Early-onset child conduct problems are common and costly. A large number of studies and some previous reviews have focused on behavioural and cognitive-behavioural group-based parenting ...interventions, but methodological limitations are commonplace and evidence for the effectiveness and cost-effectiveness of these programmes has been unclear.
To assess the effectiveness and cost-effectiveness of behavioural and cognitive-behavioural group-based parenting programmes for improving child conduct problems, parental mental health and parenting skills.
We searched the following databases between 23 and 31 January 2011: CENTRAL (2011, Issue 1), MEDLINE (1950 to current), EMBASE (1980 to current), CINAHL (1982 to current), PsycINFO (1872 to current), Social Science Citation Index (1956 to current), ASSIA (1987 to current), ERIC (1966 to current), Sociological Abstracts (1963 to current), Academic Search Premier (1970 to current), Econlit (1969 to current), PEDE (1980 to current), Dissertations and Theses Abstracts (1980 to present), NHS EED (searched 31 January 2011), HEED (searched 31 January 2011), DARE (searched 31 January 2011), HTA (searched 31 January 2011), mRCT (searched 29 January 2011). We searched the following parent training websites on 31 January 2011: Triple P Library, Incredible Years Library and Parent Management Training. We also searched the reference lists of studies and reviews.
We included studies if: (1) they involved randomised controlled trials (RCTs) or quasi-randomised controlled trials of behavioural and cognitive-behavioural group-based parenting interventions for parents of children aged 3 to 12 years with conduct problems, and (2) incorporated an intervention group versus a waiting list, no treatment or standard treatment control group. We only included studies that used at least one standardised instrument to measure child conduct problems.
Two authors independently assessed the risk of bias in the trials and the methodological quality of health economic studies. Two authors also independently extracted data. We contacted study authors for additional information.
This review includes 13 trials (10 RCTs and three quasi-randomised trials), as well as two economic evaluations based on two of the trials. Overall, there were 1078 participants (646 in the intervention group; 432 in the control group). The results indicate that parent training produced a statistically significant reduction in child conduct problems, whether assessed by parents (standardised mean difference (SMD) -0.53; 95% confidence interval (CI) -0.72 to -0.34) or independently assessed (SMD -0.44; 95% CI -0.77 to -0.11). The intervention led to statistically significant improvements in parental mental health (SMD -0.36; 95% CI -0.52 to -0.20) and positive parenting skills, based on both parent reports (SMD -0.53; 95% CI -0.90 to -0.16) and independent reports (SMD -0.47; 95% CI -0.65 to -0.29). Parent training also produced a statistically significant reduction in negative or harsh parenting practices according to both parent reports (SMD -0.77; 95% CI -0.96 to -0.59) and independent assessments (SMD -0.42; 95% CI -0.67 to -0.16). Moreover, the intervention demonstrated evidence of cost-effectiveness. When compared to a waiting list control group, there was a cost of approximately $2500 (GBP 1712; EUR 2217) per family to bring the average child with clinical levels of conduct problems into the non-clinical range. These costs of programme delivery are modest when compared with the long-term health, social, educational and legal costs associated with childhood conduct problems.
Behavioural and cognitive-behavioural group-based parenting interventions are effective and cost-effective for improving child conduct problems, parental mental health and parenting skills in the short term. The cost of programme delivery was modest when compared with the long-term health, social, educational and legal costs associated with childhood conduct problems. Further research is needed on the long-term assessment of outcomes.
Refugees who have fled war zones are at a heightened risk of psychosocial problems that can impact their ability to function in day-to-day life and place a significant burden on the family structure. ...This study aimed to assess the psychosocial problems and needs and coping mechanisms of Adolescent Syrian refugees in Jordan.
Between October and December 2018, we conducted a qualitative study using semi-structured interviews with a sample of key and individual informants. Our sample included 20 primary healthcare professionals, 20 schoolteachers, 20 Syrian parents, and 20 adolescents aged 12-17 years. All interviews were transcribed verbatim, and we utilized thematic analysis to group, categorize, and analyze the original Arabic language transcripts. To ensure thorough analysis, we adopted a bottom-up inductive approach that covered the six-phase iterative process proposed by Braun and Clarke.
The main psychosocial problems encountered by Syrian adolescents included stress, depression, loneliness, lack of a sense of security, isolation, aggressiveness, fear of war, and family disintegration. Almost all schoolteachers reported that they observed that Jordanian adolescents are more settled, self-confident, and financially stable relative to their Syrian peers. The Jordanian government and community were praised for their support, including education, recreational centers, health services, and awareness campaigns. Going to school, praying and reading the Holy Quran, listening to music, and talking to friends and engaging with them were reported as the main coping mechanisms. The majority of respondents said that more services are still needed for adolescents, including more places for entertainment, psychosocial support and psychological counseling, medical care, job creation, and providing health insurance.
Syrian refugees are aware of the psychological aspects of their situation, but they are not always able to access clinic-based humanitarian assistance for mental health and psychosocial support. Stakeholders must interact with refugees to learn about their needs and develop services that are appropriate for their culture.
To investigate the prevalence of adolescent sleep disturbances and their relation to psychosocial difficulties and health risk behaviors with the use of data from a province-wide health survey (n = ...16,781).
Psychosocial difficulties were measured with the Strength and Difficulties Questionnaire. Additional assessments included self-reported sleep disturbances, suicidality, and health risk behaviors including current use of tobacco, alcohol, and drugs, physical inactivity, and compulsive use of multimedia. We used multilevel analyses to investigate the relationhips, including differences, between boys and girls, as well as the mediating role of emotional problems.
Just under 20% of adolescents reported sleep disturbances in the previous month. These sleep disturbances were associated with psychosocial problems (odds ratio OR, 6.42; P < .001), suicidality (OR, 3.90–4.14; P < .001), and all health risk behaviors (OR, 1.62–2.66; P < .001), but not with physical inactivity. We found moderation by gender for the relations between sleep and suicide attempts (OR, 0.38; P < .002) and between sleep and cannabis use (OR, 0.52; P = .002), indicating attenuated relationships in girls compared with boys. Emotional problems partially mediated the relationships between sleep disturbances and multimedia use.
This study reiterates the high prevalence of sleep disturbances during adolescence. These sleep disturbances were strongly related to psychosocial problems and a wide range of health risk behaviors. Although the direction of causality cannot be inferred, this study emphasizes the need for awareness of impaired sleep in adolescents. Moreover, the gender differences in associated suicide attempts and cannabis use call for further research into tailored intervention strategies.
In common with elite athletes from other sport disciplines, severe or recurrent injuries in professional footballers are considered to be major physical and psychosocial stressors, which may ...predispose to mental health problems during and after their career.
To determine the prevalence of mental health problems and psychosocial difficulties in current and former professional footballers, and to explore the association between psychosocial stressors and the health conditions studied.
Based on validated scales, a paper and electronic questionnaire was developed for current and former professional footballers and distributed by the World Footballers' Union (FIFPro) and players' unions in six countries. Prevalence was calculated and cross-sectional analyses were conducted.
The response rate was 29% with 253 responses available for analysis. The prevalence of mental health complaints ranged from 5% (burnout) to 26% (anxiety/depression) in 149 current players and from 16% (burnout) to 39% (anxiety/depression) in 104 former footballers. The prevalence of psychosocial problems ranged from 3% (low self-esteem) to 26% (adverse nutrition behaviour) in current players and from 5% (low self-esteem) to 42% (adverse nutrition behaviour) in former footballers. In both current and former players, mental health problems were significantly associated with low social support (odds ratio OR = 1.1) and recent life events (OR = 1.4-1.6). In former players, previous surgery was significantly associated with smoking (OR = 1.9).
The prevalence of mental health problems and/or psychosocial difficulties in current and former professional footballers was found to be high. The presence of mental health problems was associated with low social support and recent life events.
Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric conditions affecting children and adolescents. Amphetamines are among the most commonly prescribed medications to ...manage ADHD. There are three main classes of amphetamines: dexamphetamine, lisdexamphetamine and mixed amphetamine salts, which can be further broken down into short- and long-acting formulations. A systematic review assessing their efficacy and safety in this population has never been conducted.
To assess the efficacy and safety of amphetamines for ADHD in children and adolescents.
In August 2015 we searched CENTRAL, Ovid MEDLINE, Embase, PsycINFO, ProQuest Dissertation and Theses, and the Networked Digital Library of Theses and Dissertations. We also searched ClinicalTrials.gov, and checked the reference lists of relevant studies and reviews identified by the searches. No language or date restrictions were applied.
Parallel-group and cross-over randomized controlled trials (RCTs) comparing amphetamine derivatives against placebo in a pediatric population (< 18 years) with ADHD.
Two authors independently extracted data on participants, settings, interventions, methodology, and outcomes for each included study. For continuous outcomes, we calculated the standardized mean difference (SMD) and for dichotomous outcomes we calculated the risk ratio (RR). Where possible, we conducted meta-analyses using a random-effects model. We also performed a meta-analysis of the most commonly reported adverse events in the primary studies.
We included 23 trials (8 parallel-group and 15 cross-over trials), with 2675 children aged three years to 17 years. All studies compared amphetamines to placebo. Study durations ranged from 14 days to 365 days, with the majority lasting less than six months. Most studies were conducted in the United States; three studies were conducted across Europe. We judged 11 included studies to be at a high risk of bias due to insufficient blinding methods, failing to account for dropouts and exclusions from the analysis, and failing to report on all outcomes defined a priori. We judged the remaining 12 studies to be at unclear risk of bias due to inadequate reporting.Amphetamines improved total ADHD core symptom severity according to parent ratings (SMD -0.57; 95% confidence interval (CI) -0.86 to -0.27; 7 studies; 1247 children/adolescents; very low quality evidence), teacher ratings (SMD -0.55; 95% CI -0.83 to -0.27; 5 studies; 745 children/adolescents; low quality evidence), and clinician ratings (SMD -0.84; 95% CI -1.32 to -0.36; 3 studies; 813 children/adolescents; very low quality evidence). In addition, the proportion of responders as rated by the Clinical Global Impression - Improvement (CGI-I) scale was higher when children were taking amphetamines (RR 3.36; 95% CI 2.48 to 4.55; 9 studies; 2207 children/adolescents; very low quality evidence).The most commonly reported adverse events included decreased appetite, insomnia/trouble sleeping, abdominal pain, nausea/vomiting, headaches, and anxiety. Amphetamines were associated with a higher proportion of participants experiencing decreased appetite (RR 6.31; 95% CI 2.58 to 15.46; 11 studies; 2467 children/adolescents), insomnia (RR 3.80; 95% CI 2.12 to 6.83; 10 studies; 2429 children/adolescents), and abdominal pain (RR 1.44; 95% CI 1.03 to 2.00; 10 studies; 2155 children/adolescents). In addition, the proportion of children who experienced at least one adverse event was higher in the amphetamine group (RR 1.30; 95% CI 1.18 to 1.44; 6 studies; 1742 children/adolescents; low quality evidence).We performed subgroup analyses for amphetamine preparation (dexamphetamine, lisdexamphetamine, mixed amphetamine salts), amphetamine release formulation (long acting versus short acting), and funding source (industry versus non industry). Between-group differences were observed for proportion of participants experiencing decreased appetite in both the amphetamine preparation (P < 0.00001) and amphetamine release formulation (P value = 0.008) subgroups, as well as for retention in the amphetamine release formulation subgroup (P value = 0.03).
Most of the included studies were at high risk of bias and the overall quality of the evidence ranged from low to very low on most outcomes. Although amphetamines seem efficacious at reducing the core symptoms of ADHD in the short term, they were associated with a number of adverse events. This review found no evidence that supports any one amphetamine derivative over another, and does not reveal any differences between long-acting and short-acting amphetamine preparations. Future trials should be longer in duration (i.e. more than 12 months), include more psychosocial outcomes (e.g. quality of life and parent stress), and be transparently reported.
Helplines are generally a population-level resource for providing free, timely, easy-to-access, and anonymous counseling and/or information. Helplines have been developed and widely implemented for ...specific use by young people. The current study aimed to systematically review the literature to determine the status of research into the use of helplines among young people.
Following the PRISMA checklist, 5 electronic databases were searched using relevant terms for literature published until May 2020. The extracted studies were summarized with the intention of identifying key themes that highlighted common findings, key implications, and important gaps in understanding.
A total of 52 articles fitting study inclusion criteria were identified. Most studies were quantitative papers from the United States and Australia. The types of helpline interactions studied were a mixture of telephone-based and SMS/text-based interactions. Three major themes were identified: awareness of and engagement with helpline services, nature of problems faced by young people, and service-related factors. Subthemes were use and awareness, barriers to help seeking, psychosocial problems, suicidality, telephone- versus text-based interactions, counselor-caller interaction, and provision of services to historically and systemically marginalized groups.
It appears that helplines may provide a beneficial service to youths, and that myriad psychosocial concerns provide the basis for calling. The literature is limited by a lack of controlled trials, on one hand, and complex methodological/ethical barriers preventing such trials, on the other hand. However, more research is needed before conclusions regarding effectiveness in youths can be made, particularly for services provided to systemically marginalized groups and using online text-based approaches.
Introduction: Mental health knowledge is a substantial part of mental health literacy. Many psychosocial problems are transient and are often not noticed. This study aimed to analyze the factors ...related to student self-awareness in conducting psychosocial screening.Methods: This study used a descriptive-analytic design with cross-sectional approach. The study was conducted at the Faculty of Nursing, Universitas Airlangga Surabaya. A total of 160 respondents was chosen using simple random sampling techniques. The instrument used was a questionnaire. The dependent variable in this study was students’ awareness in conducting psychosocial problems screening. The independent variables in this study were knowledge, social interaction, family support, perceived vulnerability, perceived severity, perceived benefits, perceived barriers, and self-confidence. Analysis used multiple linear regression statistical tests.Results: The results showed there was a relationship between social interaction (p=0.00), perceived vulnerability (p=0.00), perceived benefits (p=0.001) and self-confidence (p=0,000) with students’ self-awareness in conducting psychosocial screening. There was no relationship between knowledge (p=0.555), family support (p=0.720), perceived severity (p=0.070), perceived barriers (p=0.748) with students’ self-awareness in conducting psychosocial screening.Conclusion:Mental health awareness in nursing student should be enhanced and strengthened with health education. Self-awareness of mental health is important for students. This can prevent mental disorders in the future
Hospitalization is a traumatic experience for children. Especially in the case of childhood cancers that require long-term hospitalization, children need psychosocial support. The study aimed to ...examine the effectiveness of drama in reducing psychosocial problems in hospitalized paediatric children diagnosed with cancer.
The study used a mixed method approach, combining both qualitative and quantitative methods with a single group. Drama sessions prepared according to the Tasks and Skills Model were used to support their psychosocial conditions. The Facial Expression Form, The Assessment Scale for Psychosocial Symptoms in Hospitalized Children, and the Drawing and Writing Technique were used before and after the drama sessions.
This study differs from others in its use of drama intervention to reduce psychosocial problems in children undergoing cancer treatment. As a result of the study, it was found that there was a decrease in anxiety, hopelessness, anger-aggression and communication difficulties among psychosocial problems and a change in mood towards feeling happy. The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.
The study suggests that drama sessions were effective in relieving emotional distress in paediatric cancer patients.
Applying drama to children undergoing long-term hospital treatment can help alleviate psychosocial problems by reducing stress, emotional suppression, and compensating for trauma.
•Children diagnosed with cancer experience psychosocial problems.•Drama have a positive emotional impact on children diagnosed with cancer.•Drama reduces anxiety, communication difficulties, anger, hopelessness, and regression behaviors in hospitalized children.•Practices like drama can alleviate the psychosocial problems of children diagnosed with paediatric cancer.