Interpreting information about medication side effects: differences in risk perception and intention to comply when medicines are prescribed for adults or young children

This study investigates whether, and how, people's perception of risk and intended health behaviours are affected by whether a medicine is prescribed for themselves or for a young child. The question is relevant to the issue of whether it is beneficial to produce medicines information that is tailored to particular subgroups of the population, such as parents of young children. In the experiment, participants read scenarios which referred either to themselves or their (imagined) 1-year-old child, and were required to make a number of risk judgements. The results showed that both parents and non-parents were less satisfied, perceived side effects to be more severe and more likely to occur, risk to health to be higher, and said that they would be less likely to take (or give) the medicine when the recipient was the child. On the basis of the findings, it is suggested that it may well be beneficial to tailor materials to broader classes of patient type.

Knowing who likes who: The early developmental basis of coalition understanding

Group biases based on broad category membership appear early in human development. However, like many other primates humans inhabit social worlds also characterised by small groups of social coalitions which are not demarcated by visible signs or social markers. A critical cognitive challenge for a young child is thus how to extract information concerning coalition structure when coalitions are dynamic and may lack stable and outwardly visible cues to membership. Therefore, the ability to decode behavioural cues of affiliations present in everyday social interactions between individuals would have conferred powerful selective advantages during our evolution. This would suggest that such an ability may emerge early in life, however, little research has investigated the developmental origins of such processing. The present paper will review recent empirical research which indicates that in the first 2 years of life infants achieve a host of social-cognitive abilities that make them well adapted to processing coalition-affiliations of others. We suggest that such an approach can be applied to better understand the origins of intergroup attitudes and biases. Copyright © 2010 John Wiley & Sons, Ltd.

Parent and child perspectives on the nature of anxiety in children and young people with Autism Spectrum Disorders: a focus group study

Anxiety disorders are common among children and young people with Autism Spectrum Disorders (ASD). Despite growing knowledge about the prevalence, phenomenology and treatment of anxiety disorders, relatively little is understood about the nature and impact of anxiety in this group and little is known about autism-specific factors that may play a role in the increased prevalence of anxiety disorders. In this exploratory study, we report on a series of 5 focus groups with 17 parents of children and adolescents with ASD and anxiety. Across groups, parents gave strikingly similar descriptions of the triggers and behavioural signs associated with anxiety. Another consistent finding was that many parents reported that their children had great difficulty expressing their worries verbally and most showed their anxiety through changes in their behaviour. The impact of anxiety was reported to often be more substantial than the impact of ASD itself. The implications of the focus group findings are discussed in relation to existing literature.

Safeguarding inheritance and enhancing the resilience of orphaned young people living in child- and youth-headed households in Tanzania and Uganda

This paper explores the resilience of orphaned young people in safeguarding the physical assets (land and property) that they inherited from their parents and in sustaining their households without a co-resident adult relative. Drawing on the concept of resilience and the sustainable livelihoods framework, this paper analyses the findings of an exploratory study conducted with 15 orphaned young people heading households,18 of their siblings and 39 NGO workers and community members in Tanzania and Uganda. The research suggests that inherited land and property represent key determining factors in the formation and viability of child- and youth-headed households in both rural and urban areas. Despite experiences of stigma and marginalisation in the community, social networks were crucial in enabling young people to protect themselves and their property, in providing access to material and emotional resources and in enhancing their skills and capabilities to develop sustainable livelihoods. Support for child- and youth-headed households needs to recognise young people's agency and adopt a holistic approach to their lives that analyses the physical assets, material resources, human and social capital available to the household, as well as individual young people's wellbeing, outlook and aspirations. Alongside cash transfers and material support, youth-led collective mobilisation that is sustained over time may also help to build resilience and foster more supportive social environments that challenge property grabbing and the stigmatisation of child- and youth-headed households.

Dying young: a palaeopathological analysis of child health in Roman Britain

Children represent the most vulnerable members of society, and as such provide valuable insight into past lifeways. Adverse environmental conditions translate more readily into the osteological record of children, making them primary evidence for the investigation of ill-health in the past. To date, most information on growing up in Roman Britain has been based on the Classical literature, or discussed in palaeopathological studies with a regional focus, e.g. Dorset or Durnovaria. Thus, the lifestyles and everyday realities of children throughout Britannia remained largely unknown. This study sets out to fill this gap by providing the first large scale analysis of Romano-British children from town and country. The palaeopathological analysis of 1643 non-adult (0-17 years) skeletons, compiled from the literature (N=690) and primary osteological analysis (N=953), from 27 urban and rural settlements has highlighted diverse patterns in non-adult mortality and morbidity. The distribution of ages-at-death suggest that older children and adolescents migrated from country to town, possibly for commencing their working lives. True prevalence rates suggest that caries (1.8%) and enamel hypoplasia (11.4%) were more common in children from major urban towns, whereas children in the countryside displayed higher frequencies of scurvy (6.9%), cribra orbitalia (27.7%), porotic hyperostosis (6.2%) and endocranial lesions (10.9%). Social inequality in late Roman Britain may have been the driving force behind these urban-rural dichotomies. The results may point to exploitation of the peasantry on the one hand, and higher status of the urban population as a more ‘Romanised’ group on the other. Comparison with Iron Age and post-medieval non-adults also demonstrated a decline in health in the Roman period, with some levels of ill-health, particularly in the rural children, similar to those from post-medieval London. This research provides the most comprehensive study of non-adult morbidity and mortality in Roman Britain to date. It has provided new insights into Romano-British lifeways and presents suggestions for further work.

A follow-up study of characteristics of young people that dropout and continue psychotherapy: service implications for a clinic in the community

Background: The paper reports the findings from a follow-up study of the factors that contribute to whether young people dropout or continue once-weekly psychotherapy at a voluntary sector psychotherapy service for young people aged 12 to 21 years. Method: The study uses data from an ongoing audit of the psychotherapy service that started in 1993; 882 young people were included in the study. Premature termination of treatment was defined as dropping out before the 21st session. Continuation in treatment was defined as remaining in therapy after 20 sessions. Measures and areas of interest used in the study include diagnostic measures, the Youth Self Report Form and Young Adult Self Report Form, demographic characteristics and treatment related information. Results: Young people who continued in treatment were more likely to be older, have anxieties about sexual and relationship issues and have higher scores on self-reported anxiety-depression. Young people who dropped out of treatment were more likely to be younger, have higher self-reported delinquency scores, have a diagnosis of hyperactivity-conduct disorder and be homeless. Conclusions: The study of treatment termination has demonstrated the value of service audit and has led to a significant change in clinical practice.

Child labour in African Artisanal Mining Communities: experiences from Northern Ghana

The issue of child labour in the artisanal and small-scale mining (ASM) economy is attracting significant attention worldwide. This article critically examines this ‘problem’ in the context of sub-Saharan Africa, where a lack of formal sector employment opportunities and/or the need to provide financial support to their impoverished families has led tens of thousands of children to take up work in this industry. The article begins by engaging with the main debates on child labour in an attempt to explain why young boys and girls elect to pursue arduous work in ASM camps across the region. The remainder of the article uses the Ghana experience to further articulate the challenges associated with eradicating child labour at ASM camps, drawing upon recent fieldwork undertaken in Talensi-Nabdam District, Upper East Region. Overall, the issue of child labour in African ASM communities has been diagnosed far too superficially, and until donor agencies and host governments fully come to grips with the underlying causes of the poverty responsible for its existence, it will continue to burgeon.

Anxiety problems in young people with Asperger syndrome: a case series

It is now well established that the prevalence of mental health difficulties in individuals with autism spectrum disorders (ASD) is considerably higher than in the general population. With recent estimates of the prevalence of autism spectrum disorders being as high as one percent, increasing numbers of children and young people are presenting to local and specialist services with mental health problems in addition to a diagnosis of ASD. Many families report that the impact of the mental health problems can be as or more impairing than the autism spectrum difficulties themselves. Clinical services are frequently called upon to treat these difficulties; however, there is limited evidence for the effectiveness of treatments in this population. This paper reports a case series of children and adolescents with ASD and an anxiety disorder who were treated with a standard cognitive behaviour therapy (CBT) rationale adapted to take account of the neuropsychological features of ASD. Common features of the presentation of the disorders and also treatment processes are discussed.

Doll Play narratives about starting school in children of socially anxious mothers, and their relation to subsequent child school-based anxiety

Background: Child social anxiety is common, and predicts later emotional and academic impairment. Offspring of socially anxious mothers are at increased risk. It is important to establish whether individual vulnerability to disorder can be identified in young children. Method: The responses of 4.5 year-old children of mothers with social phobia (N = 62) and non-anxious mothers (N = 60) were compared, two months before school entry, using a Doll Play (DP) procedure focused on the social challenge of starting school. DP responses were examined in relation to teacher reports of anxious-depressed symptoms and social worries at the end of the child’s first school term. The role of earlier child behavioral inhibition and attachment, assessed at 14 months, was also considered. Results: Compared to children of non-anxious mothers, children of mothers with social phobia were significantly more likely to give anxiously negative responses in their school DP (OR = 2.57). In turn, negative DP predicted teacher reported anxious-depressed and social worry problems. There were no effects of infant behavioral inhibition or attachment. Conclusion: Vulnerability in young children at risk of anxiety can be identified using Doll Play narratives.

Do early father–infant interactions predict the onset of externalising behaviours in young children? Findings from a longitudinal cohort study

Background Factors related to parents and parenting capacities are important predictors of the development of behavioural problems in children. Recently, there has been an increasing research focus in this field on the earliest years of life, however, relatively few studies have addressed the role of fathers, despite this appearing to be particularly pertinent to child behavioural development. This study aimed to examine whether father–infant interactions at age 3 months independently predicted child behavioural problems at 1 year of age. Method A sample of 192 families was recruited from two maternity units in the United Kingdom. Father–infant interactions were assessed in the family home and coded using the Global Rating Scales. Child behaviour problems were assessed by maternal report. Hierarchical and logistic regression analyses were used to examine associations between father–infant interaction and the development of behavioural problems. Results Disengaged and remote interactions between fathers and their infants were found to predict externalising behavioural problems at the age of 1 year. The children of the most disengaged fathers had an increased risk of developing early externalising behavioural problems [disengaged (nonintrusive) interactions – adjusted Odds Ratio 5.33 (95% Confidence Interval; 1.39, 20.40): remote interactions adj. OR 3.32 (0.92, 12.05)] Conclusions Disengaged interactions of fathers with their infants, as early as the third month of life, predict early behavioural problems in children. These interactions may be critical factors to address, from a very early age in the child’s life, and offer a potential opportunity for preventive intervention.

Parent-child interactions and adolescent anxiety: a systematic review

Parental behaviours have been implicated in the development and maintenance of anxiety in children and young people; however the degree to which findings apply to adolescents specifically remains unclear. We conducted a systematic review of studies examining the evidence for an association between parental behaviours and adolescent anxiety. Twenty two studies were identified. The results of this systematic review provide fairly consistent preliminary evidence for an association between anxiety and perceived parental control and anxious rearing in adolescence. The findings relating to an association between adolescent anxiety and perceived parental rejection and lack of warmth are somewhat less consistent. Methodological shortcomings in the studies mean that these results should be interpreted with caution. Future research should be conducted using observational and experimental design with adolescents from referred, clinical populations to help identify the critical parental processes and clarify the direction of effects.

The Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP): development and psychometric properties

Background: There is increased interest in developing training in cognitive behaviour therapy (CBT) with children and young people. However, the assessment of clinical competence has relied upon the use of measures such as the Cognitive Therapy Scale-Revised (CTSR: Blackburn et al., 2001) which has been validated to assess competence with adults. The appropriateness of this measure to assess competence when working with children and young people has been questioned. Aim: This paper describes the development and initial evaluation of the Cognitive Behaviour Therapy Scale for Children and Young People (CBTSCYP) developed specifically to assess competence in CBT with children and young people. Method: A cross section of child CBT practitioners (n = 61) were consulted to establish face validity. Internal reliability, convergent validity and discriminative ability were assessed in two studies. In the first, 12 assessors independently rated a single video using both the Cognitive Behaviour Therapy Scale for Children and Young People (CBTS-CYP) and Cognitive Therapy Scale-Revised (CTS-Revised: Blackburn et al., 2001). In the second, 48 different recordings of CBT undertaken with children and young people were rated on both the CBTS-CYP and CTS-R. Results: Face validity and internal reliability of the CBTS-CYP were high, and convergent validity with the CTS-R was good. The CBTS-CYP compared well with the CTSR in discriminative ability. Conclusion: The CBTS-CYP provides an appropriate way of assessing competence in using CBT with children and young people. Further work is required to assess robustness with younger children and the impact of group training in reducing interrater variations.