BACKGROUND: Adolescents have high rates of nonfatal suicide attempts, but clinically practical risk prediction remains a challenge. Screening can be time consuming to implement at scale, if it is done at all. Computational algorithms may predict suicide risk using only routinely collected clinical data. We used a machine learning approach validated on longitudinal clinical data in adults to address this challenge in adolescents. METHODS: This is a retrospective, longitudinal cohort study. Data were collected from the Vanderbilt Synthetic Derivative from January 1998 to December 2015 and included 974 adolescents with nonfatal suicide attempts and multiple control comparisons: 496 adolescents with other self-injury (OSI), 7,059 adolescents with depressive symptoms, and 25,081 adolescent general hospital controls. Candidate predictors included diagnostic, demographic, medication, and socioeconomic factors. Outcome was determined by multiexpert review of electronic health records. Random forests were validated with optimism adjustment at multiple time points (from 1 week to 2 years). Recalibration was done via isotonic regression. Evaluation metrics included discrimination (AUC, sensitivity/specificity, precision/recall) and calibration (calibration plots, slope/intercept, Brier score). RESULTS: Computational models performed well and did not require face-to-face screening. Performance improved as suicide attempts became more imminent. Discrimination was good in comparison with OSI controls (AUC = 0.83 [0.82-0.84] at 720 days; AUC = 0.85 [0.84-0.87] at 7 days) and depressed controls (AUC = 0.87 [95% CI 0.85-0.90] at 720 days; 0.90 [0.85-0.94] at 7 days) and best in comparison with general hospital controls (AUC 0.94 [0.92-0.96] at 720 days; 0.97 [0.95-0.98] at 7 days). Random forests significantly outperformed logistic regression in every comparison. Recalibration improved performance as much as ninefold - clinical recommendations with poorly calibrated predictions can lead to decision errors. CONCLUSIONS: Machine learning on longitudinal clinical data may provide a scalable approach to broaden screening for risk of nonfatal suicide attempts in adolescents.
Colin G. Walsh, Jessica D. Ribeiro, Joseph C. Franklin
Abstract There has been an increased interest in the delivery of Mindfulness-Based Programmes (MBPs) in schools yet little is known about how people who deliver MBPs in schools carry out and experience implementation. In this qualitative study, we aimed to examine the experiences of school staff who have a personal mindfulness practice, and who also deliver MBPs to their students. We recruited eight school staff (age range 34–64) who taught students mindfulness, and carried out semi-structured interviews focusing on investigating their positive and negative experiences of delivering mindfulness in schools, how practicing and delivering mindfulness affected their work-life, and their experiences of implementing school-based MBPs. School staff reported that delivering MBPs deepened their own mindfulness practice. The practice enabled them to feel better attuned to others, increased compassion for both themselves and students, helped their emotional regulation, and enhanced resilience to stress. Unexpectedly, half of the participants reported making changes to their work roles and several explicitly linked these changes to the increased self-compassion developed through mindfulness practice. They reported enjoying teaching school students MBPs (and noted that some students embraced mindfulness, and some were reluctant to engage) and sometimes found driving the implementation of MBPs in their school challenging. There appear to be numerous benefits of a personal mindfulness practice for school staff and delivering school-based MBPs can increase feelings of personal accomplishment. Future research is needed into whether MBPs can improve student–teacher relationships, and how some schools have successfully implemented MBPs.
Katie R. Norton, Gemma Maria Griffith
Development
Peer-reviewed article·Journal of Child Psychology and Psychiatry·
Educational neuroscience is an interdisciplinary research field that seeks to translate research findings on neural mechanisms of learning to educational practice and policy and to understand the effects of education on the brain. Neuroscience and education can interact directly, by virtue of considering the brain as a biological organ that needs to be in the optimal condition to learn ('brain health'); or indirectly, as neuroscience shapes psychological theory and psychology influences education. In this article, we trace the origins of educational neuroscience, its main areas of research activity and the principal challenges it faces as a translational field. We consider how a pure psychology approach that ignores neuroscience is at risk of being misleading for educators. We address the major criticisms of the field comprising, respectively, a priori arguments against the relevance of neuroscience to education, reservations with the current practical operation of the field, and doubts about the viability of neuroscience methods for diagnosing disorders or predicting individual differences. We consider future prospects of the field and ethical issues it raises. Finally, we discuss the challenge of responding to the (welcome) desire of education policymakers to include neuroscience evidence in their policymaking, while ensuring recommendations do not exceed the limitations of current basic science.
Michael S. C. Thomas, Daniel Ansari, Victoria C. P. Knowland
DevelopmentGBCA
Peer-reviewed article·Journal of Child and Family Studies·
Abstract Socially prescribed perfectionism (SPP) has been shown to be a risk factor for parental burnout (Sorkkila & Aunola, 2020). In the present study, we investigated the moderating role of self-esteem in this association. A total of 479 Finnish mothers of infants filled in questionnaires measuring their self-esteem, SPP, and symptoms of parental burnout. The results of structural equation modelling (SEM) showed that mothers’ self-esteem moderated the effect of SPP on parental burnout: Mothers with high self-esteem were at lower risk of showing burnout symptoms even when SPP co-occurred, whereas for mothers with low self-esteem, the effect of SPP on burnout symptoms was further strengthened. The results can be applied when aiming to improve maternal well-being by recognizing the risk factors of parental burnout and by offering counseling for parents at high risk.
Currently, in the United States and worldwide, the vast majority of children and adolescents in need of mental health services receive no treatment. Although there are many barriers, a key barrier is the dominant model of delivering psychosocial interventions. That model includes one-to-one, in-person treatment, with a trained mental health professional, provided in clinical setting (e.g., clinic, private practice office, health-care facility). That model greatly limits the scale and reach of psychosocial interventions. The article discusses many novel models of delivering interventions that permit scaling treatment to encompass children and adolescents who are not likely to receive services. Special attention is accorded the use of social media, socially assistive robots, and social networks that not only convey the ability to scale interventions but also encompass interventions that depart from the usual forms of intervention that currently dominate psychosocial treatment research.
Abstract Maternal emotion socialization and children’s temperament are two foundations of children’s emotional development. Yet, emotion socialization and temperament are multidimensional, which suggests behavioral profiles are important to consider. We used a person-centered approach to compare children’s emotion regulation and anxiety and depressive symptoms between maternal emotion socialization and child temperament profiles, uniquely and interactively. The participants were 322 mothers of a child ages 6–8 years (Mage = 7.4 years, SD = 0.84, 51% boys). Mothers completed survey questions about children’s emotion regulation, anxiety and depressive symptoms, temperament traits, and mothers’ emotion socialization behaviors. Four profiles of maternal emotion socialization (coaching/accepting, blended, punishing/minimizing, and low involved) were identified that explained significant variation in children’s emotion regulation and anxiety symptoms. Four temperament profiles were found which revealed two vulnerable groups, namely emotional/cautious and emotional/impulsive, which distinguished children with more emotion dysregulation and anxiety and depressive symptoms. Unique associations of maternal and temperament profiles were found, but no interaction of profiles was significant in relation to children’s emotion regulation or their internalizing symptoms. There is merit in continuing to examine parenting behaviors and their influence by drawing from a person-centered perspective.
BACKGROUND: It is proposed that some individuals with Autism Spectrum Disorder (ASD) can 'compensate' for their underlying difficulties (e.g. in theory of mind; ToM), thus demonstrating relatively few behavioural symptoms, despite continued core cognitive deficits. The mechanisms underpinning compensation are largely unexplored, as is its potential impact on mental health. This study aimed to estimate compensation patterns in ASD, by contrasting overt social behaviour with ToM task performance, in order to compare the characteristics of 'Low' and 'High' Compensators. METHODS: A total of 136 autistic adolescents, from the ongoing Social Relationships Study, completed a range of cognitive tasks, the Autistic Diagnostic Observation Schedule (ADOS) and a self-report anxiety questionnaire. Participants were assigned compensation group status; High Compensators demonstrated good ADOS scores despite poor ToM performance, while Low Compensators demonstrated similarly poor ToM, accompanied by poor ADOS scores. RESULTS: High Compensators demonstrated better IQ and executive function (EF), but greater self-reported anxiety, compared with Low Compensators. Such differences were not found when comparing individuals who had good versus poor ADOS scores, when ToM performance was good. Other core autistic characteristics (weak central coherence, nonsocial symptoms) did not differentiate the High and Low Compensators. CONCLUSIONS: IQ, EF and anxiety appear to be implicated in the processes by which certain autistic young people can compensate for their underlying ToM difficulties. This tendency to compensate does not appear to reflect the severity of 'hit' for ASD per se, suggesting that well-compensated individuals are not experiencing a milder form of ASD. The construct of compensation in ASD has implications for research and clinical practice.
Lucy A. Livingston, Emma Colvert, the Social Relationships Study Team et al.
GB
Peer-reviewed article·Journal of Child and Family Studies·
Abstract This study investigated whether having a dual identity as both a mother and an employed person constitutes a threat to well-being, or whether it is a positive resource. The study focused on indices of life satisfaction and self-esteem. A convenience sample of 208 mothers were exposed to a manipulation of identity conflict, whereby we manipulated whether working mothers perceived their identities as a mother and an employed person to be in conflict with each other or not. It was hypothesized that generally having multiple identities (as an employee and a mother) would be positively associated with well-being, that perceived identity conflict would have a negative impact on well-being, and that identity conflict would exacerbate the negative effects of identity-related stressors on well-being. Results supported these predictions. The applied implication is that policies that enable mothers to work will be conducive to maternal well-being, but that the policies must minimize conflict between demands associated with employment and parental responsibilities.
Hanna Zagefka, Diane M. Houston, Leonie Duff et al.
BACKGROUND: There is increasing interest in digital technologies to help improve children and young people's mental health, and the evidence for the effectiveness for these approaches is rising. However, there is concern regarding levels of user engagement, uptake and adherence. Key guidance regarding digital health interventions stress the importance of early user input in the development, evaluation and implementation of technologies to help ensure they are engaging, feasible, acceptable and potentially effective. Co-design is a process of active involvement of stakeholders, requiring a change from the traditional approaches to intervention development. However, there is a lack of literature to inform the co-design of digital technologies to help child and adolescent mental health. METHODS: We reviewed the literature and practice in the co-design of digital mental health technologies with children and young people. We searched Medline, PsycInfo and Web of Science databases, guidelines, reviews and reference lists, contacted key authors for relevant studies, and extracted key themes on aspects of co-design relevant to practice. We supplemented this with case studies and methods reported by researchers working in the field. RESULTS: We identified 25 original articles and 30 digital mental health technologies that were designed/developed with children and young people. The themes identified were as follows: principles of co-design (including potential stakeholders and stages of involvement), methods of involving and engaging the range of users, co-designing the prototype and the challenges of co-design. CONCLUSIONS: Co-design involves all relevant stakeholders throughout the life and research cycle of the programme. This review helps to inform practitioners and researchers interested in the development of digital health technologies for children and young people. Future work in this field will need to consider the changing face of technology, methods of engaging with the diversity in the user group, and the evaluation of the co-design process and its impact on the technology.
Rhys Bevan Jones, Paul N. Stallard, Sharifah Shameem Agha et al.
Peer-reviewed article·Journal of Child and Family Studies·
Children Born of War (CBOW) are important but largely uninvestigated populations. As a result of being fathered by a foreign soldier and born to a local mother, these children often struggle with identity issues and search for their absent fathers their whole lives. Despite CBOW being a part of every society, which has been involved in armed conflicts, there is almost no systematic research about them. We provided a systematic insight into issues of identity that many CBOW face throughout their lives by assessing N = 146 German and N = 101 Austrian Occupation Children born after WWII. We applied a descriptive analysis of our quantitative questionnaire data. Our results suggest that CBOW were often not told the truth about their origin until they were adults. The older they were, the more the disclosure seemed to impact them. After learning the truth, almost all CBOW set out on a search for their biological fathers and wanted to get in touch. Approximately half were able to locate them but many of those had not contacted them eventually. German and Austrian Occupation Children report largely similar experiences. Growing up as a CBOW can come with specific difficulties. Locating and getting to know their biological father seems to be a core aspect. It seems particularly important to CBOW to find out about similarities in personality and physical appearance. The possibilities to find their fathers, however, are extremely limited. Implications of the findings are discussed within the context of limitations and potential intervening factors.
Saskia Mitreuter, Marie Kaiser, Sophie Roupetz et al.
