Social and Relational Health Risks and Common Mental Health Problems Among US Children

Bethell, Christina; Garner, Andrew S.; Gombojav, Narangerel; Blackwell, Courtney K.; Heller, L.; Mendelson, Tamar

doi:10.1016/j.chc.2021.08.001

Cited by 41 publications

(18 citation statements)

References 66 publications

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“…Given the known associations between poverty and economic disadvantage and multiple child physical health outcomes, it is not surprising that low household income is associated with higher rates of child emotional dysfunction (Council on Community Pediatrics et al, 2016;Ghandour et al, 2019;Harris & Santos, 2020;Ogundele, 2018). Evidence suggests that associations between poverty and child health are mediated by poverty-related social risk factors and social needs (Beck et al, 2016;Bethell et al, 2022;Fierman et al, 2016;Rodems & Shaefer, 2020). Social risk factors include specific adverse social conditions associated with poor health (Alderwick & Gottlieb, 2019;Bethell et al, 2022).…”

Section: Child Emotional Dysfunction and Unmet Social Needsmentioning

confidence: 99%

“…Evidence suggests that associations between poverty and child health are mediated by poverty-related social risk factors and social needs (Beck et al, 2016;Bethell et al, 2022;Fierman et al, 2016;Rodems & Shaefer, 2020). Social risk factors include specific adverse social conditions associated with poor health (Alderwick & Gottlieb, 2019;Bethell et al, 2022). While some ambiguity still exists in identifying the most salient social risk factors for child health, multiple health professionals and policy organizations have delineated and recommended screening for common domains of risk that include food, housing, employment, transportation, financial strain, safety, and access to health care (Kreuter et al, 2021).…”

Section: Child Emotional Dysfunction and Unmet Social Needsmentioning

confidence: 99%

“…Rates of child emotional dysfunction and stress in the U.S. are high. Reducing these rates will require recognizing the multifactorial etiology of these disorders and developing interventions across the many relevant domains of child and family well-being (Bethell et al, 2022). A small but growing body of literature suggests that unmet social needs contribute to child emotional dysfunction and stress.…”

Section: Biomarkers Of Stressmentioning

confidence: 99%

“…The first group included respondents who reported no needs, and the remainder of the sample was divided evenly across three additional groups: "none" (0 needs=ref), "1-2 needs", "3-4 needs", and "5 or more needs". This approach using the number of needs reported has been used in other published studies (Bethell et al, 2022;Rodems & Shaefer, 2020). Options for individual social needs included: financial (problems paying utility or medical bills, denied other income support, no health insurance), housing (difficulty finding housing, or habitability concerns), food (running out of food before having money to buy more), employment (difficulty finding, or problems with, a job, disability interfering with work, difficulty obtaining unemployment benefits), transportation (difficulty affording transportation or disability paratransit), legal (deportation, child support, family law issues), and other (no primary care provider, difficulty finding childcare or after-school activities, bullying, or household mental health concerns).…”

Section: Independent Variablesmentioning

confidence: 99%

“…Poor child emotional health can influence child development, interfere with daily functioning, and impact well-being into adulthood (Ghandour et al, 2019;Ogundele, 2018). Over the last two decades, the prevalence of emotional disorders such as anxiety and depression in children in the U.S. has steadily increased (Bethell et al, 2022;Bitsko et al, 2018;Ghandour et al, 2019), though it still may be underestimated secondary to well-studied barriers to accessing mental health diagnosis and treatment services in disadvantaged communities (Alegria et al, 2010;Ghandour et al, 2019;Marrast et al, 2016). At almost $11 billion annually, the costs associated with child mental health conditions are higher than for any other child health disorder (Davis, 2014;Ghandour et al, 2019).…”

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confidence: 99%

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Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers

et al. 2023

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Latinx families may be particularly vulnerable to emotional dysfunction, due to higher rates of economic hardship and complex social influences in this population. Little is known about the impact of environmental stressors such as unmet social needs and maternal stress on the emotional health of Latinx children from low-income families. We conducted secondary analyses using survey and biomarker data from 432 Latinx children and mothers collected in a separate study. We used binomial and multinomial logistic regression to test if household social needs, or maternal perceived stress or hair cortisol concentration (HCC), predicted child measures of emotional functioning or child HCC, independent of relevant sociodemographic factors. Approximately 40% of children in the sample had symptoms consistent with emotional dysfunction, and over 37% of households reported five or more social needs. High perceived maternal stress predicted higher odds of child emotional dysfunction (OR = 2.15; 95% CI [1.14, 4.04]; p = 0.01), and high maternal HCC was positively associated with high child HCC (OR = 10.60; 95% CI [4.20, 26.74]; p < 0.01). Most individual household social needs, as well as the level of household social need, were not independently associated with child emotional dysfunction or child HCC. Our findings begin to define a framework for understanding emotional health, stress, and resilience when caring for Latinx children and mothers living with high levels of social need, and the need for integrated mental health and social needs screening and interventions in settings that serve this population.

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Section: Child Emotional Dysfunction and Unmet Social Needsmentioning

confidence: 99%

Section: Child Emotional Dysfunction and Unmet Social Needsmentioning

confidence: 99%

Section: Biomarkers Of Stressmentioning

confidence: 99%

Section: Independent Variablesmentioning

confidence: 99%

mentioning

confidence: 99%

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Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers

et al. 2023

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Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions

Bryant,

Sisk,

McGuire

2024

JAMA Pediatr

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ImportanceAnxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) affect up to 20% of children and adolescents. Despite demonstrated efficacy, evidence-based treatments for these conditions are often inaccessible; innovative solutions are essential to meet the demand for pediatric mental health care.ObjectiveTo examine the efficacy and moderators of gamified DMHIs for anxiety, depression, and ADHD in randomized clinical trials (RCTs) for children and adolescents.Data SourcesA systematic search of PubMed, PsycInfo, and Web of Science was conducted for RCTs published before March 20, 2024.Study SelectionRCTs that evaluated the efficacy of gamified DMHIs for treating pediatric ADHD, depression, or anxiety were included. Studies were excluded if they did not use a gamified DMHI, provide sufficient data for effect sizes, or were unavailable in English.Data Extraction and SynthesisEfficacy data were extracted from rating scales for ADHD, depression, and anxiety. Extracted moderator variables included participant characteristics (eg, age and sex), intervention characteristics (eg, delivery modality and time limit), and trial design characteristics (eg, outcome measure and risk of bias).Main Outcomes and MeasuresThe primary outcome was change in ADHD, depression, or anxiety severity in the treatment group compared to the control group. Hedges g quantified treatment effects.ResultsThe search strategy identified 27 RCTs that included 2911 participants across ADHD, depression, and anxiety disorders. There were modest significant effects of gamified DMHIs on ADHD (g, 0.28; 95% CI, 0.09 to 0.48) and depression (g, 0.28; 95% CI, 0.08 to 0.47) but small, nonsignificant effects for anxiety disorders (g, 0.07; 95% CI, −0.02 to 0.17). Moderator analyses revealed that DMHIs for ADHD delivered on a computer and those RCTs that had a greater preponderance of male participants produced larger treatment effects. DMHIs for depressive disorders that used preset time limits for gamified DMHIs also exhibited larger treatment effects.Conclusions and RelevanceThe findings suggest a benefit of gamified DMHIs for youth with ADHD or depressive disorder. Pediatricians and other health care professionals have new information about novel, accessible, and efficacious options for pediatric mental health care.

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Evaluation of Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) implemented in community‐based settings

Mena,

Lazarus,

Otero

et al. 2023

Journal Community Psychology

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Effective family‐based interventions are needed for youth who are experiencing emotional and behavioral difficulties and who are impacted by powerful environmental stressors. Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) is a manualized and evidence‐based, multicomponent family‐based treatment that has been shown to be efficacious in research settings. The purpose of this paper is to report on the effectiveness of implementing CIFFTA for the treatment of Latino and Black youth and families in community settings. Utilization of services offered and changes in youth presenting problems and family functioning were used to evaluate the program. Two hundred thirty‐two youth (11–18 years of age) and their caregivers were recruited over 2 years and CIFFTA was delivered by experienced masters‐level family therapists over a 12–16‐week period. Seventy‐six percent met the 8‐session criteria for retention in treatment and 71% completed treatment. Results showed significant improvements in youth behavioral and emotional presenting problems, reduction in family conflict and improvement in family cohesion and communication. Caregiver well‐being such as reductions in parental stress, relational frustration, and improvement in parental confidence also showed significant improvement. Analyses of reliable change indices showed a substantial improvement in youth who entered the program in the clinical range of presenting problems. The findings point to CIFFTA's ability to retain youth and families who tend to underutilize needed services, to significant reductions in presenting problems, and to improvements in family functioning when implemented in a community setting.

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Social and Relational Health Risks and Common Mental Health Problems Among US Children

Cited by 41 publications

References 66 publications

Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers

Household Social Needs, Emotional Functioning, and Stress in Low-Income Latinx Children and their Mothers

Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions

Evaluation of Culturally Informed and Flexible Family‐Based Treatment for Adolescents (CIFFTA) implemented in community‐based settings

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