Destigmatizing Child and Adolescent Mental Health through Group Chat: A Workshop to Support the Emotional and Social Needs of Youth

The purpose of this project was to raise awareness surrounding child and adolescent mental health in an effort to reduce preconceived stigmas in relation to this specialized field. This project presented a literature review of the current state of child and adolescent mental health in Canada today, including the prevalence and several treatment options for young people confronting mental health challenges. Consideration of the powerful role of the education system upon youth with mental health issues became evident, specifically regarding early identification and prevention. A needs assessment was conducted to gather feedback from the clinical practitioners of a Section 23 classroom within a Southern Ontario hospital. This assessment was used to develop an informational and pedagogical workshop resource to extend practitioner understanding of this pertinent issue and support the social and emotional needs of young people confronting mental heath challenges. Results of the assessment indicated the significant need for such a workshop resource, and these responses were used to guide the development of Group Chat: A Workshop to Support the Emotional and Social Needs of Youth. The latter was subsequently presented to participants, whereby evaluative questionnaires indicated the efficacy and usefulness of this workshop resource to both practitioners and students alike.

Bone properties and skeletal maturity in adolescent males, as assessed by quantitative ultrasound

ABSTRACT Background: Previous studies have implied that weight-bearing, intense and prolonged physical activities optimize bone accretion during the grow^ing years. The majority of past inquiries have used dual-energy X-ray absorptiometry (DXA) to examine bone strength and hand-wrist radiography to determine skeletal maturity in children. Recently, quantitative ultrasound (QUS) technologies have been developed to examine bone properties and skeletal maturity in a safe, noninvasive and cost-effective manner. Objective: The purpose of this study was to compare bone properties and skeletal maturity in competitive male child and adolescent athletes with minimallyactive, age-matched controls, using QUS technology. >. Methods: In total, 224 males were included in the study. The 115 pre-pubertal boys aged 10-12 years consisted of control, minimally-active children (n=34), soccer players (n=26), gymnasts (n=25) and hockey players (n=30). In addition, the 109 late-pubertal boys aged 14-16 years consisted of control, minimally-active adolescents (n=31), soccer players (n=30), gymnasts (n=17) and hockey players (n=31). The athletic groups were elite level players that predominantly trained year-round. Physical activity, nutrition and sports participation were assessed with various questionnaires. Anthropometries, such as height, weight and relative body fat percentage (BF%) were assessed using standard measures. Skeletal strength and age were evaluated using bone QUS. Lastly, salivary testosterone (sT) concentration was measured using Radioimmunoassay (RIA). Results: Within each age group, there were no significant differences between the activity groups in age and pubertal stage. An age effect was apparent in all variables, as expected. A sport effect was noted in all physical characteristics: the child and adolescent gymnasts were shorter and lighter than other sports groups. Adiposity was greater in the controls and in the hockey players. All child subjects were pubertal stage (fanner) I or II, while adolescent subjects were pubertal stage IV or V. There were no differences in daily energy and mineral intakes between sports groups. In both age groups, gymnasts had a higher training volume than other athletic groups. Bone speed of sound (50s) was higher in adolescents compared with the children. Gymnasts had signifieantly higher radial 50S than controls, hockey and soccer players in both age cohorts. Hockey athletes also had higher radial 50S than controls and soccer players in the child and adolescent groups, respectiyely. Child gymnasts and soccer players had greater tibial 50S compared with the hockey players and control groups. Likewise, adolescent gymnasts and soccer players had higher tibial SoS compared with the control group. No interaction was apparent between age and type of activity in any of the bone measures. » Lastly, maturity as assessed by sT and secondary sex characteristics (Tanner stage) was not different between sports group within each age group. Despite the similarity in chronological age, androgen levels and sexual maturity, differences between activity groups were noted in skeletal maturity. In the younger group, hockey players had the highest bone age while the soccer players had the lowest bone age. In the adolescent group, gymnasts and hockey players were characterized by higher skeletal maturity compared with controls. An interaction between the age and sport type effects was apparent in skeletal maturity, reflecting the fact that among the children, the soccer players were significantly less mature than the rest of the groups, while in the adolescents, the controls were the least skeletally mature. Summary and Conclusions: In summary, radial and tibial SOS are enhanced by the unique loading pattern in each sport (i.e, upper and lower extremities in gymnastics, lower extremities in soccer), with no cumulative effect between childhood and adolescence. That is, the effect of sport participation on bone SOS was apparent already among the young athletes. Enhanced bone properties among athletes of specific sports suggest that participation in these sports can improve bone strength and potential bone health.

Correlates and outcomes of severe bullying: internalizing maladjustments of adolescent bullies, victims and bully- victims

The current study examined the association between involvement in bullying and victimization and internalizing difficulties such as self-esteem, social anxiety, depression and body image. Possible gender differences were also examined. The participants, high school students from Southern Ontario (N=533), were drawn from a larger, data set as part ofa study that was completed by the Youth Lifestyle Choices: Community Research Alliance (YLCCURA). The students completed a self-report questionnaire on a number ofmeasures; including, bullying, victimization, self-esteem, social anxiety, depression and body image. The results of this study suggest that those students who self-identified as victims and bully-victims also report higher levels of anxiety and depression than controls and bullies. Severe victims and bullyvictims had a lower body image than severe bullies and controls, whereas severe bullies seem to have a higher body image score than controls. These results are relevant when considering treatments and interventions for students experiencing adjustment difficulties who may also be at risk for bullying victimization. The results also suggest that particular attention needs to be focused on those adolescents who play multi-roles in bullying situations (i.e., bully-victims), since these students may come to the attention ofthe school system for externalizing behaviours, but may also need assistance for internalizing maladjustments.

Examining the potential application of childhood stature in assessing adolescent overweight and obesity

Background: Increasing Overweight and Obesity (OwOb) prevalence in pediatric populations is becoming a public health concern in many countries. The purpose of this study was to determine if childhood stature components, particularly the Leg Length Index (LLI = [height - sitting height]! height), were useful in assessing risk of OwOb in adolescence. Methods: Data was from a longitudinal study conducted in south Ontario since 2004. Approximately 2360 students had body composition measurements including sitting height and standing height at baseline. Among them, 1167 children (573 girls, 594 boys) who had weight and height measured at the 5 th year follow-up, were included in this analysis. OwOb was defined using age and sex specific BMI (kg!m 2 ) cut-off points corresponding to adults' BMI ~ 25. Results: Overall, 34% (n=298) of adolescents were considered as OwOb. The results from logistic regression analysis indicated that with 1 unit increase in LLI the odds of OwOb decreased 24% (Odds Ratio, [95% Confidence Interval], 0.76, [0.66-0.87]) after adjusted for age, sex and baseline waist circumference. Further adjusting for birth weight, birth order, breastfeeding, child's physical activity, maternal smoking, education, mother's age at birth and mother's BMI, did not change the relationship. Our results also indicated that mother's smoking status is associated with LLI. Discussion: Although LLI measured at childhood in this study is related to OwOb risk in adolescents, the underlying mechanism is unclear and further study is needed.

Perceived parental monitoring, adolescent disclosure, and adolescent depressive symptoms : a longitudinal examination

Parental monitoring has long been stressed as an important parenting practice in reducing adolescent susceptibility to depression. An extensive review by Stattin and Kerr (2000), however, , revealed that researchers had confounded perceptions of parental monitoring (i.e., parental solicitation and control) with parental knowledge, and neglected to consider the role of adolescent willingness to disclose. In the present study, adolescents (N = 1995; 51.3% female) were surveyed at two time points (grade 10 and 11). To disentangle the role of perceived parenting, three central issues were addressed. First, the present study examined whether parental knowledge, adolescent disclosure, and parental monitoring (i.e., parental solicitation and control) in grade 10 predicted adolescent depression in grade 11. Second, the predictive value of adolescent depression in grade lOon parental knowledge, adolescent disclosure, parental solicitation and parental control in grade 11 was considered. Lastly, associations among parental knowledge, adolescent disclosure, parental solicitation and parental control were examined over time. Findings indicated that higher levels of parental knowledge were associated with subsequent lower levels of depressive symptoms, and that depressive symptoms predicted lower levels of parental knowledge over time. Both adolescent willingness to disclose and parental control predicted higher parental knowledge. These findings underscore the role of adolescent and perceived parent contributions to parental knowledge, and highlight the importance of perceived parental knowledge in predicting reduced adolescent susceptibility to depression.

Relation of temperament and authoritative parenting on subtypes of adolescent behaviour

Over the years, researchers have investigated direct, conditional, and meditational pathways of adolescent aggression in relation to both temperament and parenting behaviours. However, no study to date has considered these relations with respect to a measure of aggression differentiated by form (e.g., overt, relational) and function (e.g., proactive, reactive). The present study examined the differential association of adolescent temperament and authoritative parenting on four subtypes of aggression. Participants included mothers, fathers, and one adolescent (between the ages of 10-19) from 663 families, recruited through random digit dialing. Parents reported on their child's temperament and occurrence of aggressive behaviours in addition to the perception of their own authoritative parenting. Adolescents reported on their own temperament and aggressive behaviours as well as on both their mother and father's authoritative parenting. Multiple regression analyses confirmed predictions that some aspects of temperament and authoritative parenting provide motivation towards the engagement of different aggressive behaviours. For example, higher negative affect was related to reactive types of aggression, whereas a strong desire for novel or risky behaviours related to proactive aggression. However, differences in effortful control altered the trajectory for both relationships. Higher levels of self-regulation reduced the impact of negative affect on reactive-overt aggression. Greater self-regulation also reduced the impact of surgency on proactive-overt aggression when age was a factor. Structural equation modeling was then used to assess the process through which adolescents become more or less susceptible to impulsive behaviours. Although the issue ofbi-directionality cannot be ruled out, temperament characteristics were the proximal correlate for aggression subtypes as opposed to authoritative parenting dimensions. Effortful control was found to partially mediate the relation between parental acceptancelinvolvement and reactive-relational and reactive-overt aggression, suggesting that higher levels of warmth and support as perceived by the child related to increased levels of self-regulation and emotional control, which in tum lead to less reactive-relational and less reactive-overt types of aggression in adolescents. On the other hand, negative affect partially mediated the relation between parental psychological autonomy granting and these two subtypes of aggression, supporting predictions that higher levels of autonomy granting (perceived independence) related to lower levels of frustration, which in tum lead to less reactive-relational and reactive-overt aggression in adolescents. Both findings provide less evidence for the evocative person-environment correlation and more support for temperament being an open system shaped by experience and authoritative parenting dimensions. As one of the first known studies examining the differential association of authoritative parenting and temperament on aggression subtypes, this study demonstrates the role parents can play in shaping and altering their children's temperament and the effects it can have on aggressive behaviour.

The form and function of aggressive subtypes: Relations with the goodness of fit between adolescent temperament and parent personality

The current research investigated whether the interaction between adolescent temperament and parent personality, consistent with the goodness of fit perspective, differentially predicted overt (e.g., kicking, punching, insulting) and relational (e.g., gossiping, rumour spreading, ostracising) forms of reactive (e.g., provoked, a response to goal blocking, unplanned and emotional) and proactive (e.g., unprovoked, goal-directed, deliberate and relatively unemotional) aggression. Mothers, fathers and their adolescent child (N = 448, age 10-17) from southern Ontario, Canada filled out questionnaires on adolescent temperament (i.e., frustration, fear, and effortful control) and aggression. Parents reported on their own personality traits (i.e., agreeableness, conscientiousness, and emotional stability). The form and function of aggression not encompassed by the subtype under investigation were controlled in each regression analysis. Consistent with the hypothesis, results indicated that a poor fit between adolescent temperament vulnerabilities and lower parent personality traits, including agreeableness, conscientiousness and emotional stability, was predictive of greater levels of differentiated aggression. For instance, lower father conscientiousness strengthened the relation between higher frustration and reactive overt aggression. Unexpectedly in some cases, temperament risk factors were more strongly associated with aggression subtypes when personality scores were at higher levels, particularly agreeableness and conscientiousness, traits normally considered to be at the optimal end of the dimension. For example, higher father agreeableness strengthened the relation between higher frustration and reactive relational aggression. At the main effects level, low fearfulness was significantly associated with only the overt subtypes of aggression, and unexpectedly, higher frustration and lower effortful control were related to both proactive and reactive subtypes of aggression. A temperamentally vulnerable adolescent was also at greater risk of displaying aggressive behaviour when the father lacked emotional stability, but not the mother. These results are broadly consistent with the prediction that temperament risk factors are more strongly associated with aggression subtypes when an adolescent predisposition does not fit well with parent personality traits. Mechanisms pertaining to stress in the family environment and the fostering of self-regulation abilities are discussed with respect to why a poor fit between temperament and parent personality is predictive of adolescent differentiated aggression.