Adolescent Stressors and Their Perceived Effects on Mental Well-Being: A Qualitative Study


Abstract: Previous studies have focused on individual stressors in adolescents’ lives, and less on the subjective experience of how stressors interact. There is a gap in the literature exploring English adolescents’ subjective experiences of stressors. The present study aimed to explore the types of stressors identified by a sample of adolescents (n = 54) and the perceived effects on their mental wellbeing, noting differences in perspective by age and gender.

Eisenstadt, M., Stapley, E., Deighton, J. & Wolpert, M. (2020) Mental Health & Family Medicine, 16: 992-1001. 

Enduring Mental Health in Childhood and Adolescence: Learning From the Millennium Cohort Study

Abstract: Enduring mental health (EMH) is a relatively new concept, which refers to a long-term state of not experiencing a mental illness (ie, enduring mental wellness). No analysis using this concept has been undertaken on UK data nor specifically in the childhood years. The present study seeks to consider the extent and predictors of EMH in children aged 9 months to 14 years who were part of the UK-wide Millennium Cohort Study.

Deighton, J., Lereya, S. T. & Wolpert, M. (2020). Journal of the American Academy of Child & Adolescent Psychiatry. doi:10.1016/j.jaac.2020.11.012.

School characteristics and children’s mental health: A linked survey-administrative data study

Abstract: Mental health difficulties are childhood-onset with lifelong health, social and economic consequences. Children spend a large amount of time in schools, making schools an important context for mental health prevention and support. We examine how school composition and school climate, controlling for individual child-level characteristics, are associated with children's mental health difficulties (emotional and behavioural difficulties). Data from 23,215 children from 648 primary schools in England were analysed to examine the associations of school composition (size, gender, socioeconomic and ethnicity) and school climate with mental health (emotional symptoms, behavioural symptoms and above clinical cut-off scores) adjusting for individual child socio-demographic characteristics.

Patalay, P., O'Neill, E., Deighton, J., Fink., E. (2020) Preventive Medicine 141 (2020) 106292. DOI: 10.1016/j.ypmed.2020.106292

Problem severity and waiting times for young people accessing mental health services


Abstract: Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services.

Edbrooke-Childs, J., & Deighton, J. (2020). BJPsych Open, 6(6), E118. DOI: 10.1192/bjo.2020.103

A comprehensive mapping of outcomes following psychotherapy for adolescent depression: The perspectives of young people, their parents and therapists


Abstract: As mental health systems move towards person-centred care, outcome measurement in clinical research and practice should track changes that matter to young people and their families. This study mapped the types of change described by three key stakeholder groups following psychotherapy for depression, and compared the salience of these outcomes with the frequency of their measurement in recent quantitative treatment effectiveness studies for adolescent depression. Using qualitative content analysis, this study identified and categorized outcomes across 102 semi-structured interviews that were conducted with depressed adolescents, their parents, and therapists, as part of a randomized superiority trial. Adolescents had been allocated to Cognitive-Behavioral Therapy, Short-Term Psychoanalytic Psychotherapy, or a Brief Psychosocial Intervention.

Krause, K., Midgley, N., Edbrooke-Childs, J. et al. Eur Child Adolesc Psychiatry (2020). DOI: 10.1007/s00787-020-01648-8

Exploring harm in psychotherapy: Perspectives of clinicians working with children and young people


Abstract: The potential for harm to occur from talking therapies has been acknowledged in academic literature. However, there is a paucity of research when it comes to exploring this phenomenon when working with young patients. This study explores clinicians’ perspectives on harm from talking therapies when working with children and young people. Eleven clinicians were interviewed on the types of harm that could occur from talking therapies, as well as the potential mechanisms. Data were analysed inductively using thematic analysis.

Castro Batic, B. & Hayes, D. Couns Psychother Res. 2020;00:1–10 (2020). DOI: 10.1002/capr.12347

Children and young people’s experiences of completing mental health and wellbeing measures for research: learning from two school-based pilot projects


Abstract: In recent years there has been growing interest in child and adolescent mental health and wellbeing, alongside increasing emphasis on schools as a crucial site for research and intervention. This has coincided with an increased use of self-report mental health and wellbeing measures in research with this population, including in school-based research projects. We set out to explore the way that children and young people perceive and experience completing mental health and wellbeing measures, with a specific focus on completion in a school context, in order to inform future measure and research design. We conducted semi-structured interviews and focus groups with 133 participants aged 8–16 years following their completion of mental health and wellbeing measures as part of school-based research programmes, using thematic analysis to identify patterns of experience.

Demkowicz, O., Ashworth, E., Mansfield, R., Stapley, E., Miles, H., Hayes, D., Burrell, K., Moore, A., & Deighton, J. Child Adolesc Psychiatry Ment Health 14, 35 (2020). DOI: 10.1186/s13034-020-00341-7 

A retrospective case note review of young people in transition from adolescent medium secure units to adult services

Abstract: There is substantial evidence that young people moving from child and adolescent mental health services to adult services are more likely to experience poor transitions. However, little is known about the care pathways of young people transitioning from forensic services. This retrospective case note review sought to examine the clinical characteristics, transition pathways and psychosocial indicators of transition outcomes amongst young people in forensic medium secure services discharged to adult services.

Livanou, M.I., Lane, R., D'Souza, S. & Singh, S.P. The Journal of Forensic Practice (2020) 22, 3, 161-172 (2020). DOI: 10.1108/JFP-02-2020-0007 

Internet-based psychodynamic versus cognitive behaviour therapy for adolescents with depression: study protocol for a non-inferiority randomized controlled trial (the ERiCA study)


Abstract: Adolescent depression is a common mental health problem and there is an urgent need for effective and accessible treatments. Internet-based interventions solve many obstacles for seeking and receiving treatment, thus increasing access to effective treatments. Internet-based cognitive behavioural therapy (ICBT) for adolescent depression has demonstrated efficacy in previous trials. In order to broaden the range of evidence-based treatments for young people, we evaluated a newly developed affect-focused Internet-based psychodynamic treatment (IPDT) in a previous study with promising results. The purpose of the planned study is to evaluate the efficacy of IPDT for adolescent depression in a non-inferiority trial, comparing it to ICBT.

Mechler, J., Lindqvist, K., Carlbring, P., Lilliengren, P., Falkenström, F., Andersson, G., Topooco, N., Johansson, R., Midgley, N., Edbrooke-Childs, J., Dahl, H. S. J., Sandell, R., Thorén, A., Ulberg, R., Lindert Bergsten, K., & Philips, B. Trials 21, 587 (2020). DOI: 10.1186/s13063-020-04491-z

Is Mental Health Competence in Childhood Associated With Health Risk Behaviors in Adolescence? Findings From the UK Millennium Cohort Study


Abstract: Promoting positive mental health, particularly through enhancing competencies (such as prosocial behaviors and learning skills), may help prevent the development of health risk behaviors in adolescence and thus support future well-being. Few studies have examined how mental health competencies in childhood are associated with adolescent health risk behaviors, which could inform preventative approaches. Using UK Millennium Cohort Study data (n = 10,142), we examined how mental health competence (MHC) measured at the end of elementary school (11 years) is associated with self-reported use of cigarettes, e-cigarettes, alcohol, illegal drugs, antisocial behavior, and sexual contact with another young person at age 14 years. A latent measure of MHC was used, capturing aspects of prosocial behavior and learning skills, categorized as high MHC, high–moderate MHC, moderate MHC, and low MHC. Logistic and multinomial regression estimated odds ratios and relative risk ratios for binary and categorical outcomes, respectively, before and after adjusting for confounders. Weights accounted for sample design and attrition and multiple imputation for item missingness.

Rougeaux, E., Hope, S., Viner, R. M., Deighton, J., Law, C., & Pearce, A. Journal of Adolescent Health (2020). DOI: 10.1016/j.jadohealth.2020.04.023

Engaging Children and Young People in Digital Mental Health Interventions: Systematic Review of Modes of Delivery, Facilitators, and Barriers


Abstract: There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcomes. However, the modes of delivery used to engage CYP in digital MH interventions may differ, with implications for the extent to which findings pertain to the level of engagement with the DHI. Knowledge of the various modalities could aid in the development of interventions that are acceptable and feasible.

Liverpool, S., Mota, C.P., Sales, C.M.D., Čuš, A., Carletto, S., Hancheva, C., Sousa, S., Cerón, S.C., Moreno-Peral, P., Pietrabissa, G., Moltrecht, B., Ulberg, R., Ferreira, N. & Edbrooke-Childs, J. J Med Internet Res (2020);22(6):e16317. DOI: 10.2196/16317

Chronic illness in childhood and early adolescence: A longitudinal exploration of co-occurring mental illness

Abstract: Chronic health conditions are hypothesized to disrupt the typical trajectory of child and adolescent development, and subsequently lead to increased levels of mental illness. However, due to methodological limitations in existing studies, this theory remains to be fully substantiated by empirical research. This study aimed to more thoroughly test hypotheses in the field. This study used data from the Avon Longitudinal Study of Parents and Children to examine the co-occurrence of mental illness among children with chronic illness in late childhood into early adolescence and explore mediating factors in these outcomes. Children with chronic health problems presented with a disproportionate rate of psychiatric illness at 10 years, and these chronic health problems continued to be associated with poor mental health outcomes at 13 years and 15 years. These outcomes were mediated by high levels of peer victimization and health-related school absenteeism. This study suggests that chronic illness may impact on functioning and social development in early adolescence, and consequently lead to increased rates of mental illness. Examining rates of school absenteeism and peer victimization may be key to identifying children at risk over time.

Brady, A., Deighton, J., & Stansfeld, S. (2020). Development and Psychopathology, 1-14. DOI: 10.1017/S0954579420000206

How Contextual Constraints Shape Midcareer High School Teachers' Stress Management and Use of Digital Support Tools: Qualitative Study


Abstract: Persistent psychosocial stress is endemic in the modern workplace, including among midcareer high school (secondary comprehensive) teachers in England. Understanding contextual influences on teachers' self-management of stress along with their use of digital health technologies could provide important insights into creating more usable and accessible stress support interventions. The aim of this study was to investigate the constraints on stress management and prevention among teachers in the school environment and how this shapes the use of digitally enabled stress management tools.

Manning, J.B., Blandford, A., Edbrooke-Childs, J., Marshall, P. JMIR Ment Health (2020);7(4):e15416.

A scoping review and assessment of essential elements of shared decision-making of parent-involved interventions in child and adolescent mental health


Abstract: Parents play a critical role in child and adolescent mental health care and treatment. With the increasing implementation of shared decision-making (SDM) across health settings, there is a growing need to understand the decision support interventions used to promote SDM in child and adolescent mental health services (CAMHS). The overall aim of this review is to identify and examine the existing decision support interventions available for parents. A broad search was conducted using the key concepts “shared decision-making”, “parents” and “child and adolescent mental health”. Five electronic databases were searched: PsycInfo, Embase, Medline, Web of Science and the Cochrane Library. In addition to these relevant databases, we searched the Ottawa’s Inventory of Decision Aids, Children’s Hospital of Eastern Ontario website, Google, Google Play and known CAMHS’ websites. The search identified 23 interventions available for use with parents. These interventions targeted parents providing care for children with ADHD, ASD, emotional and behavioural problems including depression (EBD), self-harm or universal mental health care. Various modalities including face-to-face, digital and paper-based versions were adopted. The majority of the interventions were able to “present options” (87%) and “discuss the pros and cons” (83%) of treatment. Time, accessibility and appropriateness of the intervention emerged as factors influencing usage and implementation of interventions. Our findings suggest that SDM interventions involving parents have been implemented differently across various presenting mental health difficulties in CAMHS. This review brings awareness of existing parent-involved interventions and has implications for the development, implementation and usage of new interventions.

Liverpool, S., Pereira, B., Hayes, D., Wolpert, M and Edbrooke-Childs, J. Eur Child Adolesc Psychiatry (2020). DOI: 10.1007/s00787-020-01530-7.

Affect-Focused Psychodynamic Internet-Based Therapy for Adolescent Depression: Randomized Controlled Trial


Abstract: Adolescent depression is one of the largest health issues in the world and there is a pressing need for effective and accessible treatments. This trial examines whether affect-focused internet-based psychodynamic therapy (IPDT) with therapist support is more effective than an internet-based supportive control condition on reducing depression in adolescents. The trial included 76 adolescents (61/76, 80% female; mean age 16.6 years), self-referred via an open access website and fulfilling criteria for major depressive disorder. Adolescents were randomized to 8 weeks of IPDT (38/76, 50%) or supportive control (38/76, 50%). The primary outcome was self-reported depressive symptoms, measured with the Quick Inventory of Depressive Symptomatology for Adolescents (QIDS-A17-SR). Secondary outcomes were anxiety severity, emotion regulation, self-compassion, and an additional depression measure. Assessments were made at baseline, postassessment, and at 6 months follow-up, in addition to weekly assessments of the primary outcome measure as well as emotion regulation during treatment.

Lindqvist, K., Mechler. J., Carlbring, P., Lilliengren, P., Falkenström, F., Andersson, G., Johansson, R., Edbrooke-Childs, J., Dahl, H.S.J., Lindert Bergsten, K., Midgley, N., Sandell, R., Thorén, A., Topooco, N., Ulberg, R., Philips,B J Med Internet Res (2020). 22(3):e18047. DOI: 10.2196/18047.

Effectiveness of current psychological interventions to improve emotion regulation in youth: a meta-analysis


Abstract: Research investigating the role of emotion regulation (ER) in the development and treatment of psychopathology has increased in recent years. Evidence suggests that an increased focus on ER in treatment can improve existing interventions. Most ER research has neglected young people, therefore the present meta-analysis summarizes the evidence for existing psychosocial intervention and their effectiveness to improve ER in youth. A systematic review and meta-analysis was conducted according to the PRISMA guidelines. Twenty-one randomized-control-trials (RCTs) assessed changes in ER following a psychological intervention in youth exhibiting various psychopathological symptoms. We found moderate effect sizes for current interventions to decrease emotion dysregulation in youth (g = − 0.46) and small effect sizes to improve emotion regulation (g = 0.36). Significant differences between studies including intervention components, ER measures and populations studied resulted in large heterogeneity. This is the first meta-analysis that summarizes the effectiveness for existing interventions to improve ER in youth. The results suggest that interventions can enhance ER in youth, and that these improvements correlate with improvements in psychopathology. More RCTs including larger sample sizes, different age groups and psychopathologies are needed to increase our understanding of what works for who and when.

Moltrecht, B., Deighton, J., Patalay, P. & Edbrooke-Childs, J. Eur Child Adolesc Psychiatry (2020). DOI: 10.1007/s00787-020-01498-4.

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