Showing papers by "Lilly Shanahan published in 2021"

Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes.

Abstract: Objective Depression is common, impairing, and the leading cause of disease burden in youths. This study aimed to identify the effects of childhood/adolescent depression on a broad range of longer-term outcomes. Method The analysis is based on the prospective, representative Great Smoky Mountains Study of 1,420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to 8 times in childhood (age 9−16 years; 6,674 observations; 1993−2000) for DSM-based depressive disorders, associated psychiatric comorbidities, and childhood adversities. Participants were followed up 4 times in adulthood (ages 19, 21, 25, and 30 years; 4,556 observations of 1,336 participants; 1999−2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric outcomes and functional outcomes. Results In all, 7.7% of participants met criteria for a depressive disorder in childhood/adolescence. Any childhood/adolescent depression was associated with higher levels of adult anxiety and illicit drug disorders and also with worse health, criminal, and social functioning; these associations persisted when childhood psychiatric comorbidities and adversities were accounted for. No sex-specific patterns were identified. However, timing of depression mattered: individuals with adolescent-onset depression had worse outcomes than those with child-onset. Average depressive symptoms throughout childhood and adolescence were associated with more adverse outcomes. Finally, specialty mental health service use was protective against adult diagnostic outcomes. Conclusion Early depression and especially persistent childhood/adolescent depressive symptoms have robust, lasting associations with adult functioning. Some of these effects may be attenuated by service use.

Self-injury from early adolescence to early adulthood: age-related course, recurrence, and services use in males and females from the community

Abstract: Adolescent self-injury is a widespread public health problem, but long-term longitudinal studies from European countries are rare Self-injury in males and sex differences are poorly understood This study describes the prevalence, frequency, age-related course, and recurrence of, and mental health services use related to adolescent self-injury Data came from a Swiss prospective-longitudinal cohort study (N = 1482) Adolescents (52% male) reported frequency of self-injury and mental health services use (including reasons for and types of services use, hospitalizations) at ages 13, 15, 17, and 20 Between ages 13-20, 27% of adolescents reported self-injury at least once In males, prevalence decreased from 12 to 5%; in females self-injury peaked at age 15 (16%) and then decreased (11% at age 20) In males, recurrence of self-injury increased after age 15 (from odds ratio [OR] 10); in females, recurrence was high from age 13 onwards (OR > 5) Predictors of recurrence included childhood/early adolescent internalizing symptoms and early self-injury onset Typically, less than half of adolescents with self-injury used mental health services Males with self-injury used services mainly for externalizing problems, learning difficulties, and attention/concentration problems; females for depression or self-injury, family problems, and victimization Types of services used changed with age, and adolescents with self-injury had increased rates of hospitalization There are notable sex differences in the longitudinal course of self-injury and reasons for related mental health services use Treating early internalizing symptoms could be a promising target for preventing recurrent self-injury Males are at particular risk of not receiving adequate treatment for self-injury

Cohort profile: the zurich project on the social development from childhood to adulthood (z-proso)

Abstract: The Zurich Project on Social Development from Childhood to Adulthood (z-proso) began in 2004 in response to the need for a better evidence base to support optimal child social development and prevent crime and violence. Since then, the study has tracked the development of a diverse sample of youths (N = 1,675 in the target sample; ~50% female) from age 7 (n = 1,360) to age 20 (n = 1,180), with primary data collection waves at ages 7, 8, 9, 10, 11, 12, 13, 15, 17, and 20. The study uses a multi-method, multi-informant design that combines teacher, youth, and parent reports with observational and behavioural measures, biosampling, functional imaging, and ecological momentary assessment. Analyses of the data have contributed important evidence to a diversity of topics in child and adolescent development, illuminating the developmental roots of crime and aggression, the impacts of exposure to different forms and combinations of victimisation, and trajectories of mental health and neurodevelopmental symptoms.

Health-related quality of life in children with and without physical–mental multimorbidity

Abstract: This study examined health-related quality of life (HRQL) in children across different physical illnesses; estimated parent–child agreement on HRQL reports; compared HRQL between children with and without physical–mental multimorbidity; and tested if multimorbidity was associated with HRQL. Children aged 6–16 years (mean = 11.1; n = 198) with one physical illness and their parents were recruited from a pediatric hospital. Physical illnesses were classified according to the International Statistical Classification of Diseases and Related Health Problems (ICD)-10, mental illnesses were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents, and HRQL was measured using the KIDSCREEN-27. Children who screened positive for ≥ 1 mental illness were classified as having physical–mental multimorbidity. χ2/t tests compared sample characteristics of children with vs. without multimorbidity; Kruskal–Wallis tests compared KIDSCREEN-27 scores across ICD-10 categories; interclass correlation coefficients estimated parent–child agreement; and multiple regression examined effects of the number of mental illnesses on HRQL. HRQL was similar across ICD-10 categories. Parent–child agreement was fair to good for all HRQL domains, regardless of multimorbidity status. Parent-reported HRQL was significantly lower for children with multimorbidity compared to norms across all domains, whereas child-reported HRQL was significantly lower for physical well-being, psychological well-being, and school environment. Number of mental illnesses was negatively associated with psychological well-being and school environment in a dose–response manner. Children with physical–mental multimorbidity are vulnerable to experiencing lower HRQL, particularly for psychological well-being and school environment. Longitudinal studies documenting trajectories of HRQL and school-based interventions that target these domains of HRQL for children with multimorbidity are warranted.

Self-Injury and Domestic Violence in Young Adults During the COVID-19 Pandemic: Trajectories, Precursors, and Correlates.

Abstract: We examined the longitudinal course of, and pre- and during-pandemic risk factors for, self-injury and domestic physical violence perpetration in young adults during the COVID-19 pandemic. Data came from a Swiss longitudinal study (N = 786, age Eœ22 in 2020), with one prepandemic (2018) and four during-pandemic assessments (2020). The prevalence of self-injury did not change between April (during the first Swiss national lockdown) and September 2020 (postlockdown). Domestic violence perpetration increased temporarily in males. Prepandemic self-injury was a major risk factor for during-pandemic self-injury. Specific living arrangements, pandemic-related stressor accumulation, and a lack of adaptive coping strategies were associated with during-pandemic self-injury and domestic violence. Stressor accumulation had indirect effects on self-injury and domestic violence through negative emotions.

Childhood loneliness as a specific risk factor for adult psychiatric disorders.

Abstract: Background Loneliness is a major risk factor for both psychological disturbance and poor health outcomes in adults. This study aimed to assess whether childhood loneliness is associated with a long-term disruption in mental health that extends into adulthood. Methods This study is based on the longitudinal, community-representative Great Smoky Mountains Study of 1420 participants. Participants were assessed with the structured Child and Adolescent Psychiatric Assessment interview up to eight times in childhood (ages 9-16; 6674 observations; 1993-2000) for childhood loneliness, associated psychiatric comorbidities and childhood adversities. Participants were followed up four times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1334 participants; 1999-2015) with the structured Young Adult Psychiatric Assessment Interview for psychiatric anxiety, depression, and substance use outcomes. Results Both self and parent-reported childhood loneliness were associated with adult self-reported anxiety and depressive outcomes. The associations remained significant when childhood adversities and psychiatric comorbidities were accounted for. There was no evidence for an association of childhood loneliness with adult substance use disorders. More associations were found between childhood loneliness and adult psychiatric symptoms than with adult diagnostic status. Conclusion Childhood loneliness is associated with anxiety and depressive disorders in young adults, suggesting that loneliness - even in childhood - might have long-term costs in terms of mental health. This study underscores the importance of intervening early to prevent loneliness and its sequelae over time.

Attitudes Toward COVID-19 Vaccination Among Young Adults in Zurich, Switzerland, September 2020

Abstract: Objectives: Young adults are essential to the effective mitigation of the novel coronavirus (SARS-CoV-2/COVID-19) given their tendency toward greater frequency of social interactions. Little is known about vaccine willingness during pandemics in European populations. This study examined young people's attitudes toward COVID-19 vaccines in Fall 2020. Methods: Data came from an ongoing longitudinal study's online COVID-19-focused supplement among young adults aged 22 in Zurich, Switzerland (N = 499) in September 2020. Logistic regressions examined young adults' likelihood of participating in COVID-19 immunization programs. Results: Approximately half of respondents reported being unlikely to get vaccinated against COVID-19. Compared to males, females were more likely to oppose COVID-19 vaccination (p < 0.05). In multivariate models, Sri Lankan maternal background and higher socioeconomic status were associated with a greater likelihood of getting vaccinated against COVID-19 (p < 0.05). Respondents were more likely to report a willingness to get vaccinated against COVID-19 when they perceived 1) an effective government response (p < 0.05) and 2) their information sources to be objective (p < 0.05). Conclusion: This study communicates aspects important to the development of targeted information campaigns to promote engagement in COVID-19 immunization efforts.

Cohort Profile: Multimorbidity in Children and Youth Across the Life-course (MY LIFE) Study

Abstract: Objective: This manuscript serves to provide an overview of the methods of the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study, profile sample characteristics of the cohort, and provide baseline estimates of multimorbidity to foster collaboration with clinical and research colleagues across Canada Method: MY LIFE is comprised of 263 children (2-16 years) with a physical illness recruited from McMaster Children's Hospital, their primary caregiving parent, and their closest-aged sibling Participants are followed with data collection at recruitment, 6, 12, and 24 months which includes structured interviews, self-reported measures, and biological samples and occur in a private research office or at participants' homes Post-COVID-19, data collection transitioned to mail and telephone surveys Results: At recruitment, children were 9 4 (4 2) years of age and 52 7% were male The mean duration of their physical illness was 4 5 (4 1) years;25% represent incident cases (duration <1 year) Most (69 7%) had healthy body weight and intelligence in the average range (73 5%) Overall, 38 2% of children screened positive for =1 mental illness according to parent report (24 8% screened positive based on child self-report) Compared to 2016 Census data, the MY LIFE cohort overrepresents families of higher socioeconomic status Conclusions: Multimorbidity is common among children and these baseline data will serve to measure relative changes in the mental health of children with physical illness over time MY LIFE will provide new information for understanding multimorbidity among children, though underrepresentation of lower socioeconomic families may have implications for the generalizability of findings (English) [ABSTRACT FROM AUTHOR] Objectif: Le present manuscrit sert a presenter un apercu des methodes de l'etude sur la multimorbidite chez les enfants et les jeunes tout au long de la vie (MA VIE), a esquisser des caracteristiques d'echantillon de la cohorte et a fournir des estimations de base de la multimorbidite pour faciliter la collaboration avec les collegues cliniques et chercheurs du Canada Methode: MA VIE comprend 263 enfants (de 2 a 16 ans) souffrant d'une maladie physique recrutes a l'hopital pour enfants de McMaster, leur principal parent aidant, et leurs freres et soeurs les plus rapproches en âge Les participants sont suivis par une collecte de donnees lors du recrutement, a 6, 12, et 24 mois, ce qui comporte des entrevues structurees, des mesures auto-declarees, et des echantillons biologiques qui sont preleves dans un bureau prive de la recherche ou au domicile de participants La collecte de donnees post-COVID-19 a effectue une transition par la poste et les sondages par telephone Resultats: Lors du recrutement, les enfants avaient 9,4 (4,2) ans et 52,7 % etaient de sexe masculin La duree moyenne de leur maladie physique etait de 4,5 (4,1) ans;25 % representaient des cas incidents (duree < 1 an) La plupart (69,7 %) avait un poids corporel sain et une intelligence dans la moyenne (73,5 %) En general, 38,2 % des enfants avaient un depistage positif pour = 1 maladie mentale selon le rapport des parents (24,8 % avaient un depistage positif selon l'auto-declaration des enfants) Comparativement aux donnees du recensement de 2016, la cohorte MA VIE surrepresente les familles de statut socio-economique plus eleve Conclusions: La multimorbidite est commune chez les enfants et ces donnees de depart serviront a mesurer les changements relatifs de la sante mentale des enfants souffrant de maladie physique avec le temps MA VIE fournira de nouvelles informations pour comprendre la multimorbidite chez les enfants, quoique la sous-representation des familles au faible statut socio-economique puisse avoir des implications pour la generalisabilite des resultats (French) [ABSTRACT FROM AUTHOR] Copyright of Journal of the Canadian Academy of Child & Adolescent Psychiatry is the property of Canadian Academy of Child & Adolescent Psychiatry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use.

Abstract: Objective Research on associations of early cannabis use with adult functioning reports mixed findings. This may be due, in part, to wide variations in the definitions of early cannabis use. This study aims to compare associations of 4 commonly used definitions of early cannabis use—related to timing, dose, duration, and associated symptoms—with adult outcomes. Method Analyses were based on a 20+-year longitudinal, community-representative study of 1,420 participants. Between ages 9 and 21 years (8,806 observations), participants were assessed for cannabis use and DSM-5 Cannabis Use Disorder. In early adulthood (ages 24-26 and 30; 2,424 observations of 1,266 subjects), participants were also assessed for psychiatric, substance use, and functional outcomes. Results All definitions of early use were associated with multiple adult outcomes in models that adjusted for sex and race/ethnicity. In models that also adjusted for childhood psychiatric problems and family adversities, only daily use and a persistent developmental subtype (defined as daily/problematic use that began in adolescence and continued into early adulthood) were associated with later substance use/disorders, poorer functional outcomes, and derailments in the transition to adulthood. Conclusion Daily, continued-over-time cannabis use beginning on adolescence was most problematic for a range of adult outcomes. Cessation of early use did not fully eliminate later risks; but was associated with fewer negative outcomes, with weaker effect sizes.

Prevalence and Childhood Precursors of Opioid Use in the Early Decades of Life

Abstract: Importance Opioid use disorder and opioid deaths have increased dramatically in young adults in the US, but the age-related course or precursors to opioid use among young people are not fully understood. Objective To document age-related changes in opioid use and study the childhood antecedents of opioid use by age 30 years in 6 domains of childhood risk: sociodemographic characteristics; school or peer problems; parental mental illness, drug problems, or legal involvement; substance use; psychiatric illness; and physical health. Design, Setting, and Participants This community-representative prospective longitudinal cohort study assessed 1252 non-Hispanic White individuals and American Indian individuals in rural counties in the central Appalachia region of North Carolina from January 1993 to December 2015. Data were analyzed from January 2019 to January 2020. Exposures Between ages 9 and 16 years, participants and their parents were interviewed up to 7 times using the Child and Adolescent Psychiatric Assessment and reported risk factors in 6 risk domains. Main Outcomes and Measures Participants were assessed again at ages 19, 21, 25, and 30 years for nonheroin opioid use (any and weekly) and heroin use using the structured Young Adult Psychiatric Assessment. Results Of 1252 participants, 342 (27%) were American Indian. By age 30 years, 322 participants had used a nonheroin opioid (24.2%; 95% CI, 21.8-26.5), 155 had used a nonheroin opioid weekly (8.8%; 95% CI, 7.2-10.3), and 95 had used heroin (6.6%; 95% CI, 5.2-7.9). Childhood risk markers for later opioid use included male sex, tobacco use, depression, conduct disorder, cannabis use, having peers exhibiting social deviance, parents with legal involvement, and elevated systemic inflammation. In final models, childhood tobacco use, depression, and cannabis use were most robustly associated with opioid use in young adulthood (ages 19 to 30 years). Chronic depression and dysthymia were strongly associated with any nonheroin opioid use (OR. 5.43; 95% CI, 2.35-12.55 and OR, 7.13; 95% CI, 1.99-25.60, respectively) and with weekly nonheroin opioid use (OR, 8.89; 95% CI, 3.61-21.93 and OR, 11.51; 95% CI, 3.05-42.72, respectively). Among young adults with opioid use, those with heroin use had the highest rates of childhood psychiatric disorders and comorbidities. Conclusions and Relevance Childhood tobacco use and chronic depression may be associated with impaired reward system functioning, which may increase young adults’ vulnerability to opioid-associated euphoria. Preventing and treating early substance use and childhood mental illness may help prevent later opioid use.

Emerging self-regulatory skills in childhood predict cardiometabolic risk in adolescence

Abstract: Cardiometabolic risk (CMR) has increased among adolescents. A growing literature shows that childhood self-regulatory skills are associated with obesity and CMR. However, the developmental nature of self-regulation has not been considered in existing studies. Therefore, it is unclear how specific types of self-regulation (i.e., attentional, emotional, behavioral, cognitive) at different points in development, may differentially predict CMR. Using a multi-method longitudinal design, we assessed a sample of 117 children repeatedly between ages 2 and 16. At ages 2, 4, and 7 years, self-regulation (emotional, attentional, behavioral, and cognitive) skills that were hypothesized to have emerged were assessed. Adolescent CMR indicators were assessed at age 16. Latent profile analyses identified three profiles of adolescent CMR: Low Risk (41%), Dyslipidemia Risk (49.6%), and High Risk (9.4%). Distinct self-regulation skills at each childhood age predicted CMR during adolescence. Specifically, emotional regulation skills at ages 2 and 4, food-related behavioral regulation and attentional regulation at age 4, and attentional and cognitive regulation skills at age 7 predicted adolescent CMR. Self-regulation skills are modifiable, and thus, childhood interventions aimed at improving self-regulation could reduce CMR for decades to come. However, these results suggest that the multifaceted, developmental nature of self-regulation must be considered to most effectively inform preventive interventions aimed at lowering CMR. Additionally, our study highlights the need for additional research on adolescents who show elevations of CMR without meeting criteria for obesity.

Heart Rate Dynamics During Acute Recovery From Maximal Aerobic Exercise in Young Adults.

Abstract: Introduction Resting heart rate (HRrest), heart rate variability (HRV), and HR recovery (HRR) from exercise provide valuable information about cardiac autonomic control. RR-intervals during acute recovery from exercise (RRrec) are commonly excluded from HRV analyses due to issues of non-stationarity. However, the variability and complexity within these trends may provide valuable information about changes in HR dynamics. Purpose Assess the complexity of RRrec and determine what physiologic and demographic information are associated with differences in these indices in young adults. Methods RR-intervals were collected throughout maximal treadmill exercise and recovery in young adults (n = 92). The first 5 min of RRrec were (1) analyzed with previously reported methods that use 3-interval lengths for comparison and (2) detrended using both differencing(diff) and polynomial regression(res). The standard deviation of the normal interval (SDNN), root mean square of successive differences (rMSSD), root mean square (RMS) of the residual of regression, and sample entropy (SampEn) were calculated. Repeated measures analysis of covariance (ANCOVA) tested for differences in these indices for each of the methodological approaches, controlling for race, body fat, peak oxygen uptake (VO2peak), and resting HR (HRrest). Statistical significance was set at p < 0.05. Results VO2peak and HRrest were significantly correlated with traditional measures of HRR and the variability surrounding RRrec. SampEndiff and SampEnres were correlated with VO2peak but not HRrest or HRR. The residual-method provided a significantly (p = 0.04) lower mean standard error (MSE) (0.064 ± 0.042) compared to the differencing-method (0.100 ± 0.033). Conclusions Complexity analysis of RRrec provides unique information about cardiac autonomic regulation immediately following the cessation of exercise when compared to traditional measures of HRR and both HRrest and VO2peak influence these results.

Parental perception of mental health needs in young children.

Abstract: BACKGROUND There is evidence of unmet psychiatric needs in children under 6. These young children are dependent on their parents to identify their mental health needs. This study tested child and parent associations with parent perception of young child mental health need. METHOD Parents of 917 children (aged 2-6 years) completed a diagnostic interview about their child assessing depression, anxiety, ODD/CD, ADHD, and impairment. Parents were surveyed about their own depression, anxiety, and asked about their psychiatric impairment. Parents were also asked whether they perceived their child as having a mental health need. RESULTS Only 38.8% of children who met criteria for a diagnosis were perceived by their parents as having a need, similar to previously studied rates in school-aged children. Perception of need was associated with higher levels of symptoms and impairment. Thresholds for at least half of parents perceiving their child as having a need were relatively high: 19 or more symptoms, or 4 or more impairments. There was evidence of specificity: children with depressive disorders were more likely to be perceived as in need compared with other disorders. In terms of parent factors, more parental depressive symptoms were associated with higher perception of child need when the child had a diagnosis. Parental psychological impairment was associated with higher perception of need when the child had no diagnosis. CONCLUSIONS Most preschool children that meet criteria for a psychiatric disorder are not perceived as needing help by their parents, which is dependent on both child and parent factors.

The association of polyvictimization with violent ideations in late adolescence and early adulthood: A longitudinal study.

Abstract: Violent ideations are increasingly recognized as an important psychological predictor for aggressive and violent behavior. However, little is known about the processes that contribute to violent ideations. This paper examines the extent to which polyvictimization triggers violent ideations in late adolescence and early adulthood, while also adjusting for dispositional and situational factors as well as prior violent ideations. Data came from three waves of the Zurich Project on the Social Development from Childhood into Adulthood (z-proso; n = 1465). Full-information maximum likelihood Tobit models were fitted to regress violent ideations experienced at ages 17 and 20 on multiple victimization experiences in the preceding 12 months while controlling for antecedent developmental risk factors and prior violent ideations. The results showed that violent ideations in late adolescence and early adulthood are influenced by violent thoughts, aggressive behavior, violent media consumption, moral neutralization of violence, and internalizing symptoms measured 2 years earlier. Experiences of polyvictimization significantly contributed to an increase in violent ideations both during late adolescence and in early adulthood. The exposure-response relationship between victimization and violent ideations did not significantly differ by sex. The findings are consistent with the notion that violent ideations are triggered by a retaliation-linked psychological mechanism that entails playing out other directed imaginary aggressive scenarios specifically in response to experiencing intentional harm-doing by others.

Self-rated physical attractiveness and its relation to psychological well-being across adolescence

Abstract: The goal of the current analyses was to explore associations of self-rated physical attractiveness with facets of psychological well-being across adolescence. Participants provided information on t...

Childhood Gun Access, Adult Suicidality, and Crime

Abstract: OBJECTIVES: To test the associations of childhood domestic gun access with adult criminality and suicidality. METHODS: Analyses were based on a 20+ year prospective, community-representative study of 1420 children, who were assessed up to 8 times during childhood (ages 9–16; 6674 observations) about access to guns in their home. Participants were then followed-up 4 additional times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1336 participants) about criminality and suicidality. RESULTS: During childhood, the 3-month prevalence of having a gun in the home was 55.1% (95% confidence interval [CI]: 52.1%–58.7%). Of the children in homes with guns, 63.3% (95% CI: 59.7%–66.9%) had access to a gun, and 25.0% (95% CI: 21.2%–28.8%) owned a gun themselves. Having gun access as a child was associated with higher levels of adult criminality (odds ratios = 1.1–3.5) and suicidality (odds ratios = 2.9–4.4), even after adjusting for childhood correlates of gun access. Risk of adult criminality and suicidality among those with childhood gun access was greatest in male individuals, those living in urban areas, and children with a history of behavior problems. Even in these groups, however, most children did not display adult criminality or suicidality. CONCLUSIONS: Childhood gun access is prospectively associated with later adult criminality and suicidality in specific groups of children.

Developmental Associations Between Sympathy and Mutual Disclosure in Friendships From Mid-Adolescence to Early Adulthood.

Abstract: Sympathy is regarded as an important precursor to the development of emotional intimacy, including mutual disclosure. In turn, emotional intimacy is assumed to foster the development of sympathy. Yet, research has not examined how sympathy and mutual disclosure in generic friendships are mutually related to one another during mid-adolescence to early adulthood. Data came from three waves of the Swiss Survey of Children and Youth (COCON; N = 1,258). Bidirectional links between sympathy and mutual disclosure were tested with autoregressive cross-lagged panel analyses. Sympathy at age 15 was associated with mutual disclosure in friendships at 18, which in turn was associated with sympathy at 21. Multi-group models suggested that our model better describes these processes in females than in males.

Stand-Alone KVT-basierte Interventionen via Smartphone zur Förderung der psychischen Gesundheit

Abstract: Einleitung Eine wachsende Zahl psychologischer Behandlungsangebote erfolgt über das Smartphone, bzw. über Apps. Viele der wissenschaftlich geprüften Apps basieren auf den Prinzipien der kognitiven Verhaltenstherapie (KVT), Goldstandard zur Behandlung vieler psychischer Problematiken. Ziel dieses Reviews war es, den Status Quo der Forschung zu Stand-Alone Smartphone-basierten Apps zusammenzufassen, welche auf diesen therapeutischen Ansätzen basieren und mittels App-basierten Ecological Momentary Interventions (EMIs) durchgeführt werden. Methode Eine systematische Literaturrecherche in MEDLINE, PsycINFO, Embase und PubMed identifizierte 26 zwischen 2007 und 2020 publizierte, peer-reviewte Studien, in denen Durchführbarkeit und/oder Wirksamkeit und/oder Effektivität von KVT-basierten EMIs sowohl in Studiendesigns mit inter- als auch intraindividuellen Vergleichen, sowohl bei gesunden als auch klinischen Stichproben untersucht wurden. Gemischte Interventionen (blended interventions), z. B. App-basierte Behandlungen in Kombination mit klassischer Psychotherapie wurden nicht mitberücksichtigt. Ergebnisse KVT-basierte EMIs wurden von Teilnehmern angenommen, verbesserten das Wohlbefinden der Nutzer signifikant und reduzierten Symptome psychischer Störungen. Stand-Alone EMIs wurden von den Teilnehmenden als hilfreich (M = 70,8 %) und bezüglich der Outcomes als zufriedenstellend (M = 72,6 %) eingeschätzt. Schlussfolgerung In Summe zeigten die Studien, dass EMIs dazu beitragen können, die psychische Gesundheit zu verbessern und damit Individuen in ihrem täglichen Leben zu unterstützen. Sie bieten somit eine unmittelbar verfügbare, skalierbare und evidenzbasierte Form der Unterstützung psychischer Gesundheit. Diese Charakteristiken sind nicht zuletzt relevant im Kontext der Bemühungen, die individuellen und ökonomischen Kosten psychischer Erkrankungen zu reduzieren, wie auch im Kontext globaler Pandemien.

Pathways from maternal depressive symptoms to children’s academic performance in adolescence: A 13-year prospective-longitudinal study

Abstract: The pathways through which exposure to maternal depressive symptoms in early childhood are linked to academic performance during adolescence are poorly understood. This study tested pathways from maternal depressive symptoms (age 2-5) to adolescent academic performance (age 15) through cumulative parenting risk (age 7) and subsequent child functioning (age 10), using multi-informant data from a prospective longitudinal community study spanning 13 years (N = 389, 47% male, 68% White). Structural equation models testing indirect effects revealed small associations between maternal depressive symptoms and increased cumulative parenting risk and poorer child functioning, and, via these pathways, with poorer academic performance. Thus, childhood exposure to maternal depressive symptoms may be associated with pathways of risk that could limit children's educational opportunities.