16 research outputs found
Discrepancy in psychopathological networks of caregiver’s and child’s reports of child’s mental health – the role of the Covid-19 pandemic.
No full textBackground
According to a study from 2017, approximately 2.7 million children under 18 years old live in out-of-home care worldwide (henceforth referred to as “looked-after children”) [1]. Out-of-home care is an important and timely matter also in Switzerland. For instance, the publicly-funded Swiss National Science Foundation SNSF conducted the National Research Programme "Welfare and Coercion – Past, Present and Future" between 2018 and 2023, which aimed to investigate compulsory social measures and placements in a broad context [2]. Looked-after children face greater challenges in mental health and educational achievement, experience more learning disabilities and special educational needs, and are more likely to endure negative experiences such as exclusion from mainstream schools or stigmatization by peers. This group is also at increased risk of childhood maltreatment, which is linked to a higher likelihood of depression and poorer treatment outcomes [3-5] [6, 7]. For instance, comprehensive estimates from England shows that 45% of children and young people who were looked after in England had emotional and mental health problems, compared with 10% among 5- to 15-year-old children in the general population [8]. Hence, looked-after children are an important population to consider by mental health researchers.
We conducted this research in parallel with another study using the same dataset in which we described the trends over time in internalising and externalising problems, represented as sum scores. We focused on differences between children and their caregivers, exploring some predictors of the discrepancies in scores (https://doi.org/10.17605/OSF.IO/ZPV93). In the current study we aim to expand on those findings by considering the interrelationships between individual symptoms, and changes in these relationships between before and after outbreak of the pandemic. We could identify which symptoms are often underreported or overreported by children or their caregivers and determine how these symptoms are connected to other symptoms. For example, certain symptoms like guilt, self-hatred, or sadness may be less noticeable to caregivers but are more strongly associated with overall severity and psychopathology than more visible symptoms like changes in sleep or appetite [9].
Focusing solely on the total scores of mental health reports might overlook important insights into the nature of disagreements between children and their caregivers. Additionally examining potential discrepancies in reports of the individual symptoms across the informants helps to devise the appropriate treatment plans and the assessment of whether sufficient progress is being made in treatment. In our study, there also may be some differences in reports of certain symptoms due to the way the questions were asked. For instance, children were asked whether they think about suicide whereas their caregivers responded to the question about children talking about suicide – as they could not know children’s intentions without them verbalising them. Even though the questions refer to the same symptom – suicidal ideation – thinking and talking about it may be associated with different processes hence having potentially varying links with other symptoms. For example, one could speculate that talking about suicide may be more strongly linked with externalising problems than thinking about it.
Sum score models, which treat symptoms as interchangeable indicators of an underlying common cause, are frequently used to measure depression in adolescents, particularly among looked-after children [10-13]. To gain a deeper understanding of how depressive symptoms present in adolescents, network analytic methods have been employed [14]. This network approach views a disorder as a causal system arising from complex interactions between symptoms [15]. The significance of symptoms is determined by their centrality or interconnectedness within the network, with core symptoms potentially representing key clinical targets [15, 16].
In network analysis symptoms are represented as nodes in a network, with connections between them indicating how strongly they influence or are associated with one another. This allows researchers and clinicians to identify key symptoms that might play a central role in a disorder and understand how clusters of symptoms interact, leading to a more nuanced understanding of mental health conditions. By mapping these connections, network analysis offers insights into the underlying structure of psychopathology, which can inform more targeted and effective interventions [17].
Previous research on discrepancy between informants among young people
Few studies have compared symptom networks between children and other informants, as most research has focused on discrepancies in overall scores. One study compared the network structures of clinician reports from patient interviews and patient self-reports of PTSD symptoms among adults, finding differences in only 2 out of 190 connections [18]. Another study revealed that youths and their caregivers differed in the average severity of 12 out of 21 symptoms, with caregivers reporting higher levels for all 12. However, differences between youth and caregiver networks were observed in just 3 of the 119 associations between symptom pairs ("edges"). Specifically, perfectionism and feeling unloved were more strongly linked in the youth network, while the connections between being secretive and unwilling to talk, as well as preferring to be alone and being uninvolved, were stronger in the caregiver network [19]. To our knowledge there is no previous research comparing networks of symptoms across informants of mental health of looked-after children.
The findings from network analyses conducted in general population may not be generalisable to looked-after children due to reasons such as physical, sexual, or emotional abuse, neglect, or other circumstances that hinder parental caregiving, like incarceration [20]. These challenging experiences are likely to contribute to the development of dysfunctional attachment styles in these children, leading to ongoing negative interactions and unmet emotional needs throughout their lives [21-23]. We are aware of only one study that conducted network analysis of depressive symptoms among looked-after children comparing them with general population of adolescents [24]. This was done in three population-based datasets in the United Kingdom. Self-hate emerged as a key symptom, consistent with previous network studies. The symptom "I was no good anymore" was also highly central across the datasets. For looked-after children, "I was a bad person" was a central symptom, whereas this symptom was among the least central in the other two datasets [24]. The DSM-5 symptom "I did not enjoy anything" was not central in any of the networks [24]. This suggests that negative self-evaluation may have a more significant influence on depressive symptoms in looked-after children compared to the general population. This study, however, did not explore discrepancy across different informants. We aim to fill in this gap in literature.
The Covid pandemic as a unique challenge for young people
The Covid pandemic posed unique challenges for looked-after children, as well as in the general population of young people. There is an abundance of evidence that young people, including most vulnerable ones, were particularly susceptible to an increase – at least in the short term – in mental health problems [25]. It is unclear, however, whether in addition to the augmented severity of the symptoms, the manifestation of mental health problems changed as well during the Covid pandemic. For instance, one study compared two cross-sectional surveys among over 20,000 Chinese adolescents between February 20 and 27, 2020 and between April 11 and 19, 2020. They found that the disruptions to daily life caused by the Covid-19 pandemic may have contributed to the more pronounced connections between depressed mood, somatic complaints, and interpersonal problems across at the second time point [26]. As looked-after children are quite a unique group, it is difficult to generalise findings to it from other populations – this is true during “normal” times and the Covid pandemic. Hence, our secondary aim is to explore any differences in the networks of symptoms before and after the outbreak of the Covid-19 pandemic.
References
1. Petrowski N, Cappa C, Gross P. Estimating the number of children in formal alternative care: Challenges and results. Child Abuse Negl. 2017;70:388-98.
2. Swiss National Science Foundation (SNSF). The NRP. Available online: http://www.nfp76.ch/en/the-nrp 2020 [
3. Ford T, Vostanis P, Meltzer H, Goodman R. Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J Psychiatry. 2007;190:319-25.
4. McAuley C, Davis T. Emotional well-being and mental health of looked after children in England. Child & Family Social Work. 2009;14(2):147-55.
5. Pinto C, Woolgar M. Introduction: Looked-after children. Child Adolesc Ment Health. 2015;20(4):e1-e3.
6. Li M, D'Arcy C, Meng X. Maltreatment in childhood substantially increases the risk of adult depression and anxiety in prospective cohort studies: systematic review, meta-analysis, and proportional attributable fractions. Psychol Med. 2016;46(4):717-30.
7. Nanni V, Uher R, Danese A. Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. Am J Psychiatry. 2012;169(2):141-51.
8. National Institute for Health and Care Excellence. Looked-After Children and Young People (update) [F] Evidence review for interventions to promote physical, mental, and emotional health and wellbeing of looked-after children, young people and care leavers. 2021.
9. Maasalo K, Wessman J, Aronen ET. Low mood in a sample of 5–12 year-old child psychiatric patients: a cross-sectional study. Child and Adolescent Psychiatry and Mental Health. 2017;11(1):50.
10. Thapar A, Eyre O, Patel V, Brent D. Depression in young people. Lancet. 2022;400(10352):617-31.
11. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345-65.
12. Dahl RE, Allen NB, Wilbrecht L, Suleiman AB. Importance of investing in adolescence from a developmental science perspective. Nature. 2018;554(7693):441-50.
13. Rice F, Riglin L, Lomax T, Souter E, Potter R, Smith DJ, et al. Adolescent and adult differences in major depression symptom profiles. J Affect Disord. 2019;243:175-81.
14. Malgaroli M, Calderon A, Bonanno GA. Networks of major depressive disorder: A systematic review. Clin Psychol Rev. 2021;85:102000.
15. Borsboom D, Cramer AO. Network analysis: an integrative approach to the structure of psychopathology. Annu Rev Clin Psychol. 2013;9:91-121.
16. McNally RJ. Network Analysis of Psychopathology: Controversies and Challenges. Annual Review of Clinical Psychology. 2021;17(Volume 17, 2021):31-53.
17. Robinaugh DJ, Hoekstra RHA, Toner ER, Borsboom D. The network approach to psychopathology: a review of the literature 2008-2018 and an agenda for future research. Psychol Med. 2020;50(3):353-66.
18. Moshier SJ, Bovin MJ, Gay NG, Wisco BE, Mitchell KS, Lee DJ, et al. Examination of posttraumatic stress disorder symptom networks using clinician-rated and patient-rated data. J Abnorm Psychol. 2018;127(6):541-7.
19. Mullarkey MC, Schleider JL, Jones PJ, Weisz JR. Using Network Analysis to Compare Caregiver and Youth Reports of Youths’ Depressive Symptoms. 2018.
20. Meltzer H, Gatward R, Corbin T, Goodman R, Ford T. The mental health of young people looked after by local authorities in England. Newport, UK: The Office for National Statistics (ONS); 2003.
21. Hillman S, Cross R, Anderson K. Exploring Attachment and Internal Representations in Looked-After Children. Front Psychol. 2020;11:464.
22. van Ijzendoorn MH, Juffer F. The Emanuel Miller Memorial Lecture 2006: adoption as intervention. Meta-analytic evidence for massive catch-up and plasticity in physical, socio-emotional, and cognitive development. J Child Psychol Psychiatry. 2006;47(12):1228-45.
23. Zaccagnino M, Cussino M, Preziosa A, Veglia F, Carassa A. Attachment Representation in Institutionalized Children: A Preliminary Study Using the Child Attachment Interview. Clinical Psychology & Psychotherapy. 2015;22(2):165-75.
24. Schlechter P, Ford T, Neufeld SAS. Depressive symptom networks in the UK general adolescent population and in those looked after by local authorities. BMJ Ment Health. 2023;26(1).
25. Dewa LH, Roberts L, Choong E, Crandell C, Demkowicz O, Ashworth E, et al. The impact of COVID-19 on young people's mental health, wellbeing and routine from a European perspective: A co-produced qualitative systematic review. PLoS One. 2024;19(3):e0299547.
26. Cai H, Bai W, Liu H, Chen X, Qi H, Liu R, et al. Network analysis of depressive and anxiety symptoms in adolescents during the later stage of the COVID-19 pandemic. Translational Psychiatry. 2022;12(1):98.
27. Döpfner M, Plück J, Kinnen C, Arbeitsgruppe Deutsche Child Behavior Checklist. **CBCL/4-18R, YSR and TRF**: German school-age forms of the Child Behavior Checklist by Thomas M. Achenbach. Göttingen: Hogrefe; 2014.
28. Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles: an integrated system of mult-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth & Families; 2001.
29. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing. Vienna, Austria; 2021.
30. Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods. 2018;50(1):195-212.
31. Foygel R, Drton M. Extended Bayesian Information Criteria for Gaussian Graphical Models. 2010.
32. Golino HF, Epskamp S. Exploratory graph analysis: A new approach for estimating the number of dimensions in psychological research. PLOS ONE. 2017;12(6):e0174035.
33. Pons P LMCcilnurwISoCaISOpSBH. International Symposium on Computer and Information Sciences 2005 Oct 26 (pp. 284–293). . Springer Berlin Heidelberg: Berlin, Germany 2005.
34. Christensen AP, Golino H. Estimating the Stability of Psychological Dimensions via Bootstrap Exploratory Graph Analysis: A Monte Carlo Simulation and Tutorial. Psych. 2021;3(3):479-500.
35. Epskamp S, Cramer AO, Waldorp LJ, Schmittmann VD, Borsboom D. qgraph: Network visualizations of relationships in psychometric data. Journal of Statistical Software. 2012;48:1-18.
36. Fruchterman TM, Reingold EM. Graph drawing by force‐directed placement. Software: Practice and Experience. 1991;21:1129-64.
37. van Borkulo CD, van Bork R, Boschloo L, Kossakowski JJ, Tio P, Schoevers RA, et al. Comparing network structures on three aspects: A permutation test. Psychol Methods. 2023;28(6):1273-85.
38. Opsahl T, Agneessens F, Skvoretz J. Node centrality in weighted networks: generalizing degree and shortest paths. Social Networks. 2010;32:245-51.
39. Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accu racy: a tutorial paper. Behav Res Methods. 2018;50:195-212
Mental health of children in care during the COVID-19 pandemic in Switzerland and Germany – comparing trends in reports by children and their caregivers.
No full textBackground
There is substantial evidence showing that mental health of young people has been more vulnerable to the COVID-19 pandemic than that of other age groups in Western well-off countries, including Switzerland and Germany [1-5]. However, studies of a longer trend, spanning pre-, during post-pandemic period tend to suggest that young people adapted to the challenges of the pandemic. That is, an initial increase in mental health problems has been to some extent compensated by a decline, with the trend going back to baseline – that is characterised by a continuous overall rise in mental health problems [5]. We are not aware of any existing quantitative research on how the mental health of children in care has evolved during the pandemic, with qualitative interviews constituting most of the evidence to date.
Mental health of children in care
As shown by the interviews conducted across professions with child protection responsibilities in the United Kingdom, referrals were more serious and complex during the pandemic [6, 7]. This might have been due to delays in identifying the children’s needs, because of the reduced contact with professionals [6, 7]. Moreover, transitioning to online forms of contact disrupted communication between children in care and their biological families, and between children and their caregivers, hindering reunification [8-11]. This might have contributed to the children feeling abandoned, which could negatively impact their mental health [12]. Finally, interviews with representatives from 67 non-governmental organisations in 14 different countries indicated that, because of the pandemic, children in residential care were being returned to their biological families without receiving appropriate preparation and counselling, potentially resulting in greater risk to these children [13].
On the other hand, some children reported improved mental health during the lockdowns. This was due to reduced pressure associated with not having to attend school, which was often a source of conflict with their carers [7]. Others appeared to enjoy better mental health due to improved relationships with carers and residential staff as they spent more time together [12]. Also, there were some reports of relationships between young people and families being perceived as more supportive during the pandemic, which could have also contributed to better mental health of young people in care [7, 14]. Hence, based on the current, mainly qualitative, evidence it is difficult to speculate about the nature of the population-average trend in mental health of young people in care. The experiences of children in care appear to be highly heterogeneous, which could be associated both improved and worsened mental health.
Discrepancies between children’s and caregiver’s reports
Another layer of complexity is that the trends may vary depending on who provides information about young people’s mental health. Studies show only moderate correlations between reports by young people themselves and their parents, teachers or stepparents [15-17]. A recent study investigated trends in mental health of Dutch children and adolescents (8–18 years), both from general and clinical populations, comparing reports of children and their parents [18]. It found that while in the general population the child and parents reports followed a similar secular trend – with internalising problems increasing between the pre-pandemic and during pandemic – in the clinical population there was a substantial discrepancy between the informants. Children in the clinical population disclosed increasing internalising problems from pre-pandemic and over the course of the pandemic, while a stable trend was observed in parental reports. The predictors of these disagreements are unknown. When parents reported more symptoms in previous studies, low educational level of the parent, low income and male gender of the child, parents’ mental health and the quality of parent-child relationships appeared to be important in explaining parent-child discrepancies [16, 19]. Due to these disagreements, it is important to examine trends in mental health among children in care across different informants, as they may point towards differences findings.
References
1. Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med. 2023:1-24.
2. Cénat JM, Farahi SMMM, Dalexis RD, Darius WP, Bekarkhanechi FM, Poisson H, et al. The global evolution of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis of longitudinal studies. Journal of Affective Disorders. 2022;315:70-95.
3. Sun Y, Wu Y, Fan S, Dal Santo T, Li L, Jiang X, et al. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ. 2023;380:e074224.
4. Prati G, Mancini AD. The psychological impact of COVID-19 pandemic lockdowns: a review and meta-analysis of longitudinal studies and natural experiments. Psychol Med. 2021;51(2):201-11.
5. Gondek D, Vandecasteele L, Sánchez-Mira N, Steinmetz S, Mehmeti T, Voorpostel M. The COVID-19 pandemic and wellbeing in Switzerland-worse for young people? Child and Adolescent Psychiatry and Mental Health. 2024;18(1):67.
6. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse & Neglect. 2021;116:104739.
7. Driscoll J, Hutchinson A, Lorek A, Kiss K, Kinnear E. Hearing the Voice of the Child through the Storm of the Pandemic: The Impact of covid-19 Measures on the Detection of and Response to Child Protection Concerns. The International Journal of Children's Rights. 2021;29(2):400-25.
8. Haffejee S, Levine DT. 'When will I be free': Lessons from COVID-19 for Child Protection in South Africa. Child Abuse Negl. 2020;110(Pt 2):104715.
9. Neil E, Copson R, Sorensen P. Contact during lockdown:How are children and their birth families keeping in touch? Briefing paper. London: Nuffield Family Justice Observatory/University of East Anglia; 2020.
10. Callejas LM, Abella AD, Ismajli F. Rapid Ethnographic Assessment of Pandemic Restrictions in Child Welfare: Lessons from Parent and Provider Experiences. Human Organization. 2020;79(4):304-12.
11. Singer J, Brodzinsky D. Virtual parent-child visitation in support of family reunification in the time of COVID-19. Developmental Child Welfare. 2020;2(3):153-71.
12. Ofsted. COVID-19 series: briefing on children's social care. Manchester, UK: The Office for Standards in Education, Children’s Services and Skills (Ofsted) 2020.
13. Wilke NG, Howard AH, Pop D. Data-informed recommendations for services providers working with vulnerable children and families during the COVID-19 pandemic. Child Abuse Negl. 2020;110(Pt 2):104642.
14. Ferguson H, Kelly L, Pink S. Research Briefing Two: Disruption and renewal of social work and child protection during COVID-19 and beyond. Birmingham, UK: University of Birmingham; 2020.
15. Rescorla LA, Ewing G, Ivanova MY, Aebi M, Bilenberg N, Dieleman GC, et al. Parent–Adolescent Cross-Informant Agreement in Clinically Referred Samples: Findings From Seven Societies. Journal of Clinical Child & Adolescent Psychology. 2017;46(1):74-87.
16. Brocker SA, Steinbach A, Augustijn L. Parent-child Discrepancies in Reporting Children’s Mental Health: Do Physical Custody Arrangements in Post-separation Families Matter? Child Indicators Research. 2024;17(1):197-220.
17. Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J. Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors. BMC Psychiatry. 2010;10(1):56.
18. Fischer K, Tieskens JM, Luijten MAJ, Zijlmans J, van Oers HA, de Groot R, et al. Internalizing problems before and during the COVID-19 pandemic in independent samples of Dutch children and adolescents with and without pre-existing mental health problems. Eur Child Adolesc Psychiatry. 2023;32(10):1873-83.
19. Van Roy B, Groholt B, Heyerdahl S, Clench-Aas J. Understanding discrepancies in parent-child reporting of emotional and behavioural problems: Effects of relational and socio-demographic factors. BMC Psychiatry. 2010;10:56.
20. Döpfner M, Plück J, Kinnen C, Arbeitsgruppe Deutsche Child Behavior Checklist. **CBCL/4-18R, YSR and TRF**: German school-age forms of the Child Behavior Checklist by Thomas M. Achenbach. Göttingen: Hogrefe; 2014.
21. Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles: an integrated system of mult-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth & Families; 2001.
22. Chen FF. Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling. 2007;14(3):464-504.
23. Ditzen J, Karavias Y, Westerlund J. Testing and Estimating Structural Breaks in Time Series and Panel Data in Stata," Discussion Papers 21-14. Department of Economics, University of Birmingham: Birmingham, UK; 2021.
24. Bai J, Perron P. Estimating and Testing Linear Models with Multiple Structural Changes. Econometrica. 1998;66(1):47-78
Variants of Girls and Boys with Conduct Disorder: Anxiety Symptoms and Callous-Unemotional Traits
No full textRecent research suggests that among the group of aggressive and antisocial adolescents, there are distinct variants who exhibit different levels of anxiety symptoms and callous-unemotional traits (CU traits). The purpose of the present study was to examine whether such variants are also present in male and female adolescents diagnosed with conduct disorder (CD). We used model-based cluster analysis to disaggregate data of 158 adolescents with CD (109 boys, 49 girls; mean age =15.61years) living in child welfare and juvenile justice institutions. Three variants were identified: (1) CD only, (2) CD with moderate CU traits and anxiety symptoms, and (3) CD with severe CU traits. Variants differed in external validation measures assessing anger and irritability, externalizing behavior, traumatic experiences, and substance use. The CD variant with moderate CU traits and anxiety symptoms had the most severe pattern of psychopathology. Our results also indicated distinct profiles of personality development for all three variants. Gender-specific comparisons revealed differences between girls and boys with CD on clustering and external validation measures and a gender-specific cluster affiliation. The present results extend previously published findings on variants among aggressive and antisocial adolescents to male and female adolescents diagnosed with CD
Komorbide Angststörungen bei Störungen des Sozialverhaltens
No full textObwohl Angststörungen (AS) häufig komorbid mit einer Störung des Sozialverhaltens (SSV) auftreten, wurde diese Komorbidität in der Forschung weitgehend vernachlässigt. Komorbide AS wirken sich in Studien sowohl positiv als auch negativ auf den Verlauf einer SSV aus. Diese Studie zielt darauf ab, Heranwachsende mit einer SSV mit und ohne AS hinsichtlich psychischer Belastung, traumatischen Erlebnissen, psychopathischen Persönlichkeitstraits und Legalbewährung zu untersuchen. 207 Heranwachsende mit einer SSV (9 – 25 Jahre; 73.4 % männlich; SSV: N = 180, SSV und AS: N = 27), die zum Zeitpunkt der Untersuchung in Jugendhilfeeinrichtungen lebten, konnten eingeschlossen werden. Es wurden strukturierte klinische Interviews und eine psychometrische Testbatterie eingesetzt. Die Resultate zeigen, dass die Gruppe mit SSV und AS signifikant weniger externalisierende und mehr internalisierende Symptome sowie traumatische Erlebnisse aufweisen. Bezüglich psychopathischer Persönlichkeitsmerkmale und Verurteilungen (>50 % in beiden Gruppen) ergaben sich keine signifikanten Gruppenunterschiede. Die Ergebnisse legen nahe, dass die Ausprägung der SSV für die Kriminalitätsentwicklung bedeutsamer und die spezifische Komorbidität von AS aber doch ätiologisch und symptomatisch von großem Interesse ist. Diese sollte deshalb mit Längsschnittstudien und Therapieprozessanalysen intensiver beforscht werden
Risikofaktoren für und Stabilität einer Persönlichkeitsstörung vom Jugendalter bis ins junge Erwachsenenalter in einer Hochrisikopopulation
No full textZusammenfassung. Theoretischer Hintergrund: Studien zeigen, dass
Persönlichkeitsstörungen (PS) weniger stabil und bei einer frühzeitigen Erkennung gut
behandelbar sind. Fragestellung: Ziel dieser Studie ist, 1) die Prävalenz von PS bei ehemalig
fremdplatzierten jungen Erwachsenen zu beschreiben, 2) die kategoriale Stabilität von PS vom Jugendalter
bis ins junge Erwachsenenalter zu bestimmen und 3) prospektive Risikofaktoren für eine PS im
Erwachsenenalter zu identifizieren. Methoden: 180 ehemalig fremdplatzierte junge Erwachsene
(M = 26.3 Jahre) aus einer schweizweiten Längsschnittstudie wurden untersucht.
Ergebnisse: 35 % der Teilnehmenden wiesen eine PS auf. Die kategoriale Stabilität belief sich auf
47 %. Folgende Risikofaktoren für eine PS im Erwachsenenalter wurden identifiziert: vorangehende
PS, psychopathische Persönlichkeitszüge, Substanzmissbrauch, emotionale Vernachlässigung,
kumulierte Misshandlungserfahrungen und Deliktschwere. Diskussion und Schlussfolgerung: Die kategoriale
Stabilität irgendeiner PS in dieser Stichprobe gilt als mittelgradig. Dies unterstreicht die
Notwendigkeit, PS nicht mehr mit einem lebenslangen, unveränderbaren Schicksal gleichzusetzen. Das
Erkennen möglicher Risikofaktoren ist eine wichtige Voraussetzung, um individuelle
Behandlungsmöglichkeiten zu gewährleisten und einer Chronifizierung entgegenzuwirken
Differential effects of childhood maltreatment types and timing on psychopathology in formerly out-of-home placed young adults
No full textChildhood maltreatment (CM) increases the risk of psychopathology. Besides CM types and severity, the timing of exposure is an important modulating factor in this association, as childhood and adolescence comprise sensitive developmental periods for brain maturation and socio-emotional development. Nevertheless, previously reported associations between the severity of subtypes and timing of CM and psychopathology have been heterogeneous and have hardly considered vulnerable groups broadly exposed to CM, such as out-of-home-placed youth. Thus, we investigated the association between CM types and timing and psychopathology in a sample of formerly out-of-home placed young adults (N = 185; 32% women, age mean = 26.38, SD = 3.49 years). CM was assessed using the Maltreatment of Abuse Chronology of Exposure Scale and general, internalizing and, externalizing problems were assessed using the Achenbach System of Empirically Based Assessment. We employed conditional random forest regression to estimate the importance of CM types (abuse, neglect, peer victimization, and sexual abuse), timings (ages 3–18) as well as CM severity, multiplicity, and duration on adult general, internalizing, and externalizing problems. We validated the results using diagnoses of mental disorders assessed in clinical interviews, which were classified under general, internalizing, and externalizing clusters based on the Hierarchical Taxonomy of Psychopathology model. We found that CM severity and multiplicity were stronger predictors of internalizing problems than timing-specific effects of CM types. Abuse in early childhood and peer violence in late adolescence were stronger predictors of externalizing problems compared to global CM measures. Our findings highlight the importance of considering CM type and timing when testing CM-associated risks for psychopathology. This might further be valuable in therapeutic settings to guide maltreatment-informed interventions. Reducing violent caregiving environments in early childhood and preventing peer victimization in adolescence may be especially important in counteracting CM-associated risks of externalizing behaviors
Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study – CORRIGENDUM
No full textMisshandlungs- und Vernachlässigungserfahrungen in der Kindheit: Ein Risikofaktor für die soziale Teilhabe ehemals außerfamiliär platzierter junger Erwachsener : Ergebnisse der schweizweiten Kohortenstudie „Jugendhilfeverläufe: Aus Erfahrung Lernen (JAEL)“
No full textZusammenfassung.
Theoretischer Hintergrund: Eine Reihe von Studien zeigen soziale Folgen von Misshandlung und
Vernachlässigung in der Kindheit im weiteren Lebenslauf. Fragestellung: Diese Studie
zielt darauf ab, die langfristigen Auswirkungen von Misshandlungs- und Vernachlässigungserfahrungen auf
die soziale Teilhabe in einer Stichprobe von ehemals fremdplatzierten jungen Erwachsenen in der Schweiz zu
untersuchen. Methode: Im Rahmen der Studie wurden 218 ehemals fremdplatzierte junge
Erwachsene (MAlter=26.1, 32.6 % weiblich) mit einer psychometrischen
Testbatterie befragt. Dabei wurden Misshandlungserfahrungen in der Kindheit erfasst sowie die soziale Teilhabe
bezüglich psychischer Gesundheit, Legalbewährung, sozio-ökonomische Lage und Beziehungen
untersucht. Ergebnisse: Die Ergebnisse zeigen die hohe Prävalenz und negativen Folgen
von kumulierten Misshandlungserfahrungen bei ehemals fremdplatzierten jungen Menschen. Eine höhere Anzahl
von Misshandlungserfahrungen ging mit signifikant mehr Problemen in gesundheitlichen, finanziellen und
sozialen Lebensbereichen einher. Diskussion und Schlussfolgerung: Die gravierenden Folgen von
Misshandlungserfahrungen in der Kindheit unterstreichen die Bedeutung der Prävention und
frühzeitigen Intervention. Sie zeigen aber auch, dass viele schwer betroffene junge Menschen neben
therapeutischen auch konkrete und lebensweltorientierte Hilfen benötigen, um ihre Entwicklungsaufgaben
adäquat zu bewältigen und erfolgreich an der Gesellschaft teilzuhaben
Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study
No full textBACKGROUND: Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood. METHODS: Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed. RESULTS: In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples. CONCLUSIONS: Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted
Childhood maltreatment and mental health problems in a 10-year follow-up study of adolescents in youth residential care : A latent transition analysis
No full textChildhood maltreatment and mental health problems are common among young people placed out-of-home. However, evidence on the impact of maltreatment on the course of mental health problems in at-risk populations is sparse. The aim of this longitudinal study is twofold: (a) describe the course of mental health problems and the shift in symptom patterns among adolescents in youth residential care into young adulthood and (b) assess how childhood maltreatment is related to the course of mental health problems. One hundred and sixty-six adolescents in Swiss youth residential care were followed up into young adulthood (36.1% women; MAge-Baseline = 16.1 years; MAge-Follow-Up = 26.4 years). Latent transition analysis was employed to analyze transitions of symptom patterns and their association with maltreatment exposure. We found three latent classes of mental health problems: a “multiproblem”-class (51.8% baseline; 33.7% follow-up), a “low symptom”-class (39.2% baseline; 60.2% follow-up), and an “externalizing”-class (9.0% baseline; 6.0% follow-up). Individuals in the “multiproblem”-class were likely to transition towards less-complex symptom patterns. Higher severity of self-reported childhood maltreatment was associated with more complex and persistent mental health problems. Our study underlines the need for collaboration between residential and psychiatric care systems within and after care placements, with a specialized focus on trauma-informed interventions and care.publishe
