Primary Prevention Mental Health Programs for Children and Adolescents: A Meta-Analytic Review

Used meta-analysis to review 177 primary prevention programs designed to prevent behavioral and social problems in children and adolescents. Findings provide empirical support for further research and practice in primary prevention. Most categories of programs produced outcomes similar to or higher in magnitude than those obtained by many other established preventive and treatment interventions in the social sciences and medicine. Programs modifying the school environment, individually focused mental health promotion efforts, and attempts to help children negotiate stressful transitions yield significant mean effects ranging from 0.24 to 0.93. In practical terms, the average participant in a primary prevention program surpasses the performance of between 59% to 82% of those in a control group, and outcomes reflect an 8% to 46% difference in success rates favoring prevention groups. Most categories of programs had the dual benefit of significantly reducing problems and significantly increasing competencies. Priorities for future research include clearer specification of intervention procedures and program goals, assessment of program implementation, more follow-up studies, and determining how characteristics of the intervention and participants relate to different outcomes.     

Posttraumatic Stress Disorder in Children and Adolescents: A Review and Analysis

Only recently has the mental health community recognized the applicability of diagnostic criteria for posttraumatic stress disorder (PTSD) in children and adolescents, including a consideration of specific age-related features. This paper provides a current review of the literature on PTSD pertaining to children and adolescents. Following a discussion of issues on diagnostic criteria and assessment of this affective disorder in this population, there is an overview of the existing literature on prevalence, comorbidity, risk factors, parental and family factors, and issues of gender and age of onset. The remainder of the paper focuses on the range of traumatic stressors in children and adolescents that can result in PTSD, including natural or human disasters, war and violence, chronic or life-threatening medical conditions, community violence and the witnessing of traumatic events, and physical and/or sexual abuse and other forms of interpersonal violence. Throughout the paper, there is an emphasis on the importance of considering developmental factors. Finally, implications of the existing literature for future areas of research are addressed.     

Allergies and Anxiety in Children and Adolescents: A Review of the Literature

  There is an increasing prevalence of anxiety disorders and allergic conditions in children and adolescents, with previous research showing that these illnesses are often comorbid. Knowledge of the association between anxiety and allergies in children and adolescents is important because these comorbid disorders may negatively impact functioning and development. This research is necessary for identification of at risk children and to develop intervention and prevention programs. A review of studies examining comorbid anxiety and allergies in children and adolescents demonstrated a consistent association between these disorders despite differences in methodology. Several methodological limitations are presented, followed by a discussion of theories which may explain the association between these conditions. Implications of this work and suggestions for future research are provided.     

Optimising Exposure for Children and Adolescents with Anxiety,OCD and PTSD: A Systematic Review

Clinical Child and Family Psychology Review - Cognitive behavioural therapy is an effective treatment for anxiety disorders in children and young people; however, many do not benefit. Behavioural...     

Cognitive Theories of Depression in Children and Adolescents: A Conceptual and Quantitative Review

This paper quantitatively reviews longitudinal studies examining three central cognitive theories of depression—Beck’s theory, Hopelessness theory, and the Response Styles theory—among children (age 8–12) and adolescents (age 13–19). We examine the effect sizes in 20 longitudinal studies, which investigated the relation between the cognitive vulnerability–stress interaction and its association with prospective elevations in depression after controlling for initial levels of depressive symptoms. The results of this review suggest that across theories there is a small relation between the vulnerability–stress interaction and elevations in depression among children (pr = 0.15) and a moderately larger effect (pr = 0.22) among adolescents. Despite these important findings, understanding their implications has been obscured by critical methodological, statistical, and theoretical limitations that bear on cognitive theories of depression. The evidence base has been limited by poor measurement of cognitive vulnerabilities and over reliance on null hypothesis significance testing; these have contributed to a field with many gaps and inconsistencies. The relative paucity of research on developmental applications of such theories reveals that surprisingly little is known about their hypothesized etiologic mechanisms in children and adolescents. Ways to advance knowledge in the area of cognitive theories of depression among youth are discussed.     

Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis

Depression and anxiety are common during adolescence. Whilst effective interventions are available treatment services are limited resulting in many adolescents being unable to access effective help. Delivering mental health interventions via technology, such as computers or the internet, offers one potential way to increase access to psychological treatment. The aim of this systematic review and meta-analysis was to update previous work and investigate the current evidence for the effect of technology delivered interventions for children and adolescents (aged up to 18 years) with depression and anxiety. A systematic search of eight electronic databases identified 34 randomized controlled trials involving 3113 children and young people aged 6–18. The trials evaluated computerized and internet cognitive behavior therapy programs (CBT: n = 17), computer-delivered attention bias modification programs (ABM: n = 8) cognitive bias modification programs (CBM: n = 3) and other interventions (n = 6). Our results demonstrated a small effect in favor of technology delivered interventions compared to a waiting list control group: g = 0.45 [95% CI 0.29, 0.60] p < 0.001. CBT interventions yielded a medium effect size (n = 17, g = 0.66 [95% CI 0.42–0.90] p < 0.001). ABM interventions yielded a small effect size (n = 8, g = 0.41 [95%CI 0.08–0.73] p < 0.01). CBM and ‘other’ interventions failed to demonstrate a significant benefit over control groups. Type of control condition, problem severity, therapeutic support, parental support, and continuation of other ongoing treatment significantly influenced effect sizes. Our findings suggest there is a benefit in using CBT based technology delivered interventions where access to traditional psychotherapies is limited or delayed.

     

Health-Related Quality of Life in Children and Adolescents Following Traumatic Injury: A Review

This paper comprehensively reviews the published literature investigating health-related quality of life (HRQOL) following general traumatic injury in individuals between birth and 18?years. Studies were not considered if they primarily compared medical treatment options, evaluated physical function but not other aspects of HRQOL, or focused on non-traumatic wounds. Specific injury types (e.g., burn injury) were also not included. A total of 16 studies met criteria. Participants were age 1-18?years, with 12 studies considering children 5?years of age or older. Males were overrepresented. Injury severity averaged mostly in the moderate range. HRQOL deficits were noted in injured samples in all studies except the two with the longest time to follow-up (6-11?years). Some improvement was seen 6?months to 2?years after injury. Factors associated with HRQOL deficits were investigated, with acute and posttraumatic stress disorder symptoms showing the strongest relationship. Research to date in this area is impressive, particularly the number of studies using prospective longitudinal investigations and validated measures. Challenges remain regarding methodologic differences, assessment of preinjury status, retention of participants, and management of missing data. Suggested future directions include extension of follow-up duration, utilization of pediatric self-report when possible, inclusion of younger children, and development of intervention programs.     

Children and Adolescents with Medically Unexplained Symptoms: A Systematic Review of the Literature

Abstract

Medically unexplained symptoms (MUS) in children and adolescents are confounding and concerning for patients, parents, and health care practitioners. Our goal was to review and summarize the literature for family therapists working with a diverse, challenging patient population coping with MUS. A search of multiple databases from 1994 to 2018 was conducted using MUS and related terms. The literature was then organized into subcategories based on its relevance to family therapists, particularly medical family therapists collaborating with primary care physicians. We conclude with a discussion about gaps in the literature and suggestions for clinical management.     

Outcomes for Children and Adolescents After Residential Treatment: A Review of Research from 1993 to 2003

The focus of this research review is to determine what factors increase the likelihood that positive individual and systemic changes occur for children and adolescents following discharge from residential treatment. Residential treatment outcome studies from 1993 to 2003 that fulfilled predetermined criteria were located through 4 on-line databases using key word combinations. The research selected was: (a) 7 studies that measured outcome immediately upon completion of treatment and discharge, and (b) 11 studies where outcome progress was assessed at one or more follow-up dates after discharge. Results showed that children and adolescents with severe emotional and behaviour disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic and ecological in its approach. Similar to the clinical child psychotherapy research, conclusions must be tempered due to the limited number of studies and methodological weaknesses. Future considerations highlight how research results can more realistically reflect intervention effectiveness when elements of the ecological and systemic landscape of care are addressed.     

Executive Functions in Children and Adolescents with Turner Syndrome: A Systematic Review and Meta-Analysis

Turner syndrome (TS) is a genetic disorder, affecting 1/2500 to 1/3000 live female births, induced by partial or total deletion of one X chromosome. The neurocognitive profile of girls with TS is characterized by a normal Verbal IQ and weaknesses in visual-spatial, mathematics, and social cognitive domains. Executive functions (EFs) impairments have also been reported in these young patients. However, methodological differences across studies do not allow determination of which EFs are impaired and what is the magnitude of these impairments. The aim of this review was to clarify the EF profile of children and adolescents with TS. Sixteen samples, from thirteen studies, were included in the current meta-analysis. EFs measures used in these studies were classified into working memory, inhibitory control, cognitive flexibility, or higher-order EFs tasks in accordance with Diamond’s model, Annual Review of Psychology, 64, 135–168 (2013). Results confirmed that girls with TS had significant executive impairments with effect sizes varying from small (inhibitory control) to medium (cognitive flexibility) and large (working memory, higher-order EFs). Analyses by task revealed that cognitive inhibition may be more impaired than the other inhibitory control abilities. Heterogeneity across cognitive flexibility measures was also highlighted. Between-sample heterogeneity was observed for three tasks and the impact of participants’ characteristics on EFs was discussed. This meta-analysis confirms the necessity to assess, in patients living with TS, each EF by combining both visual and verbal tasks. Results also underline that, when studying girls with TS’ executive profile, it is important to explore the impact of moderator variables, such as IQ, parental socio-economic status, TS karyotype, psychiatric comorbidities, and hormonal treatment status.     

Equine-Facilitated Psychotherapy With Children and Adolescents: An Update and Literature Review

During the past several years, there has been a large increase in the number of studies of equine-facilitated psychotherapy (EFP) with children and adolescents. However, due to the diversity of methods, samples, and publication types represented in the literature, it may be difficult for EFP practitioners to synthesize the existing research into useful guidelines and treatment recommendations for patients. This article summarizes and tabulates investigation findings by methods, theoretical underpinnings, and treatment populations. This review of 47 recent publications suggests that EFP is a useful modality with children and adolescents. In the large majority of reviewed papers, benefits were found for a variety of presenting problems and disorders. The most often studied populations were “at-risk” youth and children with an Autism Spectrum Disorder diagnosis. Recommendations for counselors and directions of future EFP research are made.     

儿童和青少年的应对发展研究新进展

本文从发展心理学的视角,综合有关儿童和青少年应对的研究,对应对的理论发展,儿童和青少年应对发展的特点和趋势以及影响因素等问题进行了梳理,并概述了该领域的研究动向。应对的理论发展体现出从静态到动态,从单因素向多因素,从单维度向多水平的特点。儿童和青少年的应对发展需要某些认知能力的支持,并和调节过程具有密切的联系。作为心理学重要研究领域的应对,对其本身结构、相关研究方法以及应对对个体心理发展的作用机制等问题的探索还有待进一步的深入。     

A Meta-Analysis of After-School Programs That Seek to Promote Personal and Social Skills in Children and Adolescents

A meta-analysis of after-school programs that seek to enhance the personal and social skills of children and adolescents indicated that, compared to controls, participants demonstrated significant increases in their self-perceptions and bonding to school, positive social behaviors, school grades and levels of academic achievement, and significant reductions in problem behaviors. The presence of four recommended practices associated with previously effective skill training (SAFE: sequenced, active, focused, and explicit) moderated several program outcomes. One important implication of current findings is that ASPs should contain components to foster the personal and social skills of youth because youth can benefit in multiple ways if these components are offered. The second implication is that further research is warranted on identifying program characteristics that can help us understand why some programs are more successful than others.     

Comorbidity of Anxiety and Depression in Children and Adolescents: An Integrative Review

Much evidence exists documenting the comorbidity of anxiety and affective disorders in youth. Furthermore, comorbidity appears to have serious implications both in terms of severity of impairment and course of disorder. Despite this, little is known about the meaning behind the high rate of co-occurrence of anxiety and depression in children and adolescents. Several conditions exist that may give rise to comorbidity. Specifically, two disorders may be comorbid when there is a high rate of symptom overlap between the disorders, when one underlying construct is split into two separate disorders, when the disorders share common risk or etiological factors, or because one disorder causes or increases the risk of developing the second disorder. The present paper examines each of these explanations as they relate to the comorbidity of anxiety and depression in youth.     

Psychological Treatments for Mental Disorders in Children and Adolescents: A Review of the Evidence of Leading International Organizations

In recent decades, the evidence on psychological treatments for children and adolescents has increased considerably. Several organizations have proposed different criteria to evaluate the evidence of psychological treatment in this age group. The aim of this study was to analyze evidence-based treatments drawn from RCTs, reviews, meta-analyses, guides and lists provided by four leading international organizations. The institutions reviewed were the National Institute for Health and Care Excellence, the Society of Clinical Child and Adolescent Psychology (Division 53) of the American Psychological Association, Cochrane Collaboration and the Australian Psychological Society in relation to mental disorders in children and adolescents. A total of 137 treatments were analyzed for 17 mental disorders and compared to determine the level of agreement among the organizations. The results indicate that, in most cases, there is little agreement among organizations and that there are several discrepancies within certain disorders. These results require reflection on the meaning attributed to evidence-based treatments with regard to psychological treatments in children and adolescents. The possible reasons for these differences could be explained by a combination of different issues: the procedures or committees may be biased, different studies were reviewed, different criteria are used by the organizations or the reviews of existing evidence were conducted in different time periods.     

Equine Facilitated Therapy for Children and Adolescents: A Qualitative Pilot Study

Despite recent growth in the use of equine facilitated therapy (EFT), and its potential to be an effective alternative to traditional therapeutic interventions, the literature has not yet provided a convincing explanatory account of the practices implemented within EFT. In this study, the author investigates consistency of clinical practices within the Equine Assisted Growth and Learning Association (EAGALA) model of EFT. Semi-structured interviews were conducted with mental health professionals and equine specialists (N = 10) from six Australian EFT clinics. Thematic analysis of data revealed: an absence of an underpinning theoretical model; variations between clinical practices; lack of parental involvement in therapy for children/adolescents; and inadequate research into perceived mechanisms of change driving EFT. This article concludes with a set of recommendations directed at EFT practitioners in order to increase the rigor of practice and maximize the potential of this intervention.