Teens more likely to disengage from school after police stops

Psychological distress after police stops includes anxiety, anger and depression

April 4, 2022

Science Daily/American Psychological Association

Teens who are stopped by the police are more likely to report greater disengagement from school the next day, and racial and ethnic minority youth reported more invasive police encounters than white youth, according to research published by the American Psychological Association.

In the study, 387 adolescents aged 13 to 17 (50% white, 32% Black and 18% other ethnic-racial minority) completed daily online diary entries over 35 days. The youth were students in five public school districts in Pittsburgh where district leaders were concerned about racially disparate juvenile justice court referrals. Half of the participants attended schools where low-income students were in the majority.

The researchers analyzed more than 13,000 diary entries. Youth who reported being stopped by the police were more likely to report disengagement from school the next day (skipping all or some classes, not staying focused, etc.). Students who were stopped also were more likely to report psychological distress, including anxiety, anger and depression. The research was published online in Developmental Psychology.

In just over a month, 9% of the youth (34 students) were stopped by police -- including school-assigned police officers -- which is a "shockingly high" number for such a short period, said lead researcher Juan Del Toro, PhD, a research associate at the University of Pittsburgh. The rate of police stops didn't vary significantly across racial or ethnic groups, but Black and other ethnic-racial minority students reported more intrusive interactions when they were frisked by police.

"Police officers use their own discretion to decide which people to stop and frisk in their aim to reduce crime," Del Toro said. "However, many of these practices result in racial disparities in policing and stop-and-frisks."

Students who reported disengagement from school were no more likely to be stopped by the police the next day, "which helps refute common stereotypes that only 'bad kids' are stopped by the police," Del Toro said.

Youth who reported psychological distress from police stops were more likely to disengage from school the following day. The cumulative negative effects of police stops could have long-term consequences for youth, including lower grades, lower standardized test scores and a lower likelihood of college admission, Del Toro said.

Prior research has found that youth of color are perceived as less innocent and more like adult criminals than their white peers, and aggressive policing has been linked to reduced test scores and school attendance for Black boys. In New York City, Black and Latino males between the ages of 14 and 24 account for only 5% of the city's population, but represented 38% of the reported police stops in recent years, according to a 2019 New York Civil Liberties Union report. Black and Latino people also were more likely to be frisked and to experience force from New York City police than white people.

Police officers should receive more training on how to interact with children and teens in a less confrontational manner, Del Toro said. There also should be increased funding for community efforts to help local youth feel more autonomous and competent at school and in their daily lives.

https://www.sciencedaily.com/releases/2022/04/220404093008.htm

Drug use severity in adolescence affects substance use disorder risk in adulthood

April 1, 2022

Science Daily/NIH/National Institute on Drug Abuse

People who reported multiple symptoms consistent with severe substance use disorder at age 18 exhibited two or more of these symptoms in adulthood, according to a new analysis of a nationwide survey in the United States. These individuals were also more likely, as adults, to use and misuse prescription medications, as well as self-treat with opioids, sedatives, or tranquillizers. Published today in JAMA Network Open, the study is funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

While use of alcohol, cannabis, or other drugs is common among adolescents, previous studies have suggested that most teens reduce or cease drug use as they enter adulthood. However, this study indicates that adolescents with multiple symptoms of substance use disorder -- indicating higher severity -- do not transition out of symptomatic substance use.

"Screening adolescents for drug use is extremely important for early intervention and prevention of the development of substance use disorder," said Nora Volkow, M.D., director of NIDA. "This is critical especially as the transition from adolescence to adulthood, when brain development is still in progress, appears to be a period of high risk for drug use initiation." Dr. Volkow further discusses the findings and implications of this study in a related commentary.

Researchers in this study argue that key knowledge gaps currently hinder the initiation of screening, diagnosis, prevention, and treatment efforts for teens with substance use disorders. For example, previous methods evaluating persistence of substance use disorder tended to treat substance use disorder as one broad category, without looking at severity. They also failed to account for the possibility of polysubstance use, whereby individuals may use multiple drugs or switch the types of drugs they use as they grow older.

The NIDA-funded Monitoring the Future Panel study at the University of Michigan-Ann Arbor helped close this research gap by examining substance use behaviors and related attitudes among 12th graders through their adulthood in the United States. Since 1976, the study has surveyed panels of students for their drug use behaviors across three time periods: lifetime, past year, and past month. In this study, researchers looked primarily at a subgroup of 5,317 12th graders first evaluated between 1976 and 1986, who were followed with additional surveys at two-year, then five-year intervals for up to 32 years, until they reached age 50. Among the respondents, 51% were female and 78% were white.

The research team examined the relationship between substance use disorder symptom severity at age 18 and prescription drug use, prescription drug misuse, and substance use disorder symptoms up to age 50 in these individuals.

To measure severity of substance use disorder symptoms in adolescence, researchers recorded the number of substance use disorder symptoms that participants reported in response to initial survey questions. These questions were based on criteria for alcohol, cannabis, and "other drug" use disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The researchers categorized substance use disorder symptoms into five levels of severity: exhibiting no symptoms, one symptom, two to three symptoms, four to five symptoms, and six or more symptoms. Symptoms included, but were not limited to, substance use resulting in a failure to fulfill major role obligations and repeating substance use even when dangerous to health.

Approximately 12% of surveyed teens indicated "severe" substance use disorder, defined by this study as reporting six or more symptoms. Among this group, more than 60% exhibited at least two symptoms of substance use disorder in adulthood -- an association found across alcohol, cannabis, and other drug use disorders. By comparison, roughly 54% of teens reporting two to three symptoms -- indicative of "mild" substance use disorder -- had two or more substance use disorder symptoms in adulthood. Higher severity of substance use disorder symptoms at age 18 also predicted higher rates of prescription drug misuse in adulthood.

Overall, more than 40% of surveyed 18-year-old individuals reported at least two substance use disorder symptoms (across all substances). More than half of the individuals who were prescribed and used opioids, sedatives, or tranquilizers as adults also reported two or more symptoms at age 18. This finding underlines the importance of strategies to increase safety and properly assess a potential history of substance use disorder symptoms when prescribing controlled medications to adults.

"Teens with substance use disorder will not necessarily mature out of their disorders, and it may be harmful to tell those with severe symptoms that they will," said Dr. Sean Esteban McCabe, senior author of this study and director of the Center for the Study of Drugs, Alcohol, Smoking and Health at University of Michigan. "Our study shows us that severity matters when it comes to predicting risk decades later, and it's crucial to educate and ensure that our messaging to teens with the most severe forms of substance use disorder is one that's realistic. We want to minimize shame and sense of failure for these individuals."

The authors note that more research is needed to uncover potential neurological mechanisms and other factors behind why adolescents with severe substance use disorder symptoms are at increased risk of drug addiction and misuse in adulthood. Characterizing possible causes of more severe substance use disorder could help improve understanding of vulnerability to chronic substance use and help make prevention and treatment strategies more effective.

https://www.sciencedaily.com/releases/2022/04/220401122203.htm

Rising parental expectations linked to perfectionism in college students

March 31, 2022

Science Daily/American Psychological Association

Rising parental expectations and criticism are linked to an increase in perfectionism among college students, which can have damaging mental health consequences, according to new research published by the American Psychological Association.

Researchers analyzed data from more than 20,000 American, Canadian and British college students. They found that young people's perceptions of their parents' expectations and criticism have increased over the past 32 years and are linked to an increase in their perfectionism.

"Perfectionism contributes to many psychological conditions, including depression, anxiety, self-harm and eating disorders," said lead researcher Thomas Curran, PhD, an assistant professor of psychological and behavioral science at the London School of Economics and Political Science.

Study co-author Andrew P. Hill, PhD, a professor of sport and exercise psychology at York St John University, added that "the pressure to conform to perfect ideals has never been greater and could be the basis for an impending public health issue."

Perfectionism often becomes a lifelong trait and prior research has shown that perfectionists become more neurotic and less conscientious as they get older. Perfectionism also can perpetuate through generations, with perfectionist parents raising perfectionist children.

Curran and Hill previously found that three types of perfectionism were increasing among young people in the U.S., Canada and the United Kingdom. They suspected that one cause might be that parents are becoming more anxious and controlling, so they analyzed the findings of other published studies in two meta-analyses for this latest piece of research, which published online in the journal Psychological Bulletin.

The first meta-analysis included 21 studies with data from more than 7,000 college students. Parental expectations and criticism had moderate associations with self-oriented and other-oriented perfectionism and a large association with socially prescribed perfectionism.

Self-oriented perfectionism involves perfectionist standards about the self. Other-oriented perfectionism is perfectionism turned outward, where someone expects others to be perfectionist. Socially prescribed perfectionism is the perception that other people and society require perfection. The three types of perfectionism overlap and can exacerbate the effects of each other in negative ways.

Parental expectations had a larger impact than parental criticism on self-oriented and other-oriented perfectionism, so parental expectations may be more damaging than parental criticism.

"Parental expectations have a high cost when they're perceived as excessive," Curran said. "Young people internalize those expectations and depend on them for their self-esteem. And when they fail to meet them, as they invariably will, they'll be critical of themselves for not matching up. To compensate, they strive to be perfect."

Self-oriented perfectionism was higher for American college students than Canadian or British students, possibly because of more intense academic competition in the U.S.

"These trends may help explain increasing mental health issues in young people and suggest this problem will only worsen in the future," Hill said. "It's normal for parents to be anxious about their children, but increasingly this anxiety is being interpreted as pressure to be perfect."

The second meta-analysis included 84 studies conducted between 1989 and 2021 with a total of 23,975 college students. Parental expectations, criticism and their combined parental pressure increased during those 32 years, with parental expectations increasing at the fastest rate by far.

"The rate of increase in young people's perceptions of their parents' expectations is remarkable," up an average 40% compared with 1989, Curran said.

The studies were conducted in the U.S., Canada and the United Kingdom, so the findings can't be generalized to other cultures. The research is correlational, so it can't prove that rising parental expectations or criticism caused an increase in perfectionism among college students, only that there is a link between them. However, the research suggests troublesome changes over time, according to the researchers.

So what are parents supposed to do? "Parents are not to blame because they're reacting anxiously to a hyper-competitive world with ferocious academic pressures, runaway inequality and technological innovations like social media that propagate unrealistic ideals of how we should appear and perform," Curran said.

"Parents are placing excessive expectations on their children because they think, correctly, that society demands it or their children will fall down the social ladder," Curran added. "It's ultimately not about parents recalibrating their expectations. It's about society -- our economy, education system and supposed meritocracy -- recognizing that the pressures we're putting on young people and their families are unnecessarily overwhelming."

Parents can help their children navigate societal pressures in a healthy way by teaching them that failure, or imperfection, is a normal and natural part of life, Curran said. "Focusing on learning and development, not test scores or social media, helps children develop healthy self-esteem, which doesn't depend on others' validation or external metrics," he said.

https://www.sciencedaily.com/releases/2022/03/220331101501.htm

Treatment for substance use reduces depression for many adolescents and young adults with both problems

When adolescents with substance use problems and depression are treated for substance use, about a third also have early improvements in depression

March 29, 2022

Science Daily/Elsevier

A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that, among youth with substance use and depression, a significant proportion show early improvements in depression during their treatment for substance use. Youth who are using cannabis less frequently prior to treatment and those without conduct disorder are more likely to experience early depression improvement.

"The combination of alcohol or cannabis use and depression is a significant problem in adolescents and young adults. In addition to the negative outcomes associated with substance use, like automobile accidents and academic problems, those with both conditions tend to have longer episodes of depression, more substance-related problems, and, most importantly, an increased risk for suicidal behavior," said lead author John Curry, PhD, Professor Emeritus in the Department of Psychiatry & Behavioral Sciences at Duke University, Durham, NC. "Yet there is no standard approach to treating them, and they are often treated in two separate systems of care."

Earlier studies have shown that some of these young people will show significant improvement in depression during treatment for substance use alone, suggesting that if that improvement is sustained, they may not need additional depression treatment. Based on this evidence, the researchers tested an adaptive approach in which everyone received substance use treatment. Yet, if they were still depressed after a month, they would receive additional depression treatment either with the same therapist or in the community.

"This approach allowed us to examine two different approaches to depression treatment for youth with substance use," said Dr. Curry. "We also wanted to discover what proportion of the youth would have an early depression response during substance use treatment and what factors predicted it."

Across two sites, a sample of 95 youths between the ages of 14 and 21 with alcohol or cannabis use and depressive symptoms received up to 12 sessions of cognitive behavior therapy (CBT) for substance use over 14 weeks. Before treatment, they completed measures of psychiatric diagnoses, alcohol or cannabis use, and severity of depression. Early depression response was defined as a 50% reduction in symptoms by week 4 of treatment. Those without early depression response were randomized to add either CBT for depression with the same therapist or depression treatment in the community.

Thirty-five participants (37%) demonstrated early depression response. Predictors of early depression response were lower frequency of cannabis use at baseline and lack of a conduct disorder diagnosis. No other variables -- including demographic characteristics, severity of depression, or other psychiatric diagnoses -- were predictors. Frequency of drinking, heavy drinking, and cannabis use declined over the full course of treatment for all participants. Among those without early depression response, depression improved significantly with either additional CBT or community treatment, with no difference between treatments.

"This treatment study emphasizes the importance of recognizing the heterogeneity of youth with substance use and co-occurring disorders such as depression, including the different trajectories of their responses to treatment," said lead author Yifrah Kaminer, MD, MBA, Professor Emeritus of Psychiatry at the University of Connecticut, Storrs, CT. "An important finding is that the level of cannabis use affects the trajectory of change in depression during treatment. Additional examination of potential biological markers or other predictors of treatment response is of paramount importance for developing cost-effective interventions."

Additional analyses will examine the course of depression and substance use after treatment, and whether the young people whose depression responded to substance use treatment continue to remain less depressed. Given the relatively small sample, it will be important to replicate the study's findings in other samples. Future research is needed to investigate the factors that underlie the relationship between substance use and depression over time.

https://www.sciencedaily.com/releases/2022/03/220329114730.htm

One in four children who have suffered a minor head injury is liable to suffer from chronic post-concussion syndrome

The long term consequences of mild head injury in children is underdiagnosed

March 28, 2022

Science Daily/Tel-Aviv University

A new study by Tel Aviv University, Kaplan Medical Center and Shamir Medical Center (Assaf Harofeh) found that one in four children (25.3%) who have been discharged from the emergency room after a mild head injury are misdiagnosed and continue to suffer from persistent post-concussion syndrome for many years. This syndrome includes chronic symptoms such as forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems and, instead of receiving treatment for the syndrome, they are mistakenly diagnosed as suffering from ADHD, sleep disorders, depression, etc. The misdiagnosis leads to treatment that is not suited to the problem, thus causing the children prolonged suffering.

The study was led by Prof. Shai Efrati of the Sagol Center for Hyperbaric Medicine and Research at Tel Aviv University and Shamir Medical Center (Assaf Harofeh), Dr. Uri Bella and Dr. Eli Fried of Kaplan Medical Center, and Prof. Eran Kotzer of Shamir Medical Center. The results of the study were published in the journal Scientific Reports.

"The objective of our study was to determine how many children in Israel suffer from persistent post-concussion syndrome," says Dr. Fried of Kaplan Medical Center. "The children participating in the study arrived at the emergency room with mild head trauma and, after staying overnight for observation or being sent for a CAT scan of the head, they were discharged to go home."

Prof. Efrati of Tel Aviv University states: "Persistent post-concussion syndrome is a chronic syndrome that results from micro damage to the small blood vessels and nerves, which may appear several months after the head injury, and therefore is often misdiagnosed as attention deficit disorders, sleep disorders, depression, etc. There are cases where children report headaches and are diagnosed as suffering from migraines or, for example, children who report difficulty concentrating and the doctor prescribes Ritalin. Unfortunately, these children continue to suffer for many years from various disorders and, instead of treating the real problem, which is the syndrome, they receive treatments that usually do not solve the problem."

The study examined 200 children who suffered from a head injury and who were released from the emergency room after the need for medical intervention was ruled out. The researchers tracked the subjects for a period between six months and three years from their date of discharge and found that about one in four children released from the emergency room suffered from the chronic syndrome.

"It should be understood that the consequences of brain injury during childhood continue throughout life," says Dr. Uri Bella, Director of the Pediatric Emergency Room at the Kaplan Medical Center. "Loss of any brain function will prevent the child from realizing his or her potential in education and in social life."

Unlike damage to large arteries and noticeable damage to brain tissue, with a minor head injury, the damage is to the small blood vessels and neurons -- and it is not detected on CAT scans of the head or on regular MRIs. Diagnosis of the syndrome requires long-term monitoring of the manifestation of symptoms as well as the use of imaging and functional tests of the brain. According to the researchers, the alarming findings demonstrate that changes in the approach are needed to be monitoring and treating these children.

"The purpose of an emergency room diagnosis is to determine whether the child suffers from a severe brain injury that requires immediate medical intervention," adds Prof. Eran Kotzer, Director of the Emergency Rooms at the Shamir Medical Center. "Unfortunately, the way most medical systems operate today, we miss long-term effects and do not continue to monitor those children who leave the emergency room without visible motor impairment."

"Treatment for a wide range of disorders will change if we know that the cause of the new problem is a brain injury," concludes Prof. Efrati. "Proper diagnosis of the cause is the first and most important step in providing appropriate treatment for the problem."

https://www.sciencedaily.com/releases/2022/03/220323101226.htm

Maternal socialization, not biology, shapes child brain activity

Probing reward-related processing in children of depressed moms

March 23, 2022

Science Daily/Elsevier

Children of mothers with clinical depression are at three times greater risk to develop depression themselves than are their low-risk peers. Researchers are working to understand the neural underpinnings of the risk, and some studies have shown altered brain processing of reward in at-risk children as young as 6. An outstanding question remains as to whether children with a maternal history of depression have a biological predisposition to blunted neural reward responding or whether it depends more on social factors. Now, new work finds those dampened responses depended on maternal feedback, suggesting the latter.

The study appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.

Researchers have long observed changes in brain activity associated with depression in adults, particularly in a brain area called the ventral striatum (VS), which is associated with motivation, pleasure, and goal-directed behaviors. Similarly, several studies have shown striatal responses to rewarding experiences are blunted in adolescent children of depressed parents, which predicts later development of depression. However, more recent work shows that these brain changes can emerge long before the teenage years, when the risk for depression typically increases.

For the current study, lead author Judith Morgan, PhD, at the University of Pittsburgh, Pennsylvania, USA, recruited 49 children aged 6 to 8 without a history of psychiatric illness. Half the kids' mothers had a history of clinical depression, and half had no psychiatric history. To measure reward-related brain activity, children played a video game in which they guessed which of two doors contained a hidden token while they underwent functional magnetic resonance imaging (fMRI).

Depression may disrupt parents' capacity for emotional socialization, a process by which kids learn from their parents' reactions to their emotional responses. Positive socialization responses include acknowledgment, imitation, and elaboration, whereas negative or emotionally dampening parental responses may be dismissive, invalidating, or punitive.

Mothers participating in the study completed an extensive questionnaire designed to measure parental emotional socialization by presenting a dozen situational vignettes of children's displays of positive emotions and collecting parents' reactions to them. Strikingly, children with a maternal history of depression were more likely to have reduced reward-related brain activity in the VS, but only if their mothers reported less enthusiastic and more dampening responses to their children's positive emotions, the researchers found.

"In our study, mothers' own history of depression by itself was not related to altered brain responses to reward in early school-age children," said Dr. Morgan. "Instead, this history had an influence on children's brain responses only in combination with mothers' parenting behavior, such as the ability to acknowledge, imitate, or elaborate on their child's positive emotions."

"This is hopeful news as interventions geared at coaching parents to encourage positive emotions in their children may have a powerful impact on child reward-related development, especially for families of children who may be at greater risk because of a family history of depression," Dr. Morgan added.

Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said,

"This important work provides a great example of how clinical neuroscience can reveal neural mechanisms underlying depression and discover new links that may explain why one person has depression and another does not. These links take us beyond clinical observation and therapy alone to open new avenues (such as parenting interventions) for prevention that can promote resilience and wellness."

https://www.sciencedaily.com/releases/2022/03/220323101221.htm

One in three children with disabilities globally have experienced violence in their lifetimes

March 23, 2022

Science Daily/Columbia University's Mailman School of Public Health

Children and adolescents (aged 0-18 years) with disabilities experience physical, sexual, and emotional violence, and neglect at considerably higher rates than those without disability, despite advances in awareness and policy in recent years. This is according to a systematic review of research involving more than 16 million young people from 25 countries conducted between 1990 and 2020. The study provides the most comprehensive picture of the violence experienced by children with disabilities around the world. The findings are published in The Lancet Child & Adolescent Health.

Young people with mental illness and cognitive or learning disabilities (e.g., attention deficit hyperactivity disorder and autism) are especially likely to experience violence, and overall, children with disabilities are more than twice as likely to experience violence compared to those without disabilities, which can have a serious and long-lasting impact on their health and wellbeing.

The findings highlight the urgent need for collaborative efforts by governments, health and social care workers, and researchers to raise awareness of all forms of violence against children with disabilities and to strengthen prevention efforts, according to the authors.

"Children with disabilities face unacceptably high levels of violence worldwide," says Dr. Ilan Cerna-Turoff in the Department of Environmental Health Sciences at Columbia University Mailman School of Public Health, who co-led the study. "Governments face a challenging time in which resources are spread thin in responding to the COVID-19 pandemic and economic and social change. We know that violence prevention leads to better development indicators for our societies. Now, more than ever, violence prevention is a worthy and important investment to secure a better future. Moreover, all people deserve the right to live in a world in which they are safe from violence. Protecting children with disabilities from violence is a fundamental aspect of social justice and equity."

An estimated 291 million children and adolescents have epilepsy, intellectual disability, vision impairment, or hearing loss -- representing about 11 percent of the total child and adolescent population globally. Many more have other physical and mental disabilities. The vast majority of children with disabilities -- more than 94 percent -- live in LMICs where multiple risks converge. Inadequate systems of social protection and access to support, stigma, discrimination, and a lack of information about disability contribute to the higher levels of violence experienced by children with disabilities. This can be further exacerbated by poverty and social isolation. The unique challenges faced by children with disabilities, such as the inability to verbalise or defend themselves, can also make them a target of violence.

In 2012, a systematic review published in The Lancet estimated that more than a quarter of children with disabilities in high-income countries experienced violence and that their odds of experiencing violence were more than three times higher than their non-disabled peers.

This new analysis includes a larger number of studies from a wider geographical area, more types of violence (e.g., peer bullying and intimate partner violence), and a wider range of disabilities (physical limitations, mental disorders, cognitive or learning disabilities, sensory impairments and chronic diseases), as well as using updated methods. It provides current global estimates of violence against children with disabilities, up to September 2020. The new estimates suggest that one in three children with disabilities are survivors of violence and that they are twice as likely to experience violence as non-disabled children.

The researchers did a systematic review and meta-analysis of all observational studies measuring violence against children with disabilities published in 18 English language databases and three regional Chinese databases between 1990 and 2020. Data were analysed for 98 studies involving over 16.8 million children (aged 0-18 years), including 75 studies from high-income countries and 23 studies from seven low-income and middle-income countries.

Analysis of data from 92 studies looking at prevalence found that the overall rates of violence varied by disability and were slightly higher among children with mental disorders (34 percent) and cognitive or learning disabilities (33 percent) than for children with sensory impairments (27 percent), physical or mobility limitations (26 percent), and chronic diseases (21 percent).

The most commonly reported types of violence were emotional and physical, experienced by about one in three children and adolescents with disabilities. The estimates suggest that one in five children with disabilities experience neglect and one in ten have experienced sexual violence.

The study also draws attention to high levels of peer bullying, with almost 40 percent of children with disabilities estimated to have experienced bullying by their peers. In-person bullying (physical, verbal, or relational acts, such as hitting and kicking; insults and threats; or social exclusion) is more common (37 percent) than cyberbullying (23 percent).

In general, children with disabilities living in low-income countries experienced higher rates of violence than those in high-income countries -- possibly as a result of limited access to prevention and support services, lower levels of legal protection, and attitudes and norms that stigmatize people with disabilities and lead to greater social tolerance for violence. A further challenge is that we continue to face gaps in information on low-income and middle-income countries, especially in Southeast and Central Asia and Eastern Europe.

"Violence against children with disabilities is preventable. These children must be given the right life chances now, said co-lead author Dr. Zuyi Fang from Beijing Normal University in China. "The UN Sustainable Development Goals aim to end all forms of violence against children by 2030. Achieving this will require political leaders, practitioners, and researchers to work together to implement what we already know works to prevent violence such as evidence-based parenting interventions, while developing and evaluating effective community, school-based, and on-line interventions that target specific forms of violence."

Writing in a linked Comment, Dr. Tania King from the University of Melbourne in Australia, who was not involved in the study, notes that it is possible that there has been an escalation in rates of violence against children with disability since the COVID-19 pandemic, adding that, "Article 19 of the United Nations Convention on the Rights of the Child, endorsed by many countries around the world, enshrines the rights of children to be protected from violence. As the number of children with disability continues to grow worldwide, we must establish the systems and processes to protect them from violence. Better services and support for children with disability will reduce many of the risk factors that underpin their increased experiences of violence. The imperatives to act are many: they are economic, as the damage wrought by violence is costly. The imperatives are social -- society has much to gain by improving inclusion of those with disability. But importantly the imperatives are moral -- it is unacceptable for current society to tolerate such rates of violence among children with disability."

https://www.sciencedaily.com/releases/2022/03/220322145741.htm

Brain differences in children with binge eating disorder

March 15, 2022

Science Daily/Keck School of Medicine of USC

Brain scans of children ages 9-10 with a type of eating disorder that causes uncontrollable overeating showed differences in gray matter density compared to their unaffected peers, according to a USC-led study.

Binge eating disorder, which affects about 3-5% of the U.S. population, is characterized by frequent episodes of eating large amounts of food and a sense of having no control over the behavior. The study's findings suggest that abnormal development in the brain's centers for reward and inhibition may play a role.

The recently published study is available online in the journal Psychiatry Research.

"In children with binge eating disorder, we see abnormality in brain development in brain regions specifically linked to reward and impulsivity, or the ability to inhibit reward," said lead author Stuart Murray, Della Martin Associate Professor of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of USC, where he serves as director of the Eating Disorders Program.

"These kids have a very, very heightened reward sensitivity, especially toward calorically dense, high-sugar foods. The findings underscore the fact that this is not a lack of discipline for these kids."

Pandemic saw increase in eating disorders among young people

Experts say eating disorders in young people soared during the pandemic, along with steep increases in hospitalizations. Social isolation, stress, disruption of routine and a social media-fueled quest for perfection all exacerbated disorders such as anorexia, muscle dysmorphia and binge eating.

Binge eating disorder puts people at risk for obesity, metabolic syndrome, abnormal cardiac function and suicidal thoughts. Treatment goals include reducing the frequency of binge eating episodes by removing "trigger" foods, as well as addressing underlying anxiety or depression. Treatment with medication and talk therapy is effective about only half the time, Murray said.

For this study, Murray and his colleagues analyzed brain scans and other data from 71 children with diagnosed binge eating disorder and 74 children without binge eating disorder, who are part of a large longitudinal study called the Adolescent Brain and Cognitive Development Study. That study includes data of 11,875 children ages 9-10 who were enrolled in 2016-2018 and recruited from 21 sites around the U.S.

In the children with binge eating disorder, they saw elevations in gray matter density in areas that are typically "pruned" during healthy brain development. Synaptic pruning, a development phase that occurs between ages 2 and 10, eliminates synapses that are no longer used, making the brain more efficient. Disturbed synaptic pruning is linked to a number of psychiatric disorders.

"This study suggests to me that binge eating disorder is wired in the brain, even from a very, very early age," Murray said. "The question that we don't know, which is something that we will address in time, is whether successful treatment of binge eating disorder in kids helps correct brain development. The prognosis of almost all psychiatric diseases is better if you can treat them in childhood."

https://www.sciencedaily.com/releases/2022/03/220315162813.htm

Early English lessons have lasting effects

March 18, 2022

Science Daily/Ruhr-University Bochum

An international research team has examined how English lessons in primary school affect language proficiency in this subject in secondary school. Children who started learning English in the first grade of primary school performed significantly better in listening and reading comprehension in grade nine than children who started in grade three. The study was a continuation of an earlier paper that had only covered the period up to the seventh grade and couldn't find any such learning advantage.

The team headed by Professor Markus Ritter from Ruhr-Universität Bochum (RUB) and Dr. Nils Jäkel from the University of Oulu, Finland, in cooperation with Dr. Michael Schurig from the Technical University of Dortmund, describes their findings in the journal System. The study will be published in the June 2022 edition, but is already freely accessible online. The researchers are collaborating within the university consortium UNIC: European University of Post-Industrial Cities.

Data from North Rhine-Westphalia

The study included data from around 3,000 students who participated in a longitudinal study conducted in North Rhine-Westphalia, Germany, between 2010 and 2014. The same data had also been used in the previous study, the results of which the researchers had published in 2017. At that time, they had compared two cohorts, one of which had started English lessons in grade one, the other in grade three. In grades five and seven, they had compared both cohorts in terms of English reading and listening comprehension. The new analysis incorporated another set of data collected in 2016 to measure the English performance of the same children in grade nine.

The previous study had found: Children who had started English lessons earlier in primary school performed worse in reading and listening comprehension in grade seven than children who had not started English lessons until grade three. However, the new analysis showed: In grade nine, the early starters in English performed better than the late starters in English.

Additional background variables such as gender, language of origin or cognitive abilities could not account for the difference between the poorer performance in the seventh grade and the late learning gains in the ninth grade.

Transition between school types decisive

"We believe the most plausible explanation is that lessons following the transition period in secondary school have been increasingly adapted to the needs of children who start to take English lessons at an early stage," concludes Nils Jäkel, formerly at RUB, now at the University of Oulu. "This explanation is in line with research that considers the transition between school types to play a key role in the long-term success of English language education across school boundaries." With this in mind, it is crucial to optimise the didactic coordination and alignment of English classes at the intersection of school types. In addition, it may be that pupils benefit in the long run from more implicit language lessons in primary school.

"We see a high need for research to elaborate factors for successful language education, and we recommend well-coordinated, evidence-based measures in educational policy overall," say the researchers.

https://www.sciencedaily.com/releases/2022/03/220318104921.htm

Air pollution linked to depressive symptoms in adolescents

Higher ozone levels predicted increase in depressive symptoms over time, study finds

March 14, 2022

Science Daily/American Psychological Association

Exposure to ozone from air pollution has been linked to an increase in depressive symptoms for adolescents over time, even in neighborhoods that meet air quality standards, according to new research published by the American Psychological Association.

Ozone is a gas that is produced when various pollutants from motor vehicle exhaust, power plants and other sources react to sunlight. Higher ozone levels have been linked to various physical ailments, including asthma, respiratory viruses and premature death from respiratory causes. This study is the first to link ozone levels to the development of depression symptoms in adolescents over time. Those symptoms may include persistent feelings of sadness or hopelessness, difficulty with concentration, sleep disturbances and thoughts about suicide.

"I think our findings really speak to the importance of considering air pollution's impact on mental health in addition to physical health," said lead researcher Erika Manczak, PhD, an assistant professor of psychology at the University of Denver.

The researchers analyzed data from a previous study about early life stress with 213 adolescent participants (aged 9 to 13 years old) in the San Francisco Bay area. The researchers compared data about the adolescents' mental health over a four-year period with Census tracts for their home addresses and air quality data for those tracts from the California Environmental Protection Agency.

Adolescents who lived in areas with relatively higher ozone levels showed significant increases in depressive symptoms over time, even though the ozone levels in their neighborhoods didn't exceed state or national air quality standards. The findings weren't affected by the participants' sex, age, race, household income, parental education or socioeconomic characteristics of their neighborhoods. The research was published online in Developmental Psychology.

"It was surprising that the average level of ozone was fairly low even in the communities with relatively higher ozone exposure," Manczak said. "This really underscores the fact that even low levels of ozone exposure have potentially harmful effects."

Ozone and other components of air pollution can contribute to high levels of inflammation in the body, which has been linked to the onset and development of depression. Adolescents may be especially sensitive to these effects because they spend more time outdoors.

The study included a relatively small sample size from one area of the United States. The findings are correlational so it can't be proven that ozone levels caused an increase in depressive symptoms, only that there is a link between them. It's also possible that other components of air pollution besides ozone could be a factor.

Because air pollution disproportionately affects marginalized communities, ozone levels could be contributing to health disparities, Manczak said. Communities also should consider ways to reduce ozone exposure, such as holding youth sporting events indoors when necessary and limiting driving during peak hours of air pollution alerts. Investment in clean and renewable energy sources that reduce air pollution also could be helpful.

"I believe state and federal air quality standards should be stricter, and we should have tighter regulations on industries that contribute to pollution," Manczak said. "Our findings and other studies suggest that even low levels of ozone exposure can pose potentially serious risks to both physical and mental health."

https://www.sciencedaily.com/releases/2022/03/220314095659.htm

Frequent external childcare can affect children's behavior

March 10, 2022

Science Daily/University of Zurich

How does childcare outside of the family affect the development of children and adolescents? To answer this question, researchers at the University of Zurich surveyed around 1,300 Zurich school children, their parents and teachers. The survey suggests that the more time children spend in external daycare, the more likely they are to exhibit problematic behavior; however, this behavior generally disappears at the end of primary school.

The Jacobs Center for Productive Youth Development at the University of Zurich has conducted a study to examine how external childcare influences the development of children into young adulthood. The analyzed data were collected as part of the Zurich Project on the Social Development from Childhood into Adulthood (z-proso) and consisted of around 1,300 school children aged between seven and 20 in the city of Zurich.

Effects at primary school age

Around 67 percent of the children in the survey received external childcare before entering kindergarten. 32 percent of these children attended a daycare center, and 22 percent a playgroup. Another 22 percent received care from an external family member, 3 percent from acquaintances or neighbors, and 12 percent from daycare mothers. The researchers asked the children as well as their parents and teachers about externalizing or internalizing behavior problems, delinquency and substance use. The survey showed that the observed behaviors in primary school-aged children differed depending on the respondents and the type of external daycare.

According to the parents, primary school pupils were more likely to show aggression, display symptoms of ADHD, and experience anxiety and depression the more time they had spent in a daycare center before entering school. This finding was also supported by some of the children's own assessments. According to the teachers, hyperactivity, lack of impulse control, inattention or aggression were more likely to occur in school children who had spent more than two days a week with a daycare mother or at least three days a week in a playgroup.

Problem behavior usually disappears

How can these findings be explained? "It's possible that external childcare may lessen the strength of child-parent attachment and interaction," says first author Margit Averdijk. But it is also possible that children in center-based care or playgroups learn problem behavior from their peers and sometimes use it to get attention from caregivers.

"Although we can't directly check which of these mechanisms is the most likely explanation for our results, both of them support our findings," explains the researcher. The good news is that the problematic behavior observed in primary school-aged children decreases as the children get older and mostly disappears from the age of 13. Symptoms of ADHD were the only ones to persist into adolescence.

No general link to substance use in adolescents

Moreover, the researchers found no evidence that generally links external childcare settings to delinquency and substance use in adolescents. An exception was the link between daycare attendance and substance use, which persisted into young adulthood for those from vulnerable backgrounds. "Our study indicates that these children are also more likely to experience anxiety or depression as they grow older, which may become more acute as a result of the parents' absence," Averdijk explains.

Interpret with caution

"Our study sheds light on some possible unfavorable links between external childcare and children's later development," says last author Manuel Eisner. However, the professor of sociology urges not to jump to conclusions. He adds that while the study meets the highest scientific standards, it is based on observational data and surveys that do not always allow clear conclusions to be drawn about causation. Furthermore, the study was not able to take into account the quality of childcare received outside of the family.

https://www.sciencedaily.com/releases/2022/03/220309140902.htm

Study hints at how early life experiences may affect brain wiring

Observing brain development in mice offers insights into neurological diseases

March 9, 2022

Science Daily/Ohio State University

A new study of brain development in mice shortly after birth may provide insights into how early life events can affect wiring patterns in the brain that manifest as disease later in life -- specifically such disorders as schizophrenia, epilepsy and autism.

Researchers focused on two types of brain cells that have been linked to adult neurological disorders: neurons in a modulating system nestled deep in the brain and other neurons in the cortex, the brain's outermost layer, that counteract excitation in other cells using inhibitory effects. The modulating cells send long-range cables to the cortex to remotely influence cortical cell activity.

The study is the first to show that these two types of cells communicate very early in brain development. A chemical released from the modulating cells initiates the branching, or arborization, of axons, the long, slender extensions of nerve cell bodies that transmit messages, on the cortical cells -- and that arborization dictates how effective the cells in the cortex are at doing their job.

Though there is still a lot to learn about the impact of this cellular interaction in the postnatal brain, the researchers said the study opens the door to a better understanding of how neurological diseases in adults may relate to early-life events.

"It's known that abnormal early-life experiences can impact kids' future sensation and behavior. This finding may help explain that kind of mechanism," said Hiroki Taniguchi, associate professor of pathology in The Ohio State University College of Medicine and senior author of the study.

"This study provides new insight into brain development and brain pathology. It's possible that during development, depending on animals' experiences, this modulating system activity can be changed and, accordingly, the cortical circuit wiring can be changed."

Taniguchi completed the work with co-authors André Steinecke and McLean Bolton while he was an investigator at the Max Planck Florida Institute for Neuroscience.

The research is published today (March 9, 2022) in the journal Science Advances.

The study involved chandelier cells, a type of inhibitory neurons in the cortical section of the brain, and neurons of the cholinergic system -- one of the systems that monitor the environment and the internal state, and send signals to the rest of the brain to trigger memory and appropriate behaviors.

"Both of these types of cells have been separately studied in the context of adult functions or modulations so far. The developmental role of cholinergic neurons in the brain wiring remains poorly understood," Taniguchi said.

Chandelier cells are named for the spray of signal-transmitting synapses (called synaptic cartridges) at the branch terminals that resemble candles of a traditional chandelier, a pattern that gives them inhibitory control over hundreds of cells at a time.

"These cells have output control," said Steinecke, first author of the study who is now working at Neuway Pharma in Germany. "Chandelier cells can put a brake on excitatory cells and tell them they're not ready to fire. As inhibitory cells, chandelier cells are thought to regulate waves of firing -- which is important, because the waves contain information that is transmitted over large distances of the brain."

Previous post-mortem studies have shown that the synaptic terminals located at the end of chandelier cell axons appear to be reduced in the brains of patients with schizophrenia.

"This axonal 'arbor' being reduced suggests they don't make as many connections to downstream targets, and the connections themselves are also altered and don't work that well," Steinecke said.

The team used two techniques to observe chandelier cells during early-life brain development in mice: genetically targeting and using a dye to label and detect cells that differentiate into chandelier cells, and transplanting genetically manipulated cells back into animals shortly after birth.

"This enabled us to watch brain development as it happens and manipulate conditions to test what the mechanisms are," Taniguchi said.

The researchers first observed how chandelier cell axons develop their branching structures, noting that small protrusions emerging from axons were the first signs that branches would sprout. And they identified the chemical needed to start that sprouting process -- the neurotransmitter acetylcholine, which is released by cholinergic system cells.

The interaction between the distant cell types was confirmed through a series of experiments: Knocking out receptors that bind to acetylcholine and decreasing activity of cholinergic neurons lessened branch development, and making cholinergic neurons more likely to fire led to more widespread branching.

"The key is that we didn't previously know how neuromodulatory systems regulate the cortical circuits -- and both of them have been implicated in brain diseases," Taniguchi said. "Now that we've found that cholinergic neurons could remotely impact cortical circuit development, especially cortical inhibitory signals, the question is what kind of environment or emotional state of change can impact cortical inhibitors' development? We may want to see if we can find a link as a next step."

https://www.sciencedaily.com/releases/2022/03/220309140836.htm

Reading builds resilience among at-risk kids

March 8, 2022

Science Daily/University of South Australia

As children settle back into a new school year, families are being encouraged to read to their children at home, as new research from the University of South Australia shows that reading aloud can triple a child's resilience at school, particularly for children at-risk.

Focussing on early primary-aged children who had suffered abuse or neglect, the study explored factors that could modify the negative effects of adverse life circumstances, finding that one of the biggest predictors of resilience in both boys and girls in struggling families was being read to at home.

While reading to children at home has long been associated with school readiness and scholastic outcomes, this is the first study that has shown the benefits of reading to mitigate some of the detrimental trajectories of child maltreatment.

In Australia in 2021, nearly 300,000 children aged 0-17years had one or more child protection notifications with 105,000 the subject of an investigation and nearly 50,000 the subject of substantiated abuse or neglect.

The study found that victims of child maltreatment are generally more developmentally vulnerable than their peers at the start of school.

Lead researcher, Professor Leonie Segal says there is an acute need to support these children and their families, before the children start school, with reading being a key factor for success.

"A good start to school is predictive of later outcomes, so it's vital that we not only identify those at risk early on, but also find ways to support children's emotional, social and physical development, before they start school," Prof Segal says.

"Reading out loud can create many positive outcomes for children. As a shared experience between parent and child, it encourages connection, while also directly contributing to child development through exposure to words and stories.

"Children in families that are struggling to create a nurturing environment will especially benefit from reading with a parent or carer, improving their resilience and keeping them developmentally more on track, despite their adversity exposure."

The study analysed data covering 65,083 children who had completed the Early Australian Development Census (AEDC) at 5 to 6 years old, when starting primary school, identifying 3414 high-risk children who had experienced maltreatment.

Boys were found to be developmentally behind girls, particularly those who had been exposed to abuse or neglect.

Prof Segal says the education sector must look at strategies to better support boys in early learning environments.

"Our study found that boys had a much higher risk of being developmentally behind than girls, as did children living in remote or rural areas, and those with a physical, sensory, or learning disability. All these groups need far greater supports," Prof Segal says.

"Paying particular attention to boys, especially those who are victims of child maltreatment is critical. Encouraging parents to read to their boys while valuable, is not enough, the onus is on the education sector to identify other mechanisms to support boys."

"This could include recruiting more male educators into early childhood settings and ensuring learning approaches are sensitive to the specific needs of boys."

"Males currently make up less than five per cent of the early childhood education workforce, with their presence in primary schools also declining. Boosting the gender balance among educators could be an important step to helping boys."

"Understanding which attributes can help young children to be more resilient -- or conversely which factors can put them at greater risk -- can form the basis of interventions for child victims of maltreatment to improve life trajectories."

"Every child deserves the chance for a bright future. We must not overlook those most at risk."

https://www.sciencedaily.com/releases/2022/03/220308102826.htm

Time off after high school makes college less likely

March 3, 2022

Science Daily/Cornell University

Academic breaks after high school -- even those lasting just a few months -- can cause some students, especially those from disadvantaged backgrounds, to forgo enrolling in college altogether, according to new Cornell University research.

In the paper, "Disrupted academic careers: The returns to time off after high school," Evan Riehl, assistant professor in the ILR School, and co-author Nicolás de Roux of the Universidad de los Andes found that even a brief academic break led to an 8% reduction in college enrollment rates in two regions of Colombia. The researchers found that among those students, the break had the largest impact on those from disadvantaged academic and socioeconomic backgrounds.

The researchers also found that the academic break reduced the early-career earnings of high-ability students, but had little impact on the earnings for less-prepared students.

"In Colombia, as in many countries, college dropout rates are really high," Riehl said. "There is wide variation in the quality of colleges and the amount of resources that colleges have to help students graduate. So students must be academically prepared and motivated to earn a degree.

"We find that individuals who were prepared to succeed in college would have had large returns to attending college, and in this sense they made a 'mistake' by not enrolling," he said. "Other students, however, may have dropped out of college anyway, and so forgoing college did not have a big impact on their careers."

To conduct their study, Riehl and de Roux took advantage of a policy change that altered academic calendars in two Colombian regions, requiring nearly 30,000 high school graduates to wait an extra semester to start college. For data, they merged records from a national standardized high school exit exam to college enrollment and earnings records from the Ministries of Education and Social Protection.

The results of the study suggest that a variety of "mistakes" can arise in the transition from high school to college, and that there can be benefits to education systems, like those used in some European countries, that track students into appropriate postsecondary options.

"In the U.S. and Colombia, students have more flexibility in choosing which colleges to apply to after high school," wrote the authors. "More flexible education systems can lead to indecision in the transition from high school to college, and thus create breaks in students' academic careers. … The returns to college may be low if students are less prepared or less motivated."

https://www.sciencedaily.com/releases/2022/03/220303125018.htm

Children eat what they like, but food intake driven more by what they dislike

February 22, 2022

Science Daily/Penn State

It is often said that "children eat what they like," but the results of a new study by Penn State nutritionists and sensory scientists suggests that when it comes to meals, it is more accurate and more relevant to say, "children do not eat what they dislike."

There is an important difference, according to lead researcher Kathleen Keller, associate professor in the departments of Nutritional Sciences and Food Science, who conducted an experiment involving 61 children ages 4-6 years to assess the relationship between their liking of foods in a meal and subsequent intake. The research revealed that when presented with a meal, disliking is a stronger predictor of what youngsters eat than liking.

"In other words, rather than high-liking driving greater intake, our study data indicate that lower-liking led children to avoid some foods and leave them on the plate," she said. "Kids have a limited amount of room in their bellies, so when they are handed a tray, they gravitate toward their favorite thing and typically eat that first, and then make choices about whether to eat other foods."

Study co-author John Hayes, professor of food science and director of the Sensory Evaluation Center in the College of Agricultural Sciences, puts it another way.

"For 50 plus years, we've known liking and intake are positively correlated, but this often leads to the mistaken assumption that if it tastes better, you will eat more," he said. "Reality is a bit more nuanced. In adults, we know that if you really like a food, you may or may not eat it. But if you don't like it, you'll rarely or never eat it. These new data show the same pattern is true in young kids."

Children participated in two identical laboratory sessions in the study conducted in Keller's Children's Eating Behavior Laboratory in the College of Health and Human Development, where seven foods -- chicken nuggets, ketchup, potato chips, grapes, broccoli, cherry tomatoes and cookies -- were included on a tray. Also included were two beverages, fruit punch and milk.

Before eating the meals, children were asked to rate their liking of each food on the following five-point scale -- Super Bad, Bad, Maybe Good-Maybe Bad, Good and Super Good. After the children had eaten as much of the meal as they wanted, the researchers weighed what they ate and compared the results with what the kids said they liked and disliked. The correlations were striking.

In findings recently published in the journal Appetite, the researchers reported that the relationship between liking and intake was not strong for most of the foods. For instance, only liking for potato chips, grapes, cherry tomatoes and fruit punch was positively associated with the amount consumed. But no associations were found between liking and intake of other meal items.

However, there was a strong correlation between consumption -- or nonconsumption in this case -- and the foods the children said they didn't like. At a multi-component meal, rather than eating what they like, these data are more consistent with the notion that children do not eat what they dislike, the researchers concluded.

Even at a young age, children's food choices are influenced by their parents and peers, Keller pointed out. So, we need to be careful with assumptions about what truly is driving their behavior when they sit down to eat a meal.

"They pick up on what is said around the table about what foods are good, and while that may not actually correspond to kids eating them, they are taking it all in, and that's affecting their perceptions of foods," she said. "Milk is a good example of that -- for some families, there may be a health halo effect around milk. Kids learn from an early age that drinking milk will give them a strong body, so they may drink milk even if it's not their favorite beverage."

Because children in the United States continue to consume insufficient amounts of vegetables, the findings of research projects such as this one are of great interest to parents, many of whom struggle to get their kids to eat vegetables, Keller believes. Parents want to know how they can improve their kids' nutrition.

"Some parents struggle with kids who are very picky eaters," she said. "That can cause long-term nutrition issues and creates a lot of stress for the family. I think picky eating is one of the most common complaints that I hear from parents -- 'How do I get my child to accept more foods? How do I make the dinner experience better and easier for my family?'"

https://www.sciencedaily.com/releases/2022/02/220222161826.htm

Adolescent psychological well-being tied to adult risk of cardiovascular disease

Researchers find that people who are more upbeat in their youth can lower their chances for heart disease as adults

February 22, 2022

Science Daily/University of Missouri-Columbia

Scientists have known for years that a person's risk of cardiovascular disease (CVD) can be lowered with lifestyle changes such as modifying diet, exercise, alcohol and tobacco use. Now Anand Chockalingam and Sharan Srinivas at the University of Missouri demonstrate in a new study that a long-term association also exists between an adolescent's psychological well-being and their risk of CVD as an adult.

Specifically, Chockalingam, a professor of clinical medicine, and Srinivas, an assistant professor of industrial and manufacturing systems engineering, have found that people who are more optimistic or positive when they are adolescents can lower their chances of being in the high-risk category for CVD as an adult.

"Here, we are recognizing the role of the environment and lifestyle in heart disease," said, Chockalingam, who is also a cardiologist with MU Health Care. "Some prior research has shown that more than 80% of all heart attacks can be prevented with a few simple lifestyle interventions at any point in the individual's life. Although a heart attack may occur at the age of 55, the underlying buildup of plaque or atherosclerosis starts much earlier, often in teenage years. By exploring healthy habits and connecting with optimistic peers in the impressionable teenage years, it becomes intuitive to sustain a good lifestyle."

Chockalingam believes this study emphasizes the value of optimism in an adolescent's life.

"Adolescents are simultaneously understanding the world as well as their own inner nature and mindset," Chockalingam said. "Therefore, parents and other caregivers have a substantial role in the lifetime resilience and outlook of children. The biggest legacy that anyone can pass on for subsequent generations is optimism."

The team analyzed data from study participants involved with the National Longitudinal Study of Adolescent to Adult Health (Add Health). Chockalingam said the database served as a rich source of information for their study.

"The Add Health database meticulously collected data from over 20,000 adolescents when they were about 15 years of age, and followed up every few years afterwards with repeated surveys of several hundred health aspects for the same group of children," Chockalingam said. "This gives us a unique window into the lifetime risk and correlation between various social, economic, psychological and genetic health determinants."

A shared interest in tennis

Both researchers have personal experience that reflects the results of their study. Srinivas credits his involvement in sports as a youth in India, including playing competitive tennis until age 18, for leading to a life and career advocating for a healthy lifestyle, both mentally and physically.

His passion, along with a continued interest in playing tennis, also led to a serendipitous research collaboration with Chockalingam. What began as a friendly game of tennis between two working professionals -- Srinivas and Chockalingam -- grew over time to include discussions of their mutual interests in health care-related research. Eventually, the two began working together on research projects, and their expertise complements one another -- Srinivas focuses on data analytics and industrial engineering tools to improve both the patient and health care provider experience; Chockalingam provides clinical insights and a health care provider perspective.

Integrating engineering and health care

Srinivas believes this study could help clinicians develop a personalized approach to lower someone's CVD risk by integrating problem-solving techniques currently used by industrial engineers that place an emphasis on prevention and early detection.

"There are several step-by-step techniques established by industrial engineers that help with early detection of problems in the manufacturing and service industries," said Srinivas, who has a joint appointment in the Trulaske College of Business. "This is an opportunity to adapt some of these techniques to enable health care practitioners to monitor the well-being of an adolescent over time, because that's the formative stage where your outlook on life is established, and it doesn't change much after that."

Srinivas acknowledges this study is only a first step toward establishing the association between adolescent well-being and CVD risk. He believes additional analysis of other data sets are needed to help overcome a limitation they had in this study, which was only taking a snapshot of someone's life during adolescence and again during young adulthood. He says there needs to be additional insights into how people are doing in between these life stages.

In the future, Srinivas would like to explore the use of other industrial engineering and data analytics techniques, such as machine learning.

"We want to use these techniques to help predict the long-term risk for CVD among adolescents, and uncover the impact that underlying factors can have on a person's chance to develop CVD, including the influence of a person's well-being," Srinivas said.

"Adolescent psychological well-being and adulthood cardiovascular disease risk: longitudinal association and implications for care quality management," was published in Benchmarking: An International Journal. Kavin Anand, an undergraduate student at Stanford University, also contributed to this work.

https://www.sciencedaily.com/releases/2022/02/220222135446.htm

One in three young people say they felt happier during lockdown

February 22, 2022

Science Daily/University of Cambridge

One in three young people say their mental health and wellbeing improved during COVID-19 lockdown measures, with potential contributing factors including feeling less lonely, avoiding bullying and getting more sleep and exercise, according to researchers at the universities of Cambridge and Oxford.

As the COVID-19 pandemic swept the world, many countries imposed strict lockdown measures, with workplaces and businesses closing and people forced to remain at home. Measures also included school closures, with exceptions for young people whose parents were classified as essential workers and those considered 'vulnerable', for example children under the care of social services and those in families or social situations deemed by schools to be of concern.

Several studies have reported that the lockdown had a negative impact on the mental health and wellbeing of young people, but this effect has not been uniformly reported, with a number of studies suggesting that some young people may have benefited from lockdown.

Emma Soneson, a PhD student and Gates Scholar at the Department of Psychiatry, University of Cambridge, said: "The common narrative that the pandemic has had overwhelmingly negative effects on the lives of children and young people might not tell the full story. In fact, it seems as though a sizeable number of children and young people may have experienced what they felt was improved wellbeing during the first national lockdown of 2020.

"After hearing from patients in our clinical practice and informally from several parents and young people that they thought the lockdown was beneficial for their or their child's mental health, we decided to look at this trend."

Ms Soneson and colleagues explored this issue using the OxWell Student Survey, a large, school-based survey of students aged eight to 18 years living in England. More than 17,000 students took part in the June/July 2020 survey, during the tail end of the first national lockdown, answering questions about their experiences of the pandemic, school, home life, and relationships, among others. The results of their research have been published in European Child and Adolescent Psychiatry.

The team found that one in three students thought their mental wellbeing had improved during the first lockdown. In fact, an almost identical number of students fell into each of the three categories: their mental wellbeing had improved; there had been no change; or they had experienced a deterioration to their wellbeing.

The highest proportions of students who reported improved mental wellbeing were among those who were in school every day (39%) and most days (35%), while the highest proportion of students who reported worse wellbeing were those who attended just once or twice (39%).

Students who felt they had had better wellbeing during lockdown were more likely than their peers to report positive lockdown experiences of school, home, relationships, and lifestyle. For example, compared with their peers, a greater percentage of students reporting better wellbeing also reported decreases in bullying, improved relationships with friends and family, less loneliness, better management of schoolwork, more sleep, and more exercise during lockdown compared with before.

Professor Peter Jones, also from Department of Psychiatry at the University of Cambridge, said: "What we've seen is a complex mix of factors that affect whether a child's mental health and wellbeing was affected by the lockdown. These range from their mental health before the pandemic through to their relationships with their families and peers, and their attitudes towards school."

While previous studies have reported young people worrying about the impact of lockdown on friendships, nearly half of those who reported improved mental wellbeing in this new study reported feeling less left out and lonely and having better relationships with friends and family. In part, this may be because access to digital forms of social interaction can mitigate the negative effects of reduced face-to-face contact. With many parents and carers at home, there was also potential for improved family relationships.

One specific aspect of peer relationships that changed during the pandemic was bullying. The researchers found that most young people who had been bullied in the past year reported that the bullying had reduced. The proportion that reported that they were bullied less than before lockdown was higher for those who reported improved wellbeing (92%) than for those who reported no change (83%) or deterioration in their wellbeing (81%).

For approximately half of the young people who reported improved mental wellbeing, lockdown was associated with improvements in sleep and exercise -- for example, 49% of those who reported improved mental wellbeing reported sleeping more, compared with 30% of those who reported no change and 19% of those who reported deterioration.

Family relationships also clearly played a part: the proportion of students who reported that they were getting along with household members better than before lockdown was higher for the group who reported improved mental wellbeing (53%) than for the groups who reported no change (26%) or deterioration (21%), with a similar pattern for getting along with friends (41%, 26%, and 27% respectively).

Professor Mina Fazel from the Department of Psychiatry at the University of Oxford said: "While the pandemic has undoubtedly had negative consequences for many, it is important to keep in mind that this is not the case for all children and young people. We are interested in how we can learn from this group and determine if some of the changes can be sustained in order to promote better mental health and wellbeing moving forward."

Some of the school-related factors that may have influenced how a young person responded to the lockdown include: the increased opportunities for flexible and tailored teaching that encouraged different styles of learning; smaller class sizes and more focused attention from teachers for those attending school; and later waking times and more freedom during the school day.

https://www.sciencedaily.com/releases/2022/02/220222135415.htm

Want students to do better in class? Send them on culturally enriching field trips

February 22, 2022

Science Daily/Brigham Young University

Students who attended three different field trips in fourth or fifth grade scored higher on end-of-grade exams, received higher course grades, were absent less often and had fewer behavioral infractions. These benefits were strongest when students entered middle school.

School field trips have been part of the educational experience for children across the nation for decades. While many school administrators believe there's intrinsic value in letting students develop socially with out-of-classroom experiences, quantifying the impact and the value of field trips is difficult. And justifying out-of-class time can be burdensome for teachers tasked with providing a good education amid the pandemic.

As such, many art venues, science museums and zoos have reported declines in field trip attendance. Teachers and students have also reported decreasing amounts of school-sponsored trips, particularly for minority students in academically low-performing schools.

But thanks to new research from BYU, Johns Hopkins University and the Heritage Foundation, the value of field trips is finally being understood and measured. The study, published in The Journal of Human Resources, found that students who participate in multiple field trips during the school year have higher test scores, perform better in class and have increased cultural conscientiousness over time.

"Contrary to practice where schools, facing accountability pressures, trade extracurriculars for increased seat time, we found that there's no harm to academics by taking time out of the classroom," said Heidi Holmes Erickson, assistant professor of educational leadership at BYU and lead author of the study. "It's possible to expose students to a broader world and have culturally enriching curriculum without sacrificing academic outcomes, and it may actually improve academic outcomes."

The study used an experimental design and randomly assigned fourth- and fifth-grade students from fifteen elementary schools in the Atlanta, Georgia, area to participate in three culturally enriching field trips during a school year. The field trips included a trip to an art museum, a live theater performance and a symphony concert.

Students who attended three different field trips in fourth or fifth grade scored higher on end-of-grade exams, received higher course grades, were absent less often and had fewer behavioral infractions. These benefits were strongest when students entered middle school.

"We anticipated that field trips wouldn't harm test scores. However, we started seeing academic improvements and realized that students who participated in these field trips were doing better in class," said Erickson. "One potential reason for this is that field trips expand students' world concept and expose them to new ideas. Similarly, students might be more engaged in school thanks to field trips. Students find school more exciting and want to try harder in class."

In addition to the academic improvements, students who participated in multiple field trips were 12% of a standard deviation more likely to express a desire to consume arts in the future and nearly 14% of a standard deviation more likely to agree with the statement, "I believe people can have different opinions about the same thing."

Researchers say this is more evidence that field trips are beneficial not only for academic success but for individual character development as well.

"Parents are very interested in the academic quality of their child's school, but they're also interested in the social skills and social engagement habits they develop. Cultural field trips are easy ways to help facilitate both."

Erickson says she's hopeful this study will be a resource for policymakers and school principals who are interested in improving children's growth during the children's school experience. When considered in the context of the pandemic, she says this research should be a caution to administrators who are considering eliminating out-of-class opportunities.

"Field trips have been non-existent for the last two years, and many cultural institutions like museums and science centers were closed. Schools want to make up learning loss from the pandemic and might feel pressure to sacrifice a well-rounded education for increased seat-time," says Erickson. "Field trips might be the first thing to go. Addressing student learning loss is crucial, but schools should be thoughtful in their approach."

https://www.sciencedaily.com/releases/2022/02/220222125106.htm

Positive parenting can reduce the risk that children develop obesity

February 22, 2022

Science Daily/Penn State

New research from Penn State found that children with positive, early interactions with their care givers -- characterized by warmth, responsiveness, and a sitmulating home environment -- were at reduced risk of childhood obesity.

"A lot of the discussion around childhood obesity and other health risks focuses on identifying and studying the exposure to risk," said Brandi Rollins, assistant research professor of biobehavioral health. "We took a strength-based approach in our analysis. We found that a supportive family and environment early in a child's life may outweigh some of the cumulative risk factors that children can face."

The study, "Family Psychosocial Assets, Child Behavioral Regulation, and Obesity," recently appeared in the journal Pediatrics. In the article, Rollins and Lori Francis, associate professor of biobehavioral health, analyzed data from over 1,000 mother-child pairs and found that children's early exposures to family psychosocial assets -- including a quality home environment, emotional warmth from the mother, and a child's ability to self-regulate -- reduced the risk of developing childhood obesity.

Encouragingly, these factors were protective even when children faced familial risks for obesity, including poverty, maternal depression, or residence in a single-parent home.

"Research on parenting has shown that these types of family assets influence children's behavior, academic success, career, and -- not surprisingly -- health," Rollins said. "It is significant that these factors also protect against childhood obesity because the family assets we studied are not food or diet-specific at all. It is heartening to know that, by providing a loving, safe environment, we can reduce the risk that children will develop obesity."

Severe obesity

Children are deemed to have obesity when their body mass indices (BMIs) are greater than 95% of other children their age and gender. There is a great deal of variance, however, in the BMIs of children who exceed the obesity threshold. Children whose BMI is 20% higher than the obesity threshold are considered to have severe obesity.

The researchers found that children who had early-onset severe obesity did not face greater levels of family risk than children who were not obese. Children with severe obesity, however, did have fewer family assets than children who were not obese or who displayed moderate levels of obesity. More research is needed to understand which factors contribute to the development of severe obesity and which factors reduce the risk.

"Though the findings on severe obesity may seem discouraging, they offer some hope," Rollins explained. "Some risk factors, like household poverty, can be very difficult to change. Assets, on the other hand, may be easier to build. People can learn to parent responsively. It is encouraging that parenting really matters, that family matters."

What parents can do

This work is based on research in parenting and child development. Responsive parenting, one of the family assets measured in the study, involves responding to children in a timely, sensitive, and age-appropriate manner based on the child's presenting needs. Researchers in Penn State's Center for Childhood Obesity Research are also exploring how responsive parenting can reduce the risk of childhood obesity.

This study focused on childhood obesity, but the researchers said that parents may improve many outcomes for their children by learning responsive-parenting skills. Knowledge of responsive-parenting skills, however, may not lead directly to implementing those skills in the home.

"No one can read a pamphlet about cars and suddenly expect to drive," said Rollins. "Driving is a skill that requires education and practice. The same is true of responsive parenting.

"Public health professionals, clinicians, and researchers must collaborate to help families develop psychosocial assets, including responsive parenting and a structured home environment," she continued. "This could improve childhood obesity rates and other important quality-of-life outcomes."

https://www.sciencedaily.com/releases/2022/02/220222135155.htm

Children with insomnia likely to continue to suffer as adults, long-term study finds

February 17, 2022

Science Daily/Penn State

Children with insomnia symptoms are likely to persist with them as young adults and are significantly more likely to develop an insomnia disorder in early adulthood compared to children who do not have difficulty sleeping, according to new research led by scientists at Penn State College of Medicine. The study is the first long-term cohort study to describe the developmental trajectories of childhood insomnia symptoms through adolescence and into young adulthood.

"Young adulthood is a stage in life where there is a documented increase in the severity and prevalence of physical and mental health problems, such as cardiovascular disease and suicide rates," said Julio Fernandez-Mendoza, associate professor of psychiatry and behavioral health. "Sleep disorders -- especially sleep apnea and insomnia -- are linked with poorer cardiovascular and mental health. Given that up to 25% of children, 35% of adolescents and 45% of young adults suffer from insomnia symptoms, we were interested in learning how these symptoms evolve over time as the child grows into adulthood."

The team's longitudinal study, which began in the year 2000, was designed as a random, population-based study of children, ages 5-12 years. Children and their parents provided reports of the children's insomnia symptoms -- defined as moderate-to-severe difficulties initiating and/or maintaining sleep. The children also participated in an objective in-laboratory sleep study using polysomnography, which can identify sleep apnea and other indicators such as the amount and quality of sleep. The team studied 502 children 7.4 years later as adolescents (median 16 years old) and 15 years later as young adults (median 24 years old).

The team found that 43% of children with insomnia symptoms continued to suffer through adolescence into adulthood. Although about 27% of children with insomnia symptoms experienced remission of symptoms by adolescence, close to 19% experienced a waxing and waning pattern into adulthood. Among children without insomnia symptoms, about 15% of them developed insomnia symptoms in the transition to adolescence and persisted with them into adulthood, and another 21% newly developed them in young adulthood. In addition, about 16% of these children without insomnia symptoms experienced a waxing-and-waning pattern.

"We know that not everyone who complains of insomnia symptoms has the same degree of sleep disturbance when sleep is measured objectively in the laboratory, so it was important that our study included these objective in-lab measurements in addition to the self-reports," said Fernandez-Mendoza. "Indeed, the study found that insomnia symptoms in adolescents who slept short in the lab were 5.5 times more likely to worsen into adult insomnia, while those who reported the same insomnia symptoms and slept normally in the lab were not at increased risk of worsening into adult insomnia.

The results published today (Feb. 16) in the journal Pediatrics.

"The key finding of this study is that insomnia symptoms in childhood are much more likely to persist over time than we previously believed," said Fernandez-Mendoza. "Those with insomnia symptoms and laboratory-measured short sleep duration are much more likely to evolve to develop a clinical condition in early adulthood, and not just to persist with the symptoms. So, parents and clinicians should not assume that insomnia symptoms are benign complaints that will go away with age. That's not what our study shows for a significant proportion of youth."

Fernandez-Mendoza added that on the flip side, many adults who have insomnia may have had problems sleeping as a child.

"Although adults' sleep issues tend to be triggered by their most recent life stressors, for some people, their insomnia may track back to sleep problems starting in childhood," he said.

Although the team did not investigate the underlying causes for children's sleep issues, Fernandez-Mendoza said the primary causes are typically 'behavioral,' such as when a child does not want to go to sleep or needs a parent in the room to fall asleep or resume sleep; psychiatric and behavioral disorders, such as attention deficit hyperactivity disorder, autism or mood disorders; and medical conditions, such as headaches or gastrointestinal problems. However, he emphasized that gender, race and socioeconomic factors need always to be taken into account.

"We know there are health disparities in insomnia symptoms," said Fernandez-Mendoza. "For example, our prior studies showed that females after puberty; racial and ethnic minorities, specifically Black/African American; and children from low socioeconomic households are more likely to have insomnia symptoms that persist in the transition to adolescence."

Fernandez-Mendoza noted that the team's findings suggest that childhood insomnia symptoms require early intervention, while adolescence is a critical time to address chronic sleep issues. Interventions can include behavioral therapy for behavioral insomnia of childhood and appropriate treatments for medical or psychiatric conditions. The first-line intervention in adults is cognitive behavioral therapy for insomnia (CBTI), which is also demonstrating to be highly effective in youth, particularly in adolescents.

In addition to examining the trajectory of insomnia symptoms over time, the researchers also collected data on health outcomes and are currently in the process of finalizing the publication of those data.

"We know that poor sleep is related to adverse health outcomes," said Fernandez-Mendoza. "We suspect that many children who experience insomnia symptoms that persist into adulthood will also suffer from some negative health consequences."

Other Penn State authors on the paper include Kristina Lenker, assistant professor of psychiatry and behavioral health; Susan L. Calhoun, associate professor of psychiatry and behavioral health; Myra Qureshi, administrative assistant; Anna Ricci, graduate student; Fan He, instructor; Alexandros N. Vgontzas, professor of psychiatry; Jiangang Liao, professor of public health sciences; Duanping Liao, professor of public health sciences and vice chair for research; and Edward O. Bixler, professor of psychiatry. Elizaveta Bourchtein, postdoctoral fellow, University of Michigan, also is an author.

The National Heart, Lung, and Blood Institute; National Institute of Mental Health; and National Center for Advancing Translational Sciences supported this research.

https://www.sciencedaily.com/releases/2022/02/220217122401.htm