A latent class analysis of trauma based on a nationally representative sample of US adolescents.

PURPOSE: Traumatic events in adolescence rarely occur in isolation. Multiple traumatic experiences are prevalent, diverse and a well-established risk factor for mental health disorders. The aim of this study was to explore and explain the heterogeneity in trauma profiles in a nationally representative sample of US adolescents. METHOD: Using latent class analysis, data on 10,123 adolescents aged between 13 and 18 from the National Comorbidity Survey Adolescent Supplement were examined. In addition, the relationships between the emergent classes and demographic and clinical variables were explored. RESULTS: A four-class solution was the best fit of adolescent trauma patterns, with classes labelled as low risk, sexual assault risk, non-sexual risk and high risk. When compared to the low risk class, those in the other classes were significantly more likely not to live with either biological parent, display symptoms indicative of mood and anxiety disorders, and to have higher rates of disorder comorbidity. CONCLUSIONS: This provides evidence of four distinct groups of adolescents who have experienced a variety of traumas. Evidence demonstrates the increased risk of adolescents with a history of trauma meeting the diagnostic criteria for not only individual disorders but also comorbidity across disorder categories.

Service use patterns and mental health symptoms among adolescents exposed to multiple types of trauma.

Few studies have explored how different trauma experiences influence service use. This study explores patterns of service use amongst 6483 adolescents aged between 13 and 18, and examines if such patterns are associated with trauma profiles, demographic variables, and mental health disorders. Data from the National Comorbidity Survey--Adolescent Supplement (NCS-A) were used. A latent class analysis identified four adolescent trauma sub-groups: 'high risk', 'sexual risk' 'non-sexual risk', and 'low risk'. Regression analysis was used to explore the relationship between service use, trauma classes, and mental health outcomes. Significant relationships were found between service use, trauma sub-groups, demographics and mental health outcomes. Despite the effectiveness of mental health services, only a minority of adolescents exposed to different traumas use such resources. However, this study may go some way towards providing an understanding of the trauma backgrounds, demographic predictors and mental health disorders associated with service use.

Associations Between Covid-19-Related Threat, Stress, and Smoking in UK Adults Aged Under- and Over-30.

It has been suggested that smoking and age are associated with higher vulnerability to Covid-19. While threat of Covid-19 may reduce or stop smoking, increased stress due to lockdown could increase smoking behaviour. This study aimed to investigate changes in smoking behaviour in relation to age, Covid-19-related threat and subjective perceived stress during the UK lockdown. A cross-sectional study was performed. Online adverts were used to recruit UK residents who smoked combustible tobacco any time from January 2020. A questionnaire measured demographic information, smoking behaviour pre- and during-lockdown, perceived subjective stress (PSS), and Covid-19 related threat. Data were collected from a total of 145 participants (58% women, 39% men, 3% non-binary; mean age: 26 years, SD = 7.7), during UK lockdown between 22nd May and 22nd June 2020. Independent of stress and Covid-19-related threat, smoking was reduced in those aged less than 30 years. In participants aged 30 and above, increases in smoking behaviour were associated with higher PSS. The results highlight the relevance of the different stages of life on the relationship between stress, threat, and smoking behaviour. Greater emphasis should be placed on stress reduction for adult smokers aged 30 and above to enable smoking cessation.

How has COVID-19 lockdown impacted smoking? A thematic analysis of written accounts from UK smokers.

Objective. This study was designed to investigate UK smokers' accounts of impacts of COVID-19 on their smoking, to develop implications for supporting smoking cessation.Design. One hundred and thirty-two smokers aged 19-52 years (mean age 25 years), recruited through an advert distributed through social media and a dedicated Twitter page, completed an anonymous online questionnaire.Main Outcome Measures. Smokers produced written accounts of how COVID-19 had impacted their smoking. Responses were of unlimited length and completed online 22nd May-22nd June 2020 during UK COVID-19 lockdown.Results. Inductive thematic analysis generated three themes: i) increased smoking as a coping mechanism to deal with anxiety, boredom, stress, and anger in COVID-19 lockdown; ii) lockdown as enabling quitting through lifting social barriers and enabling a focus on health benefits; and iii) no change, avoiding Government/media COVID-19 information due to disbelief, lack of trust, and perceptions of bias.Conclusions. Results demonstrate a need for credible public health messaging on COVID-19 risk aimed at smokers. Implications for supporting smoking cessation are discussed, including maintaining quitting in those "social smokers" who quit during lockdown, and support on stress-management and emotion regulation in those who use smoking as a way to cope with stress, anger, and boredom.

Precursors of sibling bullying in middle childhood: Evidence from a UK-based longitudinal cohort study.

BACKGROUND: There is increasing evidence that sibling bullying is associated with various social, emotional, and mental health difficulties. It is, however, unclear which factors predict sibling bullying in middle childhood and whether child-level individual differences make some children more susceptible to sibling bullying involvement. OBJECTIVE: To investigate the precursors of sibling bullying in middle childhood in a UK based population sample. PARTICIPANTS AND SETTING: Existing data from the prospective Millennium Cohort Study (N = 16,987) were used. Primary caregivers reported on precursors (child age 7 years or earlier) whilst children self-reported on sibling bullying (child age 11 years). ANALYSIS: A series of multinomial logistic regression models were fitted. First, testing for crude associations between sibling bullying and the precursors individually. Culminating in a final model with the significant predictors from all of the previous models. RESULTS: Structural family-level characteristics (e.g. birth order, ethnicity, and number of siblings) were found to be the strongest predictors of sibling bullying involvement followed by child-level individual differences (e.g. emotional dysregulation and sex). Parenting and parental characteristics (e.g. primary caregiver self-esteem and harsh parenting) predicted sibling bullying, but to a lesser extent. CONCLUSIONS: These findings suggest that structural family characteristics and child-level individual differences are the most important risk factors for sibling bullying. If causality can be established in future research, they highlight the need for interventions to be two-pronged: aimed at parents, focusing on how to distribute their time and resources appropriately to all children, and the children themselves, targeting specific sibling bullying behaviors.

Sibling Bullying in Middle Childhood is Associated with Psychosocial Difficulties in Early Adolescence: The Case of Individuals with Autism Spectrum Disorder.

Sibling bullying is associated with various psychosocial difficulties. We investigated this in 231 individuals with Autism Spectrum Disorder (ASD) and 8180 without ASD between middle childhood (age 11 years) and early adolescence (age 14 years). On the whole, self-reported sibling bullying decreased from middle childhood to early adolescence. Despite this, individuals with ASD continued to report more sibling bullying as both perpetrator and victim in early adolescence than those without ASD. We found that self-report sibling bullying in middle childhood was associated with psychosocial difficulties in early adolescence. Moreover, individuals with ASD were more likely to report being bullied by both siblings and peers in middle childhood and this pattern of victimisation was associated with concurrent and longitudinal psychosocial difficulties.

Happiness, self-esteem, and prosociality in children with and without autism spectrum disorder: Evidence from a UK population cohort study.

High levels of childhood happiness, self-esteem, and prosociality are associated with positive social and emotional outcomes. Little is known about whether these constructs co-occur and how levels of co-occurrence are different in children with or without Autism Spectrum Disorder (ASD). Data was obtained from 13,285 11-year olds (408 with ASD) from a UK based prospective cohort study. Latent class analysis revealed five distinct classes: The "very low prosociality class" (with ASD 32% vs. without ASD 7%) was characterized by children who were happy and had high self-esteem but they were not prosocial. The "low happiness class" (with ASD 3% vs. without ASD 3%), included those children who had moderate self-esteem and were prosocial but were the least happy. Children in the "low to moderate positive functioning class" (with ASD 16% vs. without ASD 6%) were moderately happy and had the lowest self-esteem but were prosocial. The "moderate to high positive functioning class" (with ASD 17% vs. without ASD 23%) was characterized by children who were happy, had moderate self-esteem, and were very prosocial. The majority of children were in the "optimum class" (with ASD 31% vs. without ASD 62%), and were very happy, very prosocial with high self-esteem. Our findings demonstrate that for the majority of children in our sample, happiness, self-esteem, and prosociality co-occur. Furthermore, although as a group children with ASD have lower levels of positive functioning, our multivariable latent class approach suggests that nearly half of children with ASD are happy, have good levels self-esteem, and are prosocial. Autism Res 2018, 11: 1011-1023. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: High levels of childhood happiness, self-esteem, and prosociality are associated with positive social and emotional outcomes. In this study, we investigated whether happiness, self-esteem and prosociality co-occur in children, and how possible co-occurrence differs between those with and without Autism Spectrum Disorder. We found that for the majority of children happiness, self-esteem, and prosociality co-occur. Furthermore, although as a group children with ASD have lower levels of positive functioning, our findings suggest that nearly half of children with ASD are happy, have good levels of self-esteem, and are prosocial.

The Prevalence and Psychopathological Correlates of Sibling Bullying in Children with and without Autism Spectrum Disorder.

Using data from a prospective population based study, the prevalence and psychopathological correlates of sibling bullying in children with and without autism spectrum disorder (ASD) were estimated. There were 475 children with ASD and 13,702 children without ASD aged 11 years. Children with ASD were more likely to be bullied by their siblings compared to those without ASD. They were also more likely than those without ASD to both bully and be bullied by their siblings, which was associated with lower prosocial skills as well as more internalizing and externalizing problems compared to those not involved in any sibling bullying. Interventions to improve social and emotional outcomes in children with ASD should focus on both the affected and the unaffected sibling.