Hayley Hamilton

The nature and characteristics of psychiatric comorbidity in incarcerated adolescents

Objectives: To determine the prevalence of psychiatric disorders, the degree of psychiatric comorbidity, and the relationship between these and sociodemographic variables in a sample of incarcerated adolescents. A comparison with an age- and sex-matched community sample was conducted. Method: Age- and sex-matched samples of 49 incarcerated adolescents and 49 nondelinquents were compared for psychiatric morbidity and psychosocial characteristics. Psychiatric diagnoses were determined using the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Additional information on psychosocial, family, and offence characteristics was obtained using a semistructured interview designed specifically for this study. The prevalence of single and comorbid psychiatric disorders was determined. Results: Approximately 63.3% of incarcerated adolescents had 2 or more psychiatric disorders. The degree of psychiatric morbidity was directly related to indicators of family adversity, physical abuse, other psychosocial variables, or polysubstance abuse. Psychiatric comorbidity was more frequent in females. Incarcerated adolescents were more likely to endorse symptoms of thought disorder. Conclusions: Findings identify preventive intervention foci for policy makers and planners in the area of adolescent corrections. Implications for education and training of nonclinical custodial staff are discussed as is the need for a more therapeutic orientation in correctional facilities.

Mental Distress, Economic Hardship and Expectations of Life in Canada among Sudanese Newcomers

As part of a settlement needs assessment of 220 recently arrived Sudanese refugees and immigrants in seven cities, we examined overall health status, indicators of mental distress, economic hardship and expectations of life in Canada. Data were collected in a community-based study using qualitative and quantitative techniques. Results indicate that those Sudanese for whom life in Canada was not what they expected and those who experienced economic hardship as measured by worry over having enough money for food or medicine experienced poorer overall health and reported a greater number of symptoms of psychological distress. After controlling for demographic and related variables, we found that individuals who were experiencing economic hardship were between 2.6 and 3.9 times as likely to experience loss of sleep, constant strain, unhappiness and depression, and bad memories as individuals who do not experience hardship. Healthcare providers should be aware of how postmigration social disadvantages may increase the risk of mental distress particularly among refugees.

Stepfather Involvement and Adolescent Well-Being Do Mothers and Nonresidential Fathers Matter?

Using the National Longitudinal Study of Adolescent Health, the authors explore how aspects of stepfather involvement are related to adolescent well-being and whether these relationships depend on maternal involvement, non-residential father involvement, or amount of time in the household. Results indicate that a close, nonconflictual stepfather-stepchild relationship improves adolescent well-being, but it is most beneficial when the adolescent also has a close, nonconflictual mother-child relationship. Engaging in shared activities with the stepfather decreases depression when the stepfather has been in the household for a longer period of time. The relationships between stepfather involvement and adolescent well-being are separate from nonresidential father involvement.

Predictors of emotional problems and physical aggression among children of Hong Kong Chinese, Mainland Chinese and Filipino immigrants to Canada

Background and study aimsData from the New Canadian Children and Youth Study (NCCYS), a national study of immigrant children and youth in Canada, are used to examine the mental health salience of putatively universal determinants, as well as of immigration-specific factors. Universal factors (UF) include age, gender, family and neighbourhood characteristics. Migration-specific (MS) factors include ethnic background, acculturative stress, prejudice, and the impact of region of resettlement within Canada.MethodsIn a sample of children from Hong Kong, the Philippines and Mainland China, the study examined the determinants of emotional problems (EP), and physical aggression (PA). A two-step regression analysis entered UF on step 1, and MS variables on step 2.ResultsUniversal factors accounted for 12.1% of EP variance. Addition of MS variables increased explained variance to 15.6%. Significant UF predictors: parental depression, family dysfunction, and parent’s education. Significant MS variables: country of origin, region of resettlement, resettlement stress, prejudice, and limited linguistic fluency. UF accounted for 6.3% of variance in PA scores. Adding migration-specific variables increased variance explained to 9.1%. UF: age, gender, parent’s depression, family dysfunction. MS: country of origin, region of resettlement, resettlement stress, and parent’s perception of prejudice.ConclusionsNet of the effect of factors affecting the mental health of most, if not all children, migration-specific variables contribute to understanding immigrant children’s mental health.

Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents

Objective Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario. Method and Findings Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours. Conclusions Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce injuries and comorbid problems in this age group.

Adolescent stigma towards drug addiction: effects of age and drug use behaviour.

The objective of this study was to examine adolescent age and experience with drug use on stigmatizing attitudes toward drug addiction. Data were derived from the 2005 cycle of the Ontario Student Drug Use Survey. In total, 4078, 7- to 12-graders completed self-administered questionnaires that included a measure of drug abuse stigma. Results indicated that stigma scores were higher among younger than older adolescents, and the decline across age was robust, occurring among both males and females and those from rural and non-rural areas. The decline, however, was stronger among non-drug users and among those who had no close friends that use drugs. Despite the age-related decline, the level of stigma in general suggested that drug abuse stigma may continue into adulthood. Findings highlight that individual attitudes toward drug use and drug abusers are salient factors for personal drug use. Given that stigma is a barrier to treatment, but reduced stigma may encourage greater adolescent use, this study highlights the need for more in-depth studies of drug stigma.

Perceived financial status, health, and maladjustment in adolescence.

This study examines the relationship between adolescent perception of family financial status and diverse aspects of health and maladjustment. Data were derived from the 2005 Ontario Student Drug Use Survey of 7th-12th grade students in ontario, Canada. This biennial survey monitors mental and physical health, substance use, and delinquent behavior in adolescent students. Results indicate that the significance of perceived financial status varies across adolescent outcomes. Greater emotional distress and lower self-rated health are associated with a perception of below average financial status. The associations of illicit drug use and hazardous and harmful drinking with perceived financial status vary for younger and older adolescents. Adjustments for parental education highlight differences in the influences of perceived financial status and parental education on health and behavior. Results highlight the utility of perceived family financial status in examinations of adolescent health and behavior, and the importance of examining diverse aspects of health and maladjustment.

The treatment of conduct disorder : Perspectives from across Canada

Objective: To provide a synopsis of treatment programs for conduct-disordered children in Canada. Method: Five groups of authors from British Columbia, Ontario, Quebec, and New Brunswick describe their approaches to the treatment of children with conduct disorder. Results: All programs emphasize the needs to use multimodal treatment schemes, including day and short-term residential care, and to base programs on identified factors associated with the development of conduct disorder. Conclusion: Specific forms of treatment of conduct disorder are promising but are often hampered by social and political agendas.

Substance Use and Related Harms Among Adolescents With and Without Traumatic Brain Injury

Objective:The relationship between self-reported lifetime traumatic brain injury (TBI) and drug and alcohol use and associated harms was examined using an epidemiological sample of Canadian adolescents. Settings and Design:Data were derived from a 2011 population-based cross-sectional school survey, which included 6383 Ontario 9th–12th graders who self-completed anonymous self-administered questionnaires in classrooms. Traumatic brain injury was defined as loss of consciousness for at least 5 minutes or a minimum 1-night hospital stay due to symptoms. Results:Relative to high schoolers without a history of TBI, those who acknowledged having a TBI in their lifetime had odds 2 times greater for binge drinking (5+ drinks per occasion in the past 4 weeks), 2.5 times greater for daily cigarette smoking, 2.9 times greater for nonmedical use of prescription drugs, and 2.7 times greater for consuming illegal drug in the past 12 months. Adolescents with a history of TBI had greater odds for experiencing hazardous/harmful drinking (adjusted odds ratio [aOR] = 2.3), cannabis problems (aOR = 2.4), and drug problems (aOR = 2.1), compared with adolescents who were never injured. Conclusion:There are strong and demographically stable associations between TBI and substance use. These associations may not only increase the odds of injury but impair the quality of postinjury recovery.

Energy Drink Consumption and Associations With Demographic Characteristics, Drug Use and Injury Among Adolescents

ObjectivesTo examine energy drink consumption and its association with demographic characteristics, drug use, and injury among adolescents.MethodsData on 4,342 adolescents were derived from the 2011 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12. The survey was based on a two-stage cluster design and analyses include appropriate adjustments for the complex sample design.ResultsOverall, 49.6% of adolescents had consumed energy drinks in the previous year. A total of 13.8% of seventh grade students had consumed energy drinks in the previous week compared to 19.1% of adolescents overall. Energy drink consumption in the previous year was highly associated with having used tobacco and cannabis in the previous year, the non-medicinal use of prescription drugs in the previous year, and binge drinking in the previous month. Consumption was also highly associated with sensation-seeking and self-reports of medical treatment for an injury (reported by 16% and 42% of adolescents, respectively). The odds of consuming energy drinks did not vary significantly for males and females, and sex was not a significant moderator of the associations examined.ConclusionThese findings support the need for greater awareness of the extent of energy drink consumption among individual adolescents and the potential that additional health and behavioural risks may be associated with consumption.RésuméObjectifsExaminer la consommation de boissons énergisantes et son association avec le profil démographique, la consommation de drogue et les traumatismes chez les adolescents.MéthodeLes données sur 4 342 adolescents provenaient du Sondage sur la consommation de drogues et la santé des élèves de l’Ontario (2011), une enquête provinciale menée en milieu scolaire auprès des élèves de la 7e à la 12e année. Le sondage était planifié selon un échantillonnage en grappe en deux étapes, et les analyses ont été adaptées à la complexité du plan d’échantillonnage.RésultatsGlobalement, 49,6% des adolescents avaient consommé des boissons énergisantes au cours de l’année précédente. En tout, 13,8% des élèves de 7e année en avaient consommé au cours de la semaine précédente, contre 19,1% des adolescents dans l’ensemble. La consommation de boissons énergisantes au cours de l’année précédente était fortement associée à la consommation de tabac et de cannabis au cours de l’année précédente, à l’utilisation de médicaments sur ordonnance à des fins non médicinales au cours de l’année précédente et aux excès occasionnels d’alcool au cours du mois précédent. La consommation était aussi fortement associée à la recherche de sensations fortes et aux déclarations autonomes de soins médicaux pour traumatisme (déclarées par 16% et 42% des adolescents, respectivement). La probabilité d’avoir consommé des boissons énergisantes ne variait pas sensiblement entre les garçons et les filles, et le sexe n’était pas une variable modératrice significative dans les associations examinées.ConclusionCes constatations confirment le besoin de mieux connaître l’ampleur de la consommation des boissons énergisantes par les adolescents et la possibilité que cette consommation soit associée à des risques supplémentaires pour la santé et le comportement.