Translational research to prevent internalizing problems early in childhood

Abstract

This article discusses the importance of and one approach to translational research to prevent internalizing problems very early in life. The World Health Organisation (WHO) predicts that by 2,030 internalizing problems will be second only to HIV/AIDS in the international burden of disease. Internalizing problems affect one in every seven school age children, with negative impacts on peer relations, school engagement, and later mental health, adult relationships, and employment. There is persuasive evidence that intervention in the preschool years can have a cost-effective impact on general developmental outcomes, compared to later school or adult intervention. However, the development of early childhood prevention for internalizing problems is in its infancy. Two significant risk factors for child internalizing problems are temperamental inhibition (characterized by fearfulness and withdrawal) and overinvolved/protective parenting practices. Rapee et al. have conducted two randomized "efficacy" trials with inhibited preschoolers in which a parenting group intervention reduced internalizing disorders up to 3 years later. Translational "effectiveness" research is now underway at the population level, to determine the balance of benefits and harms of systematically screening preschoolers for inhibition and subsequent intervention for all those affected. This rigorous public health research, followed by effective dissemination, addresses gaps identified in the WHO Prevention of Mental Disorders report.

Computer-Based and Online Therapy for Depression and Anxiety in Children and Adolescents

“…The current generation of ''digital natives'' is growing up immersed in and surrounded by technology. Even in low-income countries, mobile phones are used widely (Bayer et al 2011). Effective psychological treatments for depression and anxiety have been developed, but access to these is problematic, provision is expensive, and young people may be reluctant to see a therapist face-to-face.…”

Wechsler profiles in referred children with intellectual giftedness: Associations with trait-anxiety, emotional dysregulation, and heterogeneity of Piaget-like reasoning processes

“…Since trait-anxiety has been considered as a broad marker of childhood psychopathology, 32,33 this result suggests that, among gifted children who are clinically-referred, asynchronous and intellectually homogeneous ones do not clearly differ as for their levels of general psychopathology. Comparisons regarding the physiological and worry/oversensitivity dimensions of the R-CMAS neither distinguished both groups (though proportion of physiological anxiety cases tended to be higher in the SVPD group); what significantly differentiated the two groups was social preoccupation only, which cases were significantly more prevalent in the non-SVPD group.…”

“…31 Though it is mainly linked to the internalizing range of emotional-behavioural problems, it is also considered as a broad marker of childhood psychopathology. 32,33 We used here Reynolds' model of childhood trait-anxiety, as operationalized in the Revised-Children's Manifest Anxiety Scale (R-CMAS). 28 …”

Programa de prevenção seletiva de orientação a pais de crianças com crises de sibilância

“…Supõe-se que tais dificuldades podem estar relacionadas ao problema de saúde que elas apresentam, pois dados da literatura sinalizam que crianças com problemas crônicos de saúde apresentam alto risco para o desenvolvimento de problemas de comportamento, principalmente os internalizantes, tais como depressão e ansiedade (Miyazaki et al, 2006;Otsuki et al, 2009). Ademais, se tais dificuldades não forem superadas ao longo do desenvolvimento destes indivíduos, aumentase o risco do agravamento de tais problemas e de prejuízos para o funcionamento desses mesmos indivíduos na idade adulta (Bayer et al, 2011;Catalano et al, 2012;Maia & Williams, 2005;Mrazek & Haggerty, 1994;Nation et al, 2003).…”

“…De acordo com a análise do comportamento, os pais são modelos importantes de interação para seus filhos e grande parte da aprendizagem das crianças na primeira infância é vicariante, ou seja, provavelmente a ressonância de problemas de comportamento entre os cuidadores e seus filhos sinaliza que tais dificuldades podem ser aprendidas pelos filhos a partir do modelo de interação de seus pais. Tais contingências parecem estar contribuindo, em parte, pois o comportamento é multideterminado, para o desenvolvimento e manutenção dos problemas de comportamento apresentados pelos infantes avaliados no estudo (Bayer et al, 2011;Bolsoni-Silva & Marturano, 2002;Del Prette & Del Prette, 2005;Gomide, 2004;Skinner, 1998).…”