Paul McArdle

Cohort Profile: The Gateshead Millennium Study

The Gateshead Millennium Baby Study (GMBS) originated from the observation that slower than expected weight gain in infancy, traditionally known as failure to thrive, but more recently as ‘weight faltering’, had never been satisfactorily explained. There were methodological problems associated with much previous research. The first was the use of attained weight criteria to identify slow weight gain in infancy, which confounds poor postnatal weight gain with poor prenatal weight gain. The second was the use of referred samples of children, leading to selection biases. The third was the use of retrospective accounts from parents after poor weight gain had already been identified. The GMBS was thus originally designed to investigate the antecedents of weight faltering in a population-based prospective study that addressed the main methodological problems of previous research.

The changing mental health of children and adolescents: evidence for a deterioration?

This paper reviews the evidence for changing patterns of mental health over time in childhood and youth in Western societies. The evidence suggests that the prevalence of major depression, substance abuse and offending behaviour, as well as the incidence of suicide, is increasing in adolescent populations, particularly among males. There are also indications that problem behaviours among younger children are becoming more common. There is no evidence of a deterioration in the adjustment of the pre-school population.

School‐based indicated prevention: a randomised trial of group therapy

BACKGROUND One hundred and twenty-two children identified by teachers as at risk for behavioural or emotional problems were randomly allocated to drama-group therapy or to a curriculum-studies control, based in school. METHODS One hundred and seventeen completed the intervention phase of the trial, which comprised 12 hour-long sessions. Post-intervention self-reports showed significant effects associated with both interventions. RESULTS However, there was a clear advantage of group therapy over both a waiting list control and curriculum studies, according to teacher reports. This was true also of categorical analyses focusing on those with the most severe symptoms. CONCLUSIONS These analyses confirmed sustained teacher-reported improvement over a year-long follow-up period.

Prevalence of psychiatric disorder: with and without psychosocial impairment

ObjectiveTo identify rates of psychiatric disorder in a representative sample of primary school children in a North of England city.MethodThe study obtained multi-criterion screen data on a representative one-in-three sample of 7- and 8-year-old children in Newcastle upon Tyne. It also obtained psychiatric interview data for screen-positive and a proportion of screen negative children. In addition the clinically trained interviewers rated psychiatric impairment.ResultsEstimated rates of disorder with impairment, calibrated to be equivalent to that of children attending local child psychiatric clinics, were 1.2% for emotional disorder, 5.6% for disruptive behaviour disorder and 6.7% for any disorder.ConclusionThese findings are consistent with other contemporary studies using similar impairment criteria.

International Variations in Youth Drug Use: The Effect of Individual Behaviours, Peer and Family Influences, and Geographical Location

This international study investigates factors underlying international variations in rates of youth drug use among representative samples of 15-year-olds in five cities (Bremen, n = 871; Dublin, n = 983; Groningen, n = 487; Newcastle upon Tyne, n = 880; Rome, n = 666). It reveals a higher level of drug use in English-speaking compared to continental populations. Drug use was associated with peer, family and individual factors. Logistic regression showed that family structure and sport were associated with lower rates and delinquent behaviour with higher rates of drug use in all cities and among males and females. Among males, city of residence also independently predicted drug use. The effect of traditional families and studiousness in reducing drug use was most evident for male drug use in low-use cities: higher rates of use in English-speaking cities appear partially due to the drug use of low-risk males.

Preteen children and illegal drugs

In this paper we report the results of research on the nature and extent of legal and illegal drug use among preteens and those factors associated with illegal drug use at this young age. The paper is based upon a survey of 2318 ten to twelve year olds in Glasgow and Newcastle. Overall around 30% of children reported having been exposed to illegal drugs and 3.9% had started to use illegal drugs. There was a significant difference in the level of illegal drug use between our two cities. In most cases the illegal drug use identified on the part of preteens related to cannabis although in a small number of instances children were using heroin, cocaine and LSD. On the basis of this research we estimate that around 60 children in the ten to twelve age range will have used heroin in Glasgow and around 34 pupils will have used the drug in Newcastle. Preteen drug use was significantly associated with frequent smoking and alcohol consumption, with preteens’ involvement in a range of problem behaviours, and with family difficulties including the presence of someone else within the family using illegal drugs. The paper concludes by noting some of the challenges that are likely to be faced by services seeking to support children who are using illegal drugs by their preteens.

Substance use among schoolchildren in the north of England

A confidential and anonymous survey of 3623 adolescents was carried out in eight schools (six state comprehensive and two independent) in Newcastle upon Tyne. The survey enquired about cigarette use, alcohol consumption and illicit drug use together with key demographic variables. The results showed that 21% were currently smoking and 11% on a frequent basis. Regular smoking was more prevalent among girls. There was substantial use of alcohol, with 75% having used, and 20% drinking on a regular basis. This high level of alcohol consumption may be characteristic of northern Britain. The relatively low reported use of cannabis and relatively high reported use of naturally occurring hallucinogens may constitute a further regional variation. A minority of the sample (1.5%) were using illicit substances on a regular basis. Findings are discussed in terms of previous literature.

The peer relations of disruptive children with reference to hyperactivity and conduct disorder

Abstract Literature reviews indicate that children with disruptive behaviour disorders have peer relationship problems, but little information is available concerning the differential effects of hyperactivity and conduct disorder on peer relationships. Using a database from North of England research, this paper uses standard frequency analysis complemented by multivariate analyses to explore the independent effects of pervasive hyperactivity and conduct disorder on the sociometry of peer relations among 7- to 8- and 11- to 12-year-olds. The findings suggest that (a) social isolation in 7–8-year-olds shows no significant association with hyperactivity. However there is a significant association with conduct disorder in 11–12-year-olds. (b) Rejection is not significantly associated with hyperactivity alone nor with conduct disorder alone in 7–8-year-olds. However, it is associated with a combination of hyperactivity and conduct disorder. In 11–12-year-olds rejection is associated with conduct disorder alone and with conduct disorder and hyperactivity in combination. It is also associated with low cognitive ability alone and in combination with conduct disorder. Overall, these findings provide some limited evidence of adverse sociometric responses to both hyperactivity and below average cognitive ability. However, in the at-risk samples analysed here, conduct disorder emerges as the most powerful independent predictor of isolation and rejection, and this is especially so among older children.

Early intervention for at risk children: 3-year follow-up

Childhood behavioral and emotional symptoms are linked with distress and dysfunction that may persist into adulthood. Effective and practical early prevention could make a significant contribution to the well-being of individuals and the functioning of communities. School-based targeted interventions are relatively easy and inexpensive to deliver and have been shown to reduce symptoms in the short term. The current study evaluates the 2- and 3-year outcome of targeted school-based drama group therapy (DGT) as compared to teaching maths and English. It shows a rapid decline in teacher-observed behavioral symptoms following DGT. By a year post intervention, symptom rates following both interventions converged and remained low throughout follow-up. Drama group therapy is rapidly effective in reducing symptoms. However, the findings also suggest that despite differing content, school-based small-group interventions are likely to share some effective components.

Secular trends in the mental health of primary school children

Over the recent past, reports have argued that there has been a decline in the mental health of children and young people in Western societies. This is said to have occurred gradually over the second half of the last century and possibly longer. This view is based on evidence of a progressively declining peak age for adult type depressive disorders, and an apparent increase in adolescent disturbance such as substance abuse, attempted and completed suicide, perhaps eating disorders, and behaviour disorders. These phenomena have been attributed to the major changes in social values and behaviour, with their impact on child rearing and family life that gathered pace over the course of the last century.