Exploring mediating factors in the association between parental psychological distress and psychosocial maladjustment in adolescence

Abstract: Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family’s well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents

Family social environment in childhood and self-rated health in young adulthood

<p>Abstract</p> <p>Background</p> <p>Family social support, as a form of social capital, contributes to social health disparities at different age of life. In a life-course epidemiological perspective, the aims of our study were to examine the association between self-reported family social environment during childhood and self-reported health in young adulthood and to assess the role of family functioning during childhood as a potential mediating factor in explaining the association between family breakup in childhood and self-reported health in young adulthood.</p> <p>Methods</p> <p>We analyzed data from the first wave of the Health, Inequalities and Social Ruptures Survey (SIRS), a longitudinal health and socio-epidemiological survey of a random sample of 3000 households initiated in the Paris metropolitan area in 2005. Sample-weighted logistic regression analyses were performed to determine the association between the quality of family social environment in childhood and self-rated health (overall health, physical health and psychological well-being) in young adults (n = 1006). We used structural equation model to explore the mediating role of the quality of family functioning in childhood in the association between family breakup in childhood and self-rated health in young adulthood.</p> <p>Results</p> <p>The multivariate results support an association between a negative family social environment in childhood and poor self-perceived health in adulthood. The association found between parental separation or divorce in childhood and poor self-perceived health in adulthood was mediated by parent-child relationships and by having witnessed interparental violence during childhood.</p> <p>Conclusion</p> <p>These results argue for interventions that enhance family cohesion, particularly after family disruptions during childhood, to promote health in young adulthood.</p

La résilience (d'un concept clinique à son application dans le champ de la santé publique)

Le concept de résilience est né de l observation clinique du développement d enfants ayant survécu à des événements de vie traumatiques. Les interrogations qu ont soulevées les trajectoires de vie de ces enfants ayant poursuivi une existence riche de sens, ont ouvert la voie à un champ de recherche théorique et clinique sur le potentiel que ces enfants pouvaient mobiliser malgré et au-delà des épreuves. S appuyant sur un modèle psychosocial en tant que modèle théorique, l objet de la présente recherche a été d identifier à partir d une approche épidémiologique des facteurs liés aux processus de résilience lors des évènements ou circonstances de vie suivant(e)s : ruptures familiales, détresse psychologique parentale, violences entre les parents et pauvreté des familles. Les indicateurs de l état de santé des adolescents ont été les troubles de l adaptation psychosociale et les difficultés scolaires. L opérationnalisation des hypothèses de recherche s est faite par la recherche de facteurs médiateurs ou modérateurs de l association entre ces circonstances de vie et l'état de santé des adolescents.A partir de la base de données de l Enquête sociale et de santé des enfants et des adolescents du Québec réalisée en 1999 par l Institut de la Statistique du Québec et des données de la première vague de la cohorte française SIRS -Santé, Inégalités et Ruptures sociales- réalisée en 2005 par l unité 707 de l' Inserm, 3 dimensions de la sphère du développement des adolescents ont été individualisées comme facteurs impliqués dans les processus de résilience : l estime de soi, la qualité du fonctionnement familial et le soutien social.PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Neurodevelopmental consequences of very preterm births.

International audienceno abstrac

Family breakup and adolescents' psychosocial maladjustment: public health implications of family disruptions.

International audienceOBJECTIVES: Recent changes in family structure are associated with an increase in psychosocial maladjustment in adolescents. We examined, from a public health intervention perspective, the association between family breakup and psychosocial maladjustment in adolescents and assessed the mediating role of family-functioning variables. METHODS: We analyzed data from the Social and Health Survey of Children and Adolescents in Quebec, Montreal, Canada, which was conducted in 1999. Sample-weighted logistic regression analyses were performed to determine the risk of internalizing disorders, externalizing disorders, substance abuse, and alcohol consumption in relation to family breakups and family-functioning variables, after adjusting for socioeconomic factors. RESULTS: All 4 of the indicators of psychosocial maladjustment were significantly associated with family breakup. The association between family breakups and internalizing disorders was mediated by parental psychological distress and low paternal emotional support. Independently, the witnessing of interparental violence was also strongly associated with internalizing disorders. For the other 3 outcomes, that is, externalizing disorders, substance abuse, and alcohol consumption, family breakup and family-functioning variables had independent effects. CONCLUSIONS: Family-based interventions and social approaches are complementary support modalities for adolescents experiencing family disruptions

The role of daily mobility in mental health inequalities: the interactive influence of activity space and neighbourhood of residence on depression.: The interactive influence of activity space and neighbourhood of residence on depression.

International audienceThe literature reports an association between neighbourhood deprivation and individual depression after adjustment for individual factors. The present paper investigates whether vulnerability to neighbourhood features is influenced by individual "activity space" (i.e., the space within which people move about or travel in the course of their daily activities). It can be assumed that a deprived residential environment can exert a stronger influence on the mental health of people whose activity space is limited to their neighbourhood of residence, since their exposure to their neighbourhood would be greater. Moreover, we studied the relationship between activity space size and depression. A limited activity space could indeed reflect spatial and social confinement and thus be associated with a higher risk of being depressed, or, conversely, it could be linked to a deep attachment to the neighbourhood of residence and thus be associated with a lower risk of being depressed. Multilevel logistic regression analyses of a representative sample consisting of 3011 inhabitants surveyed in 2005 in the Paris, France metropolitan area and nested within 50 census blocks showed, after adjusting for individual-level variables, that people living in deprived neighbourhoods were significantly more depressed that those living in more advantaged neighbourhoods. We also observed a statistically significant cross-level interaction between activity space and neighbourhood deprivation, as they relate to depression. Living in a deprived neighbourhood had a stronger and statistically significant effect on depression in people whose activity space was limited to their neighbourhood than in those whose daily travels extended beyond it. In addition, a limited activity space appeared to be a protective factor with regard to depression for people living in advantaged neighbourhoods and a risk factor for those living in deprived neighbourhoods. It could therefore be useful to take activity space into consideration more often when studying the social and spatial determinants of depression

: Recherche d'information en santé sur Internet

International audienceD'un point de vue de santé publique, l'internet est rapidement apparu comme un outil potentiellement utile pour l'information des patients et la promotion de la santé. Si les facteurs individuels impliqués dans le recours à l'internet santé sont maintenant bien connus, l'effet du lieu de résidence reste peu étudié. L'objectif de cette étude était d'évaluer l'impact des caractéristiques contextuelles du quartier de résidence sur l'utilisation de l'internet pour s'informer en matière de santé. Des analyses de régression logistique multiniveau ont été réalisées sur les données de la cohorte SIRS, échantillon représentatifde la population de l'agglomération parisienne en 2005. Une variation entre quartiers de résidence a été mise en exergue à la fois dans l'utilisation générale de l'internet et plus spécifiquement pour s'informer en matière de santé. Cette variabilité diminue lors de la prise en compte de facteurs individuels, traduisant un " effet de composition " et disparaît lorsque les caractéristiques du lieu de résidence sont ajoutées, traduisant un " effet contextuel ". Les inégalités individuelles d'accès à l'internet sont renforcées dans les quartiers les plus défavorisés. En revanche, si les obstacles individuels sont retrouvés, la probabilité d'utiliser l'internet pour des questions de santé est plus importante dans les quartiers comptant une proportion plus grande de non diplômés. Dans la perspective de réduire les inégalités sociales de santé, une promotion active de la diffusion d'internet ainsi que la formation des individus et des médecins sont nécessaires à un niveau individuel et sociétal pour qu'il puisse constituer un media de prévention et de promotion de la santé utile et utilisépour tous

Les facteurs biographiques et contextuels de la dépression : analyses à partir des données de la cohorte SIRS, agglomération parisienne, 2005.

National audienceIntroduction - Depression, by virtue of its conceptual and/or etiological frameworks, is an emblematic disease of new approaches that have been developed in social epidemiology: life-course epidemiology and contextual epidemiology. The objective of this study is to propose hypotheses for understanding this disease using these two approaches in a complementary way. Its goal is to look for an association between potentially traumatic life events during childhood and the occurrence of a depressive state during adulthood, and if, after adjustment for individual characteristics associated with depression, differences persist according to the type of neighborhood of residence. Methods - The SIRS study has been following a random sample of 3,000 individuals representative of the adult French-speaking population of Paris and its inner suburbs since 2005. The present analysis uses individual baseline data gathered through face-to-face interviews concerning, among other things, the subjects' depressive state, as evaluated by the MINI-Diag, life events and social conditions during childhood. The respondents' type of socioeconomic census block of residence was taken into account as well. The analyses use logistic and multilevel regression models. Results - After adjustment for the subjects' demographic and socioeconomic characteristics, several life-course events during childhood and certain characteristics of family functioning appeared to be strongly and independently associated with depression on the day of the survey, in particular, having been a victim of sexual abuse or having witnessed interparental violence, but also the parents having experienced long periods of unemployment or serious financial difficulties. In addition, after adjustment for these individual characteristics, depression was still more frequent in the neighborhoods considered to be in vulnerable urban areas. Conclusion - Several different life events and conditions during childhood appear to be detrimental to mental health during adulthood, and territorial inequalities persisted after adjustment for these factors