Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood worldwide, and causes significant impairments in overall functioning. In order to ...develop effective prevention and intervention programs, knowledge of the determinants that have an impact on the onset and development of ADHD symptoms is essential. So far, little is known about factors affecting ADHD symptoms in children and adolescents over time. Therefore, this study investigates potential psychosocial risk and protective factors for ADHD symptoms based on cross-sectional and longitudinal data of a German population-based study.
Data on children and adolescents (n = 1,384 aged 11 to 17 years) were collected at three measurement points (baseline, 1-year and 2-year follow-ups) covering a period of two years. We used latent growth modelling to investigate effects of parental mental health problems (risk factor) and self-efficacy, family climate and social support (protective factors) on symptoms of ADHD based on cross-sectional as well as longitudinal data. Sociodemographic factors, pre- and postnatal factors, and comorbid symptoms of internalizing and externalizing mental health problems were considered as covariates.
At baseline, male gender, younger age, stronger aggressive behavior, and stronger parental mental health problems were related to more ADHD symptoms. Longitudinal analyses showed that female gender, migration status, increasing symptoms of generalized anxiety, increasing aggressive behavior and increasing parental mental health problems were associated with stronger increase of ADHD symptoms over time. However, improving family climate was related to decreasing ADHD symptoms over time. We further found moderator effects for social support.
The findings of the study provide important information concerning risk and protective factors in the context of ADHD. Hence, the results may be integrated into the planning and implementation of future prevention and early intervention strategies that target affected children and adolescents.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an ...11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7–31 years participated (
n
= 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.
The basis for healthy development is established during the first years of one's life. In this early phase, parents can significantly influence the health conditions under which their child grows up. ...Parental education can play a key role in this regard. This study examines the association of maternal education with health and health behavior in infants.
A subsample of the representative German KiGGS study (Wave 1, 2009-2012) on the health of children and adolescents was investigated. Data from 1727 mothers who reported on health-specific characteristics of their infants (0 to 2 years), on their own educational background, and on characteristics of the family were analyzed. The influence of maternal education on indices of health and health behavior in infants was investigated by means of logistic regression; additional predictors were considered in regression models.
Higher maternal education was associated with better health behavior, but not with overall infant health. The impact of maternal education on health behavior remained significant when considering other predictors (financial worries, low maternal age at childbirth, premature birth/low birth weight). Overall, low maternal education was accompanied by an accumulation of additional risks.
Higher maternal education can help infants have a good start in their lives. The impact of poor health behavior on infant health may not become apparent until later in their lives. For prevention and intervention, it is important to identify sensitive stages of development during childhood and the underlying mechanisms of the relationship between maternal education and infant health behavior.
Zusammenfassung
Hintergrund
Der Grundstein für eine gesunde Entwicklung wird schon in den ersten Lebensjahren gelegt, wobei Eltern die Bedingungen, unter denen ihr Kind aufwächst, maßgeblich ...beeinflussen können. Hierbei kann die Bildung der Eltern eine Schlüsselrolle spielen. Diese Studie untersucht den Zusammenhang zwischen mütterlicher Bildung und der Gesundheit sowie dem Gesundheitsverhalten ihrer Kleinkinder.
Methoden
Im Rahmen der repräsentativen Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS Welle 1, 2009–2012) gaben 1727 Mütter Auskunft zur Gesundheit, zum Gesundheitsverhalten und zu weiteren Merkmalen ihrer Kleinkinder (0 bis 2 Jahre) sowie zu ihrer eigenen Person und zur Familie. Mithilfe logistischer Regressionen wurde der Einfluss der mütterlichen Bildung auf Indizes der Gesundheit und des Gesundheitsverhaltens der Kleinkinder unter Berücksichtigung weiterer Prädiktoren untersucht.
Ergebnisse
Höhere mütterliche Bildung war mit einem besseren Gesundheitsverhalten, aber nicht mit der Gesundheit der Kleinkinder assoziiert; der gefundene Zusammenhang blieb auch unter Hinzunahme weiterer Prädiktoren bedeutsam (finanzielle Sorgen, junges Alter der Mütter bei Geburt des Kindes, Frühgeburt/niedriges Geburtsgewicht). Bei niedriger Bildung lag eine Kumulation von Risiken vor.
Diskussion
Eine höhere mütterliche Bildung kann Kleinkinder bei einem guten Start in ihr Leben unterstützen. Auswirkungen eines schlechten Gesundheitsverhaltens bei Kleinkindern auf deren Gesundheit zeigen sich eventuell erst in späteren Lebensjahren. Für Präventions- und Interventionsmaßnahmen ist es bedeutend, sensitive Entwicklungsphasen in der Kindheit sowie zugrunde liegende Mechanismen des Zusammenhangs mütterlicher Bildung und kindlichen Gesundheitsverhaltens zu identifizieren.
The terms affective dysregulation (AD) and irritability describe transdiagnostic dimensions and are characterized by an excessive reactivity to negative emotional stimuli with an affective (anger) ...and a behavioral component (aggression). Due to early onset, high prevalence and persistence, as well as developmental comorbidity, AD in childhood is one of the most psychosocially impairing and cost-intensive mental health conditions. AD is especially prevalent in children in the youth welfare service. Despite continuous research, there remains a substantial need for diagnostic approaches and optimization of individualized treatment strategies in order to improve outcomes and reduce the subjective and economic burden.
The ADOPT (Affective Dysregulation - Optimizing Prevention and Treatment) Consortium integrates internationally established, highly experienced and interdisciplinary research groups. The work program encompasses (a) epidemiology, including prevalence of symptoms and disorders, (b) development and evaluation of screening and assessment tools, (c) stepped care approaches for clinically useful personalized medicine, (d) evaluation of an easily accessible and cost-effective online intervention as indicated prevention (treatment effects, moderation/mediation analysis), and (e) evaluation of an intensive personalized modular outpatient treatment in a cohort of children with AD who live with their parents and in a cohort of children with AD who live in out-of-home care (treatment effects, moderation/mediation analysis).
The results will lead to significant recommendations for improving treatment within routine clinical care in two cohorts of children with AD and coexisting conditions, especially oppositional-defiant disorder, conduct disorder and disruptive mood dysregulation disorder.
Trial registration ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963 . Registered 27 June 2018. Trial registration ADOPT Treatment: German Clinical Trials Register (DRKS) DRKS00013317 . Registered 27 September 2018. Trial registration ADOPT Institution: German Clinical Trials Register (DRKS) DRKS00014581 . Registered 04 July 2018.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Zusammenfassung
Gesundheitsbezogene Lebensqualität ist ein multidimensionales Konstrukt, welches körperliche, mentale und soziale Komponenten des Wohlbefindens aus subjektiver Sicht des Befragten ...umfasst. Zur Erhebung der Lebensqualität im Kindes- und Jugendalter stehen verschiedene altersangemessene Instrumente zur Verfügung. Durch den Einsatz von innovativen Verfahren, wie computer-adaptiven Tests, kann Lebensqualität in der Zukunft effizienter und routinemäßiger in der Versorgung erhoben werden.
Gesundheitsbezogene Lebensqualität ist ein multidimensionales Konstrukt, welches körperliche, mentale und soziale Komponenten des Wohlbefindens aus subjektiver Sicht des Befragten umfasst. Zur ...Erhebung der Lebensqualität im Kindes- und Jugendalter stehen verschiedene altersangemessene Instrumente zur Verfügung. Durch den Einsatz von innovativen Verfahren, wie computer-adaptiven Tests, kann Lebensqualität in der Zukunft effizienter und routinemäßiger in der Versorgung erhoben werden.
PDF
