Search

BackgroundMany adolescents in residential care have been exposed to prolonged traumatic experiences such as violence, neglect, or abuse. Consequently, they suffer from posttraumatic stress. This not only negatively affects psychological and behavioral outcomes (eg, increased anxiety, depression, and aggression) but also has adverse effects on physiological outcomes, in particular on their neurobiological stress systems. Although current evidence-based treatment options are effective, they have their limitations. An alternative to traditional trauma treatment is meditation-based treatment that focuses on stress regulation and relaxation. Muse is a game-based meditation intervention that makes use of adolescents’ intrinsic motivation. The neurofeedback element reinforces relaxation abilities. ObjectiveThis paper describes the protocol for a randomized controlled trial in which the goal is to examine the effectiveness of Muse (InteraXon Inc) in reducing posttraumatic stress and normalizing neurobiological stress systems in a sample of traumatized adolescents in residential care. MethodsThis will be a multicenter, multi-informant, and multimethod randomized controlled trial. Participants will be adolescents (N=80), aged 10 to 18 years, with clinical levels of posttraumatic symptoms, who are randomized to receive either the Muse therapy sessions and treatment as usual (intervention) or treatment as usual alone (control). Data will be collected at 3 measurement instances: pretest (T1), posttest (T2), and at 2-month follow-up. Primary outcomes will be posttraumatic symptoms (self-report and mentor report) and stress (self-report) at posttest. Secondary outcomes will be neurobiological stress parameters under both resting and acute stress conditions, and anxiety, depression, and aggression at posttest. Secondary outcomes also include all measures at 2-month follow-up: posttraumatic symptoms, stress, anxiety, depression aggression, and neurobiological resting parameters. ResultsThe medical-ethical committee Arnhem-Nijmegen (NL58674.091.16) approved the trial on November 15, 2017. The study was registered on December 2, 2017. Participant enrollment started in January 2018, and the results of the study are expected to be published in spring or summer 2021. ConclusionsStudy results will demonstrate whether game-based meditation therapy improves posttraumatic stress and neurobiological stress systems, and whether it is more effective than treatment as usual alone for traumatized adolescents. Trial RegistrationNetherlands Trial Register NL6689 (NTR6859); https://www.trialregister.nl/trial/6689 International Registered Report Identifier (IRRID)DERR1-10.2196/19881

Background: It is unclear whether the limitations of young persons with a mild intellectual disability or borderline intellectual functioning preclude feasibility of the daily diary method. Method: For 60 consecutive days, 50 participants (M[subscript age] = 21.4, 56% male) who receive care in an ambulatory, residential, or juvenile detention setting, self-rated both standardised and personalised diary questions through an app. Diary entries were used for feedback in treatment. Interviews were used to explore acceptability. Results: Average compliance was 70.4%, while 26% of participants dropped out. Compliance was good in ambulatory (88.9%) and residential care (75.6%), but not in the juvenile detention setting (19.4%). The content of self-selected diary items varied widely. Participants deemed the method acceptable. Conclusions: Daily monitoring is feasible for individuals with a mild intellectual disability or borderline intellectual functioning receiving ambulatory or residential care, and can provide scientists and practitioners with important insights into day-to-day behavioural patterns.

Background: The prevalence of Substance Use Disorder (SUD) in people with Mild Intellectual Disability and Borderline Intellectual Functioning (MID-BIF) is high and evidence-based treatment programs are scarce. The present study describes the development of a personalised SUD treatment for people with MID-BIF. Method: The personalised SUD treatment is developed according to the steps of the Intervention Mapping approach, based on literature review, theoretical intervention methods, clinical experience and consultation with experts in the field of addiction and intellectual disability care. Results: We developed a treatment manual called Take it Personal!+. Take it Personal!+ aims to reduce substance use, is based on motivational interviewing and cognitive behavior therapy and personalised based on the client's personality profile. Furthermore, an mHealth application supports the treatment sessions. Conclusion: Take it Personal!+ is the first personalised SUD treatment for individuals with MID-BIF. Future research should test the effectiveness of Take it Personal!+ in reducing SU.

Cultures could influence parents in the way they perceive adverse situations and in how external factors influence resilience, which in turn, may differentially affect the quality of life of a child. The present study aimed to examine the associations between different dimensions of parental resilience and the quality of life of children in Indonesia. The samples consisted of 497 families. This study used the Parenting Resilience Elements and the Quality of Life Questionnaire. Parental resilience consists of three dimensions, knowledge of child's characteristics, positive perception of parenting, and perceived social support. Knowledge of child's characteristics, one of the parental resilience dimensions, significantly related to the Quality of Life dimensions of communication and influence, and development. Positive perceptions of parenting related to socio-emotional well-being. Perceived social support related to material well-being, activity, and socio-emotional well-being. We found that the parental resilience related to Quality of Life of children with developmental disabilities. Some findings could be unique for a collectivist culture and highlight the complexities of the association between different factors of parent resilience and Quality of Life of children with developmental disabilities in Indonesia.

The aim of the present study was to examine the additive effect of elements of cognitive behavioral therapy (CBT) on the video game Mindlight in decreasing anxiety of children with an autism spectrum disorder (ASD). A non-concurrent multiple baseline design with 8 children with ASD in the age of 8-12 was used. CBT did not have the hypothesized additive effect on Mindlight in decreasing anxiety of children with ASD. Instead, multiple participants already experienced a decrease in anxiety during the Mindlight sessions. Yet, several participants did experience a stabilization in anxiety at a low level during the CBT sessions. For now, it can be concluded that CBT does not have an additive effect on Mindlight.

Background: This study examines participant satisfaction and effectiveness of the online mindset intervention 'The Growth Factory' (TGF) for youth with intellectual disabilities using a randomised controlled trial design. Method: Youth with mild to borderline intellectual disabilities (N = 119; 12-23 years) were randomly assigned to TGF (n = 60) or control group (n = 59). Primary outcome measures were mindsets and perseverance. Secondary outcomes were empowerment, mental health problems, self-esteem, treatment motivation, therapeutic alliance and challenge seeking. Measurements were conducted at pre-test, post-test and at 3 and 6 months follow-up. Results: TGF had positive effects on perseverance, mental health problems, self-esteem and therapeutic alliance at post-test. TGF had follow-up effects on mental health problems (3 months), mindset of intelligence (3 and 6 months) and mindset of emotion and behaviour (6 months). Conclusions: TGF offers a promising add-on intervention complementing usual care programmes accelerating improvements in mindsets and mental health in youth with intellectual disabilities.

The objective of the study is to investigate the role of mental health in the relationship between moderately low birthweight MLBW ([greater than or equal to] 1500 g &[less than or equal to]2500) and academic achievement in a large cross-country study. Data were drawn from the School Children Mental Health in Europe study (n = 4305). Achievement in mathematics and reading was categorized by teachers as being below average, average or above average. Parents reported birthweight, and both parents and teachers evaluated mental health status using the Strengths and difficulties Questionnaire. When controlling for child age, number of children in the household, maternal age, education, employment status and psychological distress and country of residence, MLBW was associated with lower odds of above average performance in mathematics and reading. Once mental health was added into the model, MLBW remained significant but mental health problems largely surpassed its influence: conduct disorders decreased the probability to perform above average in mathematics RRR = 0.37 and increased the risk of performing below average RRR = 4.45 as did ADHD and emotional disorders. A similar trend was found for reading achievement except for ADHD which decreased the probability of above average performance RRR = 0.13 and did not have a significant effect on below average performance. A path analysis highlights the prominent role of mental health. Among children attending regular education settings, MLBW is associated with academic performance but mental health has much stronger effects. Teachers and parents should be sensitized to child mental health problems and be informed of the special needs of MLBW children in order to help children overcome potential academic difficulties and to adapt their teaching taking into account mental health problems., Author(s): Viviane Kovess-Masfety [sup.1] , Wietske A. Ester [sup.2] [sup.3] , Katherine Wild [sup.3] , Adina Bitfoi [sup.4] , Dietmar Goelitz [sup.5] , Sigita Lesinskiene [sup.6] , Zlatka Mihova [sup.7] [...]

Background: This paper describes the theory and development of Take it personal! an indicated prevention programme aimed at reducing substance use in individuals with mild intellectual disabilities and borderline intellectual functioning. Method: The process of the development of Take it personal! followed the steps of the Intervention Mapping protocol. Take it personal! is based on the theory that personality traits are an important construct to understand substance use (14-30 years old). A small modelling study was conducted with six adolescents to examine the feasibility, user-friendliness and potential effectiveness of the intervention. Results: The results showed that the intervention has good feasibility and user-friendliness. Post-intervention evaluation of frequency, binge drinking and problematic use indicated that use was lower than at pre-intervention. Conclusions: Take it Personal! can be a promising preventive intervention designed to reduce substance use in individuals in this target group. A larger scale study is needed to draw further conclusions.

Using coercive strategies to resolve conflicts with romantic partners has toxic effects on relationships. Coercion predicts relationship dissatisfaction, instability, and intimate partner violence. The early adult romantic relationships model hypothesizes that such strategies first emerge within the family and continue to affect romantic relationships into adulthood. We tested whether adolescent antisocial behaviors and deviancy training with peers mediated between early disruptive parenting and adult romantic relationship coercion. Furthermore, we tested the impact of trauma in this longitudinal model. We studied 230 adults in committed relationships, whom we initially recruited and studied when they were age 11. We collected videotaped observations with friends (when participants were ages 16-17) and with intimate partners (when participants were ages 28-30). As hypothesized, disruptive parenting predicted antisocial behaviors and deviancy training with friends in adolescence, which in turn predicted coercion within intimate adult relationships. Moreover, disruptive parenting in early adolescence also directly predicted romantic partner coercion 15 years later. No significant effects were found for trauma. Findings suggest the promise of promoting healthy adult intimate relationships through early relationships with parents and friends.

Many adolescents in residential care have experienced traumatic events and suffer from posttraumatic stress. This study examined the effectiveness of Muse, a game-based meditation intervention played with guidance, as an addition to treatment as usual (TAU) for adolescents with posttraumatic symptoms in residential care. Seventy-seven adolescents with posttraumatic symptoms (10–18 years old) received either Muse and TAU (n = 37) or treatment as usual (n = 40). TAU consisted of evidence-based treatments that did not specifically target posttraumatic symptoms. Outcomes were measured at T1, T2, and two-months follow-up (FU). Primary outcomes were posttraumatic symptoms (self-report and mentor-report) and stress (self-report) at T2. The Muse group showed significantly greater improvements than the control group at T2 regarding self-reported posttraumatic symptoms, stress, anxiety, depression, and aggression. Mentor reports showed marginally significant decreases in posttraumatic stress at T2. There were no differences between the groups at FU, except for a marginally significant difference in self-reported posttraumatic symptoms, where the Muse participants showed larger decreases. This study showed that game-based meditation therapy is a promising intervention that is more effective than TAU alone. Yet, further studies on its immediate and long-term effects, and mechanisms of change are warranted. Implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Staff-client relationships impact the quality of support and life of people with severe to profound intellectual disabilities and challenging behavior, but are challenging to build due to clients' intense, complex and varying support needs. The present study explores the perspectives of professionals and relatives on what affects these interpersonal relationships. Method: 17 professionals and 11 relatives participated in focus groups and interviews. Data collection and analysis was performed in collaboration with a co-researcher. Data were synthesized thematically. Results: Interpersonal relationships constituted equivalence, striving for mutual understanding, trust and exploring clients' potential. The combination of staff characteristics (enthusiasm/passion, patience, resilience, creativity/humor, flexibility) and expertise (knowledge, vulnerability/sincerity, self-reflection) enabled staff to build these relationships. The importance of involving relatives was addressed. Contextual influences included the team (cooperation, flexibility, culture), organization (cooperation, boundary conditions) and setting (predictability, interior/atmosphere). Conclusions: The findings make practical knowledge explicit and scientifically underpinned for this specific population. [ABSTRACT FROM AUTHOR]

The present study evaluated long-term effects of a home-based smoking prevention program targeting smoking-specific parenting in families with children with and without asthma. A total of 1398 non-smoking children ("mean age" 10.1) participated, of which 197 (14.1%) were diagnosed with asthma. Families were blinded to group assignment. The intervention group (n = 684) received booklets with assignments that actively encouraged parents to engage in smoking-specific parenting strategies. Control families (n = 714) received booklets containing basic information about youth smoking. Latent growth curve modeling was used to calculate intercepts and slopes to examine whether there was change in the different parenting aspects over the study period. Regression analyses were used to examine whether a possible change was different for intervention and control condition families with and without a child with asthma. For those smoking-specific parenting aspects that changed over time, families in the intervention and control condition increased similarly. Families with a child with asthma did not engage in parenting at higher levels due to the intervention program than parents of non-asthmatic children. This prevention program did not affect smoking-specific parenting in the Netherlands. Future prevention research could focus on other risk factors for smoking initiation among adolescents with asthma.