Journal of Child and Adolescent Mental Health

Editorial

John Goodwin — 2024-08-04

No Abstract

Does self-compassion protect adolescents with non-suicidal self-injury from developing borderline features? A two-wave longitudinal study

Diogo Carreiras — 2024-08-04

Background: Adolescence is a vulnerable developmental stage for the onset of non-suicidal self-injury (NSSI) and borderline features, which are related psychological phenomena. Self-compassion reflects a sensitivity to own suffering and a motivation to relieve it, consisting of a more positive and beneficial self-to-self relationship. The aim of the present study was to test the effect of self-compassion between borderline features at baseline and six months with a sample of adolescents with a history of NSSI.

Methods: At assessment wave one, participants were 139 Portuguese adolescents with an NSSI history (mean age = 15.52 years, SD = 0.87). Of these, 87 were re-assessed six months later (mean age = 15.46 years, SD = 0.86). Data were analysed through SPSS and PROCESS Macro.

Results: The moderation model explained 56% of borderline features six months later, and the interaction between initial borderline features and the low and medium levels of self-compassion was significant. Youth with lower initial borderline features presented higher borderline features six months later if they had low self-compassion.

Conclusions: These findings suggest that among adolescents with a history of NSSI, those with lower levels of self-compassion tend to exhibit higher borderline features in six-month when compared to their peers with higher levels of self-compassion. This observation emphasises the potential beneficial effect of self-compassion within this population.

On return to school: disorder symptoms, stress at home and evaluations of school COVID-19 measures

Virginia L. Lam — 2024-08-04

Background: Social restrictions during the COVID-19 pandemic had a major impact on the mental health of children. Yet, analyses on the mental health of younger children in the later course of the pandemic are scarce. The present study assessed 8- to 11-year-olds’ internalising disorder symptoms during the last three weeks, from the third week of February through to the first week of March, of the 2021 national lockdown.

Method: One hundred and forty-five pupils, including a subset of keyworkers’ children who had face-toface schooling, completed the validated Revised Child Anxiety and Depression scales, items on COVID-related stress at home, and evaluations of home-learning and school’s measures for reopening.

Results: Symptoms increased with age in months and/or number of siblings. Girls reported more symptoms and home stress than boys did. Pupils who had face-to-face schooling were more satisfied with school measures and less satisfied with home learning compared with those who only had home learning. Hierarchical regression analyses corroborated the contributions of sociodemographic characteristics and found that home stress and school measures evaluations were associated most with major depression, generalised anxiety, and social phobia.

Conclusion: Findings can contribute to mental health practice by promoting school communications and family and educator awareness of stressors, vulnerabilities and symptoms to boost pupils’ readiness for school returns.

Examining the relationship between social withdrawal motivations and symptoms of hikikomori

Simone Amendola — 2024-08-04

Objective: This study aimed to examine the association between social withdrawal motivations (peer isolation, shyness, unsociability, low mood, and avoidance) and symptoms of hikikomori using both variable- and person-oriented analyses.

Method: Adolescents (N = 212) participated in this cross-sectional study. Data were collected using the Social Withdrawal Motivations Scale and the Avoidance subscale of the Child Social Preference Scale-Revised, the 25-item Hikikomori Questionnaire, the Personality Inventory for the DSM-5 Brief Form, and the Interpersonal sensitivity subscale of the Brief Symptom Inventory.

Results: Path analysis revealed that peer isolation, shyness, unsociability, and avoidance were associated with symptoms of hikikomori while covarying for age, sex, maladaptive personality, and interpersonal sensitivity. Cluster analysis based on social withdrawal motivations identified four subtypes of adolescents. The group with high social withdrawal motivations showed the highest level of overall personality dysfunction and interpersonal sensitivity. Additionally, the group with high social withdrawal motivations and the group with high avoidance demonstrated higher symptoms of hikikomori compared to the other two groups, after accounting for the effects of the covariates.

Conclusions: The findings highlight that the evaluation of co-occurrent social withdrawal motivations may improve the ability to identify those adolescents most in need of support.

Gender differences in the pathway of childhood trauma, impulsivity and adult eating behaviour: a cross-sectional study

Antonio Bonfada Collares Machado — 2024-08-04

Objective: The current cross-sectional study aimed to examine the association between childhood trauma, impulsivity, binge eating symptoms, and body mass index (BMI) in a sample of males and females. We also aimed to investigate the indirect association of childhood trauma with binge eating through impulsivity while controlling for BMI.

Method: Participants were 410 young adults (mean age = 20.9 years, range 18–24; female = 73.9%) who completed online measures of childhood trauma, impulsivity, binge eating symptoms, and self-reported height and weight. Mediation models were tested using multi-group structural equation modelling.

Results: Childhood trauma and impulsivity were associated with an increased risk of binge eating symptoms in females but not males, corroborating previous studies. There was a significant difference in the binge eating symptoms index between sexes, but not regarding the index of childhood trauma and impulsivity. Additionally, adverse childhood experiences were associated with impulsivity and the association of childhood trauma with binge eating was mediated by impulsivity in the female sample.

Conclusions: Our results suggest sex-dependent patterns and risk factors that may impact binge eating symptoms. The implications of our results suggest that impulsivity might be a vulnerability factor for binge eating, especially for females.

Developing and validating a scale to measure traumainformed practices used by teachers in inclusive schools in Ghana and the United Arab Emirates

Maxwell Peprah Opoku — 2024-08-04

Research on trauma-informed practices is common in Western countries, but non-Western countries have made minimal contributions in this regard. This study aimed to develop an instrument which could be used to measure perceived competence of teachers in the implementation of trauma-informed practices for students with disabilities in Ghana and the United Arab Emirates (UAE). The Teacher Trauma Management Scale (TTMS), developed using the trauma framework by the Substance Abuse and Mental Health Services Administration was used to collect data from 514 teachers in Ghana (n 270) and the UAE (n = 244). Data were subjected to confirmatory factor analysis) and a two-way factorial analysis of variance was conducted. While one hypothesis was supported by the study findings, the other was only partially supported. The findings provided theoretical and structural support for the newly developed TTMS in a non- Western context. This study highlights the need to develop contextual trauma management training models or a curriculum for training teachers.

Navigating social and academic isolation: a qualitative exploration of American university students’ perspectives and experiences early in the COVID-19 pandemic

Ashlynn Lawston — 2024-08-04

Objective: To qualitatively explore the multifaceted impacts of the early months of the COVID-19 pandemic on the lives of American university students.

Method: Undergraduate students in general education courses at a mid-sized public Western U.S. university were recruited to complete a Qualtrics survey that evaluated their perceptions, beliefs, and behaviours towards COVID-19. Thematic analysis identified prevailing themes regarding the positive and negative changes to students’ lives during the pandemic.

Results: Participants included undergraduate students (N = 241) between the ages of 18 and 24 (74.7% women), with 49.4% identifying as White. Thematic analysis of the survey identified several codes encompassed by six key themes: (1) shifting social interactions; (2) wellness; (3) school; (4) financial changes; (5) loss of experiences; and (6) political turmoil.

Conclusion: Some students identified positive consequences (e.g., more family time, more flexible schedule), while almost all students reported negative consequences (e.g., difficulty with time management and organisation, loss of job or income) of the COVID-19 pandemic. University communities should consider providing additional academic, financial, and mental health resources to students to further mitigate the lasting consequences of the pandemic.

Adolescent psychiatric inpatients’ perceptions of treatment and seclusion

Miriam K. Yurtbasi — 2024-08-04

Objectives: A great deal of attention is being directed at the use of seclusion in adolescent inpatient psychiatric units due to its forceful nature and negative impact on inpatients and staff. This mixed methods study aimed to explore and compare the level of satisfaction with the services received and perspectives on seclusion in secluded and non-secluded adolescent inpatients.

Methods: This study included 188 participants, across three adolescent inpatient psychiatric units in Australia; 17% reported having experienced seclusion. A mixed methods approach was employed. Participants completed the Consumer Satisfaction Questionnaire–8 and Perceptions of Treatment and Seclusion Questionnaire shortly before or at discharge. Qualitative data was analysed using thematic analysis.

Results: Secluded participants were more likely to report issues with broader care experiences on the Consumer Satisfaction Questionnaire–8. Secluded individuals reported ongoing negative effects from seclusion but were more likely than non-secluded participants to believe seclusion is necessary. Qualitative analyses showed that both secluded and non-secluded individuals considered seclusion to be traumatic, many did not agree with its use.

Conclusions: Communication between inpatients and staff regarding seclusion needs to be improved and there needs to be ongoing support in relation to seclusion during and after discharge. Many adolescent inpatients acknowledge the necessity of seclusion whilst advocating for reduced seclusion.

Play therapy efficacy in ADHD-symptom reduction as measured by the Test of Variables of Attention (TOVA)

Susi Rutmalem Bangun — 2024-08-04

Objective: We aimed to investigate the effect of play therapy combined with the standard psychotropic medication treatment, compared to only standard psychotropic medication treatment in ADHD children as measured by the test of variables of attention (TOVA).

Methods: This is a case-control study conducted at Soerojo Hospital, Magelang, Indonesia. Children (N = 66) were purposively recruited. The children were divided into two groups based on the intervention received: the experimental group (play therapy and standard psychotropic medication) and control group (standard psychotropic medication only). Methylphenidate was used as the standard psychotropic therapy. The TOVA was performed before and after intervention. The pre-intervention and post-intervention mean difference (MD) in the Attention Comparison Score (ACS) and Comparison to the Normative Sample (CNS) for each group was compared and statistically analysed using t-tests and Wilcoxon tests.

Results: There was a significant difference between the ACS score of the experimental group’s MD and the control group’s MD (p < 0.05). For most TOVA parameters on CNS scores, the experimental group had a significantly higher MD than the control group.

Conclusion: Play therapy coupled with psychotropic medication reduced ADHD symptoms, including inattention and impulsivity, as objectively measured by the TOVA.

Experimental evaluation of a neurophysiological intervention designed to increase student resilience: a pilot study

Alex Kresovich — 2024-08-04

Social and emotional learning (SEL) interventions have shown promise for building resilience and protecting youth from adverse outcomes. This study reports on an experimental pilot evaluation of the Smart Brain Wise Heart SEL intervention during the 2021–2022 school year. Smart Brain Wise Heart (SBWH) uses a neurophysiological approach among ninth-grade students to evaluate the intervention’s impact on youth resiliency, self-compassion, peer violence exposure, internalising disorders, and hyperactivity. Results did not indicate any significant universal changes in target outcomes. These null findings regarding universal impact may be explained by the unprecedented difficulty of implementing a school-based intervention amid ongoing COVID-19 restrictions and administrative issues. Despite these obstacles, students with lower academic achievement in the intervention condition scored significantly higher for resilience and self-compassion and lower on depressive symptoms than their peers in the comparison condition, even when controlling for baseline scores, sex, attachment (father, mother, peer), and exposure to adverse childhood experiences. Our findings suggest SBWH programming may have important implications for the trajectories of students exhibiting lower academic achievement, at a minimum, by significantly improving their emotional resilience, self-compassion, and depressive symptoms during a vital developmental stage. More research is urgently needed under optimal conditions to assess the universal implementation of the program.

Mapping the contextual mental health interventions for perinatal adolescent mothers with self-reported common mental symptoms (anxiety and depression) in sub-Saharan African countries: a scoping review

Chimwemwe Pindani Tembo — 2024-08-04

Introduction: Early preventive interventions may support adolescent mothers’ mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub- Saharan African countries.

Methods: The process was guided by the Joanna Briggs Institute’s methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).

Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.

Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.