Childhood mental health: an ecological analysis of the effects of neighborhood characteristics

Research on childhood mental illness traditionally examines risk factors most proximal to the child. However, current trends reflect growing interest in how broader contextual factors contribute to psychopathology risk. In this study, we examined neighborhood‐level indicators as potential sources of chronic strain in a sample of 156 mother–child dyads; children were 8 to 12 years old. For most neighborhood indicators, data were collected at the level of census tracts using publicly available data sets. We hypothesized that these indicators would be both associated with greater overall mental health symptoms and specifically predictive of childhood symptoms of depression. We also examined potential mediators (maternal functioning and family cohesion) and moderators (maternal depression). Neighborhood indicators correlated with parents’ ratings of children's overall mental health problems, but did not correlate with children's self‐report of depression symptoms. Maternal functioning mediated neighborhood effects on children's overall mental health problems. Implications and directions for future research are presented.The current work was supported by the following grants from the National Institutes of Health, National Institute of Mental Health MH066077, MH082861, PI: Martha C. Tompson, Ph.D. and MH082861S1, PI: Gail N. Kemp, M.A., M.P.H. (MH066077 - National Institutes of Health, National Institute of Mental Health; MH082861 - National Institutes of Health, National Institute of Mental Health; MH082861S1 - National Institutes of Health, National Institute of Mental Health)Published versio

Maternal depression and youth internalizing and externalizing symptomatology: severity and chronicity of past maternal depression and current maternal depressive symptoms

Maternal depression is a well-documented risk factor for youth depression, and taking into account its severity and chronicity may provide important insight into the degree of risk conferred. This study explored the degree to which the severity/chronicity of maternal depression history explained variance in youth internalizing and externalizing symptoms above and beyond current maternal depressive symptoms among 171 youth (58 % male) ages 8 to 12 over a span of 3 years. Severity and chronicity of past maternal depression and current maternal depressive symptoms were examined as predictors of parent-reported youth internalizing and externalizing symptomatology, as well as youth self-reported depressive symptoms. Severity and chronicity of past maternal depression did not account for additional variance in youth internalizing and externalizing symptoms at Time 1 beyond what was accounted for by maternal depressive symptoms at Time 1. Longitudinal growth curve modeling indicated that prior severity/chronicity of maternal depression predicted levels of youth internalizing and externalizing symptoms at each time point when controlling for current maternal depressive symptoms at each time point. Chronicity of maternal depression, apart from severity, also predicted rate of change in youth externalizing symptoms over time. These findings highlight the importance of screening and assessing for current maternal depressive symptoms, as well as the nature of past depressive episodes. Possible mechanisms underlying the association between severity/chronicity of maternal depression and youth outcomes, such as residual effects from depressive history on mother–child interactions, are discussed.The current work was supported by grants from the National Institutes of Health (MH066077, PI: Martha C. Tompson, PhD; MH082861, PI: Martha C. Tompson, PhD;). (MH066077 - National Institutes of Health; MH082861 - National Institutes of Health)Published versio

A randomized clinical trial comparing family-focused treatment and individual supportive therapy for depression in childhood and early adolescence

OBJECTIVE: Despite the morbidity and negative outcomes associated with early-onset depression, few studies have examined the efficacy of psychosocial treatment for depressive disorders during childhood. Integrating family in treatment could have particularly salutary effects during this developmental period. This trial compared immediate posttreatment effects of family-focused treatment for childhood depression (FFT-CD) with those of individual supportive psychotherapy (IP) for children 7 to 14 years old with depressive disorders. METHOD: Children were randomized to 15 sessions of FFT-CD (n = 67) or IP (n = 67) over 4 months. The primary treatment outcome was adequate clinical depression response, defined as at least a 50% decrease in score on the Children's Depression Rating Scale-Revised (CDRS-R). Additional outcomes included patient-centered outcomes (parent- and child-reported treatment satisfaction), remission (defined as CDRS-R score ≤28), change in continuous CDRS-R score, and change in child and parent reports of depressive and non-depressive symptoms and social adjustment. RESULTS: Significant improvement was evident across groups for depressive and non-depressive symptoms, global response, and functioning and social adjustment. Compared with children randomized to IP, children randomized to FFT-CD showed higher rates of adequate clinical depression response (77.7% versus 59.9%; number needed to treat = 5.72; odds ratio 2.29; 95% CI 1.001-5.247; t = 1.97, p = .0498). Across treatments, families reported high satisfaction; compared with IP families, FFT-CD families reported greater knowledge and skills for managing depression. There were no significant differences between treatment arms on secondary outcomes. CONCLUSION: Results support the value of psychosocial intervention, emphasize the important role that families play, and highlight the potential for FFT-CD for supporting recovery in children with depression. Clinical trial registration information-Systems of Support Study for Childhood Depression; http://clinicaltrials.gov; NCT01159041.R01 MH082856 - NIMH NIH HHS; R01 MH082861 - NIMH NIH HH

Family-focused treatment for childhood depression: model and case illustrations

Although the evidence base for treatment of depressive disorders in adolescents has strengthened in recent years, less is known about the treatment of depression in middle to late childhood. A family-based treatment may be optimal in addressing the interpersonal problems and symptoms frequently evident among depressed children during this developmental phase, particularly given data indicating that attributes of the family environment predict recovery versus continuing depression among depressed children. Family-Focused Treatment for Childhood Depression (FFT-CD) is designed as a 15-session family treatment with both the youth and parents targeting two putative mechanisms involved in recovery: (a) enhancing family support, specifically decreasing criticism and increasing supportive interactions; and (b) strengthening specific cognitive-behavioral skills within a family context that have been central to CBT for depression, specifically behavioral activation, communication, and problem solving. This article describes in detail the FFT-CD protocol and illustrates its implementation with three depressed children and their families. Common themes/challenges in treatment included family stressors, comorbidity, parental mental health challenges, and inclusion/integration of siblings into sessions. These three children experienced positive changes from pre- to posttreatment on assessor-rated depressive symptoms, parent- and child-rated depressive symptoms, and parent-rated internalizing and externalizing symptoms. These changes were maintained at follow-up evaluations 4 and 9 months following treatment completion.K23 MH101238 - NIMH NIH HHS; R01 MH082856 - NIMH NIH HHS; R01 MH082861 - NIMH NIH HH

A latent class analysis of parental bipolar disorder: examining associations with offspring psychopathology

Bipolar disorder (BD) is highly heterogeneous, and course variations are associated with patient outcomes. This diagnostic complexity challenges identification of patients in greatest need of intervention. Additionally, course variations have implications for offspring risk. First, latent class analysis (LCA) categorized parents with BD based on salient illness characteristics: BD type, onset age, polarity of index episode, pole of majority of episodes, rapid cycling, psychosis, anxiety comorbidity, and substance dependence. Fit indices favored three parental classes with some substantively meaningful patterns. Two classes, labeled “Earlier-Onset Bipolar-I” (EO-I) and “Earlier-Onset Bipolar-II” (EO-II), comprised parents who had a mean onset age in mid-adolescence, with EO-I primarily BD-I parents and EO-II entirely BD-II parents. The third class, labeled “Later-Onset BD” (LO) had an average onset age in adulthood. Classes also varied on probability of anxiety comorbidity, substance dependence, psychosis, rapid cycling, and pole of majority of episodes. Second, we examined rates of disorders in offspring (ages 4–33, Mage=13.46) based on parental latent class membership. Differences emerged for offspring anxiety disorders only such that offspring of EO-I and EO-II parents had higher rates, compared to offspring of LO parents, particularly for daughters. Findings may enhance understanding of BD and its nosologyThis study was funded by two Brain & Behavior Research Foundation (formerly NARSAD) Independent Investigator Awards (PI: Nierenberg), a Brain & Behavior Research Foundation Young Investigator Award (PI: Henin) generously supported in part by the SHINE Initiative, and an MGH Claflin Award (PI: Henin). We thank David A. Langer, Ph.D., Thomas M. Olino, Ph.D., and Meredith Lotz Wallace, Ph.D. for their consultation. (Brain & Behavior Research Foundation; Brain & Behavior Research Foundation Young Investigator Award; SHINE Initiative; MGH Claflin Award)Accepted manuscrip

Dynamics of a self--gravitating magnetized source

We consider a magnetized degenerate gas of fermions as the matter source of a homogeneous but anisotropic Bianchi I spacetime with a Kasner--like metric. We examine the dynamics of this system by means of a qualitative and numerical study of Einstein-Maxwell field equations which reduce to a non--linear autonomous system. For all initial conditions and combinations of free parameters the gas evolves from an initial anisotropic singularity into an asymptotic state that is completely determined by a stable attractor. Depending on the initial conditions the anisotropic singularity is of the ``cigar'' or ``plate'' types.Comment: 7 pages, 1 figur

Fast Neural Network Predictions from Constrained Aerodynamics Datasets

Incorporating computational fluid dynamics in the design process of jets, spacecraft, or gas turbine engines is often challenged by the required computational resources and simulation time, which depend on the chosen physics-based computational models and grid resolutions. An ongoing problem in the field is how to simulate these systems faster but with sufficient accuracy. While many approaches involve simplified models of the underlying physics, others are model-free and make predictions based only on existing simulation data. We present a novel model-free approach in which we reformulate the simulation problem to effectively increase the size of constrained pre-computed datasets and introduce a novel neural network architecture (called a cluster network) with an inductive bias well-suited to highly nonlinear computational fluid dynamics solutions. Compared to the state-of-the-art in model-based approximations, we show that our approach is nearly as accurate, an order of magnitude faster, and easier to apply. Furthermore, we show that our method outperforms other model-free approaches

A systematic review of tagging as a method to reduce theft in retail environments

Background: Retailers routinely use security tags to reduce theft. Presently, however, there has been no attempt to systematically review the literature on security tags. Guided by the acronym EMMIE, this paper set out to (1) examine the evidence that tags are effective at reducing theft, (2) identify the key mechanisms through which tags are expected to reduce theft and the conditions that moderate tag effectiveness, and (3) summarise information relevant to the implementation and economic costs of tagging. Methods: In this mixed-methods review, we performed systematic keyword searches of the published and unpublished literature, hand searched relevant journals, conducted forward and backward citation searches and consulted with four retailers. Studies were included if they reported an explicit goal of reducing the theft or shrinkage of items through the use of security tags in retail environments. Results: We identified 50 eligible studies, eight of which reported quantitative data on the effectiveness of tags in retail environments. Across these eight studies, five showed positive results associated with the introduction of tags, but heterogeneity in the type of tag and reported outcome measures precluded a meta-analysis. We identified three mechanisms through which tags might plausibly reduce theft-increase the risks, reduce the rewards, increase the effort-which were found to vary by tag type, and their activation dependent on five broad categories of moderator: retail store and staff, customers (including shoplifters), tag type, product type, and the involvement of the police and criminal justice system. Implementation challenges documented in the literature related mainly to staffing issues and tagging strategy. Finally, although estimates are available on the costs of tagging, our searches identified no highquality published economic evaluations of tagging. Conclusions: Through applying the EMMIE framework this review highlighted the complexity involved in security tagging in retail environments, whereby different kinds of tags are expected to reduce theft through different casual mechanisms which are dependent on a distinctive configuration of conditions. Based on the available evidence it is difficult to determine the effectiveness of tags as a theft reduction measure, albeit there is suggestive evidence that more visible tags are associated with greater reductions in theft than less visible tags

A configurative synthesis of evidence for fear in the criminal decision-making process

This paper reviews what previous research has found on the role of fear and other associated feelings in the criminal decision-making process, and the techniques that might plausibly amplify such emotions so as to reduce or disrupt intent. To this aim, we conduct a systematic review of the offender decision-making literature (23 studies), incorporating a qualitative synthesis of the role of fear in the criminal decision-making process. The results section is formed of six parts based on dominant themes identified in our eligible studies, namely evidence of fear in offender decision-making, the presumed sources of fear, variation in levels and/or the effect of fear across offenders, the specific role of fear across aspects of the crime process (before, during, after), the results of fear and offender fear management processes. We conclude with a discussion of the implication for crime prevention policies