A comparison of psychiatric inpatient admissions in youth before and during the COVID-19 pandemic.

Background: The current understanding of the effect of COVID-19 on child and youth admissions to psychiatric inpatient units over time is limited, with conflicting findings and many studies focusing on the initial wave of the pandemic. Objectives: This study identified changes in psychiatric inpatient admissions, and reasons for admission, including suicidality and self-harm, before and during the COVID-19 pandemic. Method: This time series study analyzed 3,723 admissions of youth (ages 0-18.88 years) admitted to four major psychiatry inpatient units in a large Canadian city between January 1st, 2016 and December 31st, 2021. Pre-pandemic (before March 11, 2020) and during-pandemic (after March 11, 2020) trends of admissions were explored using a Bayesian structural time series model (BSTS). Results: The model revealed that overall admissions during the pandemic period exceeded what would have been predicted in the absence of a pandemic, a relative increase of 29%. Additionally, a rise in the total number of admissions due to self-harm and suicidality (29% increase), externalizing/behavioral issues (69% increase), and internalizing/emotional issues (28% increase) provided strong evidence of increased admissions compared to what might have been expected from pre-pandemic numbers. Conclusions: There was strong evidence of increases in psychiatric inpatient admissions during the COVID-19 pandemic compared to expected trends based on pre-pandemic data. To ensure accessible and continuous mental health supports and services for youth and their families during future pandemics, these findings highlight the need for rapid expanse of inpatient mental health services, similar to what occurred in many intensive care units across Canada.

Contexte: La compréhension actuelle de l'effet de la COVID-19 sur les enfants et jeunes patients admis aux unités d'hospitalisation psychiatrique avec le temps est limitée, avec des conclusions contradictoires et des études portant sur la vague initiale de la pandémie. Objectifs: La présente étude a identifié les changements dans les admissions de patients hospitalisés en psychiatrie, et les raisons de l'admission, notamment la suicidabilité et l'automutilation, avant et durant la pandémie de la COVID-19. Méthode: Cette étude de séries chronologiques a analysé 3 723 admissions de jeunes (de 0 à 18,88 ans) admis à quatre grandes unités d'hospitalisation en psychiatrie dans une grande ville canadienne entre le 1er janvier 2016 et le 31 décembre 2021. Les tendances des admissions pré-pandémiques (avant le 11 mars 2020) et pendant la pandémie (après le 11 mars 2020) ont été explorées à l'aide d'un Modèle bayésien de séries chronologiques structurelles (BSTS). Résultats: Le modèle a révélé que globalement, les admissions durant la période pandémique excédaient ce qui aurait été prédit en l'absence d'une pandémie, une hausse relative de 29%. En outre, une hausse du nombre total d'admissions attribuables à l'automutilation et à la suicidabilité (hausse de 29%), à des problèmes de comportement/d'externalisation (hausse de 69%), et à des problèmes d'internalisation/émotionnels (hausse de 28%) a fourni des preuves solides des admissions accrues comparé à ce qu'on aurait pu attendre des chiffres pré-pandémiques. Conclusions: Il y avait des preuves solides des augmentations des admissions de patients hospitalisés en psychiatrie durant la pandémie de la COVID19 comparé aux tendances prévues selon les données pré-pandémiques. Afin d'assurer des soutiens et des services de santé mentale accessibles et continus pour les jeunes et leur famille durant les futures pandémies, ces résultats soulignent la nécessité d'une expansion rapide des services de santé mentale pour patients hospitalisés, pareillement à ce qui s'est produit dans de nombreuses unités de soins intensifs du Canada.

Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic: A Systematic Review and Meta-analysis.

Importance: There is a growing body of high-quality cohort-based research that has examined changes in child and adolescent mental health during the COVID-19 pandemic vs before the pandemic. Some studies have found that child and adolescent depression and anxiety symptoms have increased, while others have found these symptoms to have remained stable or decreased. Objective: To synthesize the available longitudinal cohort-based research evidence to estimate the direction and magnitude of changes in depression and anxiety symptoms in children and adolescents assessed before and during the pandemic. Data Sources: Medline, Embase, and PsycInfo were searched for studies published between January 1, 2020, and May 17, 2022. Study Selection: Included studies reported on depression and/or anxiety symptoms, had cohort data comparing prepandemic to pandemic estimates, included a sample of children and/or adolescents younger than 19 years, and were published in English in a peer-reviewed journal. Data Extraction and Synthesis: In total, 53 longitudinal cohort studies from 12 countries with 87 study estimates representing 40 807 children and adolescents were included. Main Outcomes and Measures: Standardized mean changes (SMC) in depression and anxiety symptoms from before to during the pandemic. Results: The analysis included 40 807 children and adolescents represented in pre-COVID-19 studies and 33 682 represented in during-COVID-19 studies. There was good evidence of an increase in depression symptoms (SMC, 0.26; 95% CI, 0.19 to 0.33). Changes in depression symptoms were most conclusive for study estimates among female individuals (SMC, 0.32; 95% CI, 0.21 to 0.42), study estimates with mid to high income (SMC, 0.35; 95% CI, 0.07 to 0.63), and study estimates sourced from North America (SMC, 0.25; 95% CI, 0.15 to 0.36) and Europe (SMC, 0.35; 95% CI, 0.17 to 0.53). There was strong evidence that anxiety symptoms increased slightly during the pandemic (SMC, 0.10; 95% CI, 0.04 to 0.16), and there was some evidence of an increase in study estimates with mid to high income. Conclusions: This systematic review and meta-analysis of longitudinal studies including children and adolescents found an increase in depression symptoms during the COVID-19 pandemic, particularly among female individuals and those from relatively higher-income backgrounds.

The Relations Among Stress, Executive Functions, and Harsh Parenting in Mothers.

Stress is a common experience that can spillover into parenting, which in turn has important implications for child behavior. Parents' executive functioning (EF) may buffer the association between feelings of stress and parenting. However, using lower socioeconomic status (SES) and household chaos as indicators of stress, research has demonstrated inconsistent patterns with regard to this moderating role of EF. This study's first aim examined the moderating role of maternal EF on the associations between SES and household chaos, and harsh parenting. The second aim investigated the effects of experimentally induced stress on harsh parenting and whether maternal EF moderated these effects. A final sample of 101 mothers of 6 to 10-year-old children participated by completing measures of EF, household chaos, SES, and harsh parenting. Additionally, mothers were randomly assigned to either a stress group or a control group. Throughout the stress (or control) induction, mothers rated their harsh parenting in response to child misbehavior vignettes. Findings revealed that stronger EF reduced the association between household chaos and harsh parenting. There were no significant effects of SES or experimentally induced stress on harsh parenting, and EF was not a significant moderator for these stressors. These results highlight the buffering role of EF for more chronic stressors such as household chaos. SES and more acute stress, as manipulated by the TSST, at least in the current sample, may be less relevant.

Detecting the neural correlates of episodic memory with mobile EEG: Recollecting objects in the real world.

Episodic memory supports recognition of the details of complex real world experiences, providing a continuous record of events embedded within spatial and temporal context. Despite the inherently dynamic nature of real events, the bulk of neuroscientific research to date examines recognition in absence of the detailed contextual information that is known to be a defining characteristic. Given the importance of environmental context for episodic memory, examining ERP correlates of memory in more naturalistic settings is vital for progress in understanding how retrieval operates in daily life. The current study capitalized on recent advances in mobile EEG technology to address this issue and is the first to investigate ERP correlates of episodic retrieval in real world contexts. Participants were guided around a pre-defined route inside a building on campus, while performing a recognition memory task, which paired images of objects with actual physical locations in the building to provide context. Importantly, the findings clearly demonstrate that it is possible to observe reliable neural correlates of memory in real world contexts. Replicating two well established ERP correlates of episodic retrieval reported in prior laboratory based studies, we detected FN400 old/new effects traditionally associated with familiarity between 300 and 500 ms, and a late posterior negativity (LPN) often linked to reconstructive processing or evaluation of retrieval outcomes between 500 and 800 ms. Moreover, the FN400 effect was found to be sensitive to retrieval of context, with more sustained effects for objects encountered in a different context at study and test. Overall, the current work highlights the power of mobile EEG technology for examining complex cognitive functions in more naturalistic real world settings.

Mothers' Attributions for Positive and Negative Child Behavior: Associations With Mothers' ADHD Symptoms.

OBJECTIVE: Previous research has shown that parent attributions for child behavior have important implications on the parent-child relationship. The current study investigates whether mothers' level of ADHD symptoms is associated with their child-responsibility attributions for positive and negative child behavior. METHOD: Seventy-nine mothers of 6- to 11-year-old boys participated in this online study. Mothers completed questionnaires assessing their attributions, their ADHD symptoms, and their child's behavior. RESULTS: All mothers offered more child-responsibility attributions for positive behaviors than for negative behaviors. However, mothers with greater levels of ADHD symptoms did this to a lesser extent, blaming their child relatively more for negative behavior and giving their child relatively less credit for positive behavior. CONCLUSION: This is the first study demonstrating the association between mothers' ADHD symptoms and child-responsibility attributions. It is possible that these relatively more negative attributions could be underlying some of the parenting difficulties reported by parents with ADHD.

Navigation in Real-World Environments: New Opportunities Afforded by Advances in Mobile Brain Imaging.

A central question in neuroscience and psychology is how the mammalian brain represents the outside world and enables interaction with it. Significant progress on this question has been made in the domain of spatial cognition, where a consistent network of brain regions that represent external space has been identified in both humans and rodents. In rodents, much of the work to date has been done in situations where the animal is free to move about naturally. By contrast, the majority of work carried out to date in humans is static, due to limitations imposed by traditional laboratory based imaging techniques. In recent years, significant progress has been made in bridging the gap between animal and human work by employing virtual reality (VR) technology to simulate aspects of real-world navigation. Despite this progress, the VR studies often fail to fully simulate important aspects of real-world navigation, where information derived from self-motion is integrated with representations of environmental features and task goals. In the current review article, we provide a brief overview of animal and human imaging work to date, focusing on commonalties and differences in findings across species. Following on from this we discuss VR studies of spatial cognition, outlining limitations and developments, before introducing mobile brain imaging techniques and describe technical challenges and solutions for real-world recording. Finally, we discuss how these advances in mobile brain imaging technology, provide an unprecedented opportunity to illuminate how the brain represents complex multifaceted information during naturalistic navigation.

Parents' Attributions for Negative and Positive Child Behavior in Relation to Parenting and Child Problems.

Previous research has stressed the importance of parents' attributions and parenting for child problems. Based on social cognitive models, studies have focused on the interrelations among parents' child-responsibility attributions for negative behavior, harsh parenting, and child problems. Little is known about the extent to which child-responsibility attributions for positive behavior and other types of parenting play a role in these models. The purpose of this study was to examine whether parents' child-responsibility attributions for positive and negative child behaviors are related to child problems, and whether these relations are mediated by harsh, lax, and positive parenting. Mothers' and fathers' attributions and parenting were examined separately. A community sample of 148 couples and their 9- to 12-year-old child (50% boys) participated in the study. Mothers and children participated by completing questionnaires and a laboratory interaction task. Fathers participated by completing the same questionnaires as mothers. Harsh parenting was the only parenting variable that uniquely mediated the relations between more child-responsibility attributions for (a) negative child behaviors and child problems for both parents and (b) the inverse relation between attributions for positive child behaviors and child problems for fathers. Findings confirm the importance of harsh parenting and demonstrate the importance of parents' attributions for positive child behaviors in relation to decreasing harsh parenting and child problems. Clinically, it may be useful not only to reduce child-responsibility attributions for negative behaviors but also to increase the extent to which parents give their child credit for positive behaviors.

Unmet Needs of Adult Survivors of Childhood Cancers: Associations with Developmental Stage at Diagnosis, Cognitive Impairment, and Time from Diagnosis.

PURPOSE: Adult survivors of childhood cancers (ASCCs) are a unique and growing population. Because these individuals were diagnosed in childhood, their developmental stage at diagnosis may influence medical sequelae and perception of their cancer diagnosis and potentially result in long-term complications and challenges. Our aim was to determine how developmental stage, time since diagnosis, and cognitive impairment relate to Canadian ASCC distress and unmet needs. METHODS: Canadian ASCCs aged 19-77 years (N = 115) diagnosed between ages 0 and 5 (n = 25), 6 and 12 (n = 22), or 13 and 18 (n = 68) completed demographic, neurocognitive self-report, depression, and anxiety and unmet needs questionnaires. RESULTS: The developmental stage predicted distress, ß = -0.29, p = 0.01. Survivors diagnosed in middle childhood reported significantly more distress than those diagnosed in adolescence. Shorter time since diagnosis predicted greater psychosocial needs, ß = -0.24, p = 0.05, and greater distress, ß = -0.22, p = 0.05. Greater memory impairment predicted higher need across outcomes, ß = -0.36-0.61, p < 0.05. In adjusted analyses for unmet needs, endorsement of cancer affecting education and/or work importantly altered outcomes. CONCLUSION: Our results indicate that greater self-reported memory impairment increases childhood cancer survivors' care needs. We additionally suggest that supportive care interventions might best target those reporting work or education interruption due to cancer. Identification of ASCCs who report work/school interruptions may provide a quick screen for health providers to assess possible need for intervention. ASCCs still experience unmet needs long into survivorship.

Parental ADHD symptoms and parenting behaviors: A meta-analytic review.

Attention-deficit/hyperactivity disorder (ADHD) persists throughout the lifespan, and there are known impairments associated with adult ADHD. Understanding ADHD-related impairments in the parenting domain is particularly important given that the children of adults with ADHD also are likely to have ADHD, and there is potential for parenting to alter the developmental outcomes of these children. The present study quantitatively synthesizes evidence regarding the associations between parental ADHD symptoms and parenting behaviors. Across 32 studies, this meta-analysis found that parental ADHD symptoms accounted for 2.9%, 3.2%, and 0.5% of the variance of harsh, lax, and positive parenting, respectively. Greater parental ADHD symptoms were associated with less positive and more harsh and lax parenting behaviors. Variables, such as the proportion of children in the sample diagnosed with ADHD, child gender, and method/rater variance, moderated the strength of these relations. Results also suggest more similarities than differences in the associations between parenting behaviors and the two dimensions of inattention and hyperactivity/impulsivity symptoms. Overall, parental ADHD symptoms are significantly associated with parenting behaviors with effect sizes similar to the associations found between other parental psychopathologies and parenting, although the associations remain relatively small. The paper concludes with comments regarding remaining gaps in the literature that warrant further research and the clinical implications of the associations between parental ADHD symptoms and parenting.

Investigating the relationship between implicit and explicit memory: Evidence that masked repetition priming speeds the onset of recollection.

Memory theories assume that unconscious processes influence conscious remembering, but the exact nature of the relationship between implicit and explicit memory remains an open question. Within the context of episodic recognition tests research typical shows that priming impacts behavioral and neural indices of familiarity. By this account, implicit memory leads to enhanced fluency of processing, which is then attributed to 'oldness' in the context of recognition judgments. Recently, however, behavioral and neuroimaging evidence has emerged to suggest that priming can also influence recollection, suggesting that the rate of recollection increases following priming. Here, we examine the relationship between priming and recollection, using Event-Related Potentials (ERPs) to assess changes in the timecourse of processing. Participants studied a series of words, and episodic memory was assessed using a standard item recognition test, but masked repetition priming preceded half of the test cues. Results confirmed that implicit memory was engaged: priming produced robust facilitation of recognition Reaction Times (RTs), with larger effects for studied than unstudied words. Mapping onto the RT data, ERPs recorded during recognition testing over centro-parietal electrodes revealed N400-like priming effects (250-500ms) that were larger in magnitude for studied than unstudied words. More importantly, priming also had a clear impact on explicit memory, as measured by recollection-related left-parietal old/new effects. While old/new effects for unprimed trials were present during the typical 500-800ms latency interval, the old/new effects seen for primed trials were equivalent in magnitude and topography, but onset ~300ms earlier. ERPs reveal that repetition priming speeds the onset of recollection, providing a novel demonstration that unconscious memory processes can have a measureable, functional, influence on conscious remembering.

Making the case for mobile cognition: EEG and sports performance.

In the high stakes world of International sport even the smallest change in performance can make the difference between success and failure, leading sports professionals to become increasingly interested in the potential benefits of neuroimaging. Here we describe evidence from EEG studies that either identify neural signals associated with expertise in sport, or employ neurofeedback to improve performance. Evidence for the validity of neurofeedback as a technique for enhancing sports performance remains limited. By contrast, progress in characterizing the neural correlates of sporting behavior is clear: frequency domain studies link expert performance to changes in alpha rhythms, whilst time-domain studies link expertise in response evaluation and motor output with modulations of P300 effects and readiness potentials. Despite early promise, however, findings have had relatively little impact for sports professionals, at least in part because there has been a mismatch between lab tasks and real sporting activity. After selectively reviewing existing findings and outlining limitations, we highlight developments in mobile EEG technology that offer new opportunities for sports neuroscience.