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Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14-24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities.

The qualitative community embraces transparent dialogue through sharing knowledge to improve rigour and develop new initiatives. In this paper, we recognise there are many complexities within qualitative research, leading to important debates. We explore the benefits and challenges, as well as the practicalities and technicalities, of conducting research that 1) employs multiple methods within the qualitative paradigm, 2) is interdisciplinary, and 3) examines a sensitive research topic 4) with a vulnerable group of participants. Specifically, when research is also 5) cross-cultural and 6) utilises participatory techniques. Through our discussion, we draw upon an existing project and examine the complexity of designing and completing intra-paradigmatic mixed methods research with children from different sociocultural contexts, underpinned by interdisciplinary perspectives, in a complex area like mental health.

Globally, child and youth mental health needs are largely unmet, especially in resource-constrained settings. Youth are uniquely placed to provide mental health support, but there is limited evidence on what their role should involve. The aim of this study was to establish how youth themselves conceptualized the peer support worker role. We captured the perspectives of 45 youth from Pakistan and South Africa. Focus group discussions were analyzed through a thematic codebook framework. Key findings indicated how youth can improve their mental health care, as well as those of their peers, by recognizing early signs of mental health concerns, developing adaptive coping mechanisms, strengthening social relationships, and mobilizing additional resources through advocacy and mediation. Peer support can be enhanced by skills such as lack of judgement, empathy, encouragement and good communication. Peer support workers can play an important role in promoting children’s mental health, particularly in resource-constrained settings. Such posts should be clearly defined, incorporated within existing service systems, and provided with adequate funding, training and supervision.

This study compared two goal-setting approaches found in the Precision Teaching literature, namely the minimum celeration line and the beat your personal best during the mathematical practice of three male students diagnosed with autism, aged 8-9. An adapted alternating treatments design with a control condition was embedded in a concurrent multiple baseline across participants design. Each approach was randomly allocated to either the multiplication/division (×÷) table of 18 or 19, while no approach was allocated to the ×÷14 table that acted as a control. Instruction utilized number families and consisted of (a) untimed practice, (b) frequency-building, (c) performance criteria, (d) graphing, and (e) a token economy. Upon practice completion, an assessment of maintenance, endurance, stability, and application (MESA) was conducted. Participants improved with both conditions and maintained their performance well, while improvements with the control condition were weak. The beat your personal best approach was highlighted as slightly more effective in terms of average performance and more efficient in terms of timings needed to achieve criterion. No differences were identified in terms of learning rate (i.e., celeration) or performance on the MESA. More research is warranted to identify which goal-setting procedure is more appropriate for students in special education.

Precision Teaching is a behavior measurement system that emphasizes the development of behavioral repertoires and utilizes Standard Celeration Charts as its primary tool. This system has been applied across various areas, including mainstream and special education, and has successfully improved academic, motor, communication, and other skills. While previous systematic reviews have highlighted important aspects of Precision Teaching, a more comprehensive evaluation is needed to consider all its different applications and recent developments in conceptualizing it. Therefore, this systematic review and meta-analysis will assess the effectiveness of Precision Teaching in accelerating human behavior, identify all the areas of its application, and review the technical aspects of its implementation. The review aims to provide a comprehensive understanding of the system and its potential benefits for individuals in different settings.

Learning channels refer to the way students receive instruction and respond to it. We examined the relationship between See-Say and See-Write learning channel sets during the mathematical practice of four male autistic students, aged 8 to 14 years. Participants received practice in the ×7 and ×8 tables across both channel sets. Lessons included untimed practice, timed practice, graphing and goal-setting. A multiple treatments design, embedded in a multiple baseline across participants design, was used. When practice on a set was completed, an assessment of endurance, stability, application, generalisation to the other set and maintenance was conducted. Practice led to improvements that were maintained. Participants achieved learning rates above 30% per week, which is a minimum expectation in Precision Teaching. Practice on one set affected performance on the other, and the order of practice was an important variable. The See-Say channel set led to better generalisation outcomes while performance was stronger on the See-Write.

Abstract Background The involvement of young people as peer researchers, especially with lived experience, is increasingly considered important in youth mental health research. Yet, there is variation in the understanding of the role, and limited evidence on its implementation across different research systems. This case study focusses on the barriers and enablers of implementing peer researcher roles within and across majority world countries contexts. Methods Based on an international youth mental health project involving different levels of peer researchers and participants from eight countries, peer researchers and a co-ordinating career researcher reflect on lessons regarding enabling and challenging factors. These reflections are captured and integrated by a systematic insight analysis process. Results Building on existing international networks, it was feasible to actively involve peer researchers with lived experience in a multi-country mental health study, who in turn recruited and engaged young participants. Identified challenges include the terminology and definition of the role, cultural differences in mental health concepts, and consistency across countries and sites. Discussion Peer researchers’ role could be strengthened and mainstreamed in the future through ongoing international networks, training, sufficient planning, and active influence throughout the research process. Trial registration: Not applicable.

The aim of this study was to investigate the effect of a precision teaching (PT) framework on the mathematical ability of students with intellectual and developmental disabilities. We also examined if students of moderate mathematical ability could perform as well as their peers with fewer difficulties with their math skills. Sixteen students participated and were divided into three groups. One group engaged in PT, and the other two groups functioned as comparisons. The PT group practiced six skills introduced linearly. An A-B design was used for the five component skills, and a multiple baseline across participants design was used for the composite skill (addition). The intervention led to a significant improvement in all skills, including addition, and this was associated with a large effect size; student performance met or exceeded that of their peers. Overall, the findings suggest that PT is an efficient and effective approach for teaching students with IDDs.

Background: The experience of trauma during childhood is due to decrease in children's psychosocial functions, which continues during adulthood. Children's coping and reactions play the important role in adapting to traumatic events and can lead to post-traumatic disorder or post-traumatic growth. Previous research studies have quantitatively and sporadically shown some of the factors affecting coping styles, but so far, focus as depth research in this area, especially on Iranian children, has been influenced. Aims: The present study evaluated the contextual factors in selecting the effective coping strategies by children exposed to the Kermanshah earthquake in 2017 Methods: This research was the qualitative type with an approach to conventional content analysis. The participants consisted of 23 girls aged 10 to 12 years who were selected by purposive sampling, and semi-structured interviews. Data were analyzed by the 5-step method of Graneheim, & Lundman (2004). Results: The results indicated four main categories and fourteen Subcategories as the contexts of selecting coping styles. These categories include a) influence (previous life experiences, modeling), b) individual skills (responsibility to others "external commitment" and "commitment to oneself," time management, emotion control, tolerating failure and compassion with others), c) family members' relationship with the child (intimacy with family members, support of family members and how parents deal) and d) social skills (trust in peers, valuing relationships and the level of ability to make and maintain friendships). Conclusion: The findings demonstrate the effect of intrapersonal and interpersonal factors in selecting various strategies among children encountered with earthquake trauma.

Abstract Precision Teaching is a behavior measurement system that emphasizes the development of behavioral repertoires and utilizes Standard Celeration Charts as its primary tool. This system has been applied across various areas, including mainstream and special education, and has successfully improved academic, motor, communication, and other skills. While previous systematic reviews have highlighted important aspects of Precision Teaching, a more comprehensive evaluation is needed to consider all its different applications and recent developments in conceptualizing it. Therefore, this systematic review and meta‐analysis will assess the effectiveness of Precision Teaching in accelerating human behavior, identify all the areas of its application, and review the technical aspects of its implementation. The review aims to provide a comprehensive understanding of the system and its potential benefits for individuals in different settings.

The objective was to establish how stakeholders in low- and middle-income countries (LMIC) conceptualize child mental health impact. Semi-structured interviews were conducted with 18 stakeholders from disadvantaged urban communities in Kenya, South Africa, Turkey and Brazil. Participants represented education, welfare and health care agencies; as well as community and religious groups. Data were analysed through a thematic approach and three related themes were identified. Impact was defined as a process of change, with child-centred outcomes and measures that were broader than mental health symptoms improvement. Beneficiaries were identified at child, family, community and service level. Participants wished to see strategies that ensured sustainability of impact, namely child mental health policy, stakeholder engagement, interdisciplinary working, and capacity-building for all stakeholder groups. Child mental health service transformation in LMIC, especially in areas of deprivation, needs to build on existing resources and strengths by co-producing psychosocial outcomes with a range of professional and community stakeholders. Impact on children's mental wellbeing can be achieved through a co-ordinated strategy that involves designated policy, capacity-building, and interdisciplinary networks with meaningful community involvement.

There is a growing appreciation that child functioning in different domains, levels, or systems are interrelated over time. Here, we investigate links between internalizing symptoms, externalizing problems, and academic attainment during middle childhood and early adolescence, drawing on two large data sets (child: mean age 8.7 at enrolment, n = 5,878; adolescent: mean age 11.7, n = 6,388). Using a 2-year cross-lag design, we test three hypotheses - adjustment erosion, academic incompetence, and shared risk - while also examining the moderating influence of gender. Multilevel structural equation models provided consistent evidence of the deleterious effect of externalizing problems on later academic achievement in both cohorts, supporting the adjustment-erosion hypothesis. Evidence supporting the academic-incompetence hypothesis was restricted to the middle childhood cohort, revealing links between early academic failure and later internalizing symptoms. In both cohorts, inclusion of shared-risk variables improved model fit and rendered some previously established cross-lag pathways non-significant. Implications of these findings are discussed, and study strengths and limitations noted. Statement of contribution What is already known on this subject? Longitudinal research and in particular developmental cascades literature make the case for weaker associations between internalizing symptoms and academic performance than between externalizing problems and academic performance. Findings vary in terms of the magnitude and inferred direction of effects. Inconsistencies may be explained by different age ranges, prevalence of small-to-modest sample sizes, and large time lags between measurement points. Gender differences remain underexamined. What does this study add? The present study used cross-lagged models to examine longitudinal associations in age groups (middle child and adolescence) in a large-scale British sample. The large sample size not only allows for improvements on previous measurement models (e.g., allowing the analysis to account for nesting, and estimation of latent variables) but also allows for examination of gender differences. The findings clarify the role of shared-risk factors in accounting for associations between internalizing, externalizing, and academic performance, by demonstrating that shared-risk factors do not fully account for relationships between internalizing, externalizing, and academic achievement. Specifically, some pathways between mental health and academic attainment consistently remain, even after shared-risk variables have been accounted for. Findings also present consistent support for the potential impact of behavioural problems on children's academic attainment. The negative relationship between low academic attainment and subsequent internalizing symptoms for younger children is also noteworthy.

Abstract The objective was to establish how stakeholders in low- and middle-income countries (LMIC) conceptualize child mental health impact. Semi-structured interviews were conducted with 18 stakeholders from disadvantaged urban communities in Kenya, South Africa, Turkey and Brazil. Participants represented education, welfare and health care agencies; as well as community and religious groups. Data were analysed through a thematic approach and three related themes were identified. Impact was defined as a process of change, with child-centred outcomes and measures that were broader than mental health symptoms improvement. Beneficiaries were identified at child, family, community and service level. Participants wished to see strategies that ensured sustainability of impact, namely child mental health policy, stakeholder engagement, interdisciplinary working, and capacity-building for all stakeholder groups. Child mental health service transformation in LMIC, especially in areas of deprivation, needs to build on existing resources and strengths by co-producing psychosocial outcomes with a range of professional and community stakeholders. Impact on children’s mental wellbeing can be achieved through a co-ordinated strategy that involves designated policy, capacity-building, and interdisciplinary networks with meaningful community involvement.

Abstract Background Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). Methods Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12–18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. Results The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2–8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2–10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. Conclusions Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

Mental health booklets may provide a low-cost means of promoting mental health self-management and help seeking in schools. The aim of the study was to assess the (a) use, (b) acceptability and (c) impact of booklets for students in primary (10-11 years) and secondary school (12-13 years) alone and in conjunction with funding for targeted mental health support. This was a 2 × 2 factorial cluster randomized controlled trial, in which 846 schools in England were randomly allocated to receive/not receive: (1) booklets for students containing information on mental health self-management and help seeking, and (2) funding for mental health support as part of a national mental health initiative. 14,690 students (8139 primary, 6551 secondary) provided self-report on mental health, quality of life (baseline and 1 year follow-up) and help seeking (follow-up). (a) Approximately, 40 % primary school students and 20 % secondary school students reported seeing the booklets. (b) Of these, 87 % of primary school students reported that the booklet was 'very helpful' or 'quite helpful', compared with 73 % in secondary school. (c) There was no detectable impact of booklets on mental health, quality of life or help seeking, either alone or in conjunction with additional funding through the national mental health initiative. Lack of discernable impact of booklets underscores the need for caution in adopting such an approach. However, it is feasible that the impact was obscured by low uptake or that booklets may be more effective when used in a targeted way.

The research aimed to establish how psychosocial supports are experienced by children who lived on the streets, juxtaposed with caregivers’ views. Semi-structured interviews were conducted with seven children aged 12-16 years recruited from a shelter in Delhi who had lived on the streets, four parents, and five professionals. The data were analysed using thematic analysis. Three themes were identified: 1) children’s psychosocial needs, 2) risk factors, and 3) protective factors and supports. Inter-linked risk factors were deprivation of basic needs, exploitation, maltreatment, antisocial activities and substance abuse. Emotional and physical safety was a priority before instigating resilience-building strategies. These consisted of developing peer and staff relationships, education, sports and creative activities. Counselling was viewed as important, but integral to other supports.The multiple and complex psychosocial needs of street children require a co-ordinated, interdisciplinary and scaled care approach. This should prioritize protection strategies, followed by integrated resilience-building interventions.

PurposeAlthough extensive evidence indicates that being younger within a school cohort is associated with poorer academic functioning, much less is known about such relative age effects (RAEs) for mental health--the focus of the current investigation.MethodsData from 23,379 11- to 13-year-olds attending state-maintained secondary schools in England were analyzed to investigate RAEs on mental health measured using the Strengths and Difficulties Questionnaire. Participants were grouped into oldest, middle, and youngest thirds of their academic year based on their month of birth relative to their cohort. Hierarchical linear regression analysis evaluated RAEs and gender- or deprivation-related moderation of such effects.ResultsRelatively younger adolescents had significantly more emotional symptoms and peer problems compared with relatively older individuals in a year group, although effect sizes were small. These effects were not moderated by gender or deprivation. Impact of mental health difficulties on other aspects of functioning was also greater among relatively younger children. Larger RAEs are observed in the younger cohort (11-12 years) compared with those in the 12- to 13-year-olds, thereby indicating that RAEs might attenuate with age.ConclusionsBeing relatively younger than classmates is associated with increased internalizing symptoms, poorer peer relationships, and higher impact of mental health difficulties on functioning at school and home. The findings support wider inclusion of relative age in understanding mental health difficulties and its inclusion as a potential risk factor in studies investigating the development of psychopathology, especially for internalizing symptoms. Possible mechanisms of the effects detected are discussed.

Abstract Background Stress-related situations play a significant role in children’s lives and result in different reaction in children. Among various methods of evaluating the stressful environment of children, 54-item Children’s Coping Strategies Checklist-Revision1 (CCSC-R1) has been developed as one of the most powerful tools for assessing different aspects of coping in children. The purpose of the present study is to find the psychometric properties of Persian CCSC-R1 and to identify the coping strategies used by Iranian children. Method Subjects included 401 female students aged between 9 and 13 who were subjected to the Sarpol-e-Zahab earthquake (in Northeast of Iran). Construct and convergence validities were examined with confirmatory factor analysis and correlated with Children’s Coping Behavior Questionnaire (CCBQ). Reliability was obtained by internal consistency. Using repeated analysis of variance, the status of coping strategies in children were achieved. Results Confirmatory factor analysis showed a good model fit to the four-factor structure, active coping, distracting action/distraction, avoidance, and support seeking strategies. The results also demonstrated that there was a strong relationship between four-factors of CCSC-R1 including their subscales and CCBQ. Internal consistency (Cronbach’s Alpha) for the four dimensions were in the range of 0.76 to 0.88. The findings also showed that Iranian children use active coping, especially optimism, more than other strategies in order to deal with their stressful situations. Conclusions It is concluded that CCSC-R1 is a valid and reliable instrument which could be employed for Iranian children. Furthermore, in the face of traumatic events, Iranian children acted same as people in individualistic cultures.

BackgroundRecently, a general psychopathology dimension reflecting common aspects among disorders has been identified in adults. This has not yet been considered in children and adolescents, where the focus has been on externalising and internalising dimensions.AimsTo examine the existence, correlates and predictive value of a general psychopathology dimension in young people.MethodAlternative factor models were estimated using self-reports of symptoms in a large community-based sample aged 11-13.5 years (N = 23 477), and resulting dimensions were assessed in terms of associations with external correlates and future functioning.ResultsBoth a traditional two-factor model and a bi-factor model with a general psychopathology bi-factor fitted the data well. The general psychopathology bi-factor best predicted future psychopathology and academic attainment. Associations with correlates and factor loadings are discussed.ConclusionsA general psychopathology factor, which is equal across genders, can be identified in young people. Its associations with correlates and future functioning indicate that investigating this factor can increase our understanding of the aetiology, risk and correlates of psychopathology.

Abstract Child and adolescent psychiatry is in a unique position to respond to the growing public health challenges associated with the large number of mental disorders arising early in life, but some changes may be necessary to meet these challenges. In this context, the future of child and adolescent psychiatry was considered by the Section on Child and Adolescent Psychiatry of the World Psychiatric Association (WPA CAP), the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), the World Association for Infant Mental Health (WAIMH), the International Society for Adolescent Psychiatry and Psychology (ISAPP), the UN Special Rapporteur on the Right to Health, representatives of the WHO Department of Mental Health and Substance Abuse, and other experts. We take this opportunity to outline four consensus priorities for child and adolescent psychiatry over the next decade: increase the workforce necessary for providing care for children, adolescents and families facing mental disorders; reorienting child and adolescent mental health services to be more responsive to broader public health needs; increasing research and research training while also integrating new research finding promptly and efficiently into clinical practice and research training; Increasing efforts in advocacy.

The wellbeing of disadvantaged children in low-income countries (LIC) is often compromised by a range of environmental risk factors, as well as by limited access to supports and services. The aim of this exploratory study was to understand service provision barriers for children's wellbeing in an urban informal settlement in Dhaka, Bangladesh, by complementing stakeholder perspectives with a spatial method and a knowledge exchange framework. The research literature and official records informed interviews with 19 stakeholders, who identified interdisciplinary services. Visual geospatial analysis mapped services in relation to child wellbeing. These maps informed a knowledge exchange participatory workshop with 21 stakeholders, who co-produced recommendations related to child-centeredness and safety, community involvement, and accessible resources. Such a participatory approach combining stakeholder perspectives with geospatial analysis can be a useful tool in low-resource contexts.

Early detection of child mental health problems in schools is critical for implementing strategies for prevention and intervention. The development of an effective measure of mental health and well-being for this context must be both empirically sound and practically feasible. This study reports the initial validation of a brief self-report measure for child mental health suitable for use with children as young as 8 years old ("Me & My School" [M&MS]). After factor analysis, and studies of measurement invariance, 2 subscales emerged: emotional difficulties and behavioral difficulties. These 2 subscales were highly correlated with corresponding constructs of the Strengths and Difficulties Questionnaire (SDQ) and showed correlations with attainment, deprivation, and educational needs similar to ones obtained between these demographic measures and the SDQ. Results suggest that this school-based self-report measure is psychometrically sound, and has the potential of contributing to school mental health surveys, evaluation of interventions, and recognition of mental health problems within schools.

The concept of resilience is increasingly influential in the development of interventions and services for young people, yet there is limited knowledge of how resilience-building strategies are conceptualized by young people across different cultures, particularly in low- and middle-income countries. The aim of this study was to capture 274 young people’s voices in disadvantaged communities in Kenya, Turkey, Pakistan, and Brazil through participatory research methods. Young people defined strategies in response to 4 adversity scenarios reflecting socioecological systems (young person, family, school, and community). Template analysis, underpinned by thematic design, was used to establish three broad themes of intrapersonal (self-management, cognitive re-appraisal, agency), interpersonal (social engagement, informal supports, formal supports), and religious resources. Proposed strategies were largely similar across the sites, with some contextual differences depending on the scenario (stressor) and cultural group. The findings support an ecological systems approach to resilience, which is consistent with the development of multimodal interventions for vulnerable youth and their families in disadvantaged communities in low- and middle-income countries.

Background: Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed. Objective: The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms. Method: Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated. Results: The PTSD-RI-5 total score for the entire sample shows very good reliability (α = .92) as well as across all countries included (α ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance. Conclusions: The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.

School-based interventions involving teacher training programmes have been shown to benefit teachers' ability to identify and manage child mental health problems in developed countries. However, very few studies have been conducted in low-income countries with limited specialist services. The aim of the study was to evaluate the impact of the training programme on teachers' knowledge and awareness. A total of 114 primary school teachers from five schools in Karachi participated in a two-day (10-12 hours) workshop to provide them with an understanding of common child mental health problems and train them in basic skills. Their pre-and post-training knowledge was evaluated through a rating scale and open-ended questions. Single tailed "t"-test, involving paired differences, was applied for participants' scores. Pre-/post-training differences were statistically significant. The training sessions were associated with an improvement in teachers' knowledge and awareness of various signs and symptoms of common child mental health problems. The greatest improvement was noted in response to strategies of managing difficult behaviours, as 61% of respondents were able to formulate appropriate behavioural management techniques after the training. In low-income developing countries like Pakistan, teachers should be trained in early-intervention programmes for the identification and school-based management of less complex emotional and behavioural problems. Such interventions can maximise the use of sparse mental health resources.

The importance of joint working between educational and child mental health professionals is well documented but there are numerous challenges and only limited training models. While the evidence base and training programmes for educationalists regarding child mental health is growing, training mental health professionals about education is more limited. This study presents the views of 36 child mental health and education professionals from four service localities in England regarding their experiences of joint working and perceptions of training, including a preliminary evaluation of a training programme designed to bridge this gap. The findings indicate that participants perceived that a degree of knowledge in education matters is important, and reported that this could be acquired through the development of relationships with educational professionals, setting up link posts and joint training; they also described challenges related to building experience and to resource constraints. Participants were generally positive about the training package and reported that there was a clear training need in this area. (Contains 1 figure and 2 tables.)

Background: Many studies have described associations between adult psychiatric disorder among adults and their biographic, socio-demographic and social capital characteristics. Fewer studies have focused on children, and most of these have looked at structural indicators of the neighbourhood. Our objective was to examine one aspect of social capital--perceived neighbourhood trust and safety in relation to childhood psychopathology. Methods: Data on childhood psychopathology and perceived neighbourhood trust and safety were obtained on 3,340 11 to 16-year-olds included in a large survey of the mental health carried out in 426 postal sectors in Great Britain. Data were collected on biographic and socio-demographic characteristics of the child and the family, measures of social capital and neighbourhood prosperity. We entered all these variables into a logistic regression analysis to establish the strength of association between perceived neighbourhood trust and safety separately for emotional and conduct disorders. Results: Children's perception of their neighbourhoods in terms of the trustworthiness or honesty of the people who live there or feeling safe walking alone had a strong association with childhood psychopathology, particularly emotional disorders, rather than the nature of the neighbourhood itself. Children's behaviour, however, such as going to the park or shops alone, did not vary by measures of childhood psychopathology. Conclusions: Regeneration of less prosperous neighbourhoods is likely to increase children's positive perceptions of trust, honesty and safety which in turn can have a positive effect on their mental health.

This study describes the pattern of emotional and behavioural difficulties of children whose mothers have mental illness, and explores the relationship between children's behavioural and emotional difficulties and maternal perceptions of attachment. Thirteen mothers previously admitted to psychiatric hospital for mental illness completed a measure of their own symptoms (Brief Symptom Inventory), their children's emotional and behavioural problems (Strengths and Difficulties Questionnaire (SDQ)), and attachment security (Parent/Child Reunion Inventory) (n = 21). Mean scores for child SDQ profiles were found to be within the 'normal' range, although (on some indices) mothers reported more 'case' scores for their children, than would be expected from standardized norms. It was found that there were significant positive correlations between 'insecurity' scores and all problem scales of the SDQ. Best predictors from the Parent/Child Reunion Inventory factors for each SDQ scale are reported and discussed.

Background: We examined the prevalence and nature of comorbid post-traumatic stress reactions and depressive symptoms, and the impact of exposure to traumatic events on both types of psychopathology, among Palestinian children during war conflict in the region. Methods: The 403 children aged 9-15 years, who lived in four refugee camps, were assessed by completing the Gaza Traumatic Events Checklist, the Child Post Traumatic Stress Reaction Index (CPTSD-RI), and the Short Mood and Feelings Questionnaire (MFQ). Results: Children reported experiencing a wide range of traumatic events, both direct experience of violence and through the media. CPTSD-RI and MFQ scores were significantly correlated. Both CPTSD-RI and MFQ scores were independently predicted by the number of experienced traumatic events, and this association remained after adjusting for socioeconomic variables. Exposure to traumatic events strongly predicted MFQ scores while controlling for CPTSD-RI scores. In contrast, the association between traumatic events and CPTSD-RI scores, while controlling for MFQ scores, was weak. The CPTSD-RI items whose frequency was significantly associated with total MFQ scores were: sleep disturbance, somatic complaints, constricted affect, impulse control, and difficulties in concentration. However, not all remaining CPTSD-RI items were significantly associated with exposure to traumatic events, thus raising the possibility that the association between depression and PTSD was due in part to symptom overlap. Conclusions: Children living in war zones are at high risk of suffering from PTSD and depressive disorders. Exposure to trauma was not found to have a unique association with PTSD. The relationship between PTSD and depressive symptomatology requires further investigation.

Objective: To establish the nature and extent of maltreatment experiences, coping strategies, and behavioral/emotional problems, and their relationships, in a sample of Palestinian adolescents. Method: A study of 97 male adolescents aged 15-19 years, and attending a vocational training center based in the Gaza Strip. Adolescents completed the Child Maltreatment Schedule and the Ways of Coping Scale (WAYS). The Strengths and Difficulties Questionnaire (SDQ) was completed by adolescents and by their teachers. Results: Findings revealed high rates of emotional and physical maltreatment. Reliance on emotion-focused or avoidant coping strategies was associated with exposure to maltreatment. Use of maladaptive coping also predicted emotional difficulties in the respondents. Conclusions: Coping strategies are an important indicator of psychosocial functioning in adolescents who have experienced maltreatment. Identification of coping styles can augment the assessment of at-risk adolescents. Emotion-focused strategies, in particular, appear to be widely used by young people from non-Western cultural backgrounds.

Semantic or vocabulary errors were measured among 6 children with autism and mild learning disability (ages 7-8) and 6 with mild learning disability. Vocabulary errors were similar, except under extension, which was not used by children with autism. Children with autism tended to use all mechanisms in order to name something. (Contains references.) (Author/CR)

Incidents of deliberate self-harm in young people has steadily increased. This study describes adolescents' experience with medical and psychiatric services following overdose from self-poisoning. In many of the cases, young people were experiencing multiple and complex psychological difficulties. The greatest positive factor was being treated in a friendly and nonjudgmental manner by staff. (Author/JDM)

We investigated the efficacy of aerobic exercise alongside antidepressant medication as an adjuvant maintenance treatment for depression. Fifty patients in remission were randomly assigned to either medication only or medication plus exercise. Assessment of psychopathology was made at 6-weekly intervals (for 24 weeks) using the Hamilton Rating Scale for Depression. The medication-plus-exercise group showed significantly more improvement at 12 and 24 weeks than the medication-only group. This study adds to a growing evidence base that suggests aerobic exercise is worthy of further development in the treatment of depressive disorders.