Highlights in child mental health research: March 2021

Highlights

• Screen time in young children and factors influencing their screen use is under-explored in research.
• This study investigated the relationship between parenting style, parents’ self-efficacy, parental distress, child behaviour and young children’s screen time.
• An online survey was completed by 106 parents of young children aged 0-4 years old in Australia.

• Key study findings included:
  • A relationship was found between dysfunctional parenting styles (e.g. over-reactive or lax parenting) and screen time related child behaviour problems (e.g. emotional or behavioural difficulties).
  • Dysfunctional parenting was also associated with reduced parental self-efficacy in managing children’s screen time behavioural difficulties.
  • Parents reported confidence in managing their child’s problem behaviours, however these behaviours were still occurring at a moderate intensity.
  • In contrast to previous research, no relationship was found between parent psychological adjustment and child screen time behavioural difficulties.
  • Results suggest the possibility that ‘the relationship between parent distress and difficulties with managing child screen time could be mediated by parenting style and behaviour’ (p. 835).
• Some limitations were identified by the researchers, including the reliance of parent self-reporting and an over-representation of mothers in the sample. However, results identified a significant positive relationships between dysfunctional parenting behaviours and screen time related child behaviour problems.
• Targeting parenting skills and confidence in managing children’s screen time behavioural difficulties, and promoting parental self-efficacy in managing children’s screen time, were identified as potential areas for future interventions.
• These findings will be of interest to researchers and program developers targeting parenting behaviours to reduce screen-related child behavioural difficulties.

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Highlights

• This paper reviews the evidence on interventions available to children and adolescents who engage in self-harm.
• Psychosocial interventions, pharmacological agents, and natural products (such as dietary supplementation) for children up to 18 years old were investigated in comparison to other types of care (e.g., treatment-as-usual, routine psychiatric care, enhanced usual care, active comparator, placebo, alternative pharmacological treatment or a combination of these).

• Data was analysed from 17 randomised controlled trials involving 2280 children who had engaged in recent self-harm (i.e. within six months of trial entry). Children in the studies had a mean age of 7 years old and 87.6% were female.
• Key study findings included:
  • A lower rate of repeated self-harm in children receiving Dialectic Behavioural Therapy for Adolescents (DBT-A; (30%) compared to treatment as usual, enhance usual care or alternative psychotherapy (43%).
  • No difference in the occurrence of repeated self-harm post-intervention in children and adolescents receiving individual Cognitive Behavioural Therapy (CBT)-based psychotherapy and treatment as usual.
  • Little evidence to demonstrate benefits from mentalisation-based therapy for adolescents, group-based psychotherapy, enhanced assessment approaches, compliance enhancement approaches, family interventions or remote contact interventions.
• This review highlights that more research and evidence is needed to support interventions for children and adolescents who engage in self-harm, although some promising results were demonstrated in those receiving DBT-A.

• These results may be of interest to service providers or clinicians working with children and adolescents who engage in self-harm, as well as researchers and policy-makers.

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Highlights

• This review explored the literature on perceived school safety among children and adolescents, specifically exploring prevalence, factors and associated mental health difficulties.
• Data from 43 studies were analysed, using a narrative synthesis methodology. The majority of studies were from North America and published between 2016-2020.

• Children and adolescents aged up to 18 years old and who were enrolled in school were included in the analysis.

• All studies assessed students’ feelings of safety at school using self-report measures, for example, asking students to respond to the statement “I feel safe at school”.
• Key study findings included:
  • The percentage of children who reported feeling unsafe at school ranged widely from 1% to 69.1% (mean 19.4%). Variation between studies was attributed to differences in study methods and definitions of perceived school safety.
  • Students’ negative perceptions of school safety were associated with factors such as being victimised or bullied.
  • Students’ negative perceptions of school safety were also associated with mental health difficulties such as depression or suicidal behaviour.
  • A lack of cross-cultural studies and studies undertaken in non-Western countries limited researchers’ abilities to identify culture-specific factors in school safety perceptions.
  • Students’ perception of school safety was positively associated with measures such as having a security officer and fair school rule enforcement.
• These findings will be of interest to educators and policy-makers, as well as clinicians working with school-aged children who present with mental health difficulties, reports of victimisation or bullying at school, or ongoing school absenteeism.

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Highlights

• This paper outlines findings of a case file review examining characteristics of prenatal reports to a statutory child protection Specifically, the review explored risk factors and family characteristics associated with a prenatal child protection report.
• Data were extracted and coded from a random sample of prenatal child protection reports in a single Australian jurisdiction during 2014. These data related to 131 unborn children.
• Key findings included:
  • Most families with prenatal child protection reports were experiencing three or more risk factors, including:
    • Current or previous intimate partner violence (70%),
    • Parental alcohol and other drug use (63%),
    • Parental mental health difficulties (58%),
    • Parental criminal activity (34%).
  • More than 38% of parents with prenatal child protection reports had experienced abuse or neglect themselves as children.
  • 90% of older siblings in families with a prenatal child protection report had also been the subject of a child protection report.

• The review highlights that traditional assessment and referral methods in child protection may not be suitable for families with complex circumstances such as multiple co-occurring risk factors.
• It also highlights the importance of multi-agency responses to concerns about child wellbeing during pregnancy and infancy, particularly if the parents themselves have experienced abuse, neglect, or removal as a child.
• This review may be of interest to professionals working with vulnerable families and their children (including unborn children, such a maternity social workers). Giving families early support to address multiple co-occurring risk factors has the potential to benefit families and help reduce the intergenerational cycle of child abuse and neglect.

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