Attachment--and loss.

Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review

This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that affect who becomes poor as well as mechanisms through which poverty appears to influence child and youth mental health. Third, we use this conceptual framework to selectively review the growing literatures on the mechanisms through which family poverty influences the mental, emotional, and behavioral health of children. We illustrate how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty. Fourth, we describe strategies to directly reduce poverty and the implications of these strategies for prevention. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Munoz, Beardslee, & Leykin, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.

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The Effects of Poverty on the Mental, Emotional, and Behavioral Health of Children and Youth: Implications for Prevention.

Anxiety is one of the basic human emotions (Plutchik, 1980) and is present in all persons at some time, often on a daily basis to some degree. Concerns about taking a test or being late for an appointment often indicate anxiety in everyday life. Anxiety has a well-defined progression that is recognizable in infancy and progresses through childhood as an indicator of developmental progress. Anxiety and fear are related and often are used interchangeably. Arguably, anxiety has been described as reflecting concerns about subjective, anticipatory events, while fear has been considered to be in response to objective threatening events. Gray and McNaughton (2000) suggested that fear is a defensive response to a real threat, while anxiety is a defensive response to a perceived threat. This chapter will focus primarily on anxiety as a subjective experience of future events, although it is well known that children may have fears of specific stimuli, such as large animals, loud sounds, and unfamiliar people.

The Developmental Psychopathology of Anxiety

Self-management of chronic pediatric conditions is a formidable challenge for patients, families, and clinicians, with research demonstrating a high prevalence of poor self-management and nonadherence across pediatric conditions. Nevertheless, effective self-management is necessary to maximize treatment efficacy and clinical outcomes and to reduce unnecessary health care utilization and costs. However, this complex behavior is poorly understood as a result of insufficient definitions, reliance on condition-specific and/or adult models of self-management, failure to consider the multitude of factors that influence patient self-management behavior, and lack of synthesis of research, clinical practice, and policy implications. To address this need, we present a comprehensive conceptual model of pediatric self-management that articulates the individual, family, community, and health care system level influences that impact self-management behavior through cognitive, emotional, and social processes. This model further describes the relationship among self-management, adherence, and outcomes at both the patient and system level. Implications for research, clinical practice, and health care policy concerning pediatric chronic care are emphasized with a particular focus on modifiable influences, evidence-based targets for intervention, and the role of clinicians in the provision of self-management support. We anticipate that this unified conceptual approach will equip stakeholders in pediatric health care to (1) develop evidence-based interventions to improve self-management, (2) design programs aimed at preventing the development of poor self-management behaviors, and (3) inform health care policy that will ultimately improve the health and psychosocial outcomes of children with chronic conditions.

Pediatric Self-management: A Framework for Research, Practice, and Policy

PROBLEM: Poverty and accelerations of inequality, manifested by the increasing difference between the richest and poorest populations, have significant effects on the mental health of vulnerable groups. Adolescents are vulnerable to the effects of poverty. As a time of change and transition for youth and their families, adolescence creates both challenges and opportunities to intervene in the effects of poverty.

PURPOSE: The purpose of this article is to discuss the significance of poverty and its impact on adolescent mental health and mental health services.

SOURCES: An interdisciplinary literature search was conducted on the topic of poverty and adolescent mental health.

CONCLUSIONS: Results indicated that nurses need to remain active participants in the provision of mental health services to adolescents in poverty and increase their advocacy for the creation of policy changes that address mental health needs of this population.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1744-6171.2008.00166.x

Poverty and adolescent mental health.

Fathers of Children and Adolescents With Diabetes: What Do We Know?

Self-care of young adolescents with type 1 diabetes.

Title. Parent–adolescent communication and diabetes: an integrative review.



Aim.  This paper presents a synthesis of findings from empirical studies about communication and interaction between parents and their adolescents with diabetes.



Background.  Communication between parent and adolescent is essential in transitioning the adolescent to increased responsibility for diabetes self-management. Nurses are in a pivotal position to enhance the type of parent–adolescent communication that facilitates this transition.



Data sources.  A search of published studies from 1985 to 2006 featuring communication or interaction between parents and adolescents with type 1 diabetes was implemented through a computerized search.



Review methods.  Papers were organized by type of evidence and were analysed sequentially. Sources were described based on data elements which were extracted. Findings in the areas of productive and problematic parent–adolescent communications were included. Data elements were compared and critiqued, noting consistencies, and findings were summarized and evaluated.



Results.  Studies across several countries indicate that maternal support, conflict, control, involvement and emotional expression are important communication concepts that are linked to diabetes outcomes in adolescents. The influences of different family structures and cultural and socioeconomic circumstances, as well as developmental status and gender of adolescents on these types of communication, have not been systematically studied.



Conclusion.  Nurses caring for adolescents with type 1 diabetes need to consider family relationships and communication patterns in achieving health outcomes. Studies of communication, including perspectives of mothers and fathers, and the influence of family structure, economics and culture are needed to build a framework of parent–adolescent interaction and health outcomes for adolescents with type 1 diabetes.

Parent–adolescent communication and diabetes: an integrative review

Adolescence spans a wide time period during which development and its context influence behaviour and the strategies used for data collection. This article addresses problems that can be anticipated in data collection with adolescents. Problems are presented that are associated with adolescent developmental capacities, adolescent developmental change and stability, gender and ethnicity. Some problems are specific to certain settings or to certain data collection methods. The application of theoretical and empirical knowledge about adolescent development can strengthen data collection instruments and procedures. Strategies to enhance data collection include carefully defining adolescence and tailoring procedures and protocols based on a theoretical understanding of the biological, cognitive and emotional development of adolescents in conjunction with an understanding of the characteristics of the research setting. Adolescent research settings can pose challenges. Investigators must understand clinic routines in evaluating the feasibility of implementing protocols and collecting data where there are distractions and time constraints. In education settings, strategies must be used to collect data in a group context where peer pressure can affect responses. In home settings, ingrained response patterns and family norms can also impede obtaining valid perspectives from adolescents. Ethnicity as well may play an important role that must be addressed when designing and implementing data collection with adolescents. Procedures and instruments selected to collect data need to address variations in ethnicity.

Carol Dashiff

Papers

Poverty and adolescent mental health.

Fathers of Children and Adolescents With Diabetes: What Do We Know?

Self-care of young adolescents with type 1 diabetes.

Parent–adolescent communication and diabetes: an integrative review

Data collection with adolescents