An investigation of changes in children′s mental health in Wales between 2007/2008 and 2012/2013

Improving children’s mental well-being is a recognised public health priority, but evidence on recent trends is lacking. This study updates evidence on differences in child mental health since 2008 by comparing two nationally representative cohorts in Wales, UK. Parents of 4-12 year old children completed the Strength and Difficulties Questionnaire (SDQ). No significant differences were seen for younger girls between 2007/2008 and 2012/2013. There was a decrease in conduct, hyperactivity and total difficulties symptom scores and an increase in prosocial scores for boys’ and older girls. These findings suggest that rates of child mental health problems are stable or falling

Charting the trajectories of adopted children’s emotional and behavioral problems: The impact of early adversity and post-adoptive parental warmth

Children who are adopted from care are more likely to experience enduring emotional and behavioral problems across development; however, adoptees’ trajectories of mental health problems and factors that impact their trajectories are poorly understood. Therefore, we used multilevel growth analyses to chart adoptees’ internalizing and externalizing problems across childhood, and examined the associations between preadoptive risk and postadoptive protective factors on their trajectories. This was investigated in a prospective longitudinal study of case file records (N = 374) and questionnaire-based follow-ups (N = 96) at approximately 5, 21, and 36 months postadoptive placement. Preadoptive adversity (indexed by age at placement, days in care, and number of adverse childhood experiences) was associated with higher internalizing and externalizing scores; the decrease in internalizing scores over childhood was accelerated for those exposed to lower levels of preadoptive risk. Warm adoptive parenting was associated with a marked reduction in children's internalizing and externalizing problems over time. Although potentially limited by shared methods variance and lack of variability in parental warmth scores, these findings demonstrate the deleterious impact of preadoptive risk and the positive role of exceptionally warm adoptive parenting on children's trajectories of mental health problems and have relevance for prevention and intervention strategies

The Influence of Adoption on Sibling Relationships: Experiences and Support Needs of Newly Formed Adoptive Families

For better or worse, the significance of the sibling relationship throughout the life course is widely acknowledged. This paper explores the ways in which sibling relationships, in their various forms, are affected by adoption. The case-file records of 374 children recently placed for adoption in Wales were reviewed. Questionnaires were completed by ninety-six adoptive parents, with whom a sample of these children were placed, and a sub-sample of forty adoptive parents were interviewed. Most children placed for adoption together with a sibling carried a shared history of maltreatment. Many had complex, often conflictual relationships. Nevertheless, birth siblings in the adoptive home also provided support and comfort for children. New sibling relationships, created by placing children into families with existing children, carried their own set of advantages and complications. Some children placed apart from birth siblings had plans for contact that had not yet materialised. Whilst adoptive parents were often determined to help strengthen sibling bonds created and affected by adoption, this commitment was not always championed through social work intervention. The implications for social work practice in adoption are considered and a family systems framework is proposed as a way of helping to understand sibling dynamics in adoptive families

Healthcare professionals’ views on psychological support for children and families affected by skin conditions in the UK: a qualitative study

Background Skin conditions can have a psychological impact on a child and their caregivers, however, support is not equally distributed between geographical regions in the United Kingdom (UK). Objectives This study aimed to investigate the experience of National Health Service (NHS) healthcare professionals (HCPs) of addressing the psychological needs of children with skin conditions and their families, and gain expert opinion as to how services need to further develop. Design HCPs were recruited to a qualitative study with an advert posted on social media. Methods Fifteen HCPs took part in interviews, including dermatologists (n = 4), dermatology nurse consultants/specialists (n = 4), clinical psychologists (n = 4), liaison psychiatrists (n = 2), and a children's psychological well-being practitioner (n = 1). Results Thematic analysis revealed children often presented with anxiety, depression, self-harm and suicidal ideation. The impact on caregivers was equally profound. There were differences in service provision across the UK and all HCPs recognised the urgent need for psychological support to be integrated into standard care. Participants described how a range of interventions are typically required including cognitive behavioural therapy (CBT), and systemic approaches, as well as mindfulness/third-wave approaches. Barriers to the delivery of psychological services were associated with a lack of funding and training opportunities for core and specialist staff alike. However, in some instances, participants had overcome these challenges to be able to deliver unique services. Conclusions There exist several barriers to providing paediatric psychological interventions, and many locations across the UK remain vulnerable as a result of continuing lack of national guidelines for the provision of psychological services

The educational aspirations and psychological well-being of adopted young people in the UK

Much is hypothesised but little is known about the effects of early adversity on school experience, academic attainment and career aspiration for children and young people adopted from care. Drawing on data from Wave 1 of the Youth (10‒15 years old) Questionnaire (n = 4899) from the United Kingdom Household Longitudinal Survey (UKHLS), also known as Understanding Society, this study explored differences between young people adopted (n = 22) and a matched comparison group (n = 110) on measures of educational and occupational aspirations and psychological well-being. Adopted young people reported higher externalising and total difficulties scores (based on the SDQ, Goodman, 1997) than the general population comparison group, but equivalent internalising symptoms. Adopted children were more likely to show an intention to seek full-time work at the end of compulsory schooling. These findings align with previous research regarding the psychological well-being of adopted children, contribute new knowledge about the aspirations of young people adopted from care and highlight methodological issues when utilising large-scale panel survey data for narrowly defined sub-groups

Birth sibling relationships after adoption: the experience of contact with brothers and sisters living elsewhere

We examined how adoptive families manage and respond to contact with children’s birth siblings living elsewhere within a nationally representative sample of 96 families who adopted a child between 01 July 2014 and 31 July 2015. We harnessed prospective, longitudinal data to determine the extent to which plans for contact between adopted children and birth siblings living elsewhere materialised over time. We present adoptive parents’ views and experiences of the contact over four years, together with an analysis of factors that were thought to have prevented, hindered and/or enabled contact between adopted children and their birth siblings. The information shared by the adoptive families illustrates the challenges they faced in promoting sibling contact; in weighing up the complexities associated with managing contact in the short term against the anticipated benefit for their child in the longer term; of balancing a commitment to sibling contact with the psychological needs of their child; and of organising contact within the context of interactions with other families involved and social work professionals. On the basis of these findings, we make recommendations pertaining to the management of both letterbox and face-to-face contact and life story work, and underscore the importance of investing in sibling relationships

Depression and anxiety symptoms of british adoptive parents: a prospective four-wave longitudinal study

The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial

Adverse childhood experiences of children adopted from care: The importance of adoptive parental warmth for future child adjustment

We investigated the relationship between adverse childhood experiences (ACEs) and children’s internalising symptoms and externalising problems in the Wales Adoption Cohort Study, a prospective longitudinal study that used case file records (n = 374) for a sample of British children adopted from care (M = 2 years, 55% male). Parents (n = 96) completed questionnaires at 3–5 months, 15–17 months, and 31–33 months post-placement. We hypothesised that: (1) children adopted from care would have experienced more ACEs than children in the general population; (2) the number of ACEs would be associated with higher internalising symptom and externalising problem scores; and (3) adoptive parental warmth would moderate the relationship between ACEs and post-placement internalising symptoms and externalising problems. Nearly half (42%) of the children experienced four or more ACEs. Internalising symptoms and externalising problems were significantly higher than the UK general population. The number of ACEs was associated with internalising symptoms 3 years post-adoptive placement but this relationship was moderated by adoptive parental warmth. This study profiles the experiences and characteristics of a national sample of adopted children and highlights the potential importance of parent warmth as a factor that ameliorates the impact of ACEs on poor child outcomes

Parent and child experience of skin conditions: relevance for the provision of mindfulness-based interventions

Background Managing a skin condition can be difficult, and there is a lack of psychological support for children and their families. Objectives The objectives of this study were to identify issues surrounding caring for a child with a skin condition, investigate experiences of current psychological support to gain a sense of what is needed, and determine the relevance of offering mindfulness-based interventions for children and families. Design This study employed a mixed inductive and deductive form of qualitative inquiry to understand children and families experiences and needs. Methods Twenty-three participants (n = 12 parents/carers, n = 11 female, n = 1 male), (n = 11 children, n = 6 female, n = 5 male, aged 8-11 years) were recruited with an advert posted on social media. In-depth data was collected from semi-structured interviews. Interviews were recorded, transcribed, and analysed with a descriptive form of thematic analysis. Results Systematic analysis of the data led to five themes being developed: (1) Caregiver burden of childhood skin conditions; (2) Skin condition overshadowing childhood; (3) Battling for recognition and lack of support; (4) Naturalistic use and understanding of mindfulness in everyday coping: and (5) Openness and relevance of offering a mindfulness-based interventions. Conclusions Living with a skin condition was reported as being associated with mood disturbance, with impacts on schooling, sleep, and daily life. Parents and children expressed a desire for short/accessible interventions that could fit with daily routines and might provide the opportunity to connect with other families. The findings indicate that mindfulness-based interventions may be likely to be accepted, as many participants had experience of using mindful techniques in school, and described that they were naturalistically using ‘mindfulness’ to manage itch and stress. However, the findings indicate that a number of misconceptions exist about the fundamental nature and aims of mindfulness. Addressing misconceptions related to mindfulness need to be considered when planning both future studies and service delivery

Living with physical health conditions: a systematic review of mindfulness-based interventions for children, adolescents, and their parents

Objectives This systematic review aimed to identify and appraise studies investigating the efficacy of mindfulness-based interventions (MBIs) for improving depression, anxiety and parental stress in families affected by childhood physical illnesses, as well as feasibility and acceptability. Methods Embase, PsycINFO, Scopus, Medline, and PubMed were searched between February 2 and 17, 2021, and updated on August 5, 2022. Studies investigating MBIs with children and adolescents (<18 years) with physical health conditions were included, and results are presented with narrative synthesis. Results Eighteen studies met eligibility criteria. Studies included children and adolescents with chronic pain, headaches, cancer, heart conditions, esophageal atresia, inflammatory bowel disease, and polycystic ovary syndrome. Most studies reported mindfulness was feasible and acceptable, although findings for different health conditions were mixed. Some studies encountered difficulties with attrition, resulting in findings being underpowered. Conclusions MBIs show promise for improving anxiety and depression in children with physical health conditions, but there is limited support for reducing stress in the family unit. A potential direction for future research might be the inclusion of parents. However, because of the heterogeneity of studies included in this review, findings must be cautiously interpreted