A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty

Young people who have experienced homelessness, foster care, or poverty are among the most disadvantaged in society. This review examines whether young people who have these experiences differ from their non-disadvantaged peers with respect to their cognitive skills and abilities, and whether cognitive profiles differ between these three groups. Three electronic databases were systematically searched for articles published between 1 January 1995 and 1 February 2015 on cognitive functioning among young people aged 15 to 24 years who have experienced homelessness, foster care, or poverty. Articles were screened using pre-determined inclusion criteria, then the data were extracted, and its quality assessed. A total of 31 studies were included. Compared to non-disadvantaged youth or published norms, cognitive performance was generally found to be impaired in young people who had experienced homelessness, foster care, or poverty. A common area of difficulty across all groups is working memory. General cognitive functioning, attention, and executive function deficits are shared by the homeless and poverty groups. Creativity emerges as a potential strength for homeless young people. The cognitive functioning of young people with experiences of impermanent housing and poverty has been relatively neglected and more research is needed to further establish cognitive profiles and replicate the findings reviewed here. As some aspects of cognitive functioning may show improvement with training, these could represent a target for intervention

A study examining the concerns, support needs and experiences of newly formed adoptive families

This article draws on the findings from a national adoption study to examine the characteristics and experiences of children recently placed for adoption. With a focus on relevance to health visiting, it considers the early concerns, support needs and experiences of newly formed adoptive families, and examines the role health visitors play in supporting these families, as part of routine health intervention for children

Influence of prenatal maternal stress, maternal plasma cortisol and cortisol in the amniotic fluid on birth outcomes and child temperament at 3 months

This prospective, longitudinal study aimed to investigate relationships between indicators of maternal prenatal stress, infant birth outcomes and early temperament. We examined the pattern of associations and postulated pathways between physiological (cortisol plasma concentrations) and self-report indices (stress, anxiety) of maternal prenatal stress, cortisol in the amniotic fluid, birth outcomes and infant temperament at 3 months. The sample consisted of 158 women undergoing amniocentesis in the 2nd trimester of pregnancy. Questionnaire measures of maternal stress and anxiety were found to be unrelated to cortisol in plasma or amniotic fluid. Maternal cortisol was related to amniotic cortisol, which in turn was associated with lower birth weight. Birth weight predicted infant fear and distress to limitation at 3 months old. We found trend-like indirect effects of amniotic fluid on infant distress to limitation and fear via birth weight. This is one of the few studies to simultaneously assess the role of maternal and amniotic fluid cortisol on birth outcomes and infant emotional development. The results suggest that foetal cortisol may be an important predictor of infant outcomes and shed light on the mechanisms through which prenatal maternal stress affects infant psychological health

A systematic review of school performance and behavioural and emotional problems for adopted children

Education performance for children adopted from care is worthy of serious, comprehensive and robust investigation. Whilst there is a legal duty on Local Authorities in England and Wales to collate and monitor Looked After Children’s (LAC) academic achievement and attainment, adopted children’s educational progress is not specifically scrutinised. This systematic review addresses a gap in knowledge regarding the academic attainment and behavioural development of school-age children who have been adopted from care. A total of 15 published articles were selected for review, based on a stringent set of inclusion criteria. With one exception, adoption was associated with lower academic attainment and elevated levels of behavioural problems across childhood, adolescence and emerging adulthood compared with non-adopted comparison groups. Collectively, the findings suggest that the school performance of adopted children should be routinely monitored. The findings also point to a need to recognise the potential challenges faced by children adopted from care by working with families, schools, practitioners and researchers to identify the means through which children can achieve the best possible 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

Psychopathology among young homeless people: Longitudinal mental health outcomes for different subgroups

Background Homeless young people are recognized as a very vulnerable group in terms of mental health; however, few studies in the UK have examined this. Furthermore, homeless young people represent a heterogeneous group in terms of their mental health and greater characterization could improve intervention work. Objectives The aims of this study were to examine prevalence and subtypes of psychopathology among a British sample of young homeless people and to investigate potential associations between identified typologies and a priori specified current and past experiences. In addition, the study intended to explore physical health, mental health, and housing outcomes for the different mental health subgroups. Design A prospective longitudinal design was used. Methods Structured interviews including a mental health assessment were conducted with 90 young homeless people aged 16–23 years. Follow-up interviews were conducted approximately 10 and 20 months later. Cluster analysis at baseline was used to identify groups based on lifetime mental health problems. Results The current and lifetime incidence of mental health problems was high (88% and 93%, respectively). Three subgroups of homeless young people were identified: (1) minimal mental health issues; (2) mood, substance, and conduct disorder; and (3) post-traumatic stress disorder, mood, and anxiety issues. These groups differed with respect to follow-up indicators of change and stability of mental health status, service use, and suicide risk, but not housing outcome. Other characteristics (gender ratio, past experiences) also distinguished the subgroups. Conclusions Typologies of young homeless people based on psychopathology reveal differences in lifetime and future experiences including mental health at follow-up. Identified groups could be used to tailor interventions towards differing needs. Practitioner points Low mood, anxiety, post-traumatic stress disorder, and psychosis are common mental health issues among young homeless people in the UK. Subgroups of young homeless people with differing needs can be identified, and these groups can be used to predict outcomes. Tailoring support provision towards specific needs has the potential to improve mental health and other outcomes for vulnerable young homeless people. Young homeless people often do not access the support to which they are entitled. Services need to be adapted to improve access for this group

Development of fear and guilt in young children: Stability over time and relations with psychopathology

Extremes in fearful temperament have long been associated with later psychopathology and risk pathways. Whereas fearful children are inhibited and anxious and avoid novel events, fearless individuals are disinhibited and more likely to engage in aggressive behavior. However, very few studies have examined fear in infants from a multimethod and prospective longitudinal perspective. This study had the following objectives: to examine behavioral, maternal reported, and physiological indices of fearful temperament in infancy, together with their relations and stability over time; and to establish whether early indices of fear predict fear later in toddlerhood. We also examined the association between behavioral and physiological measures of fear and guilt and whether fear in infancy predicts guilt in toddlers. Finally, we investigated infant risk factors for later psychopathology. We recorded skin conductance level (SCL) and heart rate (HR) and observed children's responses during a Laboratory Temperament Assessment Battery fear paradigm across the first 3 years of life and during a guilt induction procedure at age 3 (N = 70). The results indicate that different measures of infant fear were associated across time. Observed fearlessness in infancy predicted observed fearlessness and low levels of SCL arousal to fear and guilt in toddlers. Low levels of HR and SCL to fear in infancy predicted low levels of physiological arousal to the same situation and to guilt 2 years later. Fear and guilt were significantly associated across measures. Finally, toddlers with clinically significant internalizing problems at age 3 were already notably more fearful in Year 1 as reflected by their significantly higher HR levels. The results indicated that assessments of children in infancy are predictive of how these children react 2 years later and therefore lend support to the idea that the emotional thermostat is set in the first 3 years of life. They also showed, for the first time, that infant fear is a predictor of guilt, which is an emotion that develops later. The implications of these findings for our understanding of developmental psychopathology are discussed