talk; (c) challenging anxious self-talk; (d) developing an anxiety hierarchy and in vivo exposures; and (e) planning for future challenges. Results: Three months following treatment, 20 of the 33 children and adolescents (60.91%) no longer met criteria for their principal anxiety disorders and 16 (48.48%) were free from all anxiety disorders. Self-reported anxiety, depression, and cognitive errors also decreased significantly from pre- to post-treatment and these gains were maintained at 3-month follow-up. For the most part, similar outcomes were found in both the group and individual formats of CBT. Conclusions: This study provides preliminary support for the transportability of CBT in both an individual and group format to Japan. [ABSTRACT FROM PUBLISHER]

The Spence Children's Anxiety Scale (SCAS) is a 38-item self-report questionnaire which measures symptoms of DSM-IV anxiety disorders in children and adolescents. This study examined the psychometric properties of the Greek translation of SCAS in a large community sample of children and adolescents (N = 1,072), aged 12-17 years, in the non-occupied territory of Cyprus. A subsample of these participants was retested 8 weeks after the initial assessment. The SCAS demonstrated high internal consistency (alpha = .92) and test-retest reliability (r = .88). The SCAS total scores correlated significantly with the anxious/depressed subscale of the Youth Self-Report, the Columbia Impairment Scale, and with the emotional subscale of the Strength and Difficulties Questionnaire. Confirmatory factor analyses revealed the same six-factor structure as the original SCAS. The SCAS proved to be a reliable and valid measure of anxiety symptoms in the Cypriot context. [ABSTRACT FROM AUTHOR]

Background: Research has demonstrated the effectiveness of computerized cognitive behaviour therapy (cCBT) for depression and anxiety in adults, but there has been little work with children and adolescents. Aims: To describe the development of a cCBT intervention (Think, Feel, Do) for young people, and preliminary outcomes and feedback from a pilot randomized controlled trial. Method: Twenty participants aged 11 to 16 with depression or anxiety were randomized to receive cCBT immediately or after a delay. Standardized measures were used to assess self-reported anxiety, depression, self-esteem and cognitions, as well as parent rated strengths and difficulties. A feedback form was also completed to assess young people's views of the programme. Results: A total of 15 participants completed the pre and post assessments in the trial, and 17 provided feedback on the intervention. Paired samples t-tests demonstrated significant improvements on 3 subscales in the control condition, compared to 7 subscales in the cCBT condition. Feedback showed moderate to high satisfaction for participants. Conclusions: This study provides encouraging preliminary results for the effectiveness and acceptability of cCBT with this age group. [ABSTRACT FROM AUTHOR]

Background/Aims: To evaluate effects of growth hormone (GH) treatment on behaviour and psychosocial characteristics in short-stature children. Methods: 99 referred prepubertal non-familiar short-stature children (32 GH deficiency; 67 idiopathic short stature) aged 3-11 years, randomized to fixed or individual GH doses and their parents completed questionnaires (Child Behaviour Checklist, Birleson Depression Self-Report Scale, Abbreviated Parent-Teacher Questionnaire, I Think I Am, Well-Being Visual-Analogue Scales for Short-Stature Children) at baseline (BL) and after 3, 12, and 24 months. Results: At BL, children showed higher levels of internalizing behaviour (p < 0.001), lower levels of externalizing behaviour (p < 0.006) and self-esteem (p < 0.001) compared to reference values. During GH treatment, behavioural measures (p < 0.001) and depression (p < 0.01) changed towards the mean of the population within the first 3 months and remained improved to 24 months. Self-esteem improved at all time points (p < 0.001), and in all subgroups, as did well-being dimensions stability and mood (p < 0.05). Multiple regression analysis showed that greater improvements were related to lower BL value, height gain, higher maximal GH value, being older, and being male. Conclusion: On GH treatment, prepubertal short children significantly improved on behavioural, depression, and psychosocial evaluations over a 2-year period of GH treatment. Most change occurred within the first 3 months, which highlights this short period as important not only for growth and metabolic changes but also for behaviour and psychosocial improvements following GH treatment. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Traumatic incident reduction (TIR) is a trauma resolution method that appears to be well tolerated and has yielded relatively rapid benefit in two adult treatment studies. This article reports on two open trials using TIR with 33 urban at-risk youth and 31 unaccompanied refugee minors. In both studies, participants consistently responded positively. In the second study, nearly all participants who began treatment with posttraumatic stress disorder ended without it, with an average of at least one significant trauma memory being treated per session. TIR's apparent efficiency and effectiveness in these preliminary studies indicates its promise in child and adolescent treatment. [ABSTRACT FROM AUTHOR]

Background: In situations of ongoing violence, childhood psychosocial and mental health problems require care. However, resources and evidence for adequate interventions are scarce for children in low- and middle-income countries. This study evaluated a school-based psychosocial intervention in conflict-affected, rural Nepal. Methods: A cluster randomized controlled trial was used to evaluate changes on a range of indicators, including psychiatric symptoms (depression, anxiety, posttraumatic stress disorder), psychological difficulties, resilience indicators (hope, prosocial behavior) and function impairment. Children ( n = 325) (mean age = 12.7, SD = 1.04, range 11–14 years) with elevated psychosocial distress were allocated to a treatment or waitlist group. Results: Comparisons of crude change scores showed significant between-group differences on several outcome indicators, with moderate effect sizes (Cohen d = .41 to .58). After correcting for nested variance within schools, no evidence for treatment effects was found on any outcome variable. Additional analyses showed gender effects for treatment on prosocial behavior (mean change difference: 2.70; 95% CI, .97 to 4.44), psychological difficulties (−2.19; 95% CI, −3.82 to −.56), and aggression (−4.42; 95% CI, −6.16 to −2.67). An age effect for treatment was found for hope (.90; 95% CI, −1.54 to −.26). Conclusions: A school-based psychosocial intervention demonstrated moderate short-term beneficial effects for improving social-behavioral and resilience indicators among subgroups of children exposed to armed conflict. The intervention reduced psychological difficulties and aggression among boys, increased prosocial behavior among girls, and increased hope for older children. The intervention did not result in reduction of psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Background Many children, adolescents and young people are involved in caring for parents, siblings, or other relatives who have an illness, disability, mental health problem or other need for care or supervision. The aim was to develop two new instruments for use in research with young carers to assess caring activities and their psychological effects. Method Two studies are reported. In study 1, 410 young carers were recruited via The Princess Royal Trust for Carers database of UK projects and asked to complete an initial item pool of 42 and 75 questionnaire items to assess caring activities and caring outcomes respectively. In study 2 a further 124 young carers were recruited. Results Following exploratory principal components analysis in study 1, 18 items were chosen to compose the Multidimensional Assessment of Caring Activities Checklist (MACA-YC18), and 20 items chosen to compose the Positive and Negative Outcomes of Caring Scales (PANOC-YC20). In study 2, normative and convergent validity data on the two instruments are reported. Conclusion The MACA-YC18 is an 18-item self-report measure that can be used to provide an index of the total amount of caring activity undertaken by the young person, as well as six sub-scale scores for domestic tasks, household management, personal care, emotional care, sibling care and financial/practical care. The PANOC-YC20 is a 20-item self-report measure that can be used to provide an index of positive and negative outcomes of caring. [ABSTRACT FROM AUTHOR]

Background: Negative trauma-related cognitions have been found to be a significant factor in the maintenance of post-traumatic stress disorder (PTSD) in adults. Initial studies of such appraisals in trauma-exposed children and adolescents suggest that this is an important line of research in youth, yet empirically validated measures for use with younger populations are lacking. A measure of negative trauma-related cognitions for use with children and adolescents, the Child Post-Traumatic Cognitions Inventory (CPTCI), is presented. The measure was devised as an age-appropriate version of the adult Post-Traumatic Cognitions Inventory ( Foa et al., 1999 ). Methods: The CPTCI was developed and validated within a large ( n = 570) sample, comprising community and trauma-exposed samples of children and adolescents aged 6–18 years. Results: Principal components analysis suggested a two-component structure. These components were labelled ‘permanent and disturbing change’ and ‘fragile person in a scary world’, and were each found to possess good internal consistency, test–retest reliability, convergent validity, and discriminative validity. The reliability and validity of these sub-scales was present regardless of whether the measure was completed in the acute phase or several months after a trauma. Scores on these sub-scales did not vary with age. Conclusions: The CPTCI is a reliable and valid measure that is not specific to the type of trauma exposure, and shows considerable promise as a research and clinical tool. The structure of this measure suggests that appraisals concerning the more abstract consequences of a trauma, as well as physical threat and vulnerability, are pertinent factors in trauma-exposed children and adolescents, even prepubescent children. [ABSTRACT FROM AUTHOR]

AbstractSocial phobia is a common and disabling condition for both children and adults. In recent years Clark and Wells' (1995) cognitive model of social phobia has given rise to an effective treatment protocol for the condition in adults (e.g. Clark et al., 2003, 2006). The current study investigates the applicability of this model to younger people. One hundred and seventy-one 11?14 year-old participants completed questionnaires measuring social anxiety, depression, and the variables hypothesized to maintain social phobia in Clark and Wells' (1995) cognitive model: negative social cognitions, safety behaviours, self-focused attention, and pre- and post-event processing. High socially anxious children scored significantly higher than low socially anxious children on all of the variables in Clark and Wells' model. Negative social cognitions, self-focused attention, safety behaviours, and pre- and post-event processing were all significant predictors of social anxiety, accounting for 48% of the variance in social anxiety. Furthermore, these variables showed specificity to social anxiety, predicting significantly more variance in social anxiety than in depression. Findings suggest that although Clark and Wells' (1995) model of social phobia was developed from research on adult populations, it may be equally applicable to younger people with social phobia. [ABSTRACT FROM AUTHOR]

Schools are a primary setting for the provision of services to children with social, emotional, and behavioral problems. School social workers serve a vital role in identifying, assessing, serving, and referring students suffering from myriad mental health problems, including depression. Starting with a discussion of gathering valid assessment data from and about latency-age children, ages six to 12, this article reviews available self-report instruments for assessing depression in children, with a focus on those instruments most appropriate for use by school social workers. A table detailing eight such instruments is presented, including information about reliability, validity, supporting research, and where they can be accessed. The authors identify three such instruments that are particularly suited to the needs of school social workers, which are described in more detail. Assessing Depression in Latency-Age Children: A Guide for School Social Workers. [ABSTRACT FROM AUTHOR]

Background: Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. Method: Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised. Results: Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary. Conclusion: More research is required in order to expand our limited knowledge base. [ABSTRACT FROM AUTHOR]

Objective: To determine whether an early intervention using a psychological debriefing format is effective in preventing psychological distress in child road traffic accident survivors. Design: Randomised controlled trial. Setting: Accident and Emergency Department, Royal United Hospital, Bath. Subjects: 158 children aged 7–18. Follow-up assessment completed eight months post accident with 132 (70/82 of the experimental group and 62/76 in the control group). Main outcome measures: Self-completed measures of psychological distress; fulfilment of diagnostic criteria for post-traumatic stress disorder. Results: Children in both groups demonstrated considerable improvements at follow-up. The early intervention did not result in any additional significant gains. Conclusions: Although children in this study made significant improvements it is unclear whether these are better or worse than natural recovery rates. The specific intervention did not result in additional gains although the structured assessment provided for both groups may have been helpful in reducing subsequent pathology. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of a school-based group intervention designed for children who have experienced trauma. Twenty-six children (aged 11–15 years) who were refugees or asylum-seekers from war-affected countries participated. The manual-based intervention consisted of cognitive-behavioural therapy (CBT) techniques and was implemented within secondary schools. The treatment group (n = 15) received six sessions of group CBT over a 6-week period, while the control group (n = 11) were placed on a waiting list for 6 weeks and then invited to enter treatment. Children in the CBT group showed statistically significant, but clinically modest improvements following the intervention, with decreases in overall severity of post-traumatic stress symptoms. Significant improvements were also found in overall behavioural difficulties and emotional symptoms. Children in the waiting list control group did not show any improvements over the same period. However, follow-up data, which were only available for a small subset of eight children, suggest that gains in the CBT group were not maintained at 2-month follow-up. [ABSTRACT FROM AUTHOR]

Mental illness is listed as a child protection concern for a number of families reported to child protection agencies in Australia. Parents with mental health problems are more vulnerable, as are their children, to having parenting and child welfare concerns. Studies undertaken in the Melbourne Children's Court (Victoria) have found that the children of parents with mental health problems comprise at least one-quarter of all new child protection applications brought to the Court (Sheehan, 1997; 2001). This paper reports on a study undertaken in 2002, in the Melbourne Children's Court, to examine (a) the extent to which the children of parents with mental health problems are involved in child protection matters, (b) the contribution by mental health professionals to resolving these child welfare concerns, and (c) the difficulties which confront the Court in deciding these matters. The study considered in this article found that, although parents with mental health problems are a significant group coming to Court, there is negligible involvement by mental health professionals in the child protection system. It was apparent that there was very little co-operation between adult mental health and child protection services in this field. The Court was, therefore, given little appreciation of a parent's mental health functioning and its contribution to, and impact upon, the child, and thus may not have all necessary information about the needs of, and likely outcomes for, these children and their parents. [ABSTRACT FROM AUTHOR]

Although the negative consequences of trauma have been well researched and described, posttraumatic growth has only recently come to the attention of researchers. This paper considers whether children (aged 7–18 years) who have been involved in a road traffic accident can experience posttraumatic growth outcomes. From 158 children who took part in an interview, qualitative analysis of interview notes found that 67 (42%) reported some aspect of posttraumatic growth, most notably in terms of their philosophy of life. Of these, 25 (37%) were also assessed as experiencing posttraumatic stress disorder. [ABSTRACT FROM AUTHOR]

Objective:. The aim of this prospective study was to determine the psychological effects of everyday road traffic accidents (RTAs). Methods:. A community follow-up study was made of children (75 boys and 83 girls aged 7–18)—attending an Accident and Emergency Department after being involved in an RTA. Diagnostic clinical interview and self-completed psychometric assessments were performed. Results:. Four weeks post-accident diagnostic interviews revealed that 46 (29.1 %) children fulfilled the diagnostic criteria for posttraumatic stress disorder (PTSD). Screening questionnaires identified 20.3% with significant levels of anxiety and 17.7% with scores above threshold levels for possible clinical depression. Type of accident, nature and severity of injury and age were not related to the development of PTSD. Gender was significant, with girls being more likely than boys to develop PTSD. Conclusion:. Significant psychological distress following RTAs is common. The need to raise awareness of the possible psychological sequelae of everyday RTAs is highlighted. [ABSTRACT FROM AUTHOR]

As part of a United Nations Children's Fund (UNICEF) psychosocial programme during the war in Bosnia-Hercegovina, data were collected from a community sample of 2,976 children aged between 9 and 14 years. Children completed standardized self-report measures of posttraumatic stress symptoms, depression, anxiety, and grief, as well as a report of the amount of their own exposure to war-related violence. Results showed that children reported high levels of posttraumatic stress symptoms and grief reactions. However, their self-reported levels of depression and anxiety were not raised. Levels of distress were related to children's amount and type of exposure. Girls reported more distress than boys, but there were few meaningful age effects within the age band studied. Results are discussed in the context of service development for children in war. [ABSTRACT FROM AUTHOR]

Background: The psychological effects of technological disasters have rarely been studied in children. This study assessed the aftermath of the 1986 Chornobyl disaster in children evacuated to Kyiv from the contaminated zone surrounding the nuclear power facility. Methods: In 1997, we evaluated three hundred 10- to 12-year-old children in Kyiv who were in utero or infants at the time of the disaster and who had resided near Chornobyl (evacuees) and 300 sex-matched homeroom classmates who had never lived in a radiation-contaminated area. Response rates were 92% (evacuees) and 85% (classmates). Data were obtained from children, mothers, and teachers using standard measures of well-being and risk factors for childhood psychopathology. The children also received physical examinations and basic blood tests. Results: The evacuees and classmates perceived their mental health similarly except for Chornobyl-related anxiety symptoms and perceived scholastic competence. No differences were found on the Iowa Conners' Teacher Rating Scale. Although the physical examination and blood test results were normal, the evacuee mothers rated their children's well-being as significantly worse, especially with respect to somatic symptoms on the Children's Somatization Inventory and Child Behavior Checklist. The most important risk factors for these ratings were maternal somatization and Chornobyl-related stress. Conclusions: Given the multiple stressful experiences to which evacuee families were exposed, the small differences in the children's self-reports suggest that there are protective factors in the lives of these children. The trauma experienced by the mothers was reflected in their perceptions of their children's well-being, particularly somatic symptoms, but was not transmitted to the children themselves. [ABSTRACT FROM AUTHOR]

Investigators have used various experimental paradigms to study how individuals with different emotional disorders process emotional information. However, little research has been done on relatives of individuals with emotional disorders, despite developments in the area of emotional contagion. In the current experiment, children of adults with posttraumatic stress disorder (PTSD) ( n = 18) and control participants ( n = 21), ages 9–17 years, participated in a modified Stroop color-naming task. The results indicated that the children of adults with PTSD showed increased Stroop interference for threat-related relative to neutral words and to the performance of the controls. These findings are discussed with respect to the literature on information processing in PTSD and emotional contagion in families. [ABSTRACT FROM AUTHOR]

Epilepsy in childhood may alter family relationships but the relevance of these changes for the increased rates of psychopathology has been little investigated. This study uses maternal expressed emotion (EE) to examine family relationships of children with epilepsy and the association with high risk for psychiatric disorder. EE was assessed using the Camberwell Family Interview carried out with the mothers of 22 schoolchildren with chronic epilepsy who were attending a general hospital outpatient clinic. Sixteen of these children had similarly aged healthy siblings who served as controls. High risk for psychiatric disorder in the children and mothers was assessed using behavioural, mood, and self-esteem questionnaires completed by mothers, teachers, and children. It was found that mothers showed significantly more emotional overinvolvement and a trend for more hostility towards their children with epilepsy than towards sibling controls. For the 22 children with epilepsy, maternal emotional overinvolvement was not associated with child behavioural deviance. High levels of criticism and, to a lesser extent, hostility did show associations with child behavioural deviance, and the strongest links were between maternal criticism and maternal rated antisocial and overactive behaviour in the child. Fewer positive comments by mothers towards the children were associated with child emotional symptoms and lower self-esteem in a number of areas. This study suggests that further research could consider the appropriateness of psychological intervention for families in which mothers are critical and hostile and whose children show antisocial behaviour. [ABSTRACT FROM AUTHOR]

Scores on the Children's Depression Inventory (CDI) for 103 affective and 125 Conduct disordered psychiatric inpatients aged 6-17 were subjected to cluster analysis of variables using average linkage (with arccosine transformation) as a means of investigating differences in CDI response patterns between the two groups. Both vertical (hierarchical) and horizontal (nested) clusters were examined. The investigation indicated hierarchical dusters for the affective disordered group dealing with sadness and isolation, a negative self-image, and sell-loathing. For the conduct disordered group, clusters centered hierarchically around a defeated attitude, being upset not having fn anymore and not wanting to fee wit other people, and difficulty with academic performance. [ABSTRACT FROM AUTHOR]

Attempts have been made in develop self-rating stales to assess depression in children. One of these scales, the Birleson Self-rating Scale, was administered to a non-clinical sample of boys which was larger, and covered a wider age-range, than Birleson's own non-clinical group. A comparison is made with Birleson's findings, and in addition data from the administration of the scale to a group of boys aged 13 to 18 years is presented. [ABSTRACT FROM AUTHOR]

The article reports on the post-traumatic stress disorders among children affected by disasters, with particular mention of two shipping disasters. The ferry Herald of Free Enterprise capsized in Zeebrugge harbor, Belgium, in 1987. The second incident occurred when the ship of 400 British children sank when it was holed by a tanker in Athens in 1988. The post-traumatic stress disorders in children include sleep disturbance, separation difficulties, memory problems and depression.

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]

Background. It is only recently that “comorbidity” in ADHD has come to the forefront as one of the most important aspects of the disorder. It is agreed that, often, these problems are at least as important as ADHD in contributing to the longer term outcome in the individual child. Objective. To provide the reader with basic information about clinics and treatment of “comorbidity” in ADHD. Method. Review of the empirically based literature. Results. ADHD exists in a surprisingly high frequency together with a broad range of child neuropsychiatric disorders. This is accompanied with many still unresolved treatment problems. Conclusion. It would not be appropriate to develop ADHD–services where clinicians would only have expertise in ADHD as such. Anyone working with children, adolescents and adults with ADHD would need to have training in general neuropsychiatry. Further research in this field is urgently needed. [ABSTRACT FROM AUTHOR]