4.png

Welcome to the CAMHS online newsfeed. Here you’ll find all the latest research, news stories, policy updates and guidelines. View our other newsfeeds for more subject-specific news.

Advertisements

Digital media use linked to behavioural problems in children

“We can say with confidence that teens who were exposed to higher levels of digital media were significantly more likely to develop ADHD symptoms in the future” says Professor Adam Leventhal  of the Keck School of Medicine of USC discussing the findings of a study that has now been in the JAMA (Journal of the American Medical Association).  The research assessed young people’s digital media usage any association between occurrence of ADHD symptoms during adolescence and tracked almost 2600 teenagers over a  24-month period.

online-942410_1920

The research team’s findings indicate that teens who are heavy users of digital devices are twice as likely as infrequent users to show symptoms of attention-deficit/hyperactivity disorder (ADHD), the study finds. Unlike earlier studies on this topic which were conducted before social media, mobile apps and tablets existed, this study included digital media which Leventhal explains “has increased digital media exposure far beyond what’s been studied before.”

While the researchers acknowledge the study does not show causation there was a significant association between higher frequency of modern digital media use and subsequent symptoms of ADHD over a two-year follow-up. 9.5 percent of the 114 children who used half the digital media platforms frequently and 10.5 percent of the 51 kids who used all 14 platforms frequently showed new ADHD symptoms. By contrast, 4.6 percent of the 495 students who were not frequent users of any digital activity showed ADHD symptoms, approximate to background rates of the disorder in the general population (via Science Daily).

Read the full news article from Science Daily 

Abstract

Importance  Modern digital platforms are easily accessible and intensely stimulating; it is unknown whether frequent use of digital media may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD).

Objective  To determine whether the frequency of using digital media among 15- and 16-year-olds without significant ADHD symptoms is associated with subsequent occurrence of ADHD symptoms during a 24-month follow-up.

Design, Setting, and Participants  Longitudinal cohort of students in 10 Los Angeles County, California, high schools recruited through convenience sampling. Baseline and 6-, 12-, 18-, and 24-month follow-up surveys were administered from September 2014 (10th grade) to December 2016 (12th grade). Of 4100 eligible students, 3051 10th-graders (74%) were surveyed at the baseline assessment.

Exposures  Self-reported use of 14 different modern digital media activities at a high-frequency rate over the preceding week was defined as many times a day (yes/no) and was summed in a cumulative index (range, 0-14).

Main Outcomes and Measures  Self-rated frequency of 18 ADHD symptoms (never/rare, sometimes, often, very often) in the 6 months preceding the survey. The total numbers of 9 inattentive symptoms (range, 0-9) and 9 hyperactive-impulsive symptoms (range, 0-9) that students rated as experiencing often or very often were calculated. Students who had reported experiencing often or very often 6 or more symptoms in either category were classified as being ADHD symptom-positive.

Results  Among the 2587 adolescents (63% eligible students; 54.4% girls; mean [SD] age 15.5 years [0.5 years]) who did not have significant symptoms of ADHD at baseline, the median follow-up was 22.6 months (interquartile range [IQR], 21.8-23.0, months). The mean (SD) number of baseline digital media activities used at a high-frequency rate was 3.62 (3.30); 1398 students (54.1%) indicated high frequency of checking social media, which was the most common media activity. High-frequency engagement in each additional digital media activity at baseline was associated with a significantly higher odds of having symptoms of ADHD across follow-ups. This association persisted after covariate adjustment. The 495 students who reported no high-frequency media use at baseline had a 4.6% mean rate of having ADHD symptoms across follow-ups vs 9.5% among the 114 who reported 7 high-frequency activities and vs 10.5% among the 51 students who reported 14 high-frequency activities.

Conclusions and Relevance  Among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. Further research is needed to determine whether this association is causal.

Full reference:

Ra CK, Cho J, Stone MD, et al |Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents| JAMA| 2018| 320| (3)|P.255–263|  doi:10.1001/jama.2018.8931

The article can be requested by Rotherham NHS staff here 

 

Investigation into the transition from child and adolescent mental health services to adult mental health services

Healthcare Safety Investigation Branch| July 2018 | Investigation into the transition from child and adolescent mental health services to adult mental health services

The Healthcare Safety Investigation Branch (HSIB) investigated the transition of care from child and adolescent mental health services (CAMHS) to adult mental health services (AHMS). This second report is the culmination of many months of rigorous and independent investigation, working closely with the organisations involved in the incident, as well as relevant organisations, and subject matter experts.

hsib
Image source: hsib.org.uk

A series of different methodologies were used which included: review of records, policies and procedures, and practice relating to transitioning of young people into adult services, and the identification of the needs of individual young people and the response to those needs.

A focus group involving up to 14 young people who had either transitioned from CAMHS to AMHS or were in the process of transitioning provided the investigation with a lived experience of the issues and concerns for young people and where services were not meeting their needs (Source: HSIB).

The summary report is here

The final  report can be read here  

A press release is available from HSIB 

Qualitative exploration of a targeted school‐based mindfulness course in England

McGeechan, G. J. et al. | Qualitative exploration of a targeted school‐based mindfulness course in England | Child and Adolescent Mental Health | published 27 June 2018

Abstract

Background

Mindfulness‐based training has been shown to provide benefits for adults with numerous conditions such as cancer, chronic pain, and depression. However, less is known about its impact for young people. Early adolescence (typically 10–14 years) is a time fraught with challenges such as cognitive changes, social, and academic pressures in the form of exams, all of which can provoke anxiety. While there is a lack of effectiveness studies, there is growing interest in the potential for school‐based mindfulness programmes to help young people cope with the pressures of modern life.

Methods

This study outlines a qualitative exploration of a school‐based targeted mindfulness course. We interviewed 16 young people who had taken part in a 10‐week mindfulness course, and held a focus group with three members of teaching staff who delivered the programme. Interviews and focus groups were analysed using applied thematic analysis.

Results

While young people felt that they had to take part, once they started the programme they enjoyed it. Young people felt that they learned a range of coping skills, and it had a positive impact on their behaviour. However, the targeted approach of the intervention could lead to young people being stigmatised by their peers. Teaching staff could see the potential benefit of mindfulness courses in schools but felt there were some barriers to be overcome if it were to be implemented in the long term.

Conclusions

Young people were willing to engage in mindful practice and felt it better equipped them to deal with stressful situations.

Parent-child therapy helps young children with depression

New research demonstrates that an interactive therapy involving parents and their depressed preschoolers can reduce rates of depression and lower the severity of children’s symptoms | The American Journal of Psychiatry | via ScienceDaily

Children as young as three can be clinically depressed, and often that depression recurs as they get older and go to school. It also can reappear during adolescence and throughout life.

New research from Washington University School of Medicine demonstrates that an interactive therapy involving parents and their depressed children can reduce rates of depression and lower the severity of children’s symptoms:

Abstract
Objective:
Clinical depression in children as young as age 3 has been validated, and prevalence rates are similar to the school-age disorder. Homotypic continuity between early and later childhood depression has been observed, with alterations in brain function and structure similar to those reported in depressed adults.

These findings highlight the importance of identifying and treating depression as early as developmentally possible, given the relative treatment resistance and small effect sizes for treatments later in life. The authors conducted a randomized controlled trial of a dyadic parent-child psychotherapy for early childhood depression that focuses on enhancing the child’s emotional competence and emotion regulation.

Method:
A modified version of the empirically tested parent-child interaction therapy with a novel “emotion development” module (PCIT-ED) was compared with a waiting list condition in a randomized controlled trial in 229 parent-child dyads with children 3–6.11 years of age. Both study arms lasted 18 weeks.

Results:
Children in the PCIT-ED group had lower rates of depression (primary outcome), lower depression severity, and lower impairment compared with those in the waiting list condition. Measures of child emotional functioning and parenting stress and depression were significantly improved in the PCIT-ED group.

Conclusions:
The findings from this randomized controlled trial of a parent-child psychotherapy for early childhood depression suggest that earlier identification and intervention in this chronic and relapsing disorder represents a key new pathway for more effective treatment. Manualized PCIT-ED, administered by master’s-level clinicians, is feasible for delivery in community health settings.

Luby, J. L. et al. |  A Randomized Controlled Trial of Parent-Child Psychotherapy Targeting Emotion Development for Early Childhood Depression | American Journal of Psychiatry | Published Online 20 June 2018

Why do People Overthink?

hatena-1184896_1920

Background:

The meta-cognitive model of rumination is a theoretical model regarding the relationship between rumination and depression. Although meta-cognitive therapy for rumination was established based on this model, insufficient longitudinal studies addressing this model have been conducted. Moreover, the uncontrollability of rumination, suggested to be driven by negative meta-beliefs about rumination, has not been examined using this meta-cognitive model.

Aims: We longitudinally examined the meta-cognitive model and its relationship with uncontrollability of rumination and depressive symptoms. Method: Undergraduate students (n = 117) were asked to complete two measurements (with a 6-month gap between them) of positive and negative meta-beliefs about rumination, causal analysis, understanding, uncontrollability of rumination and depression.

Results: Cross-lagged effect modelling revealed that positive meta-beliefs predicted high causal analytic rumination. However, the results did not support the causal analytic and understanding aspects of how rumination predicted negative meta-beliefs. Negative meta-beliefs predicted high depressive symptoms, and depressive symptoms predicted high negative meta-beliefs. Negative meta-beliefs predicted high uncontrollability of rumination, whereas uncontrollability of rumination did not predict depressive symptoms.

Conclusions: The results partially supported the meta-cognitive model. The prediction of depressive symptoms on negative meta-beliefs suggests that depression-related cognition might be involved in increasing negative meta-beliefs, rather than the repetitive causal analytic and understanding aspects of rumination. In line with meta-cognitive therapy, negative meta-beliefs could be a target for treating depression.

Full reference: Matsumoto, N., & Mochizuki, S. | Why do People Overthink? A Longitudinal Investigation of a Meta-Cognitive Model and Uncontrollability of Rumination |  Behavioural and Cognitive Psychotherapy | Vol 46(4), July 2018 | p504-509

Tackling bullying could help reduce depression in autistic teens

University of Bristol| June 2018 | Tackling bullying could help reduce depression in autistic teens

A new study from Bristol University has found teenagers with difficulties in social communication, including autism, have greater rates of depression, especially if they are being bullied. 

teenager-2710526_1920

The researchers used data from a longitudinal study and  discovered that children with autism, and young people with autistic traits, had greater symptoms of depression at age 10 than peers without autism. This trend continued until the children and young people were 18 (via Science Daily).

 

The full news story is available to read from Science Daily

An article based on this study has been published in JAMA Psychiatry

Abstract

Importance  Population-based studies following trajectories of depression in autism spectrum disorders (ASD) from childhood into early adulthood are rare. The role of genetic confounding and of potential environmental intermediaries, such as bullying, in any associations is unclear.

Objectives  To compare trajectories of depressive symptoms from ages 10 to 18 years for children with or without ASD and autistic traits, to assess associations between ASD and autistic traits and an International Statistical Classification of Diseases, 10th Revision (ICD-10) depression diagnosis at age 18 years, and to explore the importance of genetic confounding and bullying.

Design, Setting, and Participants  Longitudinal study of participants in the Avon Longitudinal Study of Parents and Children birth cohort in Bristol, United Kingdom, followed up through age 18 years. Data analysis was conducted from January to November 2017.

Main Outcomes and Measures  Depressive symptoms were assessed using the Short Mood and Feelings Questionnaire (SMFQ) at 6 time points between ages 10 and 18 years. An ICD-10 depression diagnosis at age 18 years was established using the Clinical Interview Schedule–Revised. Exposures were ASD diagnosis and 4 dichotomized autistic traits (social communication, coherence, repetitive behavior, and sociability). An autism polygenic risk score was derived using the Psychiatric Genomics Consortium autism discovery genome-wide association study summary data. Bullying was assessed at ages 8, 10, and 13 years.

Results  The maximum sample with complete data was 6091 for the trajectory analysis (48.8% male) and 3168 for analysis of depression diagnosis at age 18 years (44.4% male). Children with ASD and autistic traits had higher average SMFQ depressive symptom scores than the general population at age 10 years (eg, for social communication 5.55 [95% CI, 5.16-5.95] vs 3.73 [95% CI, 3.61-3.85], for ASD 7.31 [95% CI, 6.22-8.40] vs 3.94 [95% CI, 3.83-4.05], remaining elevated in an upward trajectory until age 18 years (eg, for social communication 7.65 [95% CI, 6.92-8.37] vs 6.50 [95% CI, 6.29-6.71], for ASD 7.66 [95% CI, 5.96-9.35] vs 6.62 [95% CI, 6.43-6.81]). Social communication impairments were associated with depression at age 18 years (adjusted relative risk, 1.68; 95% CI, 1.05-2.70), and bullying explained a substantial proportion of this risk. There was no evidence of confounding by the autism polygenic risk score. Analysis in larger samples using multiple imputation led to similar but more precise results.

Conclusions and Relevance  Children with ASD and ASD traits have higher depressive symptom scores than the general population by age 10 years, which persist to age 18 years, particularly in the context of bullying. Social communication impairments are an important autistic trait in relation to depression. Bullying, as an environmental intermediary, could be a target for interventions.

 

The article can  be read in full at JAMA Psychiatry 

Full reference:

Rai D, Culpin I, Heuvelman H, et al.| Association of Autistic Traits With Depression From Childhood to Age 18 Years| JAMA Psychiatry | Published online June 13, 2018| doi:10.1001/jamapsychiatry.2018.1323

 

More screen time associated with insomnia and less sleep in adolescents

Science Daily | June 2018 | Study links screen time to insomnia symptoms and depressive symptoms in adolescents

A new US study which used data from over 2000 adolescents has found an association between high screen usage and insomnia and shorter sleep duration in young people. Xian Stella Li, PhD, one of the researchers in the study said: “Higher rates of depressive symptoms among teens may be partially explained through the ubiquitous use of screen-based activities, which can interfere with high quality restorative sleep (via Science Daily).” 

apple-1034299_1920

Principal investigator Lauren Hale, said: “These results suggest that parents, educators and health care professionals could consider educating adolescents and regulating their screen time, as possible interventions for improving sleep health and reducing depression.”

The full news article is available from Science Daily