Journal of Indian Association for Child and Adolescent Mental Health

A recent priority-setting exercise reported that youth are interested in understanding what the early signs and symptoms of generalized anxiety are, and when they should seek help. This environmental scan aimed to understand what information is currently available online for Canadian youth about the signs and symptoms of generalized anxiety disorder, what resources are available for self-assessment, and what are youth’s behaviors, experiences, and information needs around seeking help.

We conducted an environmental scan of Internet resources and academic literature in August 2020. Information Sources were categorized relating to the research concepts regarding signs and symptoms, self-assessments, information needs, and experiences. We complimented our environmental scan with youth consultations to understand how generalized anxiety resources are perceived by youth, and what if anything could be improved about the information they are receiving. Consultations were conducted over Zoom with three Canadian Youth Advisory Groups (2 local, 1 national) and took a semistructured focus group format.

Of the 12874 identified Information Sources inclusion criteria were met by 98. The majority of Information Sources on signs and symptoms (n = 62) were webpage-based articles (n = 53, 85%), and 38 (61%) specifically stated that they were targeting youth. Seventy-one percent (n = 12) of the 17 self-assessment resources were provided by private organizations. The resources varied markedly in the post-assessment support provided to youth according to their source (i.e., private, academic, and governmental). The key considerations highlighted by youth across the consultations suggested resources needed to be; youth friendly; align with a credible institute (e.g., University and Health Institution); and provide tangible action items post-online assessment.

Awareness of the information and resources available to youth, coupled with an understanding of their help-seeking behaviors and information needs regarding generalized anxiety can help support the development and dissemination of appropriate knowledge translation tools targeting youth.

There has been an urgent need for the youths to be furnished with the capacity to apply the use of strategies such as problem- solving and coping skills in other to ameliorate their deliberate self-harming behavior inclinations. It is important to recognize the underlying emotional and psychological underpinnings of these self-harming behaviors.

Three data bases; Scopus, Google Scholar advanced search, and PubMed, were searched using keywords such as “problem-solving,” “coping,” “youth,” and “deliberate self-harm.” The articles were then screened to ensure that they all met the inclusion criteria and only those published in the English language were selected and deliberate self-harm.”

Deliberate self-harm behaviors pose a substantial risk to the mental health of the individuals involved. Integrating emotional regulation and coping skills has been shown to improve mental health outcomes in these youths significantly. Problem-solving and coping skills programs have emerged as effective interventions for addressing deliberate self-harm behaviors in youth. Those who are engrossed in deliberate self-harm often struggle with problem-solving abilities and resort to maladaptive social problem-solving, such as self-harming, as a coping mechanism. Incorporating problem-solving techniques within therapy approaches can be an effective strategy to address deliberate self-harm behaviors and promote healthier coping mechanisms.

There is the need for structured interventions to meet the unique and diverse need of the youths engaged in this act. Interventions can target the core issues, such as emotional dysregulation, interpersonal difficulties, or trauma history.

Children in India who have been diagnosed with celiac disease deal with a variety of challenges and difficulties as a result of their condition. Understanding their experiences is important to help the patients adapt better to the demands of celiac disease and gluten-free diet.

The present study has used a constructivism paradigm as a study design. Participants were recruited through purposive sampling. In-depth telephonic interviews were conducted with 10 children with celiac disease. Thematic analysis was used to analyze the interview data.

The main themes and sub-themes that emerged from the data were emotional responses (the feeling of deprivation, the feeling of being different from others, the novelty of gluten-free diet leading to excitement), physical health impact (getting tired easily, delayed growth), social constraints (social limitations brought on by celiac disease, peer pressure to eat gluten, and non-acceptance of celiac disease by others), future concerns (uncertainty about the future, improved physical health, celiac disease cure, dependency on others), navigating dietary changes (fear of cross-contamination, food restrictions caused by celiac disease, non-availability of gluten-free food, and limited food options outside the home), coping strategies, and management of celiac disease (eat home-cooked meals, receiving support from family, and friends, adhering to gluten-free diet).

Governmental organizations and experts in mental health must acknowledge the needs of Indian children with celiac disease. The need of the hour is to improve gluten-free product labelling and raise awareness of celiac disease.

Traumatic parental loss during childhood and adolescence can have long-lasting effects on the developmental trajectory of youngsters. While there is some literature on the advantages of positive family communication fostering better adjustment in bereaved children and adolescents, patterns of family communication post parental loss have not received much attention. An understanding of these patterns can pave the way for more holistic interventions in this vulnerable group.

The aim of the study was to explore parental loss-related communication in families of children and adolescents who have lost a parent to a road traffic accident.

The study was carried out in a tertiary hospital setting in Bengaluru. The sample comprised of 24 children and 17 surviving parents. The study employed a qualitative research design. Semi-structured in-depth interviews were conducted with surviving parents/caregivers and the children/adolescents. The interviews were analysed by using inductive thematic analysis.

The themes generated from the semi-structured interviews highlighted patterns of communication in parentally bereaved families. Four major themes emerged from the semi-structured interviews – mode of getting to know about the death, disclosure regarding the death, discussion regarding the death and individual needs related to communication.

Communication regarding parental loss as a result of road traffic accidents in the family context seems to be desirable and may enable healthy grieving in youngsters. Short-term interventions aimed at enhancing family communication patterns following traumatic parental loss need to be developed in the Indian context.

It is well known that caregivers of children with neurodevelopmental disabilities (NDD) face challenges. These challenges increased further due to the coronavirus disease 2019 (COVID-19) pandemic and the related restrictions. There was very little data from India on these challenges. This study was done with the primary aim to gain insights about the challenges faced by parents of children with NDD through their personal stories.

Participants were recruited using purposive sampling method and semi-structured interviews were conducted through a telephone or in person. Data saturation was achieved by the sixth participant and 2 more interviews were performed for further confirmation. Interviews were transcribed, and a 7-step Colaizzi’s phenomenological method was used to identify different themes.

The impact of COVID-19 on caregivers of children with NDD can be summarized into 4 broad themes. First, there were challenges related to “therapy” which included closure of day-care centers and schools, inaccessibility to professionals, and disruption in home-based learning. Second, there were “child” related challenges which included inappropriate behaviors. Third, there were “family” challenges which included misunderstandings between parents and difficulties in adhering to family routines. Lastly, there were “personal” challenges related to physical and psychological health.

The personal stories of caregivers of children with NDD highlight the pressing need to provide appropriate support and formulate holistic models to enhance well-being of caregivers during difficult periods.

Autism is a developmental disorder that impairs the skills related to behavior, communication, interaction, and learning. This study was undertaken to understand the difficulties faced by caregivers in various aspects of life while taking care of children with autism and their unique life experiences.

After obtaining ethical approval, the study was conducted in a tertiary care hospital in Bangalore, India. An informed consent and a subject information sheet were taken to obtain permission from the subjects. A baseline proforma was prepared for collecting the demographic data for both autistic children and the caregivers. An in-depth, face-to-face, semi-structured interview that consisted of around 10 questions was conducted for 30 minutes. The interview was recorded, later transcribed verbatim, and extracted into specific themes and subthemes.

The lived-in experiences throw light on many emotional, social, psychological, and physical distress the caregivers go through on a day-to-day basis. The daily hassles of every caregiver are unique and challenging. Five themes and corresponding subthemes were extracted as follows: emotional meltdown, change in family dynamics, spiritual transition, perceived social burden, and perception of a child’s future.

The caregivers of children with autism faced various challenges such as physical and emotional turmoil, financial constraints, and the deprivation of a healthy social life almost every day. Interventional measures such as nurse-led clinics, counseling measure, and planning training sessions for nurses to deal with the various issues faced by the caregivers could be taken up to address the growing concerns of caregivers of children with autism.

Deictic gestures are the first intentional form of communication that predict the emergence of first words. Deictic gestures include reaching, pointing, giving, and showing.

Forty-five Tamil-speaking children (28 male and 17 female) and their parents participated in this study. They were divided into three groups (ASD, DS, and TD). The parents were instructed to play and interact with their children, as they do at home, using the provided toy set, and this session was video-recorded. Deictic gestures such as reaching, pointing, giving, and showing were analyzed with a specific coding scheme.

On a Kruskal–Wallis test, a statistically significant difference across the three groups (P < .05) was obtained for the total frequency of deictic gestures, use of pointing, giving, and showing gestures. The total frequency of deictic gestures and their types, such as pointing, giving, and showing gestures, used by the ASD group was less compared to the DS and TD groups.

This study highlighted that, along with speech and language difficulties, children with ASD have deficits in producing deictic gestures. Children with DS have speech and language difficulties, but they use deictic gestures in order to communicate with their parents during interaction. This varied profile of deictic gesture use can be used for early identification, differential diagnosis, and setting intervention goals.

Vitamin B-12 plays a role in normal growth and development in childhood and adolescence. In this study, the effect of vitamin B-12 on attention was investigated.

A total of 138 participants who were admitted to the pediatric clinic during a three-month period between June 15, 2021, and September 15, 2021, between the ages of 9 and 16 years, who had their vitamin B-12 levels measured and met the inclusion criteria of the study were included in our study. D2 Attention Test data were obtained from the participants.

While 24.5% of the group with low vitamin B-12 levels had pathology according to the D2 Attention Test, 5.9% of the control group had pathology according to the D2 Attention Test. The percentage of pathology in those with low vitamin B-12 levels was statistically significantly higher than in the group with normal B-12 levels.

It was observed that the attention level of the group with vitamin B-12 deficiency was lower. In the follow-up of healthy children, it is recommended to pay attention to the research on vitamin B-12 values.

In Pakistan, where unintentional injuries among toddlers pose a significant public health challenge, understanding the factors that contribute to elevated injury risks is crucial. A two-dimensional approach including parental factors (internal/external health locus of control and perceived vulnerability) and child factors (the child’s temperament) is explored as contributing to the unintentional injury behaviors of toddlers.

The study involved 241 parents of toddlers aged 18–36 months from daycare centers in three major Pakistani cities who had observed multiple recent injuries in their children. The comprehensive online assessment, lasting 15–20 minutes, incorporated the child vulnerability scale, injury behavior checklist, parent health locus of control questionnaire, and early childhood behavior questionnaire. Demographic details included child and parent age distributions, with a focus on educational backgrounds. The participants comprised both fathers and mothers, and the data analysis employed Smart-PLS software for structural equation modeling.

The results suggested there is no direct relationship between parental health locus of control (internal/external) and injury behaviors in children. However, an indirect and significant path was observed from the parental health locus of control (internal/external) to perceived child vulnerability and injury behaviors through moderation of temperamental characteristics.

Our research underscores the indirect link between parental factors, child temperament, and toddler injuries in Pakistan. Culturally sensitive interventions targeting parental awareness can play a pivotal role in safeguarding the well-being of the youngest members of society.

Previous studies have shown the negative impact of institutional care on children’s physical and mental health. However, in addition to the form of care, the quality of care is an important factor in children’s mental health. This study explored the quality of care and the association between the quality of care and mental health issues among adolescents in Vietnam social support facilities (SSFs).

A cross-sectional study was conducted with 273 institutionalized adolescents who lived in SSFs and 273 adolescents cared for by family. Depressive symptoms, anxiety symptoms, sleep problems, behavioral problems, and quality of care were measured. Descriptive statistics were calculated, and multiple linear regression analysis was performed.

The quality of care was rated as quite high by institutionalized adolescents. However, the mean score for quality of care was significantly lower for institutionalized adolescents than for the comparison group. The quality of physical care did not show a significant relationship with mental health risk, except for anxiety. In contrast, emotional care was negatively associated with all common mental health problems including anxiety (beta = –0.40, P < .001), depression (beta = –0.31, P < .01), conduct behavior (beta = –0.30, P < .01) and sleep problems (beta = –0.30, P < .01). An increase in emotional care was therefore associated with a decrease in mental health problems.

Emotional care is more important than physical care for adolescents in SSFs. It is necessary to improve the quality of care, particularly emotional care, for adolescents to reduce the risk of mental health problems.

Due to a concerning rise in reported cases of childhood abuse in India, this study was initiated with the aim of uncovering the social determinants contributing to childhood trauma. Moreover, the second objective of the study was to discuss substance use initiation and patterns among children with cumulative trauma.

As a result, an in-depth interview served as a primary source of viewpoints to examine the essential objective. The study was conducted on children with a history of abuse. Twenty-eight children in the age group of 13–18 years (M_age = 16) residing in child-care institutes in Assam were taken into consideration.

Content analysis indicated child care and education, parental divorce or remarriage, domestic violence, family mental illness, household substance misuse, parental health, parental crime, poverty, and sexual and physical violence as social determinants of health for childhood trauma. Children reported using alcohol, marijuana, tobacco, cough syrup, inhalants such as paint, and glue, chewables such as betel nut and Gutka (chewing tobacco), and pharmaceutical tablets. Initiation and pattern of substance use among early initiators were likely to be encouraged by detrimental peer influence, indicating substance abuse as normal behavior and the family’s role in shaping children’s pattern of substance use. Problematic patterns of substance use were identified, for instance, health consequences, neglect of responsibilities, and increased daily frequency.

The results of this study may offer practical insights for healthcare professionals, enhancing their comprehension and addressing the social determinants of health indicating trauma and referring them to appropriate treatments. A holistic approach, which encompasses the collaboration of policymakers and healthcare providers, is vital for fostering health equity, thereby potentially preventing child abuse, childhood trauma and subsequent recidivism of substance use.