Digital technology and adolescent conduct problems

Adolescents spend an unprecedented amount of time using digital technology to access the Internet and engage with social media. There is concern that this continuous connectivity could increase their mental health symptoms, especially for at-risk adolescents. | Journal of Pediatric Nursing

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A new US study has reported that on days that at-risk adolescents used technology more, they experienced more conduct problems and higher attention-deficit hyperactivity disorder (ADHD) symptoms compared to days when they used digital technologies less.

However, the study also found that on days when adolescents spent more time using digital technologies they were less likely to report symptoms of depression and anxiety.

Key findings:

•Daily digital technology use by at-risk adolescents is associated with worse mental health symptoms.
•Higher levels of digital technology use were associated with increases in next-day conduct problems.
•Attention-deficit hyperactivity disorder symptoms increased with increased digital technology use.
•When adolescents spent more time using digital technologies they reported fewer symptoms of depression and anxiety.

Full reference: McBride, Deborah L. Daily Digital Technology Use Linked to Mental Health Symptoms for High-risk Adolescents. Journal of Pediatric Nursing: Nursing Care of Children and Families. Published online 7th June 2017

Group mindfulness for adolescent anxiety

Crowley, M.J. et al. Child and Adolescent Mental Health | Published online 4 March 2017

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Background: Group Mindfulness Therapy (GMT) is a program tailored for adolescents that targets anxiety with mindfulness skills including present moment awareness, mindfulness in everyday life (breathing, eating, walking), body scan, loving-kindness, and self-acceptance. Youth with anxiety may benefit from mindfulness exercises precisely because they learn to redirect their mind, and presumably their attention, away from wandering in the direction of worry and negative self-appraisals and toward greater acceptance of internal states. This open trial assessed the feasibility and initial effectiveness of GMT in a school setting.

 

Conclusions: We demonstrate that GMT is feasible and acceptable to adolescents presenting with anxiety as a primary concern. We provide further support for the use of a mindfulness-based intervention for anxiety reduction. The group format suggests a cost-effective way to deliver services in a school setting.

Read the full abstract here

Expert reaction to conference abstract looking at whether excessive internet use may indicate mental health problems in college students

Science Media Centre | Published online: 17 September 2016

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Unpublished work presented at the European College of Neuropsychopharmacology Congress (ECNP) has investigated possible associations between internet use and mental health issues in college students.

Dr Andrew Przybylski, Experimental Psychologist and Research Fellow at the Oxford Internet Institute, University of Oxford, said:

“This is a survey study which reports statistically significant correlations between a range of self report assessments reflecting psychopathology and a measure of so-called ‘internet addiction’. Though the topic is of importance and the researcher efforts are admirable, there are at least three reasons why this research should not inform policy or clinical practice.

“First, the findings from this survey are derived from a convenience sample of first-year Canadian undergraduates recruited though an anxiety research website. This means the sample is not representative of the Canadian population or college students who are not seeking help through an anxiety website. The findings therefore cannot “highlight that problematic internet use may be more widespread than once thought” because the sample cannot be generalised to the population. Indeed one might expect anxious or depressed individuals to use the internet differently than the general population.

“Second, the study is correlational and critical information regarding the size of the correlations is missing. In other words, it is not clear whether having psychological problems might lead to a high score on the internet addiction scale or vice versa. The most simple, and likely correct, interpretation of these observations is that anxious and depressed people have everyday issues that affect the way they use the internet, not the other way around. This problem is aggravated by the fact we only have information on statistical significance, but we cannot know if this is a inconsequential, small, or huge relationship. Because of this we cannot determine if this correlation is something to be worried about.

“Finally, the study appears to neglect to mention that the scale used to measure ‘internet addiction’ is not diagnostic of a professionally recognised psychiatric disorder. Indeed there is no such thing as ‘internet addiction’ according to the American Psychiatric Association. The self-report measure has been widely used in similar survey research but these cut-off scores are arbitrary. It is not clear what about the internet is addictive; is it gaming, commenting on social media, using Uber? This issue belies a larger important question of whether human communication can be ‘addictive’ in a clinical sense.”

Read the full commentary here

 

Diagnosis and treatment of ADHD in Primary Care

Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review

Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school-age children. This review is intended to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents.

PubMed, PsychInfo, and Science Citation Index databases were searched from March 1990 to 2015 with the keywords: ADHD, primary care/pediatrics and children/adolescents, abstracts addressing diagnosis and/or treatment with 105 citations identified including supplementary treatment guidelines/books.

Adolescent ADHD presents with significant disturbances in attention, academic performance, and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis, and limited training and time for PCPs to conduct thorough evaluations.

The evidence base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification, and treatment of conditions associated with ADHD that emerge during adolescence as substance use disorders.

Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care psychiatric models, to assist in determining the optimal care for patients at this critical period.

Full reference: Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review. Journal of Adolescent Health. Published Online:May 18, 2016