Systematic Review and Quality Appraisal of Practice Guidelines for Self‐Harm in Children and Adolescents

This study aimed to systematically identify and appraise clinical practice guidelines (CPGs) relating to the assessment and management of suicide risk and self‐harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self‐harm, what is the quality of up‐to‐date CPGs? Using the PRISMA format, we systematically identified CPGs meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPGs using the Appraisal of Guidelines for Research and Evaluation II instrument. CPGs were then classified as “poor quality,” “minimum quality,” and “high quality” using operationally defined criteria developed a priori. We identified 10 eligible CPGs published or renewed between 2005 and May 2017. Only the long‐term management of self‐harm CPGs produced by the National Institute for Health and Care Excellence met “high‐quality” criteria. Despite multiple options of CPGs published to choose from, only one was identified as “high quality,” where bias is adequately minimized. Clinicians are advised to direct resources to implementing the “high‐quality” CPG.     

Exploring the cognitive development of children born to adolescent mothers in South Africa

This study explores the cognitive development of children born to adolescent mothers within South Africa compared to existing reference data, and explores development by child age bands to examine relative levels of development. Cross-sectional analyses present data from 954 adolescents (10–19 years) and their first-born children (0–68 months). All adolescents completed questionnaires relating to themselves and their children, and standardized child cognitive assessments (Mullen Scales of Early Learning) were undertaken. Cognitive development scores of the sample were lower than USA reference population scores and relative performance compared to the reference population was found to decline with increasing child age. When compared to children born to adult mothers in the sub-Saharan African region, children born to adolescent mothers (human immunodeficiency virus [HIV] unexposed; n = 724) were found to have lower cognitive development scores. Findings identify critical periods of development where intervention may be required to bolster outcomes for children born to adolescent mothers.

Highlights

• An exploration of the cognitive development of children born to adolescent mothers within South Africa utilizing the Mullen Scales of Early Learning.
• Cognitive development scores of children born to adolescent mothers within South Africa were lower compared to USA norm reference data and declined with child age.
• Previous studies utilizing the Mullen Scales of Early Learning within sub-Saharan Africa were summarized, and comparisons were made with the current sample.
• Findings highlight a potential risk of developmental delay among children born to adolescent mothers compared to children of adult mothers in the sub-Saharan African region.

     

Adult attachment and memory of emotional reactions to negative and positive events

Relations between adult attachment and memory for earlier emotional reactions to negative and positive events were examined. Hypotheses were that avoidance would be associated with underestimating earlier negative affect, whereas anxiety would be associated with overestimating earlier negative affect. Also, both avoidance and anxiety were expected to relate to underestimating earlier positive affect intensity. Participants (119 college students) completed daily report forms three times a day for 4 days on which they described and rated their immediate emotional reactions to events within each time period. Approximately 10 days later, they were asked to estimate their immediate emotional reaction to one negative event and one positive event. Events were coded as interpersonal or non-interpersonal. Contrary to hypotheses, for those lower on avoidance, anxiety related to lower levels of recalled negative affect (i.e., greater underestimation) for negative interpersonal events. As expected, with positive events, anxiety and avoidance related to lower levels of recalled positive emotions. Results suggest that memory processes could be one explanation of how working models operate and are sustained over time.